Savvy Senior — December 2019 Columns

Savvy Senior – December Columns

  1. How Seniors Can Get Free Legal Assistance
  2. What to Do When Medicare Tells You No
  3. How to Manage a Loved One’s Social Media Afterlife
  4. Why the Risk of Heart Attack Rises in Winter

How Seniors Can Get Free Legal Assistance

Dear Savvy Senior,
Can you recommend any resources that provide free or low-cost legal services to seniors? I’m 68 and need some professional legal assistance but have limited funds.
Need Help

Dear Need,
There are actually a number of free and low-cost legal resources that can help seniors in need, but what’s available to you will depend on where you live, the type legal assistance you need and your financial situation. Here are several options to check into.

Legal Aid: Directed by the Legal Services Corporation, legal aid offers free legal assistance to low-income people of all ages. Each community program will differ slightly in the services they offer and income qualifications. See LSC.gov/find-legal-aid to locate a program in your area.

Free Legal Answers: This is an online program created by the American Bar Association that matches low-income clients with volunteer lawyers who agree to provide brief answers online for free. This service will not answer criminal law questions, and it’s not available in every state. Visit ABAfreelegalanswers.org to look for a program in your state.

Pro Bono and Senior Legal Hotlines: Usually sponsored by state or local bar associations, pro bono programs help low-income people find volunteer lawyers who are willing to handle their cases for free.

There are also a number of states that still offer senior legal hotlines, where all seniors over age 60 have access to free legal advice over the telephone. To find out if either of these services are available in your state, go to LawHelp.org, and click on “Find help near you.”

Senior Legal Services: Coordinated by the Administration on Aging, this service may offer free or low-cost legal advice, legal assistance or access to legal representation to people over the age of 60. Your Area Agency on Aging can tell you what’s available in your community. Call the Eldercare Locator at 800-677-1116 to get your local number.

National Disability Rights Network: This is a nonprofit membership organization that provides legal assistance to people with disabilities through their Protection and Advocacy System and Client Assistance Program. If you are disabled, visit NDRN.org to find help in your state.

Other Options
If you can’t get help from one of these programs, or find that you aren’t eligible, another option is to contact your state or local bar association, which may be able to refer you to a low-fee lawyer. Or, you may want to consider hiring a lawyer for only part of the legal work and doing other parts yourself. This is known as “unbundled legal services.”

Many bar associations offer public service-oriented lawyer referral services that will interview clients and help identify the problems a lawyer could help them with. If a lawyer can help with your problem, the service will provide you with a referral to a lawyer. If the problem does not require a lawyer, the service will provide information on other organizations in your community that may be able to help. Most of these lawyer referral services conduct their interviews and make referrals over the phone.

To contact your state or local bar association, go to www.FindLegalHelp.org.

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.

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What to Do When Medicare Tells You No

Dear Savvy Senior,
How do I go about appealing Medicare when they won’t pay for something that they covered in the past?
Rejected Rhonda

Dear Rhonda,
If you disagree with a coverage or payment decision made by Medicare, you can appeal, and you’ll be happy to know that around half of all appeals are successful, so it’s definitely worth your time.

 But before going that route, talk with the doctor, hospital and Medicare to see if you can spot the problem and resubmit the claim. Some denials are caused by simple billing code errors by the doctor’s office or hospital. If, however, that doesn’t fix the problem, here’s how you appeal.

Original Medicare Appeals
If you have original Medicare, start with your quarterly Medicare Summary Notice (MSN). This statement will list all the services, supplies and equipment billed to Medicare for your medical treatment and will tell you why a claim was denied. You can also check your Medicare claims early online at MyMedicare.gov, or by calling Medicare at 800-633-4227.

There are five levels of appeals for original Medicare, although you can initiate a fast-track consideration for ongoing care, such as rehabilitation. Most people have to go through several levels to get a denial overturned.

You have 120 days after receiving the MSN to request a “redetermination” by a Medicare contractor, who reviews the claim. Circle the items you’re disputing on the MSN, provide an explanation of why you believe the denial should be reversed, and include any supporting documents like a letter from the doctor or hospital explaining why the charge should be covered. Then send it to the address on the form.

You can also use the Medicare Redetermination Form. See CMS.gov/Medicare/CMS-Forms/CMS-Forms/downloads/CMS20027.pdf to download it or call 800-633-4227 to request a copy by mail.

The contractor will usually decide within 60 days after receiving your request. If your request is denied, you can request for “reconsideration” from a different claims reviewer and submit additional evidence.

A denial at this level ends the matter, unless the charges in dispute are at least $160 in 2019. In that case, you can request a hearing with an administrative law judge. The hearing is usually held by videoconference or teleconference.

If you have to go to the next level, you can appeal to the Medicare Appeals Council. Then, for claims of at least $1,630 in 2019, the final level of appeals is judicial review in U.S. District Court.

Advantage and Part D Appeals
If you’re enrolled in a Medicare Advantage health plan or Part D prescription drug plan the appeals process is slightly different. With these plans you have only 60 days to initiate an appeal. And in both cases, you must start by appealing directly to the private insurance plan, rather than to Medicare.

If you think that your plan’s refusal is jeopardizing your health, you can ask for a “fast decision,” where a Part D insurer must respond within 24 hours, and Medicare Advantage health plan must provide an answer within 72 hours.

If you disagree with your plan’s decision, you can file an appeal, which like original Medicare, has five levels. If you disagree with a decision made at any level, you can appeal to the next level.

For more information, along with step-by-step procedures on how to make an appeal, visit Medicare.gov and click on the “Claims & Appeals” tab at the top of the page.

Get Help
If you need some help contact your State Health Insurance Assistance Program (SHIP), which has counselors that can help you understand the billing process and even file your appeal for you for free. To locate your local SHIP, visit ShiptaCenter.org or call 877-839-2675. The Medicare Rights Center also offers free phone counseling at 800-333-4114.

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.

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How to Manage a Loved One’s Social Media Afterlife

Dear Savvy Senior,
How do I go about changing or canceling a person’s social media accounts when they die? My sister passed away several months ago and her social media accounts are still active.
Inquiring Sister

Dear Inquiring,
I’m sorry for your loss. This a question that’s become more frequent in recent years as most Americans have participated on some type of social media platform. Here’s a run-down of how you can change or cancel some different social media accounts after a loved one dies.

Facebook
Let’s start with the biggest and most frequently used social media platform on the Web today. When someone with a Facebook profile dies, there are two different things someone with authority over their account can do. You can either “memorialize” it or delete it.

A memorialized account serves as a place where friends and family can share stories, photos or memories to celebrate the deceased person’s life, with the word “Remembering” shown next to the deceased person’s name. Once an account is memorialized, content the person shared is still visible on Facebook to the audience it was originally shared with; however, the user’s profile will not show up in public spaces such as people you may know, ads or birthday reminders.

If you don’t wish to memorialize your sister’s profile, you can also have her account permanently deleted from Facebook.

Facebook allows users (when they’re alive) to choose a “legacy contact,” which is a person chosen to look after their account once they’ve passed away, or users can request to have their account permanently deleted after they die. (To do either of these tasks, click on “Settings” on the top right of Facebook, then click on “General” on the left-side menu and then on “Manage Account.”)

If your sister didn’t set up a legacy contact before she passed, you can submit a memorialization request at Facebook.com/help. Type in “How do I report a deceased person on Facebook that needs to be memorialized?” in the search bar. You’ll be asked to provide proof of death by providing a copy of either an obituary, death certificate or memorial card.

Or, if you would rather have her account deleted go to Facebook.com/help, and type in “How do I request the removal of a deceased family member’s Facebook account?” This also requires proof of death plus verification that you’re an immediate family member or executor of the account holder.

Instagram
Instagram’s policy on a deceased users’ account is similar to its parent company, Facebook. A deceased users’ account can either be memorialized or removed, which you can request at Help.Instagram.com/264154560391256.

Like Facebook, to memorialize an Instagram account requires proof of death, but to remove an account you’ll also need to provide verification that you’re an immediate family member.

Twitter
If your sister was a Twitter user, Twitter will work with anyone who is authorized to act on behalf of her estate, or with a verified immediate family member to have an account deactivated. To request the removal of your sister’s account, go to Help.Twitter.com/forms/privacy.

After you submit your request, Twitter will email you with instructions for providing more details, including information about the deceased, a copy of your ID, and a copy of the deceased’s death certificate.

LinkedIn
If your sister also had a LinkedIn profile, the only option is to delete her account. To request this, see LinkedIn.com/help/linkedin/ask/ts-rdmlp. You’ll need to provide her name and URL to her LinkedIn profile; the relationship you have to her; her email address; date she passed away; link to an obituary; and company she most recently worked for.

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.

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Why the Risk of Heart Attack Rises in Winter

Dear Savvy Senior,
I’ve read that people with heart problems need to be extra careful during the winter months because heart attacks are much more common. Why is this?
Cautions Senior

Dear Cautious,
Everyone knows winter is cold and flu season, but many don’t know that it’s also the prime season for heart attacks too, especially if you already have heart disease or have suffered a previous heart attack. Here’s what you should know, along with some tips to help you protect yourself.

In the U.S., the risk of having a heart attack during the winter months is twice as high as it is during the summertime. Why? There are a number of factors, and they’re not all linked to cold weather. Even people who live in warm climates have an increased risk. Here are the areas you need to pay extra attention to this winter.

Cold temperatures: When a person gets cold, the body responds by constricting the blood vessels to help the body maintain heat. This causes blood pressure to go up and makes the heart work harder. Cold temperatures can also increase levels of certain proteins that can thicken the blood and increase the risk for blood clots. So, stay warm this winter, and when you do have to go outside, make sure you bundle up in layers with gloves and a hat, and place a scarf over your mouth and nose to warm up the air before you breathe it in.

Snow shoveling: Studies have shown that heart attack rates jump dramatically in the first few days after a major snowstorm, usually a result of snow shoveling. Shoveling snow is a very strenuous activity that raises blood pressure and stresses the heart. Combine those factors with the cold temperatures and the risks for heart attack surges. If your sidewalk or driveway needs shoveling this winter, hire a kid from the neighborhood to do it for you, or use a snow blower. Or, if you must shovel, push rather than lift the snow as much as possible, stay warm, and take frequent breaks.

New Year’s resolutions: Every January 1, millions of people join gyms or start exercise programs as part of their New Year’s resolution to get in shape, and many overexert themselves too soon. If you’re starting a new exercise program this winter, take the time to talk to your doctor about what types and how much exercise may be appropriate for you.

Winter weight gain: People tend to eat and drink more and gain more weight during the holiday season and winter months, all of which are hard on the heart and risky for someone with heart disease. So, keep a watchful eye on your diet this winter and avoid binging on fatty foods and alcohol.

Shorter days: Less daylight in the winter months can cause many people to develop “seasonal affective disorder” or SAD, a wintertime depression that can stress the heart. Studies have also looked at heart attack patients and found they usually have lower levels of vitamin D (which comes from sunlight) than people with healthy hearts. To boost your vitamin D this winter, consider taking a supplement that contains between 1,000 and 2,000 international units (IU) per day.

Flu season: Studies show that people who get flu shots have a lower heart attack risk. It’s known that the inflammatory reaction set off by a flu infection can increase blood clotting which can lead to heart attacks in vulnerable people. So, if you haven’t already done so this year, get a flu shot for protection. And, if you’ve never been vaccinated for pneumococcal pneumonia, you should consider getting these two shots (given 12 months apart) too.

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.

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