The annual Medicare update book has arrived for millions of senior Medicare enrollees, and it’s a trove of information about the program, today and for tomorrow. No matter who wins the presidential election, Medicare is going to continue. President Obama has a program to trim and tighten to extend the program’s life. GOP nominee Mitt Romney has adopted running mate Paul Ryan’s idea of a voucher instead of a pay-for service, with Medicare members receiving a voucher for $6,400 to buy private medical insurance. One way or another, Medicare will continue in its present form for seniors already enrolled and for those 55 and up. Today’s seniors are not greatly affected by whoever wins; neither candidate has suggested changing the current Medicare for them.The booklet is 141 pages long and while it may be daunting to read, it can be well worth seniors’ while. In the back are tables showing all kinds of Nevada health and prescription plans which clearly describe costs and benefits.Page 4 gives a quick report on the new aspects of Medicare under the Affordable Care Act of 2010. Here’s a brief summary:• Medicare now covers screenings for depression, alcohol misuse and obesity, behavioral therapy for cardiovascular disease.• If you reach the coverage gap (the “doughnut hole”) in your Medicare prescription drug coverage you’ll pay only 47.5 percent for covered brand name drugs and 79 percent for generic drugs.• Detailed charts for Medicare plans available in Nevada.• A note reporting that Medicare premium and deductible fees are not available as yet but a phone number of where to get such information at 1-(800) 633-4227 or at www.medicare.gov.com. TTY users should call 1-877-486-2048.From Oct. 15 - Dec. 7, you can change your Medicare prescription. On Jan. 1 any changes will begin.A useful resource is the State Health Insurance Assistance Program where you can go over various plans and how they would affect you. SHIP also can help those with low income in the “Extra Help” program which helps pay drug costs. To find the office nearest you, call 1-800-307-4444.Lots of incidental information is scattered throughout the new book. For instance, you might not know that Medicare pays for ambulance services. You pay 20 percent of the Medicare approved amount, and a hepatitis B shot is given at no cost with your Medicare doctor. And don’t forget, the booklet reminds you that Medicare enrollees are eligible for a yearly “wellness report” to develop a plan to prevent disease.Not covered for obvious reasons are changes under Affordable Care Act that will come in 2013 and 2014. The presidential election will possibly affect those changes. The administration is standing pat and Romney has said some parts of ACA are good and should remain.For seniors who severed in the U.S. military, the Veterans Administration offers health care for this area at the Reno VA facility. How much care and how much it costs depends on the period of service for the individual. Congress mandated VA health care be based on periods of service, such as the Korean or Vietnam periods. The extent of treatment and cost of medication varies.The Reno VA offers senior veterans a wide variety of care, everything from epidural shots to some surgery as well as hospitalization. No plastic surgery or knee replacements at Reno, but the facility can refer veterans to VA facilities that offer more specialized procedures, such as in San Francisco or Stanford. Doctor visits are usually twice a year and the charge for Korean vets, for instance, is $25 per visit. Monitoring of such medications as blood thinners is usually monthly at no cost, and some medical supplies are free as are blood-pressure kits and blood-sugar monitoring devices.You’ll need proof of military service to enroll, but after that things move along smoothly. When the VA says you have a 10 a.m. appointment, that’s generally the time you’ll have your meeting.Presidential debate timeNeither candidate did much to change position on seniors during the debate last week, but maybe next time. Debate is the wrong word for these TV shows — in a debate something is proposed and then debaters take a pro or con position. But last week’s exchange was lively and if it seemed GOP’s candidate got the upper hand, challengers usually do in such debates. The vice presidential debate is Thursday — Joe Bidden vs. Paul Ryan. This one should be more fun and freer in rules. • Sam Bauman writes about senior affairs, among other things, for the Nevada Appeal.