Savvy Senior — February 2020 Columns

Savvy Senior – February Columns

  1. Do I Have to File Taxes?
  2. How to Detect Parkinson’s Disease
  3. When Should Dementia Patients Stop Driving?
  4. 10 Things Medicare Doesn’t Cover

Do I Have to File Taxes?

Dear Savvy Senior,
What are the IRS income tax filing requirements for seniors this year? I didn’t file a tax return last year because my 2018 income was below the filing requirements, but I got a part-time job late last year in 2019, so I’m wondering if I need to file this year.
Semi-Retired

Dear Semi,
Whether or not you are required to file a federal income tax return this year depends not only on how much you earned last year (in 2019), but also the source of that income, as well as your age and your filing status.

Here’s a rundown of this tax season’s IRS tax filing requirement thresholds. For most people, this is pretty straightforward. If your 2019 gross income – which includes all taxable income, not counting your Social Security benefits, unless you are married and filing separately – was below the threshold for your filing status and age, you may not have to file. But if it’s over, you will.

  • Single: $12,200 ($13,850 if you’re 65 or older by Jan. 1, 2020).
  • Married filing jointly: $24,400 ($25,700 if you or your spouse is 65 or older; or $27,000 if you’re both over 65).
  • Married filing separately: $12,200 at any age.
  • Head of household: $18,350 ($20,000 if age 65 or older).
  • Qualifying widow(er) with dependent child: $24,400 ($25,700 if age 65 or older).

To get a detailed breakdown on federal filing requirements, along with information on taxable and nontaxable income, call the IRS at 800-829-3676 and ask them to mail you a free copy of the “Tax Guide for Seniors” (publication 554) or see IRS.gov/pub/irs-pdf/p554.pdf.

Check Here Too
There are, however, some other financial situations that can require you to file a tax return, even if your gross income falls below the IRS filing requirements. For example, if you earned more than $400 from self-employment in 2019, owe any special taxes like an alternative minimum tax, or get premium tax credits because you, your spouse or a dependent is enrolled in a Health Insurance Marketplace (Obamacare) plan, you’ll need to file.

You’ll also need to file if you’re receiving Social Security benefits, and one-half of your benefits plus your other gross income and any tax-exempt interest exceeds $25,000, or $32,000 if you’re married and filing jointly.

To figure all this out, the IRS offers an interactive tax assistant tool on their website that asks a series of questions that will help you determine if you’re required to file, or if you should file because you’re due a refund. It takes less than 15 minutes to complete.

You can access this tool at IRS.gov/help/ita – click on “Do I Need to File a Tax Return?”  Or, you can get assistance over the phone by calling the IRS helpline at 800-829-1040. You can also get face-to-face help at a Taxpayer Assistance Center. See IRS.gov/localcontacts or call 800-829-1040 to locate a center near you.

Check Your State
Even if you’re not required to file a federal tax return this year, don’t assume that you’re also excused from filing state income taxes. The rules for your state might be very different. Check with your state tax agency before concluding that you’re entirely in the clear. For links to state tax agencies see Taxadmin.org/state-tax-agencies.

Tax Preparation Help
If you find that you do need to file a tax return this year, you can get help through the Tax Counseling for the Elderly (or TCE) program. Sponsored by the IRS, TEC provides free tax preparation and counseling to middle and low-income taxpayers, age 60 and older. Call 800-906-9887 or visit IRS.treasury.gov/freetaxprep to locate a service near you.

Also check with AARP, a participant in the TCE program that provides free tax preparation at more than 4,800 sites nationwide. To locate an AARP Tax-Aide site call 888-227-7669 or visit AARP.org/findtaxhelp. You don’t have to be an AARP member to use this service.

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 Detect Parkinson’s Disease

Dear Savvy Senior,
What are the early warning signs of Parkinson’s disease? I was just diagnosed with it after noticing hand tremors for nearly a year, but looking back, I’m wondering if I missed any other early warning signs.
Tremoring Tom

Dear Tom,
The Holy Grail in any progressive disease is to find it early enough to start effective treatment before irreversible damage has occurred. But recognizing the early warning signs of Parkinson’s disease is challenging because they’re usually subtle and can be easily overlooked, dismissed or even misdiagnosed.

Parkinson’s disease, which afflicts around 1 million Americans, is a degenerative disorder that occurs when the brain’s dopamine-producing neurons die or become impaired. This happens in the part of the brain that controls movement, which can cause tremors (or shaking), stiffness, and difficulty with walking, balance, and coordination.

The symptoms usually begin gradually and get worse over time, and the progression of symptoms is often different from one person to another. Some people with Parkinson’s become severely disabled, while others may experience only minor motor disruptions.

While the cause of Parkinson’s disease is unknown, scientists believe genetics and environmental factors (exposure to certain toxins) play a key role. Most people with Parkinson’s first develop the disease around age 60 or older, and men are more likely to develop it than are women.

Early Warning Signs
Parkinson’s disease is difficult to diagnose because there’s no definitive test to confirm it. Doctors, usually neurologists, will do an examinationand evaluate a combination of warning signs, but symptoms can vary greatly by patient which often leads to confusion and misdiagnosis. That said, here are some of the key signs and symptoms everyone should know.

Trouble sleeping: Thrashing around in bed or acting out dreams – kicking or punching – when asleep. This is a REM sleep behavior disorder and one of the strongest and earliest pre-diagnostic symptoms of Parkinson’s disease.

Loss of smell: Not being able to smell certain foods very well like bananas, dill pickles or licorice. This too is one of the earliest symptoms.

Constipation: Problems with digestion and bowel movements are a big problem for people with Parkinson’s, and an early sign that can occur up to 20 years before this disease is diagnosed.

Changes in handwriting: Writing may become harder to do, and your handwriting may appear much smaller than it has in the past.

Tremors: Slight shaking or tremor in your finger, thumb, hand or chin. The tremor usually happens at rest, and when you move the extremity it may disappear. This is the most common and recognizable outward sign of Parkinson’s disease, but by the time tremors start, the brain has already lost more than half of its dopamine-producing cells.

Slowed movement: Over time, Parkinson’s disease can slow movements, making simple tasks difficult and time-consuming. Your steps may become shorter when you walk. It may be difficult to get out of a chair. You may drag your feet as you try to walk.

Speech changes: Speaking softly, quickly, slurring or hesitating before talking. Your speech may be more of a monotone rather than with the usual inflections.

Loss of automatic movements: Decreased ability to perform unconscious movements, like blinking, smiling or swinging your arms when you walk.

Impaired posture and balance: Stooping, leaning or slouching when you stand, and/or balance problems can all be a sign of Parkinson’s.

Treatments
Currently, there is no known cure for Parkinson’s disease, but there are a variety of medications that can provide relief from the symptoms. In some later cases, surgery may be advised. Other treatments include lifestyle modifications, like getting more rest and exercise.

For more information, visit the Parkinson’s Foundation at Parkinson.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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When Should Dementia Patients Stop Driving?

Dear Savvy Senior,
Is there a good rule of thumb on when dementia patients should stop driving? My 82-year-old mom has early stage Alzheimer’s disease but still drives herself around town just fine.
Inquiring Daughter

Dear Inquiring,
Most doctors agree that people with moderate to severe dementia should never get behind the wheel, but in the early stages of Alzheimer’s, driving performance should be the determining factor of when to stop driving, not the disease itself.

With that said, it’s also important to realize that as your mom’s driving skills deteriorate over time from the disease, she might not recognize she has a problem. So, it’s very important that you work closely with her doctor to monitor her driving and help her stop when it is no longer safe for her to drive. Here are some additional tips that can help you.

Watch for Warning Signs
The best way to keep tabs on your mom’s driving is to take frequent rides with her watching out for key warning signs. For example: Does she have trouble remembering routes to familiar places? Does she drive at inappropriate speeds, tailgate, drift between lanes or fail to observe traffic signs? Does she react slowly or make poor driving decisions? Also, has your mom had any fender benders or tickets lately, or have you noticed any dents or scrapes on her vehicle? All of these are red flags.

If you need some assessment help, hire a driver rehabilitation specialist who’s trained to evaluate older drivers. See AOTA.org/older-driver orADED.net to locate one in your area.

Transition Tips
Through your assessments, if you believe it’s still safe for your mom to drive, you should start recommending some simple adjustments to ensure her safety, like driving only in daylight and on familiar routes, and avoiding busy roads and bad weather. Also, see if she will sign an Alzheimer’s “driving contract” (see ALZ.org/driving to print one) that designates someone to tell her when it’s no longer safe to drive.

You may also want to consider getting a GPS car tracking device (like MotoSafety.com or AutoBrain.com) to help you keep an eye on her. These devices will let you track where she’s driving and allow you to set up zones and speed limits that will send you alerts to your smartphone when she exits an area, or if she’s driving too fast or braking harshly.

Time to Quit
When your mom’s driving gets to the point that she can no longer drive safely, you’ll need to talk to her. It’s actually best to start having these conversations in the early stages of the disease, before she needs to quit driving, so she can prepare herself.

You also need to have a plan for alternative transportation (including a list of family, friends and local transportation options) that will help your mom get around after she stops driving.

For tips on how to talk to your mom, the Hartford Center for Mature Market Excellence offers a helpful guide called “At the Crossroads: Family Conversations About Alzheimer’s Disease, Dementia and Driving” that you can get at TheHartford.com/Publications-on-Aging.

Refuses to Quit
If your mom refuses to quit, you have several options. First, suggest a visit to her doctor who can give her a medical evaluation, and prescribe that she stops driving. Older people will often listen to their doctor before they will listen to their own family.

If she still refuses, contact your local Department of Motor Vehicles (DMV) to see if they can help. Some states require doctors to report new dementia cases to the DMV, who can revoke the person’s license.

If these fail, consider hiding her keys or just take them away. You could also disable her vehicle by disconnecting the battery, park it in another location so she can’t see it or have access to it or sell it.

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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10 Things Medicare Doesn’t Cover

Dear Savvy Senior,
I will be enrolling in Medicare in a few months and would like to find out what they don’t cover so I can avoid any surprises.
Almost 65

Dear Almost 65,
While Medicare (Part A and B) covers a wide array of health care services after you turn 65, it doesn’t cover everything. If you need or want certain services that aren’t covered, you’ll have to pay for them yourself unless you have other insurance, or you enroll in a Medicare Advantage health plan, which may offer some additional benefits. Here’s a look at some commonly needed medical services that original Medicare doesn’t pay for.

Most dental care: Routine dental care including checkups, cleanings, fillings, tooth extractions and dentures are not covered by Medicare. However, some Medicare Advantage plans do cover basic dental care services.

Routine vision care and eyeglasses: Medicare does not cover routine eye exams, eyeglasses and contact lenses (except following cataract surgery), but tests, treatments and surgeries for medical eye diseases like cataracts, glaucoma and macular degeneration are covered. Some Medicare Advantage plans do offer routine vision benefits.

Alternative medicine: Acupuncture, chiropractic services (except to fix subluxation of the spine), and other types of alternative or complementary care are not covered by Medicare.

Prescription drugs: Medicare (Part A and B) doesn’t provide coverage for outpatient prescription drugs, but you can buy a separate Part D prescription-drug policy that does, or a Medicare Advantage plan that covers both medical and drug costs.

Cosmetic surgery: Most cosmetic procedures are not covered, however, if the surgery is due to an injury or deformity, it might pay. For example, Medicare will cover a breast prosthesis for breast cancer survivors.

Hearing aids: Medicare will not pay for hearing exams or hearing aids, but may cover a hearing and balance exam if your doctor determines it’s necessary. Some Medicare Advantage plans do offer hearing benefits.

Long-term care: Nursing home care and assisted living facilities are not covered by Medicare. But, Medicare will help pay up to 100 days of skilled nursing or rehabilitation care immediately following a hospital stay of three or more days.

Personal home care: If you need to hire help for bathing, dressing or getting out of bed, Medicare typically won’t cover these costs either, unless you are homebound and are also receiving skilled nursing care. Housekeeping services, such as shopping, meal preparation and cleaning are not covered either unless you are receiving hospice care. But a few Medicare Advantage plans do offer in-home support services.

Routine foot care: Medicare does not cover most routine foot care, like the cutting or removing of corns, calluses and toenails. But they do cover medically necessary podiatrist services for foot problems like hammertoes, bunion and heel spurs, along with exams, treatments and therapeutic shoes or inserts if you have diabetic foot problems.

Overseas coverage: In most cases, health care outside of the United States is not covered by Medicare except for very limited circumstances – such as on a cruise ship within six hours of a U.S. port. But, Medigap supplemental plans D, G, M and N cover 80 percent of emergency care abroad, and some Medicare Advantage plans cover emergency care abroad too.

The best way to find out what Medicare covers is to talk to your health care provider, visit Medicare.gov/coverage and type in your test, item or service, or download the Medicare “What’s covered” app on the App Store or Google Play. And to look for Medicare Advantage plans that offer additional benefits visit Medicare.gov/plan-compare.

Also keep in mind that even if Medicare covers a service or item, they don’t pay 100 percent of the cost. You will have to pay a monthly Part B premium (which is $135.50 for most beneficiaries) and unless you have supplemental insurance, you’ll have to pay your annual deductibles and copayments too. However, most preventive services are covered 100 percent by Medicare with no copays or deductibles.

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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