Savvy Senior Columns — April 2020

Savvy Senior – April Columns

  1. How to Protect Your Elderly Parents from Coronavirus
  2. How to Get Help from Social Security During the Coronavirus Pandemic
  3. Medicare Expands Telehealth Services to Help Keep Seniors Safe at Home
  4. Beware of Coronavirus Scams
  5. Social Security Offers Lump Sum Payouts to Retirees

How to Protect Your Elderly Parents from Coronavirus

Dear Savvy Senior,
I’m concerned about my 80-year-old mother who’s at high risk for coronavirus. She lives on her own about 100 miles from me, and I’ve been keeping close tabs on her since this whole pandemic started. What tips can you offer long-distance family members?
Concerned Daughter

Dear Concerned,
Because the elderly and people with chronic medical conditions are the most vulnerable to the new coronavirus, following the Centers for Disease Control and Prevention (CDC) guideline of social distancing and staying home is critically important.

Here are some additional tips and recommendations from the CDC and public health specialists that can help keep your elderly mother safe and healthy while she’s hunkering down at home until the pandemic passes.

Know and follow the other CDC recommendations: Make sure you and your mom know and practice the CDC recommendations for older adults and those with compromised health conditions. Some of their guidelines – like washing your hands and avoid touching your face – you’re probably already familiar with, but there are many other recommendations and they’re constantly changing. For the complete list visit Coronavirus.gov – click on “Older Adults & Medical Conditions.”

Have supplies on hand: Start by contacting your mom’s healthcare provider to ask about obtaining extra necessary medications to have on hand for a prolonged period of time. If she cannot get extra medications, consider using mail-order for medications so she can avoid going into a pharmacy. Also be sure you have over-the-counter medicines and medical supplies to treat fever and other symptoms.

She should also have enough groceries and household items on hand so that she can stay at home for an extended period of time. If she needs to restock supplies, there’s online grocery delivery options like Amazon Fresh, Instacart, Peapod, Target and Walmart, and a growing number of stores including Walmart, Target, Whole Foods, Dollar General and many other that are offering early dedicated shopping times to vulnerable seniors to reduce their risk of being exposed to the virus.

There are also home delivery meal programs that can help home-bound seniors – see MealsOnWheelsAmerica.org to locate one in your mom’s area. Or, check out companies like Silver Cuisine (SilverCuisine.com) or Mom’s Meals (MomsMeals.com) that deliver nutritious pre-cooked meals to seniors that can be heated up in the microwave.

Use technology: For many seniors, social distancing can also lead to social isolation and loneliness, which is a common problem in the older population. If your mom has a computer, tablet or smartphone, she can stay connected to friends and relatives via videocalls through Skype, Zoom or FaceTime, which is a safe alternative.

If your mom isn’t familiar or comfortable with mainstream technology there are other solutions like the GrandPad (GrandPad.net), which is a simplified 4G tablet designed for seniors 75 and older that allows one-touch videocalls, email and much more.

And for peace of mind, there are also check-in services like Snug (SnugSafe.com) that send free daily check-ins to your mom’s phone to confirm she’s OK.  And, will let you know if she doesn’t respond.

Skip nonessential doctor’s appointments: Most public health experts are also recommending that seniors at risk cancel nonessential doctor’s appointments. If your mom has a condition that she feels should not be put off, see if a telemedicine session, which is now covered by Medicare would be an option.

Talk to caregivers: If your mom uses a home health or home care service, that means a number of different aides may be coming through her door.

Be sure you talk to the agency she uses or her aides about hygiene. They should all be reminded to wash their hands or use hand gel sanitizer frequently. And any equipment they bring into your mom’s home should be wiped down with disinfectant.

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 Get Help from Social Security During the Coronavirus Pandemic

Dear Savvy Senior,
I’ve heard that the Social Security Administration has closed all their offices because of the coronavirus pandemic. How are they accommodating people while they’re closed down?
Recently Retired

Dear Recently,
Yes, that’s correct. The Social Security Administration has closed its 1,200 field offices throughout the country to protect benefit recipients and workers from the coronavirus pandemic. Their offices have been closed since March 17. How long they will be closed is unclear. It will depend on the course of the pandemic.

In the meantime, services will continue to be available online at the SocialSecurity.gov website, and over the phone. You can also rest assured that monthly payments to the more than 69 million Social Security beneficiaries will not be affected in any way.

Here’s a rundown of how you can get help and get answers to your Social Security questions, while their offices are shut down.

Online Help
For any Social Security business you need to conduct, go to SSA.gov/onlineservices. There you can view your latest statement and earnings history, apply for retirement, disability, and Medicare benefits online, check the status of an application or appeal, request a replacement Social Security card (in most areas), print a benefit verification letter, and much more – from anywhere and from any of your devices.

Their website also has a wealth of information to answer most of your Social Security questions without having to speak with a representative. For answers to your Social Security questions see their frequently asked questions page at SSA.gov/ask.

Phone Assistance
If you can’t conduct your Social Security business online, check the SSA online field office locator (see SSA.gov/locator) for specific information about how to directly contact your local office. Your local office will be able to provide critical services to help you apply for benefits, answer your questions, and provide other services over the phone.

You can also call the Social Security national toll-free number at 800-772-1213 (TTY 800-325-0778). This number has many automated service options you can use without waiting to speak with a telephone representative.

If you already have an in-office appointment scheduled, Social Security will call you to handle your appointment over the phone instead. The call may come from a private number and not from a federal line.

Beware of Scams
Be aware that Social Security telephone impersonation scams are growing. These scammers may falsely tell you that there is a problem with your account, that your Social Security number has been suspended because of suspected illegal activity, that you’re owed a cost-of-living benefit increase, or that your monthly benefits will stop because of the coronavirus pandemic.

The caller may also threaten your benefits, suggest you’ll face legal action if you don’t provide information, or pressure you to send money via wire transfers, cash or gift cards. They may even “spoof” your caller ID to make it look like Social Security is actually calling.

If you receive one of these calls, hang up. Social Security rarely contacts anyone by phone unless you have ongoing business with them, and they never threaten you or ask for any form of payment.

For more information on how to get help with Social Security during the coronavirus shutdown, visit SSA.gov/coronavirus.

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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Medicare Expands Telehealth Services to Help Keep Seniors Safe at Home

Dear Savvy Senior,
Does Medicare cover telehealth services? My 71-year-old mother has chronic type 2 diabetes but is very concerned about going to the doctor for fear of exposing herself to coronavirus. What can you tell us?
Avoiding the Doctor

Dear Avoiding,
Yes! Due to the coronavirus (COVID-19) pandemic, Medicare recently announced that it will be expanding coverage for telehealth services to help keep vulnerable seniors safe at home. Here’s what you and your mom should know.

Telehealth Services
If you’re not familiar with telehealth or telemedicine services, they are full visits with a health care provider who isn’t at your location using telephone or video technology device – i.e. smartphone, tablet or computer.

Telehealth services allow Medicare beneficiaries to take care of ongoing medical problems as well as new concerns, while following public health advice to stay home during the coronavirus outbreak.

Medicare patients with chronic health conditions now don’t have to postpone a regular follow-up visit with the doctor to keep safe. They can do it via Skype or FaceTime. And people concerned they may have the virus could see their doctor or nurse practitioner virtually to find out how to get tested. Nursing home residents will also be able to have telehealth consultations with their doctors.

If your mom isn’t familiar or comfortable with technology, you or another relative or friend can assist her. You may need to go over to her house to help her do this. Bring your smartphone, tablet or laptop – but remember, don’t visit if you’re feeling sick.

Risk of serious illness from the coronavirus is much greater for older people and those with underlying health problems such as lung conditions, diabetes or heart problems. Many seniors are also managing chronic health issues that put them at heightened risk.

Until recently, telehealth coverage under original Medicare has been limited to beneficiaries only in rural areas, and patients often need to go to specially designated sites for their visits.

The expanded telehealth coverage, which will remain in effect during the coronavirus outbreak, now allows doctors and hospitals to bill Medicare for visits via telemedicine that previously had to take place in person, at a medical office or facility.

If your mom happens to get her Medicare benefits through a private Medicare Advantage plan, they will also be expanding their telehealth services. For coverage details, contact her plan directly.

Other Medicare Coverage
In addition to the expanded telehealth services, Medicare will also be covering all coronavirus testing costs to see your mom has been infected, and medically necessary hospitalizations, so if her doctor recommends that she remain in quarantine at the hospital rather than self-isolating at home, she will not have to pay for these costs.

And if your mom has a Medicare Part D prescription drug plan, it will cover the coronavirus vaccine when it becomes available and will waive prescription refill limits so she can have extra medication on hand during the pandemic.

For more information on how Medicare is covering the coronavirus see Medicare.gov/medicare-coronavirus. And for the latest information on the coronavirus, visit Coronavirus.gov.

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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Beware of Coronavirus Scams

Dear Savvy Senior,
Amid all the troubling coronavirus news, I’ve also read that there are various coronavirus scams going around right now taking advantage of innocent people who are afraid of getting sick or are worried about those that have. What can you tell me about coronavirus scams and what can I do to protect myself?
Scared Senior

Dear Scared,
Unfortunately, coronavirus scams are spreading nearly as fast as the virus itself, and seniors are often the most vulnerable.

These con artists are setting up websites to sell bogus products, and using spoofed phone calls, emails, texts, and social media posts as a ruse to take your money and get your personal information.

The emails and posts may be promoting awareness and prevention tips, and fake information about cases in your community. They also may be asking you to donate to victims, offering advice on unproven treatments, or contain malicious email attachments.

Here are some tips to help you keep the scammers at bay.

Click carefully: Don’t click on coronavirus-related links from sources you don’t know in an email or text message. The same goes for unfamiliar websites. When you click on an email or download a file, you could get a program on your computer that could either use your computer’s internet connection to spread malware or dig into your personal files looking for passwords and other information.

Ignore bogus product offers: Ignore online offers for coronavirus vaccinations or miracle cures. There are currently no vaccines, pills, potions, lotions, lozenges, or over-the-counter products available to treat or cure coronavirus online or in stores. If you see or receive ads touting prevention, treatment, or cure claims for the coronavirus, ignore them because they’re not legitimate.

Beware of CDC spoofing: Be wary of emails, text messages or phone calls claiming to come from the Centers for Disease Control and Prevention (CDC) and/or the World Health Organization (WHO). These scams could take several forms – such as fake health agency warnings about infections in your local area, vaccine and treatment offers, medical test results, health insurance cancellation, alerts about critical supply shortages, and more.

For the most up-to-date information about the coronavirus, visit CDC.gov/coronavirus.

Beware of fundraising scams: Be wary of emails or phone calls asking you to donate to a charity or crowdfunding campaign for coronavirus victims or for disease research. To verify a charity’s legitimacy use CharityNavigator.org. But, if you’re asked for donations in cash, by prepaid credit card or gift card, or by wiring money, don’t do it because it’s probably a scam.

Beware of stock scams: The U.S. Securities and Exchange Commission (SEC) is warning people about phone calls and online promotions, including on social media, touting stocks of companies with products that supposedly can prevent, detect or cure coronavirus. Buy those stocks now, they say, and they will soar in price.

But the con artists have already bought the stocks, which typically sell for a dollar or less. As the hype grows and the stock price increases, the con men dump the stock, saddling other investors with big losses. It’s a classic penny-stock fraud called “pump and dump.” Making matters worse: you may not be able to sell your shares if trading is suspended.

When investing in any company, including companies that claim to focus on coronavirus-related products and services, carefully research the investment and keep in mind that investment scam artists often exploit the latest crisis to line their own pockets.

For more tips on how to avoid getting swindled, see the Federal Communications Commission COVID-19 consumer warning and safety tips at FCC.gov/covid-scams.

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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Social Security Offers Lump Sum Payouts to Retirees

Dear Savvy Senior,
In light of the stock market crashing, I’ve heard that Social Security offers a lump-sum payment to new retirees who need some extra cash. I have not yet filed for my retirement benefits and would like to investigate this option. What can you tell me?
Seeking Cash

Dear Seeking,
There is indeed a little-known Social Security claiming strategy that’s been around for many years that can provide retirees a lump-sum benefit, but you need to be past your full retirement age to be eligible, and there are financial drawbacks you need to be aware of too.

First, let’s review the basics. Remember that while workers can begin drawing their Social Security retirement benefits anytime between ages 62 and 70, full retirement age is 66 for those born between 1943 and 1954, but it rises in two-month increments to 67 for those born in 1960 and later. You can find your full retirement age at SSA.gov/pubs/ageincrease.htm.

At full retirement age, you are entitled to 100 percent of your benefits. But if you claim earlier, your benefits will be reduced by 5 to 6.66 percent every year you start before your full retirement age. While if you delay taking your benefits beyond your full retirement age, you’ll get 8 percent more each year until age 70.

Lump Sum Option
If you are past full retirement age, and have not yet filed for your benefits, the Social Security Administration offers a retroactive lump-sum payment that’s worth six months of benefits.

Here’s how it works. Let’s say for example that you were planning to delay taking your Social Security benefits past your full retirement age of 66, but you changed your mind at 66 and six months. You could then claim a lump-sum payment equal to those six months of benefits. So, for instance, if your full retirement age benefit was $2,500 per month, you would be entitled to a $15,000 lump sum payment.

If you decided at age 66 and three months that you wanted to file retroactively, you’d get only three months’ worth of benefits in your lump sum, because SSA rules prohibit you from claiming benefits that pre-date your full retirement age.

Drawbacks
The downside to this strategy is that once you accept a lump-sum payment, you’ll lose the delayed retirement credits you’ve accrued, and your future monthly retirement benefit will be reduced to reflect the amount you already received. It will also affect your future survivor benefit to your spouse or other eligible family members after you die.

You also need to consider Uncle Sam. Depending on your income, Social Security benefits may be taxable, and a lump-sum payment could boost the amount of benefits that are taxed.

The federal government taxes up to 50 percent of Social Security benefits at ordinary income tax rates if your combined income – defined as adjusted gross income plus nontaxable interest income plus half of your Social Security benefits – exceeds $25,000, and up to 85 percent of benefits are taxable if combined income exceeds $34,000. For married couples, the comparable income thresholds for taxing benefits are $32,000 and $44,000.

To help you calculate this, see IRS Publication 915 “Social Security and Equivalent Railroad Retirement Benefits” at IRS.gov/pub/irs-pdf/p915.pdf, or call 800-829-3676 and ask them to mail you a copy.

In addition, if the lump-sum payment of retroactive Social Security benefits boosts your yearly income beyond the $85,000 level, it will increase your future Medicare premiums too. ​SeeMedicare.gov/Pubs/pdf/11579-medicare-costs.pdf for details.

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.

Savvy Senior Columns — March 2020

Savvy Senior – March Columns

  1. Beware of Potential 2020 Census Scams
  2. Important Legal Documents All Seniors Should Have
  3. How to Prevent the Silent Epidemic of Kidney Disease
  4. Travel Tips for Grandparents and Grandchildren

Beware of Potential 2020 Census Scams

Dear Savvy Senior,
Can you offer some tips to help seniors guard against census scams? With the 2020 census gearing up, I’ve read that there are a lot of potential scammers out there looking to take advantage of older people and I want to protect myself.
Cautious Judy

Dear Judy,
Unfortunately, scams have become a persistent problem when the U.S. Census Bureau does its once-a-decade count of the U.S. population. Here’s what you can expect from the 2020 Census in the coming weeks, and how you can protect yourself from potential scams.

What to Expect
In mid-March, you and nearly every other U.S. household will receive an invitation in the mail to respond to the 2020 Census. This year, you will have the option of completing the 2020 census questionnaire either online, by mail, or by phone. The invitation will include detailed instructions of what you need to do.

If you don’t respond to this invitation letter, you will receive several follow-up postcard reminders from the Census Bureau by mail. If you still don’t respond by late April, a census worker will come to your door to collect your response in person.

It only takes a few minutes to complete the census questionnaire.

While census participation is very important and required by law, you also need to be vigilant of census-linked scams. This is especially important for seniors who tend to be prime targets.

The Census Bureau warns against phishing email scams as well as con artist masquerading as census workers who will try to solicit your personal financial information. Here are some tips that can help you protect yourself.

Guard Your Information
Don’t give out your personal or financial information. The Census Bureau or a legitimate census worker will never ask for your Social Security number, bank account number, credit card number, money or donations. And they will never contact you on behalf of a political party. If you’re asked for any of these, whether it be via phone, mail, email or in person, it’s a scam and should be reported to [email protected].

Avoid Online Scams
The Census Bureau will not send you an unsolicited email to request your participation in the 2020 Census. So, ignore any emails you get that may direct you to a census website that looks real but is fake – and may be infected with malware. Also, don’t reply to the email or open any attachment because they could contain viruses that could infect your computer. Forward the email or website address to the Census Bureau at [email protected]. Then delete the message.

Be Safe at Home
If someone visits your home to collect a response for the 2020 Census, make sure you verify their identity. A legitimate census taker must present a field badge that includes a photograph of themselves, a Department of Commerce watermark and an expiration date. Census workers will also be carrying a Census Bureau laptop or cellphone, as well as a bag with a Census Bureau logo.

Also, remember that a census worker will only ask you the questions that appear on the questionnaire – your name, gender, age, race, ethnicity, phone number, type of residence and number of people living with you. They will not ask for sensitive personal information, such as your Social Security or credit card number.

If you have questions about their identity, you can call 800-923-8282 to speak with a local Census Bureau representative. If it is determined that the visitor who came to your door does not work for the Census Bureau, contact your local police department.

For more information on the 2020 Census, visit 2020census.gov.

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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Important Legal Documents All Seniors Should Have

Dear Savvy Senior,
What kinds of legal documents do I need to prepare to help my family after I’m gone? I would like to get my affairs in order but could use some help.
Almost 75

Dear Almost 75,
All adults – especially seniors – should have at least four essential legal documents to protect yourself and your family. These documents will make sure your wishes regarding your estate are legal and clear and will help minimize any conflicts and confusion with your family and your health care providers if you become seriously ill or when you die. Here are the key documents you need, along with some tips to help you create them.

Will: This document lets you spell out your wishes of how you’d like your property and assets distributed after you die, whether it’s to family, friends or a charity. It also allows you to designate an executor to ensure your wishes are carried out and allows you to name guardians if you have dependent children.

In addition to a will, if you own real estate or have considerable assets, another option you may want to consider is a “revocable living trust.” This functions like a will but allows your estate to avoid the time and expense of probate (the public legal process that examines your estate after you die) and helps ensure your estate’s privacy.

Durable Power of Attorney: This allows you to designate someone you trust to handle your financial matters if you become incapacitated.

Advanced Health Care Directive: This includes two documents that spell out your wishes regarding your end-of-life medical treatment. The two documents are a “living will” which tells your doctor what kind of care you want to receive if you become incapacitated, and a “health care power of attorney” (or health care proxy), which names a person you authorize to make medical decisions on your behalf if you’re unable.

You should also consider making a do-not-resuscitate order (DNR) as part of your advance directive, since advanced directives do little to protect you from unwanted emergency care like CPR. To create a DNR, ask your doctor to fill out a state appropriate form and sign it.

Do-It-Yourself
If you have a simple estate and an uncomplicated family situation, there are do-it-yourself resources that can help you create all these documents for very little money. Some options to consider include Quicken WillMaker & Trust 2020 software (available at Nolo.com) that costs $90 and works with Windows and Macs and is valid in every state except Louisiana. And LegalZoom.com, which offers an estate plan with professional legal guidance with an independent attorney for $179.

Get Help
If you want or need assistance or if you have a complicated financial situation, blended family or have considerable assets, you should hire an attorney. An experienced lawyer can make sure you cover all your bases – especially when writing a will or living trust – which can help avoid family confusion and squabbles after you’re gone.

Costs will vary depending on where you reside, but you can expect to pay somewhere between $500 and $2,000 for a basic estate plan that includes a will, power of attorney and advance directive. If you want your estate plan to include a living trust, that can run anywhere between $1,500 and $5,000.

The National Academy of Elder Law Attorneys (NAELA.org) and the National Association of Estate Planners and Councils (NAEPC.org) are two good resources that have directories on their websites to help you find someone in your area.

If money is tight, check with your state’s bar association (see www.FindLegalHelp.org) to find low-cost legal help in your area. Or call the Eldercare Locater at 800-677-1116 for a referral.

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 Prevent the Silent Epidemic of Kidney Disease

Dear Savvy Senior,
Do kidney problems run in families? My mother died from kidney failure 10 years ago at age 74 but didn’t know she had a kidney problem until it was too late.
Just Turned 60

Dear Just Turned 60,
Anyone who has a family history of kidney disease, or who has high blood pressure or diabetes is at increased risk and needs to have their kidneys tested.

According to the Center for Disease Control and Prevention, around 37 million U.S adults have chronic kidney disease (when the kidneys can’t properly do their job of cleaning toxins and wastes from the blood), and millions more are at risk of developing it, yet most people don’t realize it. That’s because kidney disease develops very slowly over many years before any symptoms arise. But left untreated, the disease can eventually require people to spend hours hooked up to a dialysis machine or get a kidney transplant. Even mild kidney problems can double a person’s risk of heart attack and stroke, as well as cause anemia and bone disease.

The reason kidney disease has become so widespread today is because of the rise of obesity, type-2 diabetes and high blood pressure which all strain the kidneys.

Another factor is the increasing number of people who take multiple medications, which can overtax the organs. People over age 60 are especially vulnerable both because they tend to take more drugs, and because kidney function normally declines somewhat with age.

Get Tested
Because kidney disease has no early symptoms, the only way to catch it before it advances is to have a simple blood and urine test by your doctor. So, anyone that has diabetes, high blood pressure or heart disease, a family history of kidney disease, or is age 60 or older needs to get tested. African, Hispanic, Asian and Indian Americans along with Pacific Islanders are also at increased risk.

If you’re diagnosed with kidney disease you need to know that there’s no cure, but there are steps you can take to help contain the damage, including:

Control your blood pressure: If you have high blood pressure, get it under 130/80. If you need medication to do it, ACE inhibitors and ARBs are good choices because of their proven ability to protect the kidneys.

Control your diabetes: If you have diabetes, keep your blood sugar as close to normal as possible.

Change your diet: This usually means reducing the amount of protein and phosphorus you eat and cutting back on sodium and possibly potassium. Your doctor can help you determine an appropriate eating plan, or you may want to talk to a dietitian.

Watch your meds: Dozens of commonly used drugs can damage the kidneys, especially when taken in high doses over long periods – most notably NSAIDs like ibuprofen and naproxen. Herbal supplements can also be very dangerous. Talk to your doctor about all the prescription, over the counter and herbal products you take to identify potential problems and find alternatives.

Exercise and lose weight: If you’re overweight and inactive, start an aerobic fitness routine (walk, swim, cycle, etc.) that gets your heart pumping. This will help lower blood pressure, control diabetes and help you lose excess weight all of which will help your kidneys.

Quit smoking: If you smoke, quit. Heart disease becomes a much greater risk to the kidneys if your smoke. Smoking also doubles the rate of progression to end-stage renal failure.

Limit alcohol intake: Drinking too much alcohol can worsen kidney disease too, so talk to your doctor to see if it’s safe for you to drink, and if so, limit yourself to no more than one drink per day.

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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Travel Tips for Grandparents and Grandchildren

Dear Savvy Senior,
My husband and I are interested in taking our two grandkids on a big trip this summer and are looking for some good ideas. Can you recommend some travel companies that offer special travel packages for grandparents and grandkids?
Doting Grandparents

Dear Doting,
Grandparents traveling with their grandchildren has become increasingly popular in recent years. Not only is this type of travel fun, it’s also a wonderful way to strengthen family bonds and create some lasting memories.

To help you with your traveling aspirations, there are a number of travel companies today that offer specialized multi-generational trip packages for grandparents and grandchildren. This is a nice way to go because they plan everything for you, with most activities for the two generations together, but some just for adults so you can get an occasional breather.

Available in various trip lengths and price ranges, these tours are designed for children, typically between the ages seven up to 17 or 18, and are usually scheduled in the summer, or sometimes during winter breaks when the kids are out of school. Here are some top tour companies to check into that will take you and your grandkids on a fun, well-planned vacation.

Road Scholar (RoadScholar.org): This well-established not-for-profit organization has offered educational travel to older adults since 1975. They currently offer 130 different programs geared to grandparent and grandchildren. About 75 percent of the grandparent trips are domestic; 25 percent are international. Some of the most popular destinations include the U.S. National Parks, Costa Rica, the Galapagos Islands and Paris. The average cost per person per night is $250 for domestic trips, $360 for international.

Tauck (Tauck.com): This is a large tour operator that offers 22 foreign and domestic multi-generational trips called Tauck Bridges family tours. Some of their most popular trips are Costa Rica, the European riverboat cruises, and the Cowboy Country, which tours you through Wyoming and South Dakota.

Austin Adventures (AustinAdventures.com): An adventure travel tour operator that offers 119 family friendly trips ideally suited for grandparents and grandchildren. Popular packages include destinations to Yellowstone National Park, Alaska, Costa Rica, Austria and Holland.

Adventures by Disney (AdventuresByDisney.com): Offers more than 35 vacations all over the world, including itineraries in Africa, Asia, Australia, Europe, North America and South America.

Smithsonian Journeys (SmithsonianJourneys.org): They offer seven different family journey trips to London and Paris, Tuscany, Iceland, Galapagos Islands, Botswana, Yellowstone and a Rhine River cruise.

Journeys International (JourneysInternational.com): They offer customized multi-generational trips primarily to Africa, Asia, Latin America and the Pacific.

Grandkids’ Travel Documents
Depending on where you go and your mode of transportation, you’ll need to gather some documents for your grandchildren to make sure everything goes smoothly. In general, most travel experts recommend you bring a notarized travel consent form (letter of permission from the parents), and a medical consent form in case any emergencies or problems arise. Also bring copies of insurance cards.

If you’re traveling domestically, you should know that airlines and trains don’t require any form of ID for children under 18. But if you’re traveling to Mexico, Canada, Bermuda, or other areas of the Caribbean by land or sea, grandchildren 15 and under will need certified copies of their birth certificates. And if your grandkids are 16 or older, or you’re traveling to these locations via air, passports will be required.

If you’re traveling overseas, all children, even infants, must have a passport. Some countries also require a visa for entry, and vaccinations may be required in some cases. Before booking a trip, check the U.S. Department of State’s website at Travel.State.gov for country-specific information.

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.

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.

Savvy Senior — January Columns

Savvy Senior – January 2020 Columns

  1. IRS Introduces a Tax Form Created for Older Taxpayers
  2. Monitoring Solutions for Loved Ones with Dementia
  3. Food Assistance Programs Can Help Seniors in Need
  4. Does Medicare Covers Counseling Services?
  5. How to Choose the Right Hospital for You

IRS Introduces a Tax Form Created for Older Taxpayers

Dear Savvy Senior,
A couple months back I read that the IRS will be offering a new senior-friendly tax form this tax season that will be easier to use. What can you tell me about this?
Paper Filer

Dear Filer,
It’s true. The Internal Revenue Service (IRS) has created a new federal income-tax form specifically designed for senior taxpayers, age 65 and older, that should make filing a little easier this year, particularly those who don’t file electronically. Here’s what you should know.

Form 1040-SR
Created by the 2018 Bipartisan Budget Act, the new two-page simplified federal income tax form is called the 1040-SR. Similar in style to the old 1040-EZ form that the IRS discontinued last year, the new 1040-SR has larger print and better color contrast that makes it easier to read.

In addition, it also includes a chart to help older taxpayers calculate their standard deduction, which may help ensure that fewer seniors neglect to take the additional standard deduction that they are entitled to. For 2019, the additional deduction for those 65 or older or the blind is $1,300.

The 1040-SR form also has specific lines for retirement income streams such as Social Security benefits, IRA distributions, pensions and annuities, along with earned income from work wages and tips. And, it allows a child tax credit for seniors who are still taking care of a dependent child or grandchild.

You can also report capital gains and losses, as well as interest and dividends on this new form. Any of the tax schedules available to those using the standard form 1040 may also be used with the 1040-SR.

You should also know that the 1040-SR doesn’t put a limit on interest, dividends, or capital gains, nor does it cap overall income like the old 1040-EZ form did. But, if you have to itemize because of state and local taxes or charitable giving, then you will not be able to use the new Form 1040-SR.

Paper Filing Advantage
Seniors who use tax-preparation software to file their taxes will be able to generate a 1040-SR, but the new form will provide the most significant benefit to taxpayers who still fill out and file their returns on paper.

Last year, about 88 percent of the 153 million individual federal tax returns filed to the IRS were filed electronically. About 5 percent were prepared using tax software, then printed out and mailed to the agency, while about 7 percent were prepared on paper.

To use the new 1040-SR tax form for the 2019 filing year, taxpayers, including both spouses if filing jointly, must be at least age 65 before Jan. 1, 2020. You also don’t have to be retired to use the form – older workers can use it too. But early retirees (younger than 65) cannot use 1040-SR.

To see the 2019 draft version of the new 1040-SR form, go to IRS.gov/pub/irs-dft/f1040s–dft.pdf.

Tax Preparation Help
If you need help filing your tax returns this year, consider contacting 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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Monitoring Solutions for Loved Ones with Dementia

Dear Savvy Senior,
My husband, who lives at home, has dementia and I worry about him wandering off and not being able to get back. Can you recommend some monitoring technology devices or any other solutions that can help me keep tabs on him?
Exhausted Spouse

Dear Exhausted,
This is a concern for millions of Americans caring for a loved one with dementia at home. About 60 percent of people who suffer from dementia wander at some point, according to the Alzheimer’s Association.

For caregivers, this can be frightening because many of those who wander off end up confused and lost, even in their own neighborhood, and are unable to communicate who they are or where they live. Here are some product and service solutions that may help.

Simple Solutions
For starters, there are a number of simple home modifications you can do to keep your husband from wandering away. Some solutions include adding an extra lock on the top or bottom of the exterior doors out of the line of sight or installing door alarms on the exterior doors that let you know when they’re opened. See AlzStore.com for a variety of product solutions. And, be sure you hide the car keys to keep him from driving.

You should also alert your neighbors that your husband may wander so they can keep an eye out and have a recent picture of him on hand to show around the neighborhood or to the police if he does get lost.

Monitoring Technology
For high-tech solutions, there are a variety of wearable GPS tracking devices available today that can help you keep tabs on him. Some top options to consider include AngelSense (AngelSense.com), which can be attached to clothing or worn around the waist; wristwatches like the Theora Connect (TheoraCare.com) or NurtureWatch (NurtureWatch.com); and the GPS SmartSole (GPSSmartSole.com), which is a shoe insole tracker.

All of these products come with smartphone apps that would alert you if your husband were to wander beyond a pre-established safe area and would let you know where to find him if he did. These products (except the GPS SmartSole) also provide two-way voice communication and auto pickup speakerphone so you can talk to him if he does wander off.

Locating Services
If the previously listed options don’t work for you, there are also locating services – like the MedicAlert + Safe Return program (MedicAlert.org/alz) and Vitals Aware Services (TheVitalsApp.com) – that can help you if he does wander off.

The MedicAlert + Safe Return program comes with a personalized ID bracelet that would have your husband’s medical information engraved on it, along with his membership number and the toll-free MedicAlert emergency phone number. If he goes missing, you would call 911 and report it to the local police department who would begin a search, and then report it to MedicAlert. Or, a Good Samaritan or police officer may find him and call the MedicAlert number to get him back home.

The Vitals Aware Service works a bit differently. This is a free app-based network system that comes with a small beacon that your husband would wear. If he did go missing, anyone in the Vitals app network community that came within 80 feet of him would receive an alert and information about him so they could contact you.

Another option that could help, depending on where you live, is a radio frequency locater service like SafetyNet and Project Lifesaver, which are offered by some local law enforcement agencies.

With these services, your husband would wear a wristband that contains a radio transmitter that emits tracking signals. If he goes missing, you would contact the local authorities who would send out rescue personnel who will use their tracking equipment to locate him. Visit SafetyNetTracking.com and Projectlifesaver.org to see if these services are available in your community.

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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Food Assistance Programs Can Help Seniors in Need

Dear Savvy Senior,
I would like to find out if my 73-year-old aunt is eligible for food stamps or any other type of food assistance program. It seems that she has a difficult time affording enough food each month, and I’d like to help if I can. What can you tell me?
Searching Niece

Dear Searching,
Sadly, millions of older Americans, like your aunt, struggle with food costs. According to a recent study by Feeding America, 5.5 million U.S. seniors age 60 and older are food insecure. Fortunately, there are several programs that may be able to help. Here’s what you should know.

SNAP Benefits
While there are millions of seniors who are eligible for food stamps, less than 40 percent actually take advantage of this benefit. Food stamps are now referred to as the Supplemental Nutrition Assistance Program, or SNAP. However, your state may use a different name.

For seniors to get SNAP, their net income must be under the 100 percent federal poverty guidelines. So, households that have at least one-person age 60 and older, or disabled, their net monthly income must be less than $1,041 per month for an individual or $1,410 for a family of two. Households receiving TANF or SSI are also eligible.

Net income is figured by taking gross income minus allowable deductions including a standard monthly deduction, medical expenses that exceed $35 per month out-of-pocket, and shelter expenses (rent or mortgage payments, taxes and utility costs) that exceeds half of the household’s income.

In addition to the net income requirement, a few states also require that a senior’s assets be below $3,500, not counting their home, retirement or pension plans, income from SSI or TANF, and vehicle (this varies by state). Most states, however, have much higher asset limits or they don’t count assets at all when determining eligibility.

To apply, seniors or an authorized representative will need to fill out a state application form, which can be done at the local SNAP office or, it can be mailed or faxed in. In many states it can be completed online.

If eligible, benefits will be provided on a plastic card that’s used like a debit card and accepted at most grocery stores. The average SNAP benefit for 60-and-older households is around $125 per month.

To learn more or apply, contact your local SNAP office – call 800-221-5689 for contact information or visit fns.usda.gov/snap.

Other Programs
In addition to SNAP, there are other federal programs that can help low-income seniors, age 60 and older, like the Commodity Supplemental Food Program (CSFP) and the Senior Farmers’ Market Nutrition Program (SFMNP).

The CSFP (see fns.usda.gov/csfp) is a program that provides supplemental food packages to seniors with income limits at or below the 130 percent poverty line.

And the SFMNP (fns.usda.gov/sfmnp) provides seniors coupons that can be exchanged for fresh fruits and vegetables at farmers’ markets, roadside stands and community supported agriculture programs in select locations throughout the U.S. To be eligible, your aunt’s income must be below the 185 percent poverty level.

There are also many Feeding America network food banks that host “Senior Grocery Programs” that provide free groceries to older adults, no strings attached. Contact your local food bank (see feedingamerica.org/find-your-local-foodbank) to find out if a program is available nearby.

In addition to the food assistance programs, there are also various financial assistance programs that may help your aunt pay for medications, health care, utilities and more. To locate these programs, and learn how to apply for them, go to BenefitsCheckUp.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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Does Medicare Covers Counseling Services?

Dear Savvy Senior,
Does Medicare cover outpatient counseling services for its beneficiaries? Since the death of my sister last year, I’ve struggled with depression and anxiety and would like to get some help.
Sad Senior

Dear Sad Senior,
I’m sorry for your loss. Yes, Medicare covers both outpatient and inpatient mental health services to help beneficiaries with depression, anxiety and many other needs. Here’s what you should know.

Outpatient Coverage
If you have original Medicare, your Part B coverage will pay 80 percent (after you’ve met your $198 Part B deductible) for a variety of counseling and mental health care services that are provided outside a hospital, like individual or group therapy, family counseling and more. They also cover services for treatment of beneficiaries who struggle with alcohol and drug abuse.

You or your supplemental insurance is responsible for the remaining 20 percent coinsurance.

Medicare also gives you the option of getting treatment through a variety of mental health professionals such as psychiatrists, psychologists, clinical social workers and clinical nurse specialists.

To get this coverage, you’ll need to choose a “participating provider” that accepts Medicare assignment, which means they accept Medicare’s approved amount as full payment for a service.

If you choose a “nonparticipating provider” who accepts Medicare but does not agree to Medicare’s payment rate, you may have to pay more. And if you choose an “opt-out provider” that does not accept Medicare payments at all, you will be responsible for the entire cost.

To locate a mental health care professional in your area that accepts Medicare assignment, use Medicare’s online Physician Compare tool. Go to Medicare.gov/PhysicianCompare and type in your ZIP code, or city and state, then type in the type of profession you want to locate, like “psychiatry” or “clinical psychologist” in the search box. You can also get this information by calling Medicare at 800-633-4227.

Inpatient Coverage
If you need mental health services in either a general or psychiatric hospital, original Medicare Part A covers this too (after you’ve met your $1,408 Part A deductible). Your doctor should determine which hospital setting you need. If you receive care in a psychiatric hospital, Medicare covers up to 190 days of inpatient care for your lifetime. And if you use your lifetime days but need additional care, Medicare may cover additional inpatient care at a general hospital.

Additional Coverage
In addition to the outpatient and inpatient mental health services, Medicare also covers yearly depression screenings that must be done in a primary care doctor’s office or clinic. Annual depression screenings are covered 100 percent.

And if you have a Medicare prescription drug plan, most medications used to treat mental health conditions are covered too.

Medicare Advantage
If you happen to get your Medicare benefits through a private Medicare Advantage plan, they must provide the same coverage as original Medicare does, but they may impose different rules and will likely require you to see an in-network provider. You’ll need to contact your plan directly for details.

And for more information, you can call Medicare at 800-633-4227 and request a copy of publication #10184 “Medicare & Your Mental Health Benefits,” or you can read it online at Medicare.gov.

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 Choose the Right Hospital for You

Dear Savvy Senior,
I need to get a hip replacement, and want to find a good, safe hospital to have it done in. What resources can you recommend for evaluating hospitals? I don’t currently have a doctor.
Shopping Around

Dear Shopping,
Most people spend more time shopping for a kitchen appliance or flat-screen TV than choosing a hospital. But selecting the right one can be as important as the doctor you choose. Here are some tips and resources to help you research the hospitals in your area.

Hospital Shopping
While you may not always have the opportunity to choose your hospital, especially in the case of an emergency, having a planned procedure can offer you a variety of choices.

When shopping for a hospital, the most important criteria is to choose one that has a strong department in treating your area of need. A facility that excels in coronary bypass surgery, for example, may not be the best choice for a hip replacement. Research shows that patients tend to have better results when they’re treated in hospitals that have extensive experience with their specific condition.

In order to choose a hospital that’s best for you, it is important to discuss your concerns and alternatives with the doctor who is treating you. Some doctors may be affiliated with several hospitals from which you can choose. Or, if you’ve yet to select a doctor, finding a top hospital that has expertise with your condition can help you determine which physician to actually choose.

Another important reason to do some research is the all too frequent occurrence of hospital infections, which kill around 75,000 people in the U.S. each year. So, checking your hospital’s infection rates and cleanliness procedures is also a smart move.

Free Researching Tools
There are a number of free online resources that can help you evaluate and compare hospitals in your area, including:

  • Medicare’s Hospital Compare (gov/HospitalCompare): Operated by the Centers for Medicare and Medicaid Services, this tool has data on more than 4,000 U.S. hospitals.
  • Why Not The Best (org): Created by the Commonwealth Fund, this is a private foundation that provides performance data on all U.S. hospitals.
  • The Leapfrog Group (org): This national, not-for-profit organization grades more than 2,000 U.S. hospitals on quality and safety.

These websites use publicly available data to rate hospitals on various measures of performance like death rates from serious conditions such as heart failure and pneumonia, frequency of hospital-acquired infections, patient satisfaction and more.

On these websites, you plug in your location to find hospitals in your area. You can then check to see how well or poorly each hospital manages patients in various conditions.

Two other good sites that can help you choose a good facility include U.S. News & World Report (USNews.com/best-hospitals) and Healthgrades (Healthgrades.com).

U.S News & World Report is an online publication that publishes a hospital ranking in 17 medical specialties like cancer, orthopedics and urology, and rates common procedures and conditions, such as heart bypass surgery, hip and knee replacement and COPD. They also rank hospitals regionally within states and major metro areas.

And Healthgrades, which is a private for-profit organization, provides free hospital ratings on patient safety and medical procedures, and scores hospitals using a 5-star scale. They also provide comprehensive information on most U.S. doctors including their education and training, hospital affiliations, board certification, awards and recognitions, professional misconduct, disciplinary action and malpractice records, office locations and insurance plans.

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.

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.

Savvy Senior — November 2019 Columns

Savvy Senior – November Columns

  1. How to Create an Ethical Will
  2. How to Choose a Walk-in Bathtub
  3. Does it Run in the Family? How to Create a Family Health Portrait
  4. How to Know When an Older Parent Has a Gambling Problem

How to Create an Ethical Will

Dear Savvy Senior,
Can you write a column on ethical wills and how to make one? The attorney that made up my will recently suggested I write one as a tool to explain the intentions of my will, as well as express my thoughts and feelings, but I don’t know where to start.
Interested Senior

Dear Interested,
An ethical will – also referred to as a legacy letter – can be a valuable complement to your legal will, as well as a wonderful gift to your family or other loved ones. Here’s what you should know along with some tips to help you make one.

Ethical Wills
Unlike a last will and testament, which tells your loved ones (and the legal world) what you want them to have, an ethical will (which is not a legal document) tells them what you want them to know.

With an ethical will, you can share with your loved ones your feelings, wishes, regrets, gratitude and advice, as well as explain the elements in your legal will, give information about the money and possessions you’re passing on, and anything else you want to communicate.

Usually no more than a few pages, the process of writing an ethical will can actually be quite satisfying. But be careful that you don’t contradict any aspects of your legal will or estate plan.

And, if you’re having trouble with the writing, there are resources available to help you, or you can express yourself through an audio or video recording.

Where to Start
To craft an ethical will, start by jotting down some notes about what’s really important to you and what you want your loved ones to know. Take your time and remember that you’re not trying to write for the Pulitzer Prize. This letter is a gift of yourself written for those you love.

After you’ve gathered your thoughts you can start drafting your letter. You can also revise or rewrite it anytime you want. And for safekeeping, keep your ethical will with your other legal documents in a secure location but be sure your executor has access to it. A safe-deposit box or fireproof filing cabinet or safe in your home is a good choice.

Get Help
If you need some help, there are numerous resources available like Celebrations of Life (CelebrationsofLife.net), which offers how-to information and examples of ethical wills, along with a “Ethical Wills: Putting Your Values on Paper” book, and the Ethical Wills/Legacy Letters workbook that you can purchase for $16 and $10 respectively.

Another good resource is Personal Legacy Advisors (PersonalLegacyAdvisors.com), a company that offers ethical will writing classes and workshops, along with personalized services like coaching, editing, writing and/or audio or video recording your ethical will. Prices will vary depending on the services you choose. They also sell a do-it-yourself guidebook “The Wealth of Your Life: A Step-by-Step Guide for Creating Your Ethical Will,” by Susan Turnbull for $24.

You also need to know that many people choose to share their ethical will with their family and friends while they’re still living so they can enjoy their reactions, while others think it should be read after their death. It’s up to you.

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 Choose a Walk-in Bathtub

Dear Savvy Senior,
Because of my mobility problems, I’m thinking about getting a walk-in bathtub that’s easy to get into and out of but could use some help selecting one. What can you tell me about walk-in tubs, and can you recommend some good companies that make and install them?
Bubble Bath Betty

Dear Betty,
Walk-in tubs are a good option for mobility challenged seniors because they’re much easier to get into and out of than a standard tub, and will help prevent slips, trips and falls too. Here’s what you should know.

The Basics
Walk-in bathtubs are uniquely designed tubs that have a watertight, hinged door built into the side of the tub that provides a much lower threshold to step over (usually 2.5 to 7 inches) versus a standard tub that’s around 15 inches.

In addition to the low threshold, most walk-in tubs also have a built-in seat, grab bars, anti-slip floors, anti-scald valves and a handheld showerhead. And many higher-end models offer therapeutic spa-like features that are great for seniors with arthritis and other ailments.

The kind of tub you choose will depend on your needs, preferences and budget, and the size and layout of your bathroom. The cost of a walk-in tub today with professional installation ranges anywhere from $3,000 to $10,000. Here are some other things you’ll need to consider, to help you make a good choice.

Tub size: Walk-in bathtubs vary in size. Most models have high walls between three and four feet high, and are between 28 and 32 inches wide, but will fit into the same 60-inch long space as your standard tub without having to reconfigure the room. There are also bariatric walk-in tubs that have wider door openings and larger seats to accommodate people over 300 pounds.

Wheelchair-accessible: Most walk-in tubs have an inward opening door, but if you use a wheelchair, an outward opening door may be a better option because they’re easier to access.

Tub options: The most basic and least expensive type of walk-in tub you can get is a simple soaker tub. But depending on your preferences, you have many other options like an aero therapy (air jets) tub, hydrotherapy (whirlpool water jets) tub, aromatherapy tub that mixes fragrant essential oils with the water, or a combination tub that has multiple features. Also, look for tubs that have an in-line heating system to keep your bathwater warm while you soak.

Fast fill and drain: One drawback to using a walk-in bathtub is that the bather must sit in the tub as it fills and drains, which can make for a chilly experience. To help with this, consider a tub that has fast-filling faucets and pump-assisted drainage systems, which significantly speed up the process. But these options may require some plumbing modifications to your bathroom.

Easy cleaning: Keeping the tub clean should be a priority, especially if you get a therapy tub because of the bacteria that can grow in it. So, look for tubs with self-cleaning systems.

Warranty: The best walk-in bathtubs on the market today are made in the USA. Also make sure the company you choose has a lifetime “leak-proof” door seal warranty and lengthy warranties on both the tub and the operating system.

Where to shop: While there are many companies that make, sell and install walk-in bathtubs, some of the best in the industry are American Standard (AmericanStandard-us.com), Safe Step (SafeStepTub.com) and Kohler (KohlerWalkinBath.com). Most companies offer financing with monthly payment plans.

Unfortunately, original Medicare does not cover walk-in bathtubs nor do Medicare supplemental (Medigap) policies, but some Medicare Advantage plans may help pay. There are also many states that offer Medicaid waivers that will help pay for the purchase and installation of a walk-in tub to those that qualify, and the VA offers some programs that provide financial aid too.

To get started, contact a few companies who will send a local dealer to your home to assess your bathroom and give you product options and estimates for free.

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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Does it Run in the Family? How to Create a Family Health Portrait

Dear Savvy Senior,
How do I go about making a family health history? Most of my relatives have died before age 65, so my doctor recently suggested I create a family history to help identify my own genetic vulnerabilities.
Approaching 50

Dear Approaching,
This is a very good idea. An accurate family health history remains one of the most important tools in keeping yourself healthy as you age, and the holidays when family members come together is a great time to do it. Here’s what you should know, along with some tips and tools to help you create one.

Know Your Genes
Just as you can inherit your father’s height or your mother’s eye color, you can also inherit their genetic risk for diseases like cancer, diabetes, heart disease and more. If one generation of a family has high blood pressure, for example, it is not unusual for the next generation to have it too. Therefore, tracing the illnesses suffered by your relatives can help you and your doctor predict the disorders you may be at risk for, so you can take action to keep yourself healthy.

To create a family health history, you’ll need to start by collecting some basic medical information on your first-degree relatives including your parents, siblings and children. Then move on to your grandparents, aunts, uncles and first cousins.

You need to get the specific ages of when they developed health problems like heart disease, cancer, diabetes, arthritis, dementia, depression, etc. If family members are deceased, you need to know when and how they died. If possible, include lifestyle information as well, such as diet, exercise, smoking and alcohol use.

Some relatives may not want to share their medical histories, or they may not know their family history, but whatever information you discover will be helpful.

To get information on diseased relatives, get a copy of their death certificate. This will list their cause of death and the age he or she died. To get a death certificate, contact the vital records office in the state where your relative died, or go to VitalChek.com.

Or, if you were adopted, the National Foster Care & Adoption Directory Search (see ChildWelfare.gov/nfcad) may be able to help you locate your birth parents so you can get their medical history.

Helpful Tools
To get help putting together your family health history, the U.S. Surgeon General created a free web-based tool called “My Family Health Portrait” (see phgkb.cdc.gov/FHH/html) that can help you collect, organize and understand your genetic risks and even share the information with your family members and doctors.

Another good resource that provides similar assistance is the Genetic Alliance’s online tool called “Does It Run In the Family.” At FamilyHealthHistory.org you can create a customized guide on your family health history for free.

Handling the Results
If you uncover some serious health risks that run in your family, don’t despair. While you can’t change your genes, you can change your habits to increase your chances of a healthy future. By eating a healthy diet, exercising and not smoking, you can offset and sometimes even neutralize your genetic vulnerabilities. This is especially true for heart disease, stroke, type-2 diabetes and osteoporosis.

A family medical history can also alert you to get early and frequent screening tests, which can help detect other problems (high blood pressure, high cholesterol, and cancers like breast, ovarian, prostrate and colon cancer) in their early stages when they’re most treatable.

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 Know When an Older Parent Has a Gambling Problem

Dear Savvy Senior,
I’m worried that my 76-year-old father has become addicted to gambling. He spends at least two days a week at an Indian casino about a half-hour’s drive from his house playing slot machines. What can I do?
Worried Daughter

Dear Worried,
Problem gambling among older adults is unfortunately on the rise. Studies suggest that more than 4 million Americans, age 65 and older, could have a gambling problem. The reasons behind this growing problem are because seniors have time and money on their hands and the influx of casinos that have cropped up around the country have made access to gambling much more convenient. Here’s what you should know, along with some tips and resources that can help your dad if he does indeed have a problem.

Problem Gambling
For most older adults, gambling is simply a fun recreational activity, but for those who become addicted to it, it can be a devastating disease that can financially wipe them out.

There are a number of reasons why seniors can be vulnerable to gambling problems. For starters, seniors are often catered to by casinos with free bus transportation, free drinks, discounted meals, special rewards and other prizes as a way to entice them.

In addition, many seniors use gambling as a way to distract or escape feelings of loneliness, depression or even a chronic health condition. Some may have financial problems they are seeking to overcome. And some may have cognitive impairment that interferes with their ability to make sound decisions.

Adding to the problem is that many seniors may not understand addiction, making them less likely to identify a gambling problem. Or they may be confused or embarrassed that they can’t control their urges to gamble and reluctant to seek help because they think that at their age, they should know better. And even if they recognize that they have a problem, they may not know that help is available or where to get it.

You should also know that while there are many gambling options for people to get hooked on today, casino slot machines are far and away the most popular among seniors. Slot machines are much more addictive then the old machines of yesteryear with spinning lemons, cherries and melons. Many of today’s slot machines offer intense sensory stimulation with large video screens, music and vibrating, ergonomic chairs.

Get Help
How can you know if your dad has a gambling problem? Gamblers Anonymous offers a 20-question online test at GamblersAnonymous.org that he can take to help determine if he has a problem. In the meantime, here are some questions you can ask to help evaluate his situation.

  • Is he preoccupied with gambling, constantly talking about it, or planning to gamble versus doing his normal activities?
  • Is he gambling more and more money to get the same level of excitement?
  • Is he using his retirement funds or other savings to gamble, or is he pawning or selling personal items to get money to gamble with?
  • Has he lost control to the point that he can’t set a limit of time and money to spend in the casino, and stick to it?
  • Does he become uncomfortable, angry or lie when you ask him about his gambling activities?

If your dad answers yes to any of these questions, he may have a problem. To find help contact the National Council on Problem Gambling (NCPgambling.org), a non-profit organization that operates a 24-hour national hotline at 800-522-4700. They can direct you to resources in your area, including counselors who have been trained through the National Certified Gambler Counseling Program.

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.

Savvy Senior — October 2019 Columns

Savvy Senior – October Columns

  1. Cremation: An Affordable Way to Go
  2. Flu Vaccines for Seniors That Provide Better Protection
  3. How Seniors Can Get Help with Credit Card and Mortgage Debt
  4. Getting Around When You No Longer Drive
  5. How to Help Aging Parents Manage their Medications

Cremation: An Affordable Way to Go

Dear Savvy Senior,
How much does cremation cost and how can I find a good deal in my area? I would like to get a simple, basic cremation that doesn’t cost me, or my family, a lot of money.
Frugal Senior

Dear Frugal,
Cremation costs can vary widely. Depending on your location, the provider and the services you request, cremation can range anywhere from $500 to $7,500 or more. But that’s a lot cheaper than a full-service funeral and cemetery burial that averages nearly $11,000 today. Here are some tips to help you get a good deal.

Shop Around
Because prices can vary sharply by provider, the best way to get a good price on a simple “no frills” cremation is to call several funeral homes in your area (most funeral homes provide cremation services) and compare prices.

When you call, ask them specifically how much they charge for a “direct cremation,” which is the basic option and the least expensive. With direct cremation, there’s no embalming, formal viewing or funeral. It only includes the essentials: picking up the body, completing the required paperwork, the cremation itself and providing ashes to the family.

If your family wants to have a memorial service, they can have it at home or your place of worship after the cremation, in the presence of your remains.

If you want additional services beyond what a direct cremation offers, ask the funeral home for an itemized price list that covers the other service costs, so you know exactly what you’re getting. All providers are required by law to provide this.

To locate nearby funeral homes, look in your local yellow pages, or Google “cremation” or “funeral” followed by your city and state. You can also get good information online at Parting.com, which lets you compare prices from funeral providers in your area based on what you want.

Or if you need more help, you can contact your nearby funeral consumer alliance program (see Funerals.org/local-fca or call 802-865-8300 for contact information). These are volunteer groups located in most regions around the country that offer a wide range of information and prices on local funeral and cremation providers.

Pricey Urns
The urn is an item you need to be aware of that can drive up cremation costs. Funeral home urns usually cost around $100 to $300, but you aren’t required to get one.

Most funeral homes initially place ashes in a plastic bag that is inserted into a thick cardboard box. The box is all you need if you intend to have your ashes scattered. But if you want something to display, you can probably find a nice urn or comparable container online. Walmart.com and Amazon.com for example, sells urns for under $50. Or, you may want to use an old cookie jar or container you have around the house instead of a traditional urn.

Free Cremation
Another option you may want to consider that provides free cremation is to donate your body to a university medical facility. After using your body for research, they will cremate your remains for free (some programs may charge a small fee to transport your body to their facility), and either bury or scatter your ashes in a local cemetery or return them to your family, usually within a year or two.

To find a medical school near you that accepts body donations, the University of Florida maintains a directory at Anatbd.acb.med.ufl.edu/usprograms.

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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Flu Vaccines for Seniors That Provide Better Protection

Dear Savvy Senior,
What can you tell me about the flu shots designed for older adults? I got sick last winter after getting a standard flu shot and would like to find out if the senior-specific flu vaccine is worth getting.
Approaching 80

Dear Approaching,
There are actually two different types of flu shots available to people age 65 and older. These FDA-approved vaccines are designed to offer extra protection beyond what a standard flu shot provides, which is important for older adults who have weaker immune defenses and have a great risk of developing dangerous flu complications.

The Center for Disease Control and Prevention (CDC) estimates that during the 2018-2019 flu season, up to 647,000 people were hospitalized and 61,200 died because of the flu – most of whom were seniors.

You also need to be aware that these senior-specific flu shots cannot guarantee that you won’t get the flu this season, but they will lower your risk. And if you do happen to get sick, you probably won’t get as sick as you would without it. Here’s more information on the two vaccines:

Fluzone High-Dose: Approved for U.S. use in 2009, the Fluzone High-Dose is a high-potency vaccine that contains four times the amount of antigen as a regular flu shot does, which creates a stronger immune response for better protection. This vaccine, according to a 2013 clinical trial, was 24 percent more effective than the regular-dose shot at preventing flu in seniors.

FLUAD: Available in the U.S. since 2016, the FLUAD vaccine contains an added ingredient called adjuvant MF59 that also helps create a stronger immune response. In a 2012 Canadian observational study, FLUAD was 63 percent more effective than a regular flu shot. The CDC does not recommend one vaccination over the other, and to date, there have been no studies comparing the two vaccines.

You should also know that both the Fluzone High-Dose and FLUAD can cause more of the mild side effects that can occur with a standard-dose flu shot, like pain or tenderness where you got the shot, muscle aches, headache or fatigue. And neither vaccine is recommended for seniors who are allergic to chicken eggs, or those who have had a severe reaction to a flu vaccine in the past.

If you are allergic to eggs you can ask for a Flucelvax or FluBlok shot. Neither of these vaccines uses chicken eggs in their manufacturing process.

All of these vaccines are covered 100 percent by Medicare Part B as long as your doctor, health clinic or pharmacy agrees not to charge you more than Medicare pays.

Pneumonia Vaccines
Two other important vaccinations the CDC recommends to seniors, especially this time of year, are the pneumococcal vaccines for pneumonia. Around 1 million Americans are hospitalized with pneumonia each year, and about 50,000 people die from it.

The CDC recommends that all seniors, 65 or older, get two vaccinations –Prevnar 13 and Pneumovax 23. Both vaccines, which are administered just once at different times, protect against different strains of the bacteria to provide maximum protection.

If you haven’t yet received any pneumococcal vaccine you should get the Prevnar 13 first, followed by Pneumovax 23 at least one year later. But if you’ve already been vaccinated with Pneumovax 23, wait at least one year before getting the Prevnar 13.

Medicare Part B covers both shots, if they are taken at least one year apart.

To locate a vaccination site that offers any of these shots, visit VaccineFinder.org and type in your location.

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 Seniors Can Get Help with Credit Card and Mortgage Debt

Dear Savvy Senior,
My husband and I, who are both 66 years old, have fallen behind on our mortgage payments and have accumulated quite a bit of credit card debt over the past few years. Where can we get help?
Drowning in Debt

Dear Drowning,
Unfortunately, credit card and mortgage debt have become a growing problem for many older Americans who often face medical-related expenses on top of their mortgage and other growing costs. Here are some tips and services that can help.

Credit Card Counseling
To help you get a handle on your credit card debt, a good place to turn is an accredited credit counseling agency. These are nonprofit agencies that offer free financial information and advice on how to handle financial problems.

Depending on the significance of your credit card debt, they can help you sort out your finances and set you up in a debt management plan (DMP), which allows a counselor to negotiate with your creditors to lower your interest rates and eliminate any late fees and other penalties.

The agency will then act as a consolidator, grouping your debts together into one payment that you would make, and distributes those funds to your creditors. Typically, the first counseling session is free, but a DMP comes with monthly fees of roughly $20 to $75 a month, depending on the state.

To locate a credible agency in your area, use the National Foundation for Credit Counseling website at NFCC.org (800-388-2227), or the or the Financial Counseling Association of America FCAA.org (800-450-1794).

But make sure that you don’t use a debt settlement company that claims to settle all your debt or cut it in half for a fee without counseling. Most of these companies use deceptive practices and will only leave you more in debt then you already are.

Mortgage Counseling
If you have fallen behind on your mortgage payments, or if you have already received a letter or phone call about missed payments, you should contact your lender immediately to explain your situation and see if you can work out a payment plan. Be prepared to provide your financial information, such as your monthly income and expenses.

You can also get help from a foreclosure prevention counselor. These are HUD-approved, trained counselors that will work with you, examine your financial situation, and offer guidance on how best to avoid default or foreclosure. They can also represent you in negotiations with your lender if you need them to.

To find a government-approved housing counseling agency in your area, use the National Foundation for Credit Counseling or Financial Counseling Association of America websites or phone numbers previously listed. Or, for a larger selection of housing counseling options see the Department of Housing and Urban Development website at HUD.gov – click on “Resources” at the top of the page, then on “Foreclosure Avoidance Counseling,” or call 800-569-4287.

Financial Assistance
You also need to make sure you’re not missing out on any financial assistance programs. The National Council on Aging’s website (BenefitsCheckUp.org) contains a database of more than 2,500 federal, state and local programs that can help seniors with prescription drug costs, health care, food, utilities, and other basic needs. The site will help you locate programs that you may be eligible for and will show you how to apply.

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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Getting Around When You No Longer Drive

Dear Savvy Senior,
Where can I find out about alternative transportation services for my 80-year-old mother? It’s time that she gives up driving, but before she does, we need to figure out how she’ll get around.
Inquiring Son

Dear Inquiring,
Alternative transportation options for seniors who no longer drive vary widely by community, so what’s available to your mom will depend on where she lives. Here’s what you should know.

While most urban areas offer seniors a variety of alternative transportation services, the options may be few to none for those living in the suburbs, small towns and rural areas. Depending on where your mom lives, here’s a rundown of possible solutions that can help her get around, along with some resources to help you locate them.

Family and friends: This is the most often used and favorite option among seniors. So, make a list of all possible candidates your mom can call on, along with their availability and contact information.

Volunteer transportation programs: These are usually run by local nonprofits or religious organizations and provide elderly seniors transportation to doctor’s appointments, shopping, and more. These services may charge a small fee or accept donations and often operate with a network of volunteer drivers.

Some examples of local transportation programs include Envoy America (EnvoyAmerica.com) that provides senior transportation in 78 cities in Arizona, Texas, Washington, Illinois, New Mexico, Georgia and Pennsylvania. The Independent Transportation Network (ITNAmerica.org) that serves 14 communities across 12 states. And SilverRide (SilverRide.com), which serves the San Francisco bay area and Kansas City. To search for volunteer driving programs in your area visitNationalVolunteerTransportationCenter.org – click on “Map of Volunteer Driver Programs.”

Demand response services: Often referred to as “dial-a-ride” or “elderly and disabled transportation service,” these are usually government-funded programs that provide door-to-door transportation services by appointment and usually charge a small fee or donation on a per ride basis. Many use vans and offer accessible services for riders with special needs.

Taxis and rideshare services: While taxis are a viable transportation option in many communities, rideshare services like Uber (Uber.com) and Lyft (Lyft.com), which are widely available, have become more popular among seniors who don’t drive.

To get a ride, your mom could simply use the Uber or Lyft smartphone app, a computer, or she can call a ride-hailing service like Go Go Grandparent (GoGoGrandparent.com). Or, you can make arrangements for her on your smartphone.

Cost will vary depending on your mom’s location, distance traveled and peak travel time, but rideshare services are usually cheaper than taxis. Uber and Lyft also offer carpooling services that would allow your mom to save money by splitting the tab with other consumers riding the same route. And for seniors with mobility problems, both Uber and Lyft have accessible vehicles that you can request in certain locations.

Hire someone: Consider hiring someone to drive your mom like a neighbor, retiree, high school or college student that has a flexible schedule and wouldn’t mind making a few extra bucks. You can also hire a senior driving companion through nonmedical home-care agencies, or you can find someone on your own at websites like Care.com orCareLinx.com.

 Private business transportation services: Some hospitals, health clinics, senior centers, adult day centers, malls or other businesses may offer transportation for program participants or customers.

Mass transit: Public transportation (buses, trains, subways, etc.) where available, can also be an affordable option and may offer senior reduced rates.

Where to Look
To find out what transportation services are available in your mom’s area contact Rides in Sight (RidesInSight.org, 855-607-4337), and the Eldercare Locator (800-677-1116), which will direct you to her area agency on aging for assistance. You should also contact local senior centers, places of worship and retirement communities for other possible options.

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 Help Aging Parents Manage their Medications

Dear Savvy Senior,
What tips or tools can you recommend that can help seniors and their caregivers keep up with medications? My 82-year-old mother, who lives alone, is supposed to take several different medications at various times of the day but often forgets.
Working Daughter

Dear Working,
Anybody who juggles multiple medications can relate to the problem of forgetting to take a medication, or not remembering whether they already took it. This is especially true for older adults who take medications at varying times of the day. Here are some different product and service solutions that may help.

Simple Medication Helpers
Getting organized and being reminded are the two keys to staying on top of a medication schedule. To help your mom achieve this, there are a wide variety of pillboxes, medication organizers, vibrating watches, beeping pill bottles and even dispensers that will talk to her that can make all the difference. To find these types of products, the best source is Epill.com, where you’ll find dozens to choose from.

You can also help your mom stay organized by creating a simple medication list that breaks down exactly what she should take and when she should take it. To help you with this, go to SafeMedication.com – a resource from the American Society of Health-System Pharmacists – and download and print a copy of “My Medicine List.”

Smart Pill Boxes
There are also a variety of “smart” pill boxes on the market today that will remind your mom when she needs to take her medicine and will send family members and caregivers notifications if she forgets to take her pills, or accidentally takes the wrong ones.

Three to consider here include Tricella (Tricella.com, $95), which uses Bluetooth connectivity but requires that your mom have a smartphone with data service or tablet with Wi-Fi; PillDrill (PillDrill.com, $279), a comprehensive system ideal for strict medication schedules but requires home Wi-Fi; and MedMinder (MedMinder.com, $40 per month), that operates off a cellular network (no phone line or Wi-Fi necessary).

Convenient Packaging
Another way to help simplify your mom’s medication use is to get her prescriptions filled in single-dose packets that put all her medications (vitamins and over-the-counter drugs can be included too) together in neatly labeled packets organized by date and the time of day they should be taken. This does away with all the pill bottles and pill sorting. One of the top providers of this type of service is PillPack.com, an online pharmacy owned by Amazon.

Apps and Calling Services
If you mom has a smartphone, there are apps she could use to help her keep up with her medication. One of the best is Medisafe (MyMedisafe.com), a free app works on Apple and Android phones. Medisafe will organize your mom’s pills in one place, send her timely notifications to take her meds, and send her reminders to fill her prescriptions.

Caregivers can also connect with the Medisafe app to get notifications about when it’s time for their loved one to take their medication – and they can see whether or not it’s been marked as taken.

If your mom doesn’t use a smartphone, there are also calling services, like Care Call Reassurance, which provides medication reminding calls – see Medication-Reminders.com. This service will call your mom’s phone at the scheduled times she needs to take her medication as a reminder, and if she fails to answer or acknowledge the call, a family member or caregiver will be contacted. This service runs between $15 and $20 per month.

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.

Savvy Senior September 2019 Columns

Savvy Senior – September Columns

  1. How to Get Social Security Disability Benefits When You Can’t Work
  2. Electric Bikes Are Booming Among Baby Boomers
  3. Home Sharing Programs Can Help Seniors Find Renters
  4. Who Needs to See a Geriatrician?

How to Get Disability Benefits When You Can’t Work

Dear Savvy Senior,
What do I need to do to get Social Security disability benefits? I’m 60 years old and have some health problems that won’t allow me to work, but I’ve read that getting disability benefits is difficult.
Laid Up Lenny                                                                                                  

Dear Lenny,
Getting Social Security disability benefits when you’re unable to work can be challenging. Last year, more than 2 million people applied for Social Security disability benefits, but two-thirds of them were denied, because most applicants fail to prove that they’re disabled and can’t work. Here are some steps you can take that can help improve your odds.

Get Informed
The first thing you need to find out is if your health problem qualifies you for Social Security disability benefits.

You generally will be eligible only if you have a health problem that is expected to prevent you from working in your current line of work (or any other line of work that you have been in over the past 15 years) for at least a year or result in death.

There is no such thing as a partial disability benefit. If you’re fit enough to work part-time, your application will be denied. You also need not apply if you still are working with the intention of quitting if your application is approved, because if you’re working your application will be denied.

Your skill set and age are factors too. Your application will be denied if your work history suggests that you have the skills to perform a less physically demanding job that your disability does not prevent you from doing.

To help you determine if you are disabled, visit SSA.gov/planners/disability/qualify.html and go through the five questions Social Security uses to determine disability.

How to Apply
If you believe you have a claim, your next step is to gather up your personal, financial and medical information so you can be prepared and organized for the application process.

You can apply either online at SSA.gov/applyfordisability or call 800-772-1213 to make an appointment to apply at your local Social Security office, or to set up an appointment for someone to take your claim over the phone.

The whole process lasts about an hour. If you schedule an appointment, a “Disability Starter Kit” that will help you get ready for your interview will be mailed to you. If you apply online, the kit is available at SSA.gov/disability/disability_starter_kits.htm.

It takes three to five months from the initial application to receive either an award or denial of benefits. The only exception is if you have a chronic illness that qualifies you for a “compassionate allowance” (see SSA.gov/compassionateallowances), which fast tracks cases within weeks.

If Social Security denies your initial application, you can appeal the decision, and you’ll be happy to know that roughly half of all cases that go through a round or two of appeals end with benefits being awarded. But the bad news is with backlog of around 800,000 people currently waiting for a hearing, it can take 12 to 24 months for you to get one.

Get Help
You can hire a representative to help you with your Social Security disability claim. By law, representatives can charge only 25 percent of past-due benefits up to a maximum of $6,000 if they win your case.

It’s probably worth hiring someone at the start of the application process if your disability is something difficult to prove such as chronic pain. If, however, your disability is obvious, it might be worth initially working without a representative to avoid paying the fee. You can always hire a representative later if your initial application and first appeal are denied.

To find a representative, check with the National Organization of Social Security Claimants’ Representatives (NOSSCR.org, 845-682-1881) or National Association of Disability Representatives (NADR.org, 800-747-6131). Or, if you’re low-income, contact the Legal Services Corporation (LSC.gov/find-legal-aid) for free assistance.

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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Electric Bikes Are Booming Among Baby Boomers

Dear Savvy Senior,
What can you tell me about electric bicycles? A friend of mine, who’s almost 70, recently got one and absolutely loves it. He told me he rides more now than he ever did his regular bicycle.
Interested Boomer

Dear Interested,
Electric bikes have become very popular among U.S. baby boomers over the past few years because they’re super fun to ride and easier on an aging body.

Electric bikes, also known as e-bikes, are conventional bicycles with a battery-powered “pedal” or “throttle” assist. When you saddle up and push the pedals or throttle, a small motor engages and gives you a boost, so you can whiz up hills, ride into headwinds and cruise over challenging terrain without gassing yourself or taxing your knee joints.

Many older e-bike owners say that they ride more frequently and go further and longer than they ever would with a traditional bike. Here’s what you should know about e-bikes, along with some tips to help you choose one.

What to Know
E-bikes are more complicated and expensive than regular bicycles, so you need to do some research before you purchase one. For starters, you need to know that there are three different types of e-bikes to choose from:

  • Class 1: “Pedal-assist” electric bikes that only provides assistance when the rider is pedaling, and only up to 20 miles per hour. These are the most common type of electric bikes.
  • Class 2: “Throttle-assist” e-bikes that let you use the electric motor without pedaling, like a motorcycle or scooter, but only up to 20 miles per hour.
  • Class 3: “Speed pedal-assist” e-bikes, similar to Class 1, except that the motor will assist with bike speeds of up to 28 miles per hour.

Because they’re electrically powered, states and local communities have varying regulations regarding the use of e-bikes. In many states, class one and two e-bikes are allowed to be ridden wherever a traditional bike goes, while class three are generally allowed on the street due to their higher top speed. For more information on your state’s e-bike laws, visit PeopleForBikes.org/e-bikes.

You should also know that e-bikes come in many different styles – commuter, cruiser, mountain, road, folding, etc. – just like traditional bikes to meet different riding needs. They also run on rechargeable lithium-ion batteries, and their motors are either hub-driven mounted on the front or rear wheel, or mid-drive motors that are mounted to the frame at the bottom bracket between the cranks.

The only downsides of e-bikes are weight and cost. Because of the battery and motor, e-bikes are much heavier than traditional bicycles weighing 50-plus pounds, so it can be more challenging if you have to manually lift or maneuver your bike a lot. And e-bikes are expensive, typically range between $2,500 and $3,500.

E-bikes are made by many of the same established companies that make traditional bikes like Specialized, Electra, Schwinn, Trek, Giant, Cannondale and Felt, along with a number of upstarts like Juiced Faraday, Pedego, Elby and Hi Bike. To shop for an e-bike, find some good bike shops in your area that sell them so you can test ride a few.

If you’re interested in a cheaper option, there are also e-bike kits you can purchase at places like Walmart, Amazon.com and eBikeKit.comthat can convert your regular bike into an e-bike for a few hundred dollars.

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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Home Sharing Programs Can Help Seniors Find Renters

Dear Savvy Senior,
What can you tell me about senior home sharing programs? I’m 76-years-old and am interested in renting out a spare room in my house for extra cash and for some help around the house.
Senior Homeowner

Dear Senior,
Renting out a spare room in your house is a great way to generate some extra income and even get some help with chores around the house. To find a good fit, older homeowners often turn to “home sharing programs” that will match an empty nester with someone needing affordable housing.

But be aware that home sharing isn’t for everyone. You need to carefully consider the pros and cons of renting out a spare room in your house and make a list of what you want and don’t want in a housemate/renter.

To help you figure this out visit SharingHousing.com, a website dedicated to understanding home sharing and which offers a guide and workbook ($25) to help you find and choose a good housemate.

Finding a Match
If you decide to proceed in finding a housemate/renter, your first step is to seek out a home sharing program in your area.

Home sharing programs, usually non-profits, screen both homeowners and renters. They check references, handle background checks and consider lifestyle criteria when making matches. They can also help you with the leasing agreement that the renter would sign that covers detailed issues like smoking, pets, chores, overnight guests, use of common rooms, quiet hours, etc.

Most home sharing programs are free to use or request a small donation. Others, however, may charge the homeowner and potential renter a fee for this service. To look for a home sharing program in your area visit the National Shared Housing Resource Center website at NationalSharedHousing.org.

Other Options
If you don’t find a program that serves your area, you can also search for housemates through an online home sharing service likeSilvernest.com or SeniorHomeshares.com.

These sites work more like online dating sites that require homeowners and home seekers to fill out a profile. Once a match is made, you’ll be responsible for contacting and interviewing prospective renters and making the final agreement.

If you don’t have any luck with any of these home sharing sites, put a call in to your Area Agency on Aging (call the Eldercare Locator at 800-677-1116 for contact information) who may be able to offer assistance or refer you to local agencies or nonprofit organizations that offer shared housing help.

You can also check with your local senior or community center, or local church you attend to see if you can post an ad on their bulletin board or in their newsletter. Or, you can advertise in your local newspaper or online at CraigsList.org. SpareRoom.com orRoomMates.com.

If you find someone on your own that you’re interested in renting to, ask the prospective renter to fill out a rental application (seeRentalLeaseAgreement.org to download and print one for free) and run a tenant screening and background check, and then call their references. Tenant screening/background checks can be done for free at Naborly.com.

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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Who Needs to See a Geriatrician?

Dear Savvy Senior,
What can you tell me about geriatrics doctors? My father, who’s 82, takes eight different prescription drugs for different health issues but hasn’t been feeling himself lately. I’m wondering if he would benefit by seeing a geriatrician in place of his regular primary care physician.
Concerned Daughter

Dear Concerned,
If your dad is dealing with a variety of health problems and is taking multiple medications, a visit to a geriatrician may be just the antidote to help get him back on track. Here’s a rundown of the different types of health conditions geriatricians treat and some tips to help you locate one in his area.

Geriatrics Doctors
For starters, it’s important to know that geriatricians are family practice or internal medicine physicians that have had additional specialized training to manage the unique and, oftentimes multiple health concerns of older adults. Just as a pediatrician specializes in caring for children, a geriatrician is trained to provide care for seniors, usually over age 75.

While most doctors, and even general practitioners, are trained to focus on a person’s particular illness or disease, geriatricians are trained to look at all aspects that can affect elderly patients – not just the physical symptoms. They also often work with a team of other health care professionals like geriatric-trained nurses, rehabilitation therapists, nutritionists, social workers and psychiatrists to provide care. And, they will coordinate treatments among a patient’s specialists.

Patients who can benefit from seeing a geriatrician are elderly seniors with multiple health and age-related problems such as cardiovascular disease, stroke, confusion and memory problems, Parkinson’s and Alzheimer’s disease, diabetes, hypertension, depression, respiratory problems, osteoporosis, arthritis, chronic pain, mobility issues, incontinence, vision and hearing impairment, and trouble with balance and falls.

Geriatricians are also particularly adept at tackling medication problems. Because many seniors, like your dad, take multiple medications at the same time for various health conditions, and because aging bodies often absorb and metabolize drugs differently than younger adults, unique side effects and drug interactions are not uncommon. A geriatrician will evaluate and monitor you dad’s medications to be sure they are not affecting him in a harmful way.

Geriatricians can also help their patients and families determine their long-term care needs, like how long they can remain in their own homes safely without assistance, and what type of services may be necessary when they do need some extra help.

But not all seniors need to see a geriatrician. Seniors who have fewer health problems are just fine seeing their primary care physician.

Find a Geriatrician
Unfortunately, there’s a shortage of geriatricians in the U.S., so depending on where you live, finding one may be challenging.

To locate one in your area, use Medicare’s online physician search tool. Just go to Medicare.gov/physiciancompare and type in your ZIP code, or city and state in the Enter your location box, and then type in geriatric medicine in the Search box. Or, you can also get this information by calling Medicare at 800-633-4227. The American Geriatrics Society also has a geriatrician-finder tool on their website at HealthinAging.org.

Keep in mind, though, that locating a geriatrician doesn’t guarantee your dad will be accepted as a patient. Many doctors already have a full patient roster and don’t accept any new patients. You’ll need to call the individual doctor’s office to find out.

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.Savvy

Savvy Senior August 2019 Columns

Savvy Senior – August Columns

  1. How Medicare Covers Ambulance Services
  2. How to Help an Aging Parent with a Hoarding Problem
  3. Is Pet Insurance a Good Idea for Seniors on a Budget?
  4. How to Find a Good Financial Planner

How Medicare Covers Ambulance Services

Dear Savvy Senior,
How does Medicare cover ambulance services? About three months ago, I took an ambulance to the hospital emergency room because I rarely drive anymore, and I just received a $1,100 bill from the ambulance company.
Surprised Senior

Dear Surprised,
This is a Medicare issue that confuses many seniors. Yes, Medicare does covers emergency ambulance services and, in limited cases, non-emergency ambulance services too, but only when they’re deemed medically necessary and reasonable. So, what does that means?

First, it means that your medical condition must be serious enough that you need an ambulance to transport you safely to a hospital or other facility where you receive care that Medicare covers.

If a car or taxi could transport you without endangering your health, Medicare won’t pay. For example, Medicare probably won’t pay for an ambulance to take someone with a simple arm fracture to a hospital. But if he or she goes into shock, or is prone to internal bleeding, ambulance transport may be medically necessary to ensure the patient’s safety on the way. The details make a difference.

Second, the ambulance must take you to the nearest appropriate facility, meaning the closest hospital, critical access hospital, skilled nursing facility or dialysis facility generally equipped to provide the services your illness or injury requires.

It also means that the facility must have a physician or physician specialist available to treat your condition. Thus, Medicare may pay for an ambulance to take you to a more distant hospital if, for example, you are seriously burned, and the nearest hospital doesn’t have burn unit.

Similarly, if you live in a rural area where the nearest hospital equipped to treat you is a two-hour drive away, Medicare will pay. But if you want an ambulance to take you to a more distant hospital because the doctor you prefer has staff privileges there, expect to pay a greater share of the bill. Medicare will cover the cost of ambulance transport to the nearest appropriate facility and no more.

Non-Emergency Situations
In limited cases, Medicare will also cover non-emergency ambulance services if such transportation is needed to treat or diagnose your health condition and the use of any other transportation method could endanger your health. Not having another means of transportation is not sufficient for Medicare to pay for services.

Some examples here are if you need transportation to get dialysis or if you are staying in a skilled nursing facility and require medical care. In these cases, a doctor’s order may be required to prove that use of an ambulance is medically necessary.

Ambulance Costs
The cost for ambulance services can vary from several hundred to several thousand dollars depending on where you live and how far you’re transported.

Under original Medicare, Part B pays 80 percent of the Medicare-approved amounts for ambulance rides. You, or your Medicare supplemental policy (if you have one), will need to pay the remaining 20 percent.

If you have a Medicare Advantage Plan, it must cover the same services as original Medicare, and may offer some additional transportation services. You’ll need to check with your plan for details.

How to Appeal
If an ambulance company bills you for services after Medicare denies payment, but you think the ride was medically necessary, you can appeal (see Medicare.gov/claims-appeals). Often, a lack of information about a person’s condition or need for services leads to denials.

If you need some help contact your State Health Insurance Assistance Program (SHIP), which has counselors that can help you file an appeal for free. To locate your local SHIP, visit ShiptaCenter.org or call 877-839-2675.

For more information on this topic, call Medicare at 800-633-4227 and ask them to mail you a copy of the “Medicare Coverage of Ambulance Services” booklet, or you can see it online at Medicare.gov/Pubs/pdf/11021-Medicare-Coverage-of-Ambulance-Services.pdf.

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 Help an Aging Parent with a Hoarding Problem

Dear Savvy Senior,
My 70-year-old mother has become somewhat of a hoarder. Since my father died a few years ago, her house is so disorganized and messy with stuff that it’s becoming a hazard. What should I do to help her?
Troubled Son

Dear Troubled,
Clutter addiction is a problem that effects up to five percent of Americans, many of whom are seniors. The problems can range anywhere from moderate messiness to hoarding so severe it may be related to a mental health disorder like obsessive-compulsive disorder. Here’s what you should know, along with some tips and resources that can help your mom.

Why People Hoard
The reasons most people hoard is because they have an extreme sentimental attachment to their possessions, or they believe they might need their items at a later date. Hoarding can also be a sign that an older person is depressed or showing early symptoms of dementia.

Common problems for seniors who live in excessive clutter are tripping, falling and breaking a bone; overlooking bills and missing medications that are hidden in the clutter; and suffering from the environmental effects of mold, mildew and dust, and even living among insects and rodents.

What to Do
To get a handle on your mom’s problem, the Institute for Challenging Disorganization offers a free “Clutter Hoarding Scale” that you can download off their website at ChallengingDisorganization.org.

If you find that your mom has a moderate cluttering problem, there are a number of things you can do to help.

Start by having a talk with her, respectfully expressing your concern for her health and safety, and offering your assistance to help her declutter.

If she takes you up on it, most professional organizers recommend decluttering in small steps. Take one room at a time or even a portion of a room at a time. This will help prevent your mom from getting overwhelmed.

Before you start, designate three piles or boxes for your mom’s stuff – one pile is for items she wants to keep-and-put-away, another is the donate pile and the last is the throwaway pile.

You and your mom will need to determine which pile her things belong in as you work. If your mom struggles with sentimental items that she doesn’t use, like her husband’s old tools or mother’s china for example, suggest she keep only one item for memory sake and donate the rest to family members who will use them.

You will also need to help her set up a system for organizing the kept items and new possessions.

Find Help
If you need some help with the decluttering and organizing, consider hiring a professional organizer who can come to your mom’s home to help you prioritize, organize and remove the clutter. The nonprofit group National Association of Productivity and Organizing Professionals has a directory on the website at NAPO.net to help you locate a professional in your area.

If your mom has a bigger, more serious hoarding problem (if her daily functioning is impaired, or if she is having financial difficulties, health problems, or other issues because of her hoarding) you’ll need to seek professional help. Antidepressants and/or talk therapy can help address control issues, anxiety, depression, and other feelings that may underline hoarding tendencies, and make it easier for her to confront her disorder.

To learn more and find professional help see the International OCD Foundation which provides a hoarding center on their website (Hoarding.iocdf.org) that offers information, resources, treatments, self-help groups, and more. Also see HoardingCleanup.com, a site that has a national database of qualified resources including cleaning companies and therapists that can help.

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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Is Pet Insurance a Good Idea for Seniors on a Budget?

Dear Savvy Senior,
I own two dogs and a cat that I would do almost anything for, but expensive veterinary bills put a strain on my budget. Is pet insurance a good idea?
Older Pet Owner

Dear Pet Owner,
If you’re the kind of pet owner who would do anything for their furry family, including spending thousands of dollars on medical care, pet insurance definitely is an option to consider. Here’s what you should know.

Rising Vet Costs
The cost of owning a pet has gone up in recent years. New technologies now make it possible for pets to undergo sophisticated medical treatments for many life-threatening diseases, just like humans. But these treatments don’t come cheap. That’s why pet insurance has gotten more popular in recent years. More than 2 million pets are currently insured in the U.S. and Canada, according to the North American Pet Health Insurance Association.

How Pet Plans Works
Pet insurance is actually very similar to human health insurance. Pet policies typically come with premiums, deductibles, co-payments and caps that limit how much will be paid out annually. But unlike people coverage, you usually have to pay the vet bills in full and wait for reimbursement from the insurer.

Pet policies vary greatly from basic plans that cover only accidents and illness, to comprehensive policies that provide complete nose-to-tail protection including annual checkups and vaccinations, spaying/neutering and death benefits. You should also be aware that pet policies typically don’t cover pre-existing conditions, and premiums are generally lower when your pet is young and healthy.

Costs for pet insurance will also vary by insurer and policy, but premiums typically depend on factors like the cost of veterinary care where you live and the age and breed of the pet. The average annual premium for basic accident and illness coverage was $516 per pet in 2017, while the average claim paid was $278, according to the pet health insurance association.

Shopping Tips
Major pet policy providers include the ASPCA, Embrace, Healthy Paws, Nationwide, PetFirst, Petplan and Trupanion. To help you shop and compare coverage and costs from pet insurers, go to PetInsuranceReview.com.

If you’re still working, one way to pay lower premiums, and possibly get broader coverage, is to buy pet insurance through your employer, if available. Eleven percent of employers in the U.S. offer pet health insurance benefits, according to the Society for Human Resource Management, and these plans are usually discounted.

An Alternative Option
Many animal advocates think most pet owners are better off forgoing pet insurance and instead putting the money you would have spent on premiums into a dedicated savings account to pay for vet care as needed. Depending on the policy, pet insurance can cost $1,500 to $6,000 over the life of an average pet, and most pet owners will never spend that much for treatment.

Ways to Save
If you can’t afford pet insurance or choose not to buy it, there are other ways you can save. For example, many local animal shelters offer free or low-cost spaying and neutering programs and vaccinations, and some shelters work with local vets who are willing to provide care at reduced prices for low-income and senior pet owners.

There are also a number of organizations that provide financial assistance to pet owners in need. To locate these programs, visitHumaneSociety.org/PetFinancialAid.

To save on pet medications, get a prescription from your vet (ask for generic is possible) so you can shop for the best price. Medicine purchased at the vet’s office is usually more expensive than you can get from a regular pharmacy or online.

Most pharmacies fill prescriptions for pets inexpensively, and many pharmacies offer pet discount savings programs too. You can also save by shopping online at a verified pharmacy like 1800PetMeds.com, DrsFosterSmith.com and PetCareRX.com.

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 Find a Good Financial Planner

Dear Savvy Senior,
Can you recommend some tips on finding and choosing a good financial planner? My wife and I are both in our late fifties and would like to get some professional advisement to help us better prepare for our retirement years.
Seeking Advice

Dear Seeking,
With all the different financial planners, advisers and services available today, finding and choosing a trusted professional that can help you meet your financial goals can be confusing. Here are a few suggestions to consider.

Where to Look
A good place to start your search is by asking friends or relatives for recommendations. If you don’t know anyone who can give you a referral, and you’re looking for broad-based financial advice, hire a Certified Financial Planner, or CFP, who are considered the “gold standard” in the industry. CFPs must act as fiduciaries, putting their client’ best interest above their own.

To get the CFP credential, they must have a college degree and be educated in a wide range of personal finance subjects, pass a rigorous certification exam, have three years professional experience, meet continuing-education requirements and abide by a code of ethics.

CFPs are taught to look at the big picture view of your finances, talking you through your goals, as well as advising you on the details of your financial life.

You’re also probably better off hiring a CFP that’s a fee-only planner, verses one who earns a commission by selling you financial products. Fee-only planners charge only for their services – for example you might pay $150 to $350 an hour for a financial tune-up, a flat fee per project or an asset-based fee.

To find a fee-only planner in your area, use the National Association of Personal Financial Advisors (NAPFA.org), which carefully vets all members and offers an online directory. Or see the Garrett Planning Network (GarrettPlanningNetwork.com), a network of fee-only advisers. Or the Alliance of Comprehensive Planners (ACplanners.org), a community of fee-only advisors that charge annual retainers.

If your needs are more specific, some other financial professionals to consider are a Registered Investment Adviser (RIA) who is registered with the Securities and Exchange Commission or a state securities regulator to manage investment portfolios; a Chartered Financial Consultant (ChFC), who specialize in insurance and estate planning; and a Certified Public Accountant (CPA), who can help with tax planning.

Be leery of many other financial advising titles, designations and certifications that are out there like the Certified Financial Consultant (CFC) or the Wealth Management Specialist (WMS). Many of these require no more than a few courses at a seminar or online, which means they’re not worth much. To research the different certifications or designations visit FINRA.org/investors – click on “Tools & Calculators,” then on “Professional Designations.”

How to Choose
After you find a few candidates in your area, call them up and schedule an appointment to meet and interview them. Find out about their experience, expertise and the types of services they provide; if they’re a fiduciary; how they charge and how much; what is their investment philosophy; and how will they handle your ongoing questions or financial needs. Look for someone whose clients are in situations similar to yours and who’s available as often as you need them.

It’s also wise to do a background check on your potential advisor. At LetsMakeaPlan.org, you can verify a planner’s certification as CFP (click on “Verify CFP Professional Status”). You’ll also see any information on the planner’s disciplinary history with CFP Board and on bankruptcy filings in the past 10 years.

To vet a registered investment adviser, go to Investor.gov where you can search an individual’s name and click on “Detailed Report” to see information on qualifications, employment history, disciplinary actions, criminal convictions and more.

To check out a broker, visit BrokerCheck.finra.org where you can search an individual or firm’s name to get details like years of experience, licensing, exams passed and regulatory actions.

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.

Savvy Senior July 2019 Columns

Savvy Senior – July Columns

  1. Hiring an In-Home Caregiver
  2. How Seniors Can Spot Fake News
  3. Where to Get Help Paying Your Medicare Costs
  4. Men Get Osteoporosis Too
  5. Finding an Alternative to AARP

Hiring an In-Home Caregiver

Dear Savvy Senior,
I need to locate a good in-home caregiver for my 83-year-old mother. What’s the best way to find and hire one?
Looking for Care

Dear Looking,
Finding a good in-home caregiver for an elderly parent can be challenging. How can you find one that’s reliable and trustworthy, as well as someone your parent likes and is comfortable with? Here are some tips that can help.

Know Your Needs
Before you start the task of looking for an in-home caregiver, your first step is to determine the level of care your mom needs. This can pinpoint the type of help she’ll need. For example, if she only needs help with daily living tasks like shopping, cooking, doing laundry, bathing or dressing, a “homemaker” or “personal care aide” will do.

But if she needs health care services, there are “home health aides” that may do all the things a homemaker does, plus they also have training in administering medications, changing wound dressings and other medically related duties. Home health aides often work under a nurse’s supervision.

Once you settle on a level of care, you then need to decide how many hours of assistance she’ll need. For example, does your mom need someone to come in just a few mornings a week to help her cook, clean, run errands or perhaps bathe? Or does she need more continuous care that requires daily visits or a full-time aide?

After you determine her needs, there are two ways in which you can go about hiring someone. Either through an agency, or you can hire someone directly on your own.

Hiring Through an Agency
Hiring a personal care or home health aide through an agency is the safest and easiest option, but it’s more expensive. Costs typically run anywhere between $14 and $25 an hour depending on where you live and the qualification of the aide.

How it works is you pay the agency, and they handle everything including an assessment of your mom’s needs, assigning appropriately trained and pre-screened staff to care for her, and finding a fill-in on days her aide cannot come.

Some of the drawbacks, however, are that you may not have much input into the selection of the caregiver, and the caregivers may change or alternate, which can cause a disruption.

To find a home-care agency in your mom’s area ask for referrals through friends, family or doctor’s offices, or use the home-care locator service tool atPayingForSeniorCare.com – click on “Find Quality, Affordable Care.” In addition, Medicare offers a home health compare tool at Medicare.gov/HomeHealthCompare to help you find and compare home health care agencies.

You also need to be aware that original Medicare does not cover in-home caregiving services unless your mom is receiving doctor’s ordered skilled nursing or therapy services at home too. But, if your mom is in a certain Medicare Advantage plan, or is low-income and qualifies for Medicaid, she may be eligible for some coverage.

Hiring Directly
Hiring an independent caregiver on your own is the other option, and it’s less expensive. Costs typically range between $12 and $20 per hour. Hiring directly also gives you more control over who you hire so you can choose someone who you feel is right for your mom.

However, be aware that if you do hire someone on your own, you become the employer so there’s no agency support to fall back on if a problem occurs or if the aide doesn’t show up. You’re also responsible for paying payroll taxes and any worker-related injuries that may happen. If you choose this option make sure you check the aide’s references thoroughly, and do a criminal background check, which you can do sites like eNannySource.com.

To find someone, ask for referrals or try eldercare-matching services like Care.com or CareLinx.com. Or, for a fee, an aging life care expert (see AgingLifeCare.org) can help you find someone.

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 Seniors Can Spot Fake News

Dear Savvy Senior,
I recently read that seniors are the number one purveyor of fake news on the Internet. Is this true, or is it fake news too? If it’s true, how can seniors go about spotting fake news?
Faked Out Senior

Dear Faked Out,
Yes, it’s true. According to a recent study published in the journal Science Advances, people aged 65 and older are almost four times more likely to share fake news on social media than younger people.

Why do older users share fake news more often? There are two theories. The first is that seniors, who came to the Internet later, sometimes lack the digital literacy skills of their younger counterparts to identify false or misleading content. The second is that many older people experience cognitive decline as they age, making them more likely to fall for hoaxes.

What is Fake News?
Fake news is not new, but it is more prevalent than ever before because of the Internet and social networking, which enables it to spread like wildfire.

Fake news includes false news stories, hoaxes or propaganda created to deliberately misinform or deceive readers. Usually, these stories are created to either influence people’s views, push a political agenda or cause confusion.  It can often be a profitable business for online publishers.

Also note that some fake stories aren’t completely false, but rather distortions of real events. These deceitful claims can take a legitimate news story and twist what it says, or even claim that something that happened long ago is related to current events.

How to Spot Fake News
Here are some tips from the International Federation of Library Associations, Harvard University and Facebook that can help you spot fake news stories.

Be skeptical of headlines: False news stories often have catchy headlines in all caps with exclamation points. If shocking claims in the headline sound unbelievable, they probably are.

Look closely at the Web link: A phony or look-alike link may be a warning sign of false news. Many false news sites mimic authentic news sources by making small changes to the link, for example “abcnews.com.co” (an illegitimate site) versus the actual “abcnews.com.”

Investigate the source: Ensure that the story is written by a source that you trust with a reputation for accuracy. If the story comes from an unfamiliar organization, check their “About” section to learn more. You can also find a list of websites that post deceptive and fake content at FactCheck.org – type “misinformation directory” in their search feature to find it.

Watch for unusual formatting: Many false news sites have misspellings or awkward layouts. Read carefully if you see these signs.

Inspect the dates: False news stories may contain timelines that make no sense, or event dates that have been altered.

Check the evidence: Check the author’s sources to confirm that they are accurate. Lack of evidence or reliance on unnamed experts may indicate a false news story.

Look at other reports: If no other news source is reporting the same story, it may indicate that the story is false. If the story is reported by multiple sources you trust, it’s more likely to be true.

Is the story a joke? Sometimes false news stories can be hard to distinguish from humor or satire. Check whether the source is known for parody, and whether the story’s details and tone suggest it may be just for fun.

Do some fact checking: There are many good websites, like PolitiFact.com, Snopes.com and FactCheck.org that can help you fact check a story to help you identify fact versus fiction. These sites have most likely already fact-checked the latest viral claim to pop up in your news feed.

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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Where to Get Help Paying Your Medicare Costs

Dear Savvy Senior,
Are there any sources you know of that can help me save on my Medicare coverage? I’m 65, and live primarily on my Social Security, and am having a hard time paying my Medicare out-of-pocket costs.
Need Some Help

Dear Need,
There are several financial assistance programs that can help lower-income Medicare beneficiaries who are having a difficult time paying their out-of-pocket health care costs. Here’s what’s available, along with the eligibility requirements and how to apply.

Medicare Savings Programs
Let’s start with a program that helps pay premiums and out-of-pocket costs for Medicare Parts A and B. It’s called the Medicare Savings Program (MSP), and it has several different benefit levels for people based on their income and asset level. At its most generous the program will pay your Part A and B premiums and pretty much all your Medicare deductibles, coinsurance and copayments. At its least generous the program will pay just your Part B premium.

To qualify for a MSP, the minimum standard set by Medicare, is an income under 135 percent of the federal poverty level, which at the moment works out to around $1,426 a month for individuals (or $1,923 for married couples). Everything counts towards income, including payouts from 401(k) plans, pensions, Social Security, and help from family members.

Medicare also allows states to impose an asset test, which can be as little as $7,730 per individual ($11,600 for married couples), not counting your house or car but counting retirement savings and bank accounts.

But some states have made their MSP programs a lot more generous, with much higher income limits and in some cases no asset tests at all. And the program may be called something else in your state. To find out if you qualify or to apply, contact your state Medicaid program. Visit Medicare.gov/contacts or call all 800-633-4227 for contact information.

Medication Extra Help
For help with Medicare (Part D) prescription drug plan costs, there is another completely separate program called Extra Help. To get it, you’ll need to apply through your local Social Security office.

Depending on how low your income is, this program will pay part or all of your Part D prescription drug plan’s monthly premiums, annual deductibles and prescription co-payments. In 2019, individuals with a yearly income below $18,735 ($25,365 for a married couple), and assets under $14,390 ($28,720 for a married couple) can qualify for Extra Help.

If you’re eligible to be in a Medicare Savings Program, you will automatically qualify for Extra Help. But because the requirements are slightly different, even if you don’t qualify for a Medicare Savings Program for Part B you might be able to get Extra Help for Part D. For more information or to apply, visit SSA.gov/extrahelp or call Social Security at 800-772-1213.

Other Assistance Programs
Depending on your income level, needs and location there are many other financial assistance programs that can help like Medicaid, SSI (Supplemental Security Income), PACE (Program of All-inclusive Care for the Elderly), SNAP (Supplemental Nutrition Assistance Program), (LIHEAP) Low Income Home Energy Assistance Program and many others.

To help you find out what types of assistance programs you may be eligible for, and learn how to apply for them, go to BenefitsCheckUp.org. This is a free, confidential Web tool designed for people age 55 and older that contains more than 2,500 programs.

It’s also possible to get help in person at one of the 87 Benefits Enrollment Centers scattered across the U.S. Call 888-268-6706 or visitNCOA.org/centerforbenefits/becs to locate a center in your area. Some centers also offer assistance over the phone.

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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Men Get Osteoporosis, Too

Dear Savvy Senior,
Can men get osteoporosis or is it primarily a problem for women? When I fell and broke my wrist last winter the doctor that treated me told me I might have osteoporosis, but I never got it checked. What can you tell me?
Bony Bill

Dear Bill,
Many people think osteoporosis is a woman’s disease, but men can get it too, especially in their later years. Here’s what you should know.

Osteoporosis in Men
Osteoporosis is a disease that causes the bones to become weak and brittle and more susceptible to fractures. Though women are four times more likely to acquire it, around 2 million American men have osteoporosis today, and another 12 million have “pre-osteoporosis,” or osteopenia.

Unfortunately, men are much less likely than women to get the health of their bones checked even after they break a bone. That’s because doctors are often unaware of the many factors that put men at risk of osteoporosis.

While menopause is a major component that accelerates bone loss in women, some of the key risk factors for men developing osteoporosis include: being over age 70; being thin or underweight; smoking; consuming more than three alcoholic drinks a day; having a parental history of osteoporosis; and having a previous fracture.

Certain health conditions – such as rheumatoid arthritis, celiac disease, testosterone deficiency, hyperthyroidism, COPD, kidney or liver disease, and mobility disorders like Parkinson’s disease, multiple sclerosis or stroke – can also increase your risk. In addition, so can taking certain medications like anti-inflammatory steroids, prostate cancer drugs, proton pump inhibitors for GERDs, antidepressants, immunosuppressants, and anti-seizure drugs.

To help you determine your risk of osteoporosis, the International Osteoporosis Foundation has a quick, online quiz you can take atRiskCheck.IOFBoneHealth.org.

Prevention and Treatment
A good first step in preventing and treating osteoporosis is to get screened. All men over age 70 should have a bone density test, and those who’ve had a fracture or have other risk factors should be tested after age 50. Screening for osteoporosis is a simple, painless, bone density test, which takes about five minutes. Many health insurance companies will cover bone density tests, as does Medicare.

Here’s what else you can do to protect your bones.

Boost your calcium: The best way to get bone-building calcium is through your diet.  Dairy products (low-fat milk, cheeses and yogurt), dark green leafy vegetables (broccoli, kale, collards), sardines and salmon, cooked dried beans, soy foods, almonds and fortified cereals and juices are all good sources of calcium. Vitamin D is also important to help your body absorb calcium.

The National Osteoporosis Foundation recommends 1,000 mg of calcium daily for men under 70, and 1,200 mg for those over 71. They also recommend 800 to 1,000 international units (IU) of vitamin D if you’re over 50. If you’re not getting enough vitamin D through sunlight or food, consider taking a supplement. Most daily multivitamins contain at least 400 IU.

Exercise: Weight-bearing exercises like walking, and strength training with weights or resistant bands three or four times a week, can significantly improve your bone health and reduce the risk of a fall that could cause a fracture.

Control these vices: Avoid smoking, limit alcohol to no more than two or three drinks per day, and limit caffeine (coffee, tea or caffeinated soda) to three cups a day.

Consider medications: The same drugs to treat osteoporosis in women have also been approved for men. The most widely prescribed for osteoporosis are bisphosphonates, a class of drugs designed to slow or stop bone loss. Talk to your doctor about these and other medication options, as well as potential side effects.

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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Finding an Alternative to AARP

Dear Savvy Senior,
Can you recommend any conservative membership organizations for older adults that offer discounts too? AARP is way too liberal for my liking.
Discount-Seeking Conservative

Dear Conservative,
There are actually quite a few senior advocacy organizations out there promoting themselves as conservative alternatives to AARP, and many of them offer membership benefit too. Here’s what you should know.

Anti-AARP
While AARP, with a membership of around 38 million, is by far the biggest and most powerful advocacy group for people age 50 and older, there are millions of older Americans that don’t like or agree with their stance on various issues. Many believe AARP leans too far to the left despite its stated nonpartisan nature.

For seniors that disagree with AARP, there are other conservative leaning groups that you can join that may better represent your views. And, many of them offer their members discounts on things like travel, insurance, healthcare and more. Here are several to check into.

60 Plus: American Association of Senior Citizens (60plus.org): Established in 1992, this nonprofit group was founded to lobby for issues it holds dear, namely free enterprise, fewer taxes and less Government. Their main priority is to end the federal estate tax and preserve social security. Membership fees run $12, $24 or $48 per year, or $299 for a lifetime membership. They also offer a bevy of discounts on travel and entertainment, cable, Internet and satellite services, dental, vision and hearing packages, roadside assistance and more.

American Seniors Association (AmericanSeniors.org): Founded in 2005 for people age 50 and older, this conservative organization is built on five foundations, which includes rebuilding national values, Social Security reform, Medicare reform, tax code reform and control of government overspending. Fees to join run $15 for one year, $25 for two or $35 for three years, and members receive access to a variety of benefit on travel, home and auto insurance, security services, health and wellness (medical, dental, vision and hearing) and more.

Association of Mature American Citizens (AMAC.us): With more than one million members, this organization was started in 2007 for people 50 and older. Their mission is to help seniors fight high taxes, reduce excessive government involvement in our day-to-day lives, and preserve American values. They also offer a host of benefits on home, health and auto insurance, travel, vision and dental care, prescription drugs, retail savings, roadside assistance and more. Membership fees run $16 per year, or less if you join for multiple years.

The Seniors Coalition (Senior.org): Founded in 1990, this conservative public advocacy group claims to have around four million supporters. Their key issues are to protect Social Security benefits, stop Social Security payments to illegal aliens from Mexico, eliminate the death tax, and reform the Social Security COLA system. TSC offers very few membership benefits. Annual fees run $10 for one person per, or $13 per couple and you can join at any age.

Some other senior membership organizations to consider that offer discounts include the non-for-profit American Senior Benefits Association (ASBAonline.org), and the conservative leaning National Association of Conservative Seniors (NAOCS.us), and Christian Seniors Association (CSAbenefits.site-ym.com).

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.