August 2018 Columns
Savvy Senior – August Columns
- How Medicare Covers Diabetes
- Where Seniors Can Get Help With Home Chores and Small Jobs
- Retirement Planning Tips for Single Women
- How Older People Can Find Clinical Trials
How Medicare Covers Diabetes
Dear Savvy Senior,
How well does Medicare cover diabetes? I’m 66 years old and was recently told by my doctor that I have pre-diabetes. If it progresses to full-fledged diabetes what can I expect from Medicare.
Dear Recently Retired,
Medicare actually provides a wide range of coverage to help beneficiaries who have diabetes, as well as those who are at risk of getting it – but they don’t cover everything. Here’s a breakdown of what Medicare covers when it comes to diabetes services and supplies along with some other tips that can help you save.
Screenings: If you have pre-diabetes or some other health conditions that put you at risk of getting diabetes – such as high blood pressure, high cholesterol and triglycerides, are overweight, or have a family history of diabetes – Medicare Part B (medical insurance) will pay 100 percent of the cost of up to two diabetes screenings every year.
Doctor’s services: If you’re a Medicare beneficiary, Medicare will pay 80 percent of the cost of all doctor’s office visits that are related to diabetes. You are responsible for paying the remaining 20 percent after you’ve met this year’s $183 (for 2018) Part B deductible.
Prevention program: Just launched in April, the Medicare Diabetes Prevention Program provides lifestyle change programs offered by health professionals to help you prevent diabetes. This is available for free to all Part B beneficiaries who have pre-diabetes.
Self-management: If you have diabetes, Medicare covers 80 percent of the cost of self-management training to teach you how to successfully manage your diabetes.
Supplies and medications: Medicare Part B covers 80 percent of the cost of glucose monitors, test strips (100 per month if you use insulin, or 33 per month if you don’t), lancets, external insulin pumps and insulin (if you use a pump), after you’ve met your deductible.
But if you inject insulin with a syringe, Medicare’s Part D prescription drug benefit will help pay your insulin costs and the supplies needed to inject it – if you have a plan. Part D plans also cover most other diabetic medications too. You’ll need to check your plan for coverage details.
Nutrition therapy: Medicare will pick up the entire tab for medical nutrition therapy, which teaches you how to adjust your diet so you can better manage your condition. You’ll need a doctor’s referral to get this service.
Foot care: Since foot problems are common among diabetics, Medicare covers 80 percent of foot exams every six months for diabetics with diabetes-related nerve damage. They will also help pay for therapeutic shoes or inserts as long as your podiatrist prescribes them.
Eye exams: Because diabetes increases the risks of getting glaucoma and diabetic retinopathy, 80 percent of dilated medical eye exams are covered each year, but eye refractions for glasses are not.
For more information, see “Medicare’s Coverage of Diabetes Supplies & Services” online booklet at Medicare.gov/Pubs/pdf/11022-Medicare-Diabetes-Coverage.pdf.
If you have a Medicare supplemental (Medigap) policy, it may pay some of the costs that Medicare doesn’t cover. Call your plan’s benefits administrator for more information.
Or, if you’re in a Medicare Advantage plan (like an HMO or PPO), your plan must give you at least the same diabetes coverage as original Medicare does, but it may have different rules. You’ll need to check your policy for details.
If you’re income is low, and you can’t afford your Medicare out-of-pocket costs, you may be able to get help through Medicare Savings Programs. To find out if you qualify or to apply, contact your state Medicaid program.
Also, find out if you are eligible for “Extra Help” which helps Medicare Part D beneficiaries with their medication expenses. Visit SSA.gov/prescriptionhelp or call Social Security (800-772-1213) to learn more.
Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.
Where Seniors Can Get Help With Home Chores and Small Jobs
Dear Savvy Senior,
What’s the best way to find good, trustworthy, qualified people who can help seniors with home chores or small jobs?
Looking for Mom
Getting help at home for any number of household tasks is a lot easier than it use to be thanks to a number of web-based tools that can quickly and easily connect you and your mom to a wide variety of skilled, carefully vetted workers. Here’s what you should know.
Finding Qualified Help
One of the best ways to find qualified, reliable, trustworthy people that can help with home chores and other small jobs is throughreferrals from people you trust. But if your friends or family don’t have any recommendations, there are a number of online companies you can turn to now like TaskRabbit.com and Takl.com.
These are on-demand service companies that can quickly and easily connect you to skilled workers to handle a wide variety of household chores and small jobs, like cleaning and housekeeping, moving and packing, lawn and yard cleanup, handyman tasks, grocery shopping, running errands, furniture assembly, picture hanging, closet organizing, and much more.
TaskRabbit currently has more than 60,000 Taskers (workers) in 47 U.S. cities, while Takl currently serves 75 U.S. cities with around 35,000 workers.
All you need to do is download their app, or go to their website, and select the service your mom wants done and set a time when she would like the worker to show up. The software then matches your request and provides you a list of qualified, feedback rated workers (including their hourly rate) from which to choose. Once the job is complete, payment is done through the company’s app.
You should also know that all TaskerRabbit and Takl workers have to go through a thorough vetting process before they can join their respective company including extensive background checks.
But if you can’t find a skilled worker through TaskRabbit or Takl, or if they don’t serve your area, another option is Amazon Home Services at Amazon.com/services. Like TaskRabbit and Takl, Amazon will connect you to qualified workers that handle dozens of household chores and other small jobs.
Amazon also screens all workers through media searches, online interviews, reference checks, and background checks. And all experts need to have licenses and insurance.
To purchase and book a service, you can either buy a pre-packaged service with a fixed price (like two hours of cleaning) or you can submit a custom request and receive estimates. When booking, you select three different dates and time frames and the pro confirms an appointment. All payment is done through your Amazon account.
Need a Tradesman
If your mom primarily needs of a tradesman like a plumber, electrician, painter, roofer or carpenter for home repairs or remodel projects, you should also check HomeAdvisor.com and Angi.com. Both of these sites can connect you with prescreened, customer-rated service professionals in your area for free.
Another option you should know about is AskUmbrella.com, which is a fee-based membership service for seniors 60-plus that provides qualified, vetted workers to do small jobs in and around the house for only $16 per hour. Currently available in New York, they are expanding nationally over the next year.
If your mom is on a tight budget, you should also contact her nearby Area Aging Agency (call 800-677-1116), who can refer you to services in her area, if they are available.
For example, some communities have volunteer programs that provide chore and handyman services to help seniors in need. And some local non-profit’s offer residential repair services that offer seniors minor upgrades and adaptations to their homes.
Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today showand author of “The Savvy Senior” book.
Retirement Planning Tips for Single Women
Dear Savvy Senior,
What retirement planning tips can you recommend to single women? I’m 54 and divorced with a teenage daughter and very little saved for retirement.
It’s an unfortunate reality, but most single women – whether they’re divorced, widowed or never married – face much greater financial challenges in retirement than men. Why?
Because women earn less money – about 80 cents for every dollar that men make, on average, and they have shorter working careers than men due to raising children and/or caring for aging parents. And less money earned usually translates into less money saved and a lower Social Security benefit when you retire.
In addition, women live an average of five years longer than men, which requires their retirement income to stretch farther for living expenses and healthcare costs. And according to some studies, women tend to be less knowledgeable and more intimidated about financial issues than men, which means they don’t always handle their money as well as they should.
Because of these issues, it’s very important that women educate themselves on financial matters and learn how to save more effectively. Listed below are some tips and resources that may help you.
If your employer offers a retirement plan, such as a 401K, you should contribute enough to at least capitalize on a company match, if available. And if you can swing it, contribute even more. By law, you can save as much as $18,500 in a 401(k) in 2018, or $24,500 to those 50 and older, due to the catch-up rule.
If you don’t have a workplace plan, consider opening a Traditional or Roth IRA. Both are powerful tax-advantaged retirement savings accounts that let you contribute up to $5,500 annually, or $6,500 when you’re over 50.
And if you’re self-employed, consider a SEP-IRA, SIMPLE-IRA and/or a solo 401(k), all of which can help reduce your taxable income while putting money away for retirement.
Also, if you have a high-deductible health insurance policy, you should consider opening a health savings account (see HSAsearch.com). This is an excellent tool that can be used to sock away funds pre-tax and use them before or after retirement to pay for medical expenses.
Find Your Number
It’s also important to get a handle on how much you need to save for a comfortable retirement. You can do this through a number of free online calculators like ChooseToSave.org or FinancialMentor.com/calculator.
Pay Off Debt
If you have debt, you need to get it under control. If you need some help with this, consider a nonprofit credit-counseling agency that provides free or low cost advice and solutions, and can help you set up a debt management plan. To locate an agency, use the National Foundation for Credit Counseling website at NFCC.org or call 800-388-2227.
To help you educate yourself on financial matters like retirement planning, saving and investing, health care, annuities and more, a top resource is the Women’s Institute for a Secure Retirement at WiserWomen.org.
And to help you get up to speed on Social Security, visit SSA.gov/people/women. This web page, dedicated to women, provides helpful publications like “What Every Women Should Know,” along with links to benefit calculators and your personal Social Security account to help you figure out your future earnings at different retirement ages.
You should also consider getting a financial assessment with a fee-only financial advisor. Costs for these services will vary from around $150 to $300 per hour, but this can be very beneficial to help you set-up a retirement plan you can follow. See NAPFA.org or GarrettPlanningNetwork.com to locate an advisor in your area.
Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBCToday showand author of “The Savvy Senior” book.
How Older People Can Find Clinical Trials
Dear Savvy Senior,
What can you tell me about clinical trials and how to go about finding one?
Old and Ill
Each year, hundreds of thousands of Americans participate in clinical trials in hopes of gaining access to the latest, and possibly greatest, but not yet on the market treatments for all types of illnesses.
But you need to be aware that clinical trials can vary greatly in what they’re designed to do, so be careful to choose one that can actually benefits you. Here’s what you should know along with some tips for locating one.
A clinical trial is the scientific term for a test or research study of a drug, device or medical procedure using people. These trials – sponsored by drug companies, doctors, hospitals and the federal government – are conducted to learn whether a new treatment is safe and if it works. But, keep in mind that these new treatments are also unproven, so there may be risks too.
Also be aware that all clinical trials have certain eligibility criteria (age, gender, health status, etc.) that you must meet in order to be accepted. And before taking part in a trial, you’ll be asked to sign an informed consent agreement. You can also leave a study at any time.
Find a Trial
Every year, there are more than 100,000 clinical trials conducted in the U.S. You can find them by asking your doctor who may be monitoring trials in his or her specialty.
Or you can look for them on your own at ClinicalTrials.gov. This website, sponsored by the National Institutes of Heath, contains a comprehensive database of federally and privately supported clinical studies in the U.S. and abroad on a wide range of diseases and conditions, including information about each trial’s purpose, who may participate, locations, and phone numbers for more details.
If you want some help finding the right trial, try ResearchMatch.org, a web-based resource created by Vanderbilt University that connects willing patients with researchers of clinical trial. Or, use the Center for Information and Study on Clinical Research Participation at CISCRP.org.
This is a non-profit organization that will take your information online or over the phone and do a thorough clinical trials search for you, and mail or email you the results within a week or two. Call 877-633-4376 for assistance.
Those with dementia and their caregivers can also locate clinical trials at the Alzheimer’s Association TrialMatch at TrialMatch.alz.org.
Things to Know
Before deciding to participate in a trial, you need to first discuss it with your doctor to make sure it is appropriate for you. Then, schedule an appointment with the study’s medical team and ask lots of questions, such as:
- What’s the purpose of the study and can it improve my condition?
- What are the risks?
- What kinds of tests and treatments does the study involve, and how often and where they are performed?
- Is the experimental treatment in the study being compared with a standard treatment or a placebo?
- Who’s paying for the study? Will I have any costs, and if so, will my insurance plan or Medicare cover the rest?
- What if something goes wrong during or after the trial and I need extra medical care? Who pays?
For more information on clinical trials for older adults visit the National Institute on Aging (nia.nih.gov/health/clinical-trials), which has many informative articles including one on “questions to ask before participating in a clinical trial.”
Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBCToday showand author of “The Savvy Senior”book.