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.

June 2019 Savvy Senior Columns

Savvy Senior – June Columns

  1. How a Government Pension Might Reduce Your Social Security Benefits
  2. Thrifty Travel: How Retirees Can Find Cheap Travel Accommodations
  3. How to Protect Yourself from the Social Security Imposter Scam
  4. How to Choose and Use a Home Blood Pressure Monitor

How a Government Pension Might Reduce Your Social Security Benefits

Dear Savvy Senior,
As a teacher for 20 years, I receive a pension from a school system that did not withhold Social Security taxes from my pay. After teaching, I’ve been working for a small company where I do pay Social Security taxes. Now, approaching age 65, I would like to retire and apply for my Social Security benefits. But I’ve been told that my teacher’s pension may cause me to lose some of my Social Security. Is that true?
Ready to Retire

Dear Ready,
Yes, it’s true. It’s very likely that your Social Security retirement benefits will be reduced under the terms of a government rule called the Windfall Elimination Provision (or WEP).

The WEP affects people who receive pensions from jobs in which they were not required to pay Social Security taxes – for example, police officers, firefighters, teachers and state and local government workers whose employers were not part of the national Social Security system. People who worked for nonprofit or religious organizations before 1984 may also be outside the system.

Many of these people, like you, are also eligible for Social Security retirement or disability benefits based on other work they did over the course of their career for which Social Security taxes were paid.

Because of your teacher’s pension, Social Security will use a special formula to calculate your retirement benefits, reducing them compared to what you’d otherwise get.

How much they’ll be reduced depends on your work history. But one rule that generally applies is that your Social Security retirement benefits cannot be cut by more than half the size of your pension. And the WEP does not apply to survivor benefits.

If you’re married and die, your dependents can get a full Social Security payment, unless your spouse has earned his or her own government pension for which they didn’t pay Social Security taxes. If that’s the case, Social Security has another rule known as the Government Pension Offset (or GPO) that affects spouses or widows/widowers benefits.

Under the GPO, spousal and survivor benefits will be cut by two-thirds of the amount of their pension. And if their pension is large enough, their Social Security spousal or survivor benefits will be zero.

There are a few exceptions to these rules most of which are based on when you entered the Social Security workforce.

Why Do These Rules Exist?
According to the Social Security Administration, the reason Congress created the WEP (in 1983) and GPO (in 1977) was to create a more equitable system. People who get both a pension from non-Social Security work and benefits from Social Security-covered work get an unfair windfall due to the formula of how benefit amounts are calculated.

These rules ensure that government employees who don’t pay Social Security taxes would end up with roughly the same income as people who work in the private sector and do pay them.

For more information on the WEP visit SSA.gov/planners/retire/wep.html, where you’ll also find a link to their WEP online calculator to help you figure out how much your Social Security benefits may be reduced. And for more information on GPO, including a GPO calculator, see SSA.gov/planners/retire/gpo.html.

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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Thrifty Travel: How Retirees Can Find Cheap Travel Accommodations

Dear Savvy Senior,
Can you recommend some good websites for finding cheaper travel accommodations? My husband and I love to travel but hotel costs eat up our budget so much that we can’t afford to go as often as we’d like. We’ve used Airbnb with some luck but are wondering if there are other options for budget-conscious retirees.
Retired Travelers

Dear Retired,
Accommodations are typically one of the costliest travel expenses. But, if you’re willing to do a little research and preplanning, there are a number of ways you can lower (or eliminate) your lodging costs and live more like a local when you travel. Here are some different options to consider and some websites that can help you locate them.

B&B Clubs
If you like staying in bed and breakfasts and have a spare bedroom yourself, check out the Evergreen Club (EvergreenClub.com) and the Affordable Travel Club (AffordableTravelClub.net).

These are B&B clubs for travelers over ages 50 or 40 that offer affordable lodging in the spare bedroom of other club members, or they may stay with you when they’re on the road. You pay a modest gratuity of around $20 per night, with breakfast. And the clubs charge membership fees of $65 to $75 per year.

Lower Cost Rentals
There are literally millions of privately-owned properties in the United States and abroad that are offered as short-term rentals. This has become a very popular alternative to hotels for retirees.

Renting a fully furnished apartment or house is usually cheaper than hotel rooms of comparable quality, and they almost always offer more space, a homier feel and a kitchen, which can save you the expense eating out every meal.

Short-term rentals are offered through the individual property owners or property-management companies. Some of the best sites for finding them include Airbnb.com, HomeAway.com and FlipKey.com. These sites are free to use for travelers.

Another nifty site you should check out is The Freebird Club (FreebirdClub.com) that connects 50-plus travelers with 50-plus hosts.

Unlike Airbnb and the other previously listed lodging rental sites, Freebird users pay a $31 fee to join and to have their identities verified. They then fill out a questionnaire asking where they’d like to travel and how much interaction they’d like to have with their hosts. On the other end, hosts are not offering rental properties and a key in a drop box, but their own homes, along with conversation and companionship, for much less than the price of a hotel.

House Sitting
If you have a flexible schedule and you don’t mind doing a few household chores when you travel, house sitting is another option that offers lodging for free.

How it works is you live in someone else’s home while they’re away for a long weekend or even a few months. And in exchange for the free accommodations, you take care of certain responsibilities such as their pets, lawn, garden, mail, etc.

To find these opportunities, try sites like Nomador.com, MindMyHouse.com, HouseCarers.com and TrustedHousesitters.com. They all charge a small membership fee.

Home Swapping
Another way to get free accommodations when you travel is by swapping homes with someone who’s interested in visiting the area where you live.

To make a swap, you’ll need to join an online home exchange service where you can list your home and get access to thousands of other listings. Then you simply email the owners of houses or apartments you’re interested in – or they email you – and you make arrangements.

Most home exchange sites like HomeExchange.com, HomeLink.org and Intervac-HomeExchange.com charge membership fees ranging from $50 to $150.

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 Protect Yourself from the Social Security Imposter Scam

Dear Savvy Senior,
I recently received a strange call from a Social Security employee. He told me my Social Security number had been suspended because it was involved in a crime, and that I needed to reactivate it and secure my bank funds by withdrawing them and putting them on gift cards. Is this a scam?
Worried Rita

Dear Rita,
Yes. It’s actually known as the “Social Security imposter scam” and it’s becoming a widespread problem in the U.S. The Federal Trade Commission has received more than 76,000 reports about this growing scam in the past 12 months alone. With average losses of $1,500, this scam is quickly becoming one of fraudsters’ favorite tricks.

The Social Security imposter scam usually begins with a consumer receiving a call from someone claiming to be with the Social Security Administration. The caller informs the victim that their Social Security number (SSN) has been suspended because it was stolen or has been involved in a crime.

The phone call may be a robocaller with a message to “press 1” to speak with a fake support representative who then claims to be able to help reactivate the consumer’s SSN.

In a variation on this scam, the caller may also reach out to tell a victim that they qualify for an increase in benefits. All they need to do is provide the scammer with some information. Typically, these callers will ask their victims several questions to get personal information that they can then use to steal their identity or drain their bank accounts.

Because of the numerous data breaches, these scammers may have access to accurate personal information – such as your SSN – that they can use to build trust and appear legitimate. Regardless, before concluding the scam, fraudsters will almost always request payment to “unfreeze” the SSN or to process the increase in benefits. The scammer may request that they be paid via an unusual payment method such as by gift card (and giving the fraudster the gift card number), or some form of cryptocurrency like Bitcoin.

While the scam can be devastating, there are several steps you can take to prevent yourself, and your loved ones, from falling victim to this scam:

Don’t trust your caller ID: Scammers can make it look as if the Social Security Administration is calling and even use the agency’s real number. If you receive an unexpected call from Social Security, don’t answer it. Instead, call Social Security’s customer service number at 800-772-1213 to see if they were actually trying to contact you.

Remember, Social Security will never suspend your number or call and demand money: If anyone tells you something different, you’re being scammed.

Don’t give out personal information: Never give out your Social Security number, bank information or other personal details to an unknown caller. If you already did, visit IdentityTheft.gov/SSA to find out what steps you can take to protect your credit and your identity.

Don’t trust the caller just because they may know some of your personal information: It’s most likely a scam if the person on the other end asks to confirm your information.

Talk about the experience: Those who’ve been targeted should alert friends and neighbors about the call to spread information and report the scam to the FTC at FTC.gov/complaint.

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 and Use a Home Blood Pressure Monitor

Dear Savvy Senior,
I just found out I have stage 1 hypertension and my doctor recommended I get a home blood pressure monitor to keep an eye on it. Can you offer me any tips on choosing and using one?
Hypertensive Helen

Dear Helen,
It’s a smart idea! Everyone with elevated or high blood pressure – stage 1 (or 130/80) and higher – should consider getting a home blood pressure monitor. Home monitoring can help you keep tabs on your blood pressure in a comfortable setting. Plus, if you’re taking medication it will make certain it’s working, and alert you to a health problem if it arises.

Home Monitors

The best type of home blood pressure monitors to purchase are electric/battery powered automatic arm monitors, which are more reliable than wrist or fingertip monitors. With an automatic arm monitor, you simply wrap the cuff around your bicep and with the push of one button the cuff inflates and deflates automatically giving you your blood pressure reading on the display window in a matter of seconds.

Many monitors today also come with additional features like irregular heartbeat detection; a risk category indicator that tells you whether your blood pressure is in the high range; a data-averaging function that allows you to take multiple readings and get an overall average; multiple user memory that allows two or more users to save their readings; and downloadable memory that lets you transmit your data to your computer or smartphone.

You can find these monitors at pharmacies, medical supply stores or online, and you don’t need a prescription to buy one. Prices typically range between $40 and $100.

In most cases, original Medicare will not cover a home blood pressure monitor, but if you have a Medicare Advantage plan or a private health insurance policy it’s worth checking into, because some plans may provide coverage.

Some of the best automatic arm monitors as recommended by Consumer Reports are the Omron 10 Series BP786N ($75); Rite Aid Deluxe Automatic ($60); Omron Evolv BP7000 ($70); and A&D Medical UA767F ($45).

How to Measure
After you buy a monitor, it’s a good idea to take it to your doctor’s office so they can check its accuracy and make sure you’re using it properly. Here are some additional steps to follow to ensure you get accurate readings at home.

  • Relax: Don’t exercise, smoke or drink caffeinated drinks or alcohol for at least 30 minutes before measuring. Sit quietly for at least five minutes before you take a measurement and remain quiet during the test.
  • Sit correctly: Sit with your back straight and supported (on a dining chair, rather than a sofa). Your feet should be flat on the floor and your legs should not be crossed. Your arm should be supported on a flat surface (such as a table) with the upper arm at heart level. Make sure the middle of the cuff is placed directly above the bend of the elbow. Check your monitor’s instructions for an illustration.
  • Put the cuff directly on your bare skin: Putting it over clothes can raise your systolic (upper) number by up to 40 mmHg.
  • Measure at the same time every day: It’s important to take the readings at the same time each day, such as morning and evening. It doesn’t matter whether you do it before or after taking medication. Just be consistent.
  • Go to the bathroom: A full bladder can rise your systolic pressure by 10 to 15 mmHg.
  • Take multiple readings and record the results: Each time you measure, take two or three readings one minute apart and record the results by writing them down, or using an online tracker (see com).

For more information on high blood pressure numbers and how to accurately measure it at home, visit Heart.org/HBP.

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.

May 2019 Savvy Senior Columns

Savvy Senior – May Columns

  1. 2020 Census Offers Temporary Jobs Ideally Suited for Retirees
  2. The Long-Term Care Benefit Many Veterans Are Missing Out On
  3. Understanding Medicare’s Enrollment Periods
  4. Adaptive Gardening: Tips and Tools for Older Gardeners

2020 Census Offers Temporary Jobs Ideally Suited for Retirees

Dear Savvy Senior,
The U.S. Census Bureau is in the process of recruiting thousands of workers for temporary jobs to help collect valuable data for the 2020 Census, and retirees are ideal candidates. Can you write a column to get the word out? Thanks for your help!
Census Recruiter                                                                                 

Dear Recruiter,
I’m happy to oblige, and I agree. This once-a-decade job opportunity is a great fit for retirees that have some free time on their hands who wouldn’t mind earning some extra income while helping the community.

Attention Retirees!
The United States Census Bureau is currently in the process of recruiting over 500,000 temporary workers to help carry out the upcoming 2020 Census national head count of every person living in the U.S.

The U.S Census helps determines each state’s representation in Congress, how funds are spent for schools, hospitals, roads, and provides information to guide many decisions made by government agencies, private businesses and institutions.

Jobs within the census vary from working in the field canvassing, updating maps, doing follow up interviews with citizens in your community, or working in the office as a clerk doing administrative tasks or office operation supervisor, who oversees the field staff.

Some jobs will begin this summer, but the majority of positions will begin in late April 2020 and last a month or two.

These temporary part-time positions are located in every county throughout the United States and Puerto Rico. Some positions require evening and/or weekend shifts because you must be available to interview members of the public when they’re at home. And all positions require several days of online and classroom training. The pay ranges between $13.50 and $30 per hour depending on position and location. To find the pay rates in your area, see 2020census.gov/en/jobs/locations.html.

Job Qualifications
To be able to work for the 2020 census you must:

  • Be at least 18 years old.
  • Have a valid Social Security number.
  • Be a U.S. citizen.
  • Have a valid email address.
  • Complete an application and answer assessment questions.
  • Be registered with the Selective Service System or have a qualifying exemption, if you are a male born after Dec. 31, 1959.
  • Pass a Census-performed criminal background check and a review of criminal records, including fingerprinting.
  • Commit to completing training.
  • Be available to work flexible hours, which can include days, evenings, and/or weekends.

In addition, most census jobs require employees to have access to a vehicle and a valid driver’s license, unless public transportation is readily available. And have access to a computer with internet and an email account to complete training.

How to Apply
The first step is to complete the online job application at 2020census.gov/en/jobs. The process takes about 30 minutes and will include some assessment questions about your education, work, and other experience.

If you’re a veteran who would like to claim veterans’ preference, which provides preference over nonveteran applicants, you’ll need supporting documentation.

For more information on the 2020 Census, or if you have questions or problems with the application process call 855-562-2020.

After you apply, an interviewer will reach out to potential hires to conduct a phone interview, but not all applicants will be interviewed. Job offers are made verbally, but candidates will also receive a letter by email.

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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The Long-Term Care Benefit Many Veterans Are Missing Out On

Dear Savvy Senior,
I have heard that the VA has a benefit that can help veterans and spouses with long-term care costs. We recently had to move my 86-year-old father – who served in the army nearly 60 years ago – into an assisted living facility, and my mom isn’t far behind. Can the VA help?
Seeking Aid                                                                              

Dear Seeking,
The Veterans Administration does indeed have a little-known, underutilized benefit that can help wartime veterans and their surviving spouses pay for a variety of long-term care costs.

This benefit, called “Aid and Attendance,” is a special pension that’s paid in addition to a basic pension. It pays a maximum of $2,230 a month to married veterans; $1,881 a month to single veterans; or $1,209 a month to a surviving spouse. The money is tax free, and can be used to pay for in-home care, assisted living and nursing home care.

Today, only around 230,000 veterans and survivors receiving Aid and Attendance, but millions more are eligible and either don’t know about it, or don’t think they can qualify for it.

Eligibility Requirements
To qualify, your dad must have served at least 90 days of active military service with at least one day of service during a period of war, and not have been discharged dishonorably. Single surviving spouses of wartime vets are eligible if their marriage ended due to death.

In addition, your dad will also have to meet certain thresholds for medical and financial need to be eligible.

To qualify medically he must be either disabled, or over the age of 65 and need help with basic everyday living tasks such as eating, dressing, bathing or going to the bathroom. Being blind or in a nursing home or assisted living facility due to mental disability also qualifies him. Single surviving spouses have no age restrictions, but they must require help with basic everyday living tasks to be eligible.

To qualify financially, your parents must have limited assets, under $127,061, excluding their home, vehicle and personal belongings. And their annual income (minus medical and long-term care expenses) cannot exceed the Maximum Allowable Pension Rate (MAPR), which in 2019 is $26,766 for a veteran and their spouse; $22,577 for a single veteran; and $14,509 for a surviving spouse.

To calculate your parent’s income qualifications, add up their income over the past year (including Social Security, pensions, interest income from investments, annuities, etc.), minus any out-of-pocket medical expenses, prescription drugs, insurance premiums and long-term care costs over that same period of time. If the final tally is under the MAPR, and he meets the other requirements, he should be eligible for aid.

How to Apply
To learn more, or to apply for Aid and Attendance, contact your regional VA benefit office (see Benefits.va.gov/benefits/offices.asp or call 800–827–1000) where you can apply in person. You can also apply by writing the Pension Management Center for your state (see Benefits.va.gov/pension/resources-contact.asp). You’ll need to include evidence, like VA Form 21-2680 (VA.gov/vaforms) which your dad’s doctor can fill out that shows his need for Aid and Attendance.

If you need some help, you can appoint a Veteran Service Officer (VSO), a VA-accredited attorney or claims agent to represent your dad. See www.ebenefits.va.gov/ebenefits/vso-search to locate someone.

If your dad is eligible, it will take between six and 12 months for his application to be processed, so be patient.

You should also know that if your dad’s Aid and Attendance application is approved, the VA will send a lump sum retroactive payment covering the time from the day you filed the application until the day it was approved. Then your dad receives monthly payments going forward.

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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Understanding Medicare’s Enrollment Periods

Dear Savvy Senior,
What can you tell me about the different enrollment periods for Medicare? I’m planning to work past age 65 and understand Medicare offers Initial, Special and General periods in which I can enroll. How does this work?
Medicare Illiterate

Dear Medicare,
The rules for signing up for Medicare can be quite confusing, especially if you plan to work past age 65. But it’s critical to understand the ins and outs of enrolling because the consequences of missing a deadline can be costly and last a lifetime. Here’s what you should know about Medicare’s three different enrollment periods.

Initial Enrollment Period
At age 65, the Initial Enrollment Period is the first opportunity that most people are eligible to enroll in Medicare.

If you’re already claiming Social Security benefits at least 4 months before age 65, you are automatically enrolled in Medicare, with coverage starting the first day of month you turn 65. If you’re not receiving Social Security benefits, it’s up to you to enroll in Medicare either online at SSA.gov/Medicare, over the phone at 800-772-1213 or through your local Social Security office.

You can enroll any time during the Initial Enrollment Period, which is a seven-month period that includes the three months before, the month of, and the three months after your 65th birthday.

It’s best to enroll three months before your birth month to ensure your coverage starts when you turn 65.

However, if you plan to keep working and have health coverage from your employer, or from a spouse’s employer, you may want to delay Medicare Part B, which covers outpatient services, and Part D, which covers prescription drugs. But first check with the human resources department to see how your employer insurance works with Medicare.

Typically, if your employer has fewer than 20 employees, Medicare will be your primary insurer and you should enroll. But if you work for a company that has 20 or more employees, your employer’s group health plan will be your primary insurer as long as you remain an active employee. If this is the case, you don’t need to enroll in Part B or Part D when you turn 65 if you’re satisfied with the coverage you are getting through your job.

But in most cases, unless you’re contributing to a Health Savings Account, you should at least sign-up for Medicare Part A, which is free and covers hospital services.

Special Enrollment Period
If you delay Part B and Part D past age 65, you can sign up for Medicare during the Special Enrollment Period. Once you (or your spouse) stop working and you no longer have group health coverage, you have eight months to enroll in Part B. But if you miss that deadline, you’ll pay a late-enrollment penalty for the rest of your life. The penalty increases your premiums by 10 percent for each 12-month period that you don’t have coverage.

The window for Part D is shorter. You must sign up for Part D within two months of losing drug coverage. If you go 63 days or more without drug coverage, you’ll pay a lifetime late-enrollment penalty that equals 1 percent of the monthly base premium (about $33 in 2019) times the number of months you don’t have Part D of other creditable coverage.

General Enrollment Period
If you miss either of these first two enrollment periods, you’ll have to wait until the General Enrollment Period, which is January 1 through March 31 of each year, but your Part B and Part D coverage will not begin until July 1. And you’ll be subject to late-enrollment penalties.

There is, however, no penalty for late enrollment for Part A. You can sign up anytime with coverage beginning the first day of the following 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.

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Adaptive Gardening: Tips and Tools for Older Gardeners

Dear Savvy Senior,
Can you recommend some good tools and tips for senior gardeners? My 77-year-old mother loves to work in the garden but over the past few years has been plagued by injuries.
Concerned Daughter

Dear Concerned,
Aches, pains and injuries are not uncommon among older gardeners. Because gardening is such a physical activity that often requires a lot of bending and stooping, squatting and kneeling, gripping and lifting, it can be extremely taxing on an aging body.

Back pain and knee injuries are most common among older gardeners, along with carpal tunnel syndrome and tennis elbow. To help keep your mom injury-free this summer, here are some tips and gardening equipment ideas that can make gardening a little easier.

Warm Up
With gardening, good form is very important as well as not overdoing any one activity. A common problem is that gardeners often kneel or squat, putting extra pressure on their knees. Then, to spare their knees, they might stand and bend over for long stretches to weed, dig and plant, straining their back and spine.

To help your mom protect her body, she needs to warm up before beginning. Start by stretching, focusing on the legs and lower back. And keep changing positions and activities. Don’t spend hours weeding a flowerbed. After 15 minutes of weeding, she should stand up, stretch, and switch to another activity like pruning the bushes or just take a break.

It’s also important that she recognizes her physical limitations and doesn’t try to do too much all at once. And, when lifting heaver objects, she needs to remember to use her legs to preserve her back. She can do this by keeping the item close to her body and squatting to keep her back as vertical as possible.

Labor-saving Tools
The right gardening equipment can help too. Kneeling pads can protect knees, and garden seats or stools are both back and knee savers. Lightweight garden carts can make hauling bags of mulch, dirt, plants or other heavy objects much easier. And long-handled gardening tools can help ease the strain on the back by keeping your mom in a standing upright position versus bent over.

There are also ergonomic gardening tools with fatter handles and other design features that can make lawn and garden activities a little easier.

Easier Watering
The chore of carrying water or handling a heavy, awkward hose can also be difficult for older gardeners. Some helpful options include lightweight fabric hoses instead of heavy rubber hoses; soaker or drip hoses that can be snaked throughout the garden; thin coil hoses that can be used on the patio or small areas; a hose caddy and reel for easier hose transport around the yard; and a self-winding hose chest that puts the hose up automatically.

There are also a variety of ergonomic watering wands that are lightweight, easy to grip, and reach those hard to-get-to plants.

To find ergonomic gardening tools and the recommended watering aids, check with local retail stores that sell lawn and garden supplies or try online retailers like Gardeners.com or RadiusGarden.com.

Container Gardening
If your mom’s backyard garden has become too much for her to handle, she should consider elevated garden beds or container gardening – using big pots, window boxes, hanging baskets, barrels or tub planters. This is a much easier way to garden because it eliminates much of the bend and strain of gardening but still gives her the pleasure of making things grow.

Trellises are another nice option that would allow her to garden vertically instead of horizontally.

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 — April 2019 Columns

Savvy Senior – April Columns

  1. Finding Health Insurance Before Medicare Kicks In
  2. How SSI Can Help Low-Income Seniors and the Disabled
  3. Trikes for Grown-Ups
  4. Safe Ways to Get Rid of Expired, Unused Medicine
  5. Air Travel Tips for Older Passengers

 

Finding Health Insurance Before Medicare Kicks In

Dear Savvy Senior,
I will be retiring in a few months and need to get some health insurance for my wife and me until we can enroll in Medicare. What are my options?
About to Retire

Dear About,
There are several places early retirees can find health insurance coverage before Medicare kicks in, but the best option for you and your wife will depend on your income level and your health care needs. Here’s where to look.

Government Marketplace
If your yearly income falls below the 400 percent poverty level after you retire, the Affordable Care Act (the ACA, aka Obamacare) marketplace is probably your best option for getting health coverage because of the premium subsidies they offer, which will reduce the amount you’ll have to pay for a policy.

ACA health insurance is major medical insurance that covers essential health benefits with no annual or lifetime coverage maximums. And they can’t charge you more or deny you coverage because of a pre-existing health condition.

To qualify for the subsidies, your household’s modified adjusted gross income for 2019 must be under $48,560 for an individual, or $65,840 for a couple.

If your income is just above these thresholds, you should talk to a tax advisor about perhaps making a larger IRA contribution or strategically timing retirement account withdrawals to help you qualify. To see how various levels of income might affect your premiums and subsidies, see the subsidy calculator on the Kaiser Family Foundation website at KFF.org/interactive/subsidy-calculator.

To shop for marketplace plans in your state, visit HealthCare.gov or call their toll-free helpline at 800-318-2596.

If you find that you are not eligible for the subsidies and the premiums seem unaffordable, look into ACA-compliant plans that you can purchase off the marketplace directly from the insurance carrier or through a broker. In some states, you might find plans with lower premiums, especially on silver plans.

To find off the marketplace policies, see health insurance shopping websites like eHealthInsurance.com, or contact a broker or agent to assist you. See LocalHelp.HealthCare.gov to locate someone in your area.

Short-Term Health Insurance
If you can’t find an affordable ACA plan, you may want to consider short-term health insurance, which is much cheaper. These plans, which are not available in every state, are bare-bones health plans that provide coverage for three, six or 12 months – depending on state/federal rules. But be aware that short-term plans don’t comply with the ACA so they can deny sick people coverage. They don’t cover preexisting conditions and they can exclude coverage essentials like prescription drugs.

To shop for short-term health insurance, visit eHealthInsurance.com or contact a local broker or agent via LocalHelp.HealthCare.gov.

COBRA
If you need health insurance coverage for less than 18 months, another option you may want to consider is COBRA, which allows you to remain on your former employer’s group health plan, but not every employer plan is COBRA eligible. Contact your employer benefits administrator to find out if yours is.

In most cases COBRA is expensive, requiring you to pay the full monthly premium yourself. But, if you’ve already met or nearly met your employer plan’s deductible and/or out-of-pocket maximum for the year, and don’t want to start over with a new plan; or if you find your employer’s health plan to be better or more affordable that the other options, it makes sense to keep your current coverage under COBRA.

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 SSI Can Help Low-Income Seniors and the Disabled

Dear Savvy Senior,
What can you tell me about the Supplemental Security Income program and what are the eligibility requirements? My father is very low-income, so I’m wondering if this is something he may qualify for.
Searching Daughter                                                                    

Dear Searching,
Supplemental Security Income (or SSI) is a program administered by the Social Security Administration that provides monthly cash benefits to people that are disabled or over 65 based on financial need. Currently, more than 8 million people are receiving SSI benefits. Here’s what you should know.

Eligibility Requirements
To qualify for SSI your dad must be either age 65 or older, blind or disabled, and must be a U.S. citizen or lawful resident. He must also have limited assets and income.

His assets must be less than $2,000 or $3,000 for couples. This includes cash, bank accounts, other personal property, and anything else that could potentially be converted to cash. His home, household goods and one vehicle, along with life insurance policies and burial funds valued under $1,500, do not count towards countable assets.

The income limit to qualify for SSI, however, is much more complicated. Countable income includes wages or any other kind of money your dad earned from working, plus money he gets from other sources like unemployment, Social Security retirement, or gifts from friends, but also, free food or shelter.

In 2019, the SSI allowable income limit is $771 a month for an individual or $1,157 a month for a couple. So, if your dad’s countable income is over the SSI allowable limit (this is based on a complex set of rules and calculations – see SSA.gov/ssi/text-income-ussi.htm) he would not qualify. But if he’s under it, he would qualify for some benefits depending on his countable income.

To help you determine if your dad is eligible for SSI, help him take the Social Security Administration’s benefits screening test at SSAbest.benefits.gov. This online questionnaire takes approximately 5 minutes to complete and screens for a variety of benefits, not just SSI.

You should also know that most states – except Arizona, Mississippi, North Dakota and West Virginia – supplement the federal SSI payment with payments of their own. In some of the states that pay a supplement, your dad may qualify for the state payment even if he doesn’t meet the federal SSI eligibility criteria.

How to Apply
If you think that your dad is eligible for SSI,call 800-772-1213 and set up an appointment to apply at his local Social Security office.

To help make the application process go quickly and smoothly, your dad should bring his Social Security number; birth certificate or other proof of age; information about the home where he lives, such as his mortgage, or lease and the landlord’s name; payroll slips, bank books, insurance policies, burial fund records and other information about his income and the things he owns; his proof of U.S. citizenship or eligible noncitizen status; and if he is applying for SSI because he is disabled or blind, the names, addresses and telephone numbers of doctors, hospitals and clinics that have information related to his condition.

For more information visit SSA.gov/ssi or call Social Security at 800-772-1213 and ask them to mail you a copy of publication 11000 “Supplemental Security Income (SSI).” You can also read it online at SSA.gov/pubs/EN-05-11000.pdf.

Other Assistance Programs
Depending on your dad’s income, needs and location there are other financial assistance programs that may be able to help him like Medicaid, prescription drug assistance, food stamps and energy assistance. To find out what he may be eligible for go to BenefitsCheckUp.org. This is a free, confidential Web tool that contains more than 2,500 programs.

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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Trikes for Grown-Ups

Dear Savvy Senior,
What can you tell me about three-wheeled bicycles? I’m 65 years old and would like to start cycling again but I have some occasional balance problems and don’t trust myself on a two-wheeler. What can you recommend?
Ready to Ride

Dear Ready,
Three-wheeled bikes – also known as adult trikes – are a great cycling option for older adults, especially those who have concerns with their balance or stamina. Here’s what you should know, along with some tips to help you shop for one.

Safer Cycling
If you’d like to take up, or continue bike riding, but worry about falling, adult trikes are a smart option to consider because of the stability they provide. With a trike, you can ride as slow as you want without ever losing your balance and you can put both feet on the ground while seated, which is very reassuring for many older riders.

In addition, adult trikes are also made with a low “step through” design making mounting and dismounting easier; they typically come with big tires that ensure a smooth ride; have ergonomic handlebars that are easy to reach and grip; and offer oversize seats (some even have backrests) for comfort and support. And, other than the frame, tricycles use the same standard components as traditional bikes do, so replacement parts are readily available, and repairs are not an issue.

There are dozens of different types of adult trikes to choose from with prices ranging anywhere from a few hundred to several thousand dollars. To help you figure out the right kind of trike that meets your needs and budget, here’s a breakdown of the different styles and costs, along with some popular models to check out.

Upright Trikes
If you’re primarily interested in a leisurely ride around the neighborhood for pleasure, fitness or running errands, upright trikes are a good choice. These are traditional upright-positioned tricycles that come with rear cargo baskets and limited gear options, usually ranging from one to three-speeds.

A great choice in this category is the Sun Traditional Trike (see Sun.bike/trikes) that cost between $440 and $550. For a less expensive option, consider the Schwinn Meridian Adult Tricycle sold at Walmart, Target or Amazon.com for around $300.

Recumbent Trikes
These are the low-to-the-ground, stretched-out frame trikes that allow you to recline with your legs positioned in front of you. Available in various styles, recumbent trikes are very comfy, easy on the back and aerodynamic which make them ideal for longer rides.

TerraTrikes (Terratrike.com) and Catrike (Catrike.com) are two of the biggest U.S. companies that make tadpole-style (the two wheels are in front) recumbent trikes. Or, see Sun Seeker (Sunseeker.bike), which sells several Delta recumbent trikes (two wheels in back) that offer a higher seat level. But be aware that recumbent trikes are much more expensive, typically ranging between $1,000 and $4,000.

E-Trikes
If you want a boost from time-to-time, electric trikes are a great option too. These trikes are hybrids that have pedals and a battery powered electric motor, so you can exercise when you want, or when you need a boost, you can let the motor assist you. A great place to find these is at ElectricTrike.com, which offer a variety of options ranging from $1,500 to $3,000. You can also find them on e-bike sites like PedegoElectricBikes.com, ProdecoTech.com and Evelo.com.

Folding Trikes
If you like to travel or if you have limited storage space, trikes that are designed to fold up to fit in tight spaces are another option. The Kent Adult Westport Folding Tricycle and Mantis Tri-Rad Folding Adult Tricycle sold at Amazon.com for around $300 are two popular options to check 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.
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Safe Ways to Get Rid of Expired, Unused Medicine

Dear Savvy Senior,
What’s the best, environmentally safe way to dispose of old and unused medications? My mother has a medicine cabinet chocked-full of pills, some of which haven’t been touched in 25 years, and I’d like to clean it out for her.
Protective Daughter

Dear Protective,
Cleaning out the medicine cabinet is a chore that most people don’t think about, but it’s an important task that can help prevent medication problems, and protect children who may have access to these old, unused drugs. Here’s how you can clean out your mother’s medicine cabinet so it’s safe and useful.

Return Them
Your local pharmacy, as well as hospitals, clinics, long-term-care facilities, and narcotic treatment programs, might accept your mom’s unused medications, often as part of programs that collect and destroy unused drugs. Search for an authorized facility near you at DisposeMyMeds.org.

You can also drop off her unused meds at designated police departments, fire stations, and other sites on National Prescription Take Back Day, Saturday, April 27. To find a collection site near you, visit TakeBackDay.dea.gov.

Use a Disposal Kiosk
Many Walgreens and CVS stores have free, anonymous, and secure kiosks where you can dispose of any medication. Remove your personal information from the packaging and drop unwanted medication, including opioids, in the slot.

Mail Them
Costco, Rite Aid and CVS pharmacies sell postage-paid envelopes for customers to mail any prescription, including opioids and over-the-counter medications, to a disposal facility.

Throw Them Out
If mailing them in or getting to one of the drop-off sites is not an option, you can dispose of them yourself, but do so carefully. The Food and Drug Administration recommends taking the medications out of their original bottles and putting them in a sealable plastic bag with an undesirable substance like coffee grounds, dirt or kitty litter. Then seal the plastic bag and throw it in the trash. This will make the medication less appealing to children, pets or other people who may fish through your trash.

But don’t do this with dangerous drugs, such as opioids, which can be abused. For these, the FDA says flushing them down the toilet is OK. But trace amounts of drugs can end up in the water supply so this should be done only as a last resort. To see the FDA list of medications that should be flushed when they are no longer needed, go to FDA.gov and type “flush list” into the search box.

Another option is to purchase some medication disposal bags like the Medsaway Medication Disposal System. These are carbon pouches that are designed to neutralize all medication including narcotics, liquid medication, transdermal patches and controlled substances so you can just add water, and toss them in the trash. You can find medication disposal bags at some local pharmacies or online at Amazon.com for around $15.

You’ll also want to make sure to scratch out all your mom’s personal information on the empty medicine bottles or other packaging before throwing it away to protect her identity and privacy.

If you have other questions about proper drug disposal, talk to your pharmacist.

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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Air Travel Tips for Older Passengers

Dear Savvy Senior,
My son is getting his PhD next month and I would like to fly my parents in from across the country for his graduation, but I have some concerns about the flights. My dad is 82 and has trouble walking long distances and uses an oxygen tank for his COPD. What airport or airline services are available to help elderly passengers?
Proud Mother

Dear Proud,
Flying across the country can be exhausting for anyone, but for seniors with health issues or physical limitations it can be extremely challenging. Here are a few flying tips and a number of resources that can help.

Booking: When you go to book your parent’s flight, this is the time to make special requests that can help make the trip easier for your parents. You’ll need to make these requests over the phone.

For example, you may want to book preferred aisle seats in the front of the plane for easier access or bulkhead seats that provide extra leg room, and you should probably request a wheelchair or two with attendant(s) to maneuver your parents through the airports they will be departing from and arriving to, and if there’s a connecting flight in between.

If your parents don’t want a wheelchair, but still want some help, ask about electric carts.

You also need to check with the airline regarding their policy for oxygen units for your dad. While the Federal Aviation Administration prohibits the use of personal oxygen tanks during flights because they contain compressed gas or liquid oxygen, they do permit certain portable oxygen concentrators.

Getting to the airport: If your parents need help getting to the airport there are various senior transportation options depending on your parent’s location. To find out what’s available in their area visit Rides in Sight at RidesInsight.org.

Airport assistance: If your parents are flying on their own, most airports allow elderly fliers to be escorted to and from the gate by a non-traveling companion as long as they get a gate/escort pass, which he or she can get at the airline check-in counter by showing a government-issued photo ID.

But if no one is available to help your parents, find out if the airline can assist them when you call to book their flight. Some airlines offer special check-in and escort assistance to passengers that request it.

Or you can consider hiring an independent company like Royal Airport Concierge Services (RoyalAirportConcierge.com), who will meet your parents at the curb, check their bags, expediate all check-in and security processes and escort them to a VIP lounge and to the aircraft gate when they are ready to board. Costs typically range between $200 and $400.

If you parents need even more help, there are also a number of traveling companion services you can call on like FlyingCompanions.com and FirstLightHomeCare.com. These services will do everything including making the travel arrangements, accompanying your parents on the trip, and facilitating their needs along the way. Fees for these services will vary depending on what’s needed and travel costs.

Security and boarding: To help you parents get through security screening a little easier, the Transportation Security Administration (TSA) offers special expedited screening to passengers 75 and older as well as those with disabilities and medical conditions. This allows them to move through security without removing their shoes or jacket, and some airports may have a special line. Call TSA Cares at 855-787-2227 or visit TSA.gov/travel/special-procedures to learn more.

When it’s time to board, your parents can also take advantage of the airlines pre-boarding option for elderly passengers who need some extra time to get on the plane and get settled. And for getting off the plane, they can wait for the other passengers to disembark so attendants can assist them with carry-ons and escort them from the plane.

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 — March Columns

Savvy Senior – March Columns

  1. How to Choose a Good Home Stair Lift
  2. Does Medicare Covers Vision Services?
  3. How Seniors Can Stop Frustrating Robocalls
  4. Underutilized Palliative Care Services Can Help Relieve Pain

How to Choose a Good Home Stair Lift

Dear Savvy Senior,
Can you recommend some good stair lift companies? I have a difficult time getting up and down the stairs anymore and am interested in purchasing a stair lift for my house but could use some help choosing one.
Arthritic Ann

Dear Ann,
A good home stair lift is an excellent solution for those with mobility challenges who have trouble with steps. A stair lift will carry you up and down the stairs in a safe seated position, providing easy access to the second story or basement level of your home.

To help you choose a quality stair lift that meets your needs and budget, here are a few shopping tips, along with some top-rated companies that make them.

Types of Lifts
There are two basic types of stair lifts that are sold today: straight and curved. The type you need will depend upon the design of your staircase.

A straight stair lift is one that travels in a straight line up a flight of stairs uninterrupted by landings, bends or curves, and costs between $2,500 and $5,000 installed. Curved lifts, however, are much more elaborate and will go around corners, bends and changes in direction. Curved lifts are also much more expensive, typically running between $8,500 and $15,000 or more depending on the complexity of the installation.

You also need to know that all stair lifts mount to the stair treads, not to the wall, so they are very sturdy and can be installed in almost any home.

If you are a large person, you may need to get a heavy-duty lift with a wider seat and bigger lifting capacity – all companies offer them. Or, if you’re tall, find out about raising the seat height during installation.

Most stair lifts available today also have seats, armrests and footplates that fold up out of the way, and swivel seats that make getting into and out of the chair easier. They also come with standard safety features like seatbelts, breaking systems and footrest sensors, push-button or rocker-switch controls located on the armrest for easy operation, and “call send” controls which allow you to call or send the unit to the other end of the stairs. Make sure the lift you choose has all these features.

Depending on the company, you may also have the option of choosing between an electric (AC) and a battery powered (DC) stair lift. Battery powered units charge at the base station (some recharge anywhere on the track) are quieter, smoother and better than electric lifts, and will work even if there’s a power failure in the home.

Where to Shop
While there are many companies that make and sell stair lifts, two of the best, based on reputation and customer satisfaction ratings, are Bruno (Bruno.com, 800-454-4355) and Stannah (Stannah-Stairlifts.com, 888-465-7652).

Unfortunately, original Medicare does not cover stair lifts 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 pay for lifts to those that qualify, and the VA offers cash grants to veterans with disabilities for home safety improvements.

To save some money, you may want to consider purchasing a used or refurbished model. Or, if you need a stair lift for only a short period of time, consider renting one. Most companies offer these options, and many offer financing programs too.

To get started, contact some stair lift companies who will put you in touch with a dealer in your area. All dealers provide free in-home assessments and estimates and can help you choose an appropriate lift.

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 Vision Services?

Dear Savvy Senior,
I will be enrolling in Medicare in a few months, and would like to know how Medicare covers vision services? I currently have vision insurance through my employer but will lose it when I retire.
Looking Ahead

Dear Looking,
Many people approaching 65 are unclear on what Medicare does and doesn’t cover when it comes to vision services. The good news is that original Medicare covers most medical issues like cataract surgery, treatment of eye diseases and medical emergencies. But unfortunately, routine care like eye exams and eyeglasses are the beneficiary’s responsibility. Here’s a breakdown of what is and isn’t covered.

Eye exams and treatments: Medicare does not cover routine eye exams that test for eyeglasses or contact lenses. But they do cover yearly medical eye exams if you have diabetes or are at high risk for glaucoma. They will also pay for exams to test and treat medical eye diseases if you’re having vision problems that indicate a serious eye problem like macular degeneration, dry eye syndrome, glaucoma, eye infections or if you get something in your eye.

Eye surgeries: Medicare will cover most eye surgeries that help repair the eye function, including cataract surgery to remove cataracts and insert standard intraocular lenses to replace your own. Medicare will not, however, pick up the extra cost if you choose a specialized lens that restores full range of vision, thereby reducing your need for glasses after cataract surgery. The extra cost for a specialized lens can run up to $2,500 per eye.

Eye surgeries that are usually not covered by Medicare include refractive (LASIK) surgery and cosmetic eye surgery that are not considered medically necessary.

Eyeglasses and contact lenses: Medicare does not pay for eyeglasses or contact lenses, with one exception: If you have had a conventional intraocular lens inserted during cataract surgery, Medicare will pay for eyeglasses or contact lenses following the operation.

Ways to Save
Although original Medicare’s vision coverage is limited to medical issues, there are ways you can save on routine care. Here are several to check into.

Consider a Medicare Advantage plan: One way you can get extra vision coverage when you join Medicare is to choose a Medicare Advantage plan instead of original Medicare. Many of these plans, which are sold through private insurance companies, will cover routine eye care and eyeglasses along with all of your hospital and medical insurance, and prescription drugs. See Medicare.gov/find-a-plan to shop for plans.

Purchase vision insurance: If you get routine eye exams and purchase new eyeglasses annually, a vision insurance plan may be worth the costs. These policies typically run between $12 and $20 per month. See Ehealthinsurance.com to look for plans.

Check veterans benefits: If you’re a veteran and qualify for VA health care benefits, you may be able to get some or all of your routine vision care through VA. Go to Vets.gov, and search for “vision care” to learn more.

Shop around: Many retailers provide discounts – between 10 and 30 percent – on eye exams and eyeglasses if you belong to a membership group like AARP or AAA.

You can also save by shopping at discount retailers like Costco Optical, which is recommended by Consumer Reports as the best discount store for good eyewear and low prices – it requires a $60 membership fee. Walmart Vision Centers also offer low prices with no membership.

Or you can consider buying your glasses online. Online retailers like WarbyParker.com, ZenniOptical.com, and EyeBuyDirect.com all get top marks from the Better Business Bureau and offer huge savings. To purchase glasses online you’ll need a prescription.

Look for assistance: There are also health centers and local clinics that provide free or discounted vision exams and eyeglasses to those in need. To find them put a call into your local Lions Club (see Directory.LionsClubs.org) for referrals. 

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 Stop Frustrating Robocalls

Dear Savvy Senior,
Is there anything seniors can do to stop perpetual robocalls? It seems like I get five to 10 a day on my home and cell phone, and I’m sick of it!
Frustrated Frank

Dear Frank,
Robocalls make up around 50 percent of all phone calls today, and it’s only getting worse. Americans were hit with 26.3 billion robocalls in 2018, a whopping 46 percent increase from the year before. Fortunately, there are a variety of tools available today that can help you greatly reduce them.

Register Your Numbers
If you haven’t already done so, your first step to limiting at least some unwanted calls is to make sure your home and cell phone numbers are registered with the National Do Not Call Registry. While this won’t stop illegal robocalls, it will stop unwanted calls from legitimate for-profit businesses who are trying to sell you something. But be aware that political organizations, charities and survey takers are still permitted to call you, as are businesses you’ve bought something from or made a payment to in the last 18 months. To sign up, visit DoNotCall.gov or call 888-382-1222.

Home Landline Tools
To stop calls on your home phone set up the “anonymous call rejection” option. This is a free landline-calling feature available from most telephone companies. It lets you screen out calls from callers who have blocked their caller ID information – a favorite tactic of telemarketers. To set it up, you usually have to dial *77 from your landline, though different phone services may have different procedures to set it up. Call your telephone service provider to find out if they offer this feature, and if so, what you need to do to enable it.

Another solution is to sign up for Nomorobo, which is a free service for landline phones but only if you have a VoIP landline carrier. Nomorobo uses a “simultaneous ring” service that detects and blocks robocalls on a black list of known offender numbers. It isn’t 100 percent foolproof, but it is an extra layer of protection. To sign up or see if Nomorobo works with your phone service provider, visit Nomorobo.com.

Cell Phones Tools
To stop unwanted robocalls and texts to your cell phone, ask your carrier about caller ID options that help identify, filter or prevent callers that aren’t legitimate.

For example, AT&T provides their subscribers a free app called “AT&T Call Protect” that has automatic fraud blocking and suspected spam warnings, and you can manually block unwanted calls. Starting this month, Verizon is offering free spam alerting and call blocking tools to their users. T-Mobile offers free “Scam ID” and “Scam Block” to combat robocalls and spam. And Sprint customers can sign up for its “Premium Caller ID” service for $2.99 per month to guard against robocalls and caller ID spoofers.

Call Blocking Apps
Another way to stop nuisance robocalls on your smartphone is with call blocking apps. These can identify who is calling you and block unwanted calls that show up on a crowd-sourced spam and robocaller lists.

Some top call blocking app for iPhones and Androids include Nomorobo (Nomorobo.com), Hiya Caller ID and Spam Blocker (Hiya.com) and Truecaller (Truecaller.com).

Nomorobo cost $2 per month, while Truecaller and Hiya apps are free to use, but offer upgraded services for $2 and $3 per month.

Spam-Proof Phones
There are also phones you can buy, like the Samsung Galaxy S, Samsung Note, or Google Pixel phone that have built-in spam and robocall protection in place. Samsung’s Smart Call feature flags calls it suspects are spam, while Google Pixel phones have built-in spam call protection. With this feature, users with Caller ID enabled will get a warning if a suspected spam call or robocall is received.

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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Underutilized Palliative Care Services Can Help Relieve Pain

Dear Savvy Senior,
What can you tell me about palliative care? My husband suffers from lung disease and is receiving radiation for prostate cancer but is not terminally ill. I’ve heard that palliative care can help him with his pain and discomfort. What can you tell me?
Searching Spouse

Dear Searching,
Palliative care is a very effective service that can help patients relieve the symptoms and stress that often comes with serious illness. But unfortunately, most people don’t know about it, or don’t understand how it can help them. Here’s what you should know.

What is Palliative Care?
Most people hear the words “palliative care” and think “hospice,” but they are different types of care. Hospice is reserved for situations when curative treatments have been exhausted and patients have less than six months to live.

Palliative care, on the other hand, is a medical specialty that focuses on providing relief from the symptoms such as pain, shortness of breath, fatigue, constipation, nausea, loss of appetite, trouble sleeping and even depression. It can also help patients deal with the side effects of medical treatment.

Anyone with a serious illness can benefit from palliative care, including those with cancer, heart disease, lung disease, kidney disease, Alzheimer’s, HIV/AIDS, amyotrophic lateral sclerosis (ALS), multiple sclerosis, Parkinson’s and more.

Palliative care is provided by a team including palliative care doctors, nurses, social workers and other specialists that work with your doctor to provide an extra layer of support and care. It is appropriate at any age and at any stage in a serious illness, and it can be provided along with curative treatment.

Palliative care teams are trained to help patients understand all their treatment options as well as the quality of life ramifications, so they can make informed decisions about what’s best for them.

Often patients assume their doctors will take care of their pain and stress, but most doctors in our specialized medical system have not been well trained in pain and symptom management. That’s why palliative care is invaluable.

Palliative care was developed in the United States in the 1990s but only became a formal medical subspecialty in 2008. Today, three-quarters of U.S. hospitals with more than 50 beds have a palliative care program, and 90 percent of hospitals with 300 beds or more offer it.

How to Get Care
There are around 6 million people in the U.S. that have a need for palliative care, according to the Center to Advance Palliative Care, but most patients don’t know to ask for it. If you feel that a palliative care specialist could help your husband, start by talking to his doctor and ask for a referral.

If your doctor isn’t helpful, go to GetPalliativeCare.org, where you can search for a specialist in your area.

Palliative care can be provided in in a variety of places, including hospitals, long-term care facilities, doctor’s clinics and at your own home.

You’ll also be happy to know that most private insurance plans, as well as Medicare and Medicaid, cover palliative care services.

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.