December 2018 Columns

Savvy Senior – December Columns

  1. The Retirement Benefits of a Health Savings Account
  2. Does Medicare Cover Dental Care?
  3. Have You Checked Your Social Security Statement for Errors?
  4. How to Cope with Seasonal Affective Disorder

The Retirement Benefits of a Health Savings Account

Dear Savvy Senior,
What can you tell me about health savings accounts? I’ve been reading that they are a great investment that can help with growing health care costs when I retire.
Planning Ahead

Dear Planning,
It’s true! A health savings account is a fantastic financial tool that can help you build up a tax-free stash of money for medical expenses now and after you retire – but there’s a catch. To get one, you must have a high-deductible health insurance policy.

How They Work
Health savings accounts (or HSAs) have become increasingly popular over the past few years as health care costs continue to skyrocket, and because more and more Americans have gotten high-deductible health plans.

The benefit of a HSA is the triple tax advantage that it offers: Your HSA contributions can be deducted pretax from your paycheck, lowering your taxable income; the money in the account grows tax-free; and if you use the money for eligible medical expenses, withdrawals are tax-free.

And if you change jobs, the HSA moves with you.

To qualify, you must have a health insurance policy with a deductible of at least $1,350 for an individual or $2,700 for a family.

This year (2018), you can contribute up to $3,450 if you have single health insurance coverage, or up to $6,900 for family coverage. Next year (2019) you can contribute slightly more – up to $3,500 for single coverage or up to $7,000 for family coverage. And people age 55 and older can put away an extra $1,000 each year. But you cannot make contributions after you sign up for Medicare.

The money can be used for out-of-pocket medical expenses, including deductibles, co-payments, Medicare premiums, prescription drugs, vision and dental care and other expenses (see IRS.gov/pub/irs-pdf/p502.pdf, page 5, for a complete list) either now or when you retire for yourself and your spouse as well as your tax dependents.

And unlike a flexible spending account, an HSA doesn’t require you to use the money by the end of the year. Rather, HSA funds roll over year to year and continue to grow tax-free in your HSA account for later use. In fact, you’ll get a bigger tax benefit if you use other cash for current medical expenses and keep the HSA money growing for the long term. Be sure to hold on to your receipts for medical expenses after you open your HSA, even if you pay those bills with cash, so you can claim the expenses later. There’s no time limit for withdrawing the money tax-free for eligible medical expenses you incurred anytime after you opened the account.

But be aware that if you do use your HSA funds for non-medical expenses, you’ll be required to pay taxes on the withdrawal, plus a 20 percent penalty. The penalty, however, is waived for those 65 and older, but you’ll still pay ordinary income tax on withdraws not used for eligible expenses.

How to Open a HSA
You should first check with your employer to see if they offer a HSA, and if they will contribute to it. If not, you can open an HSA through many banks, brokerage firms and other financial institutions, as long as you have a qualified high-deductible health insurance policy.

If you plan to keep the money growing for the future, look for an HSA administrator that offers a portfolio of mutual funds for long-term investing and has low fees. HealthEquity, OptumBank, The HSA Authority and Bank of America are the top ranked HSA providers for long-term investing according to the investment research firm Morningstar. To search for providers, visit HSAsearch.com.

After setting up your HSA plan, adding money is pretty straightforward. Most plans let you do online transfers from your bank, send checks directly, or set up a payroll deduction if offered by your employer. And to access your HSA funds many plans provide a debit card, some offer a checkbook and most allow for reimbursement.

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 Cover Dental Care?

Dear Savvy Senior,
I will turn 65 in a few months and will be enrolling in Medicare, but I am concerned about Medicare’s coverage of dental care. Does Medicare cover dental procedures? And if not, where can I get dental coverage?
Almost 65

Dear Almost 65,
Medicare’s coverage of dental care is extremely limited. It will not cover routine dental care including checkups, cleanings, or fillings, and it won’t pay for dentures either.

Medicare will, however, cover some dental services if they are required to protect your general health, or if you need dental care in order for another health service that Medicare covers to be successful. For example, if you have cancer and need dental services that are necessary for radiation treatment, or if you need surgery to treat fractures of the jaw or face, Medicare will pay for these dental services.

Although Medicare’s coverage of dental services is limited, there are other ways you can get coverage and care affordably. Here are several to check into.

Consider a Medicare Advantage plan: While dental services are mostly excluded under original Medicare, some Medicare Advantage plans do provide coverage for routine dental care. If you are considering joining a Medicare Advantage plan, find out what dental services, if any, it covers. Also, remember to make sure any Medicare Advantage plan you’re considering covers the doctors and hospitals you prefer to use and the medications you take at a cost you can afford. See Medicare.gov/find-a-plan or call 800-633-4227 to research plans in your area.

Purchase dental insurance: If you have frequent gum problems and need extensive dental care, a dental insurance plan may be worth the costs versus paying for care yourself. Expect to pay monthly premiums of $15 to $40 or more for insurance. To find dental plans in your state, go to NADP.org and use the “find a dental plan” tool. Then review a specific plan’s website.

Consider dental savings plans: While savings plans aren’t as comprehensive as insurance, they’re a good option for those who can’t get covered. How this works is you pay an annual membership fee – around $80 to $200 a year – in exchange for 10 to 60 percent discounts on service and treatments from participating dentists. To find a savings plan, go to DentalPlans.com (or 888-632-5353) where you can search for plans and participating dentists, as well as get a breakdown of the discounts offered.

Check veterans’ benefits: If you’re a veteran enrolled in the VA health care program or are a beneficiary of the Civilian Health and Medical Program (CHAMPVA), the VA offers a dental insurance program that gives you the option to buy dental insurance through Delta Dental and MetLife at a reduced cost. The VA also provides free dental care to vets who have dental problems resulting from service. To learn more about these options, visit VA.gov/dental or call 877-222-8387.

Shop around: FairHealthConsumer.org and HealthcareBlueBook.com lets you look up the cost of different dental procedures in your area, so you can comparison shop – or ask your regular dentist for a discount.

Try community health centers or dental schools: There are many health centers and clinics that provide low-cost dental care to those in need. And all university dental schools and college dental hygiene programs offer dental care and cleanings for less than half of what you would pay at a dentist’s office. Students who are supervised by their professors provide the care. See ToothWisdom.org to search for a center, clinic or school near 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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Have You Checked Your Social Security Statement for Errors?

Dear Savvy Senior,
I’ve heard that Social Security sometimes makes mistakes on our earnings record, which can reduce our monthly retirement benefits. How can I make sure this doesn’t happen to me?
Paranoid Paul

Dear Paul,
Mistakes in the Social Security earnings record are actually fairly common. Your Social Security benefits are based on your highest 35 years of earnings history. So, if your earnings for any particular year are underreported, it will reduce your benefits.

These errors typically occur because your employer either reported your earnings incorrectly or reported your earnings using the wrong name or Social Security number. Or if you got married or divorced and changed your name but did not report the change to Social Security.

Check Your Statement
The best way to keep an eye on your benefits and avoid any possible mistakes is to carefully review your Social Security statement every year. To do this, go to SSA.gov/myaccount and then print your statement out on paper.

If you’re age 60 or older and not yet receiving benefits and don’t have a My Social Security account online, your statement will actually be mailed to you about three months before your birthday.

Your Social Security statement lists your earnings record for each year of employment and estimates the benefits you and your family may receive as a result of those earnings.

Once you get your statement, take some time to verify its accuracy by comparing the earnings listed on your statement with your own tax records or W-2 statements. You have to correct errors within 3 years, 3 months and 15 days following the year of the mistake. If you happen to spot a discrepancy within that time limit, follow these steps.

First, call your nearest Social Security office (see SSA.gov/locator or call 800-772-1213 to get the number) to report the error. Some corrections can be made over the phone, or you may need to schedule an appointment and go in with copies of your W-2 forms or tax returns to prove the mistake, or you can mail it in.

If you suspect a discrepancy but don’t have backup records, the Social Security Administration (SSA) may be able to use your employment information to search its records and correct mistakes. If the SSA can’t locate your records, you’ll need to contact the employer to obtain a copy of your W-2 for the year in question.

Once your earnings record is corrected, Social Security will send you a confirming letter. If you don’t receive the confirmation within three months, contact them again, and double-check the correction by making sure it appears on your Social Security statement.

If corrections aren’t made on your statement start an appeals process (see SSA.gov/pubs/EN-05-10041.pdf).

Other Mistakes
Social Security earnings miscalculations can also happen if there’s a mistake in your current mailing address that the IRS has on file for you. Check your federal tax returns for this possible error, especially if you’ve moved recently.

To correct your address, contact the IRS at 800-829-3676 and ask them to mail you the “Change of Address” form 8822, or print it off at IRS.gov/pub/irs-pdf/f8822.pdf, fill it out and mail it back to the address on the form.

Other factors that can cause mistakes are if your name or date of birth in the SSA records isn’t the same as it appears in the IRS files. So double-check your Social Security statement for these possible mishaps, and if you find an error call the 800-772-1213 and ask for Form SS-5, “Application for a Social Security Card,” and submit it with the correct information. The form can also be downloaded at SSA.gov/forms/ss-5.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 Cope with Seasonal Affective Disorder

Dear Savvy Senior,
What can you tell me about seasonal affective disorder? I have always hated wintertime, but since I retired and am home a lot more, the dark and cold winter months make me depressed and lethargic.
Fighting the Blues

Dear Fighting,
If you get depressed in the winter but feel better in spring and summer, you may indeed have seasonal affective disorder (or SAD), a wintertime depression that affects roughly 6 percent of Americans.

In most cases, SAD is related to the loss of sunlight in the winter months. Reduced sunlight can upset natural sleep-wake cycles and other circadian rhythms that can affect the body. It can also cause a drop in the brain chemical serotonin, which affects mood, and can increase the levels of the hormone melatonin, which can make you feel more tired and lethargic.

If you think you may have SAD, a trip to your doctor’s office is the best way to diagnose it or you can take a SAD “self-diagnostic” test at the Center for Environmental Therapeutics website at CET.org/self-assessment. In the meantime, here are several treatment options and remedies that can help.

Light therapy: The most effective treatment for SAD is sitting in front of a specialized light therapy box for 15 to 20 minutes a day. Light therapy mimics outdoor light to cause a change in brain chemicals linked to mood. It’s most effective when timed to fit a person’s individual circadian rhythm, which varies widely from person to person depending on whether they’re a night owl or a morning lark. You can calculate the proper time for doing light therapy by taking the circadian rhythm test at CET.org/self-assessment.

The best light therapy lamps provide 10,000 lux of illumination, many times stronger than typical indoor light, and have a diffuser screen that filters out ultraviolet rays and projects downward toward the eyes.

Some top-rated products as rated by Wirecutter.com include the Carex Day-Light Classic Plus Lamp ($115), Verilux HappyLight Deluxe 10,000-Lux Sunshine Simulator ($160), and the Northern Light Technology Boxelite Desk Lamp ($190), all of which are available at Amazon.com.

Cognitive behavioral therapy: Even though SAD is considered to be a biological problem, identifying and changing thought and behavior patterns can help alleviate symptoms too. To help you with this, choose a therapist who specializes in cognitive behavioral therapy and who has experience in treating SAD. To locate someone in your area, check with the Association for Behavioral and Cognitive Therapies (FindCBT.org), or the Academy of Cognitive Therapy (AcademyofCT.org).

Antidepressants: Some people with SAD benefit from antidepressant treatment, especially if symptoms are severe. Some proven medications to ask your doctor about include the extended-release version of the antidepressant bupropion (Wellbutrin XL, Aplenzin), and antidepressants selective serotonin reuptake inhibitors (S.S.R.I.s), sertraline (also known as Zoloft) and fluoxetine (also known under the brand name Prozac).

But keep in mind that it may take several weeks to notice full benefits from an antidepressant. In addition, you may have to try different medications before you find one that works well for you and has the fewest side effects.

Lifestyle remedies: Some other things you can do to help alleviate your SAD symptoms include making your environment sunnier and brighter. So, open up your blinds, sit closer to bright windows and get outside as much as can. Even on cold or cloudy days, outdoor light can help, especially if you spend some time outside within two hours of getting up in the morning. Moderate exercise such as walking, swimming, yoga and even tai chi can also help alleviate SAD symptoms, as can social activities.

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.

November 2018 Columns

Savvy Senior – November Columns

  1. What You’ll Pay for Medicare in 2019
  2. How to Capture Your Elder Loved Ones’ Story
  3. When You Need Help Caring for an Aging Parent
  4. How to Get Veterans’ Funeral and Burial Benefits

What You’ll Pay for Medicare in 2019

Dear Savvy Senior,
I know there will be a small 2.8 percent cost-of-living increase in Social Security benefits next year but what about Medicare? What will our Medicare Part B monthly premiums and other Medicare costs be in 2019?
Curious Jim

Dear Jim,
The Centers for Medicare and Medicaid Services recently announced their cost adjustments for 2019, and you’ll be happy to know that the standard Medicare Part B monthly premium for most beneficiaries starting in January will be $135.50, a modest increase of just $1.50 per month over 2018’s standard premium.

There are, however, a small group of Medicare beneficiaries (about 2 million people) who will actually pay less than $135.50 because the 2.8 percent cost-of-living increase in their Social Security checks will not be large enough to cover the full premium increase.

Thanks to the Social Security Act’s “hold harmless” provision, Medicare cannot pass along premium increases greater than the dollar increase in their Social Security checks.

In addition, there are also a small group of high-income beneficiaries (about 3 million people) that will pay higher Part B premiums because their income is above $85,000 as a single, or $170,000 as a married couple filing jointly.

Medicare uses modified adjusted gross income from your tax return from two years ago to determine your premiums, which means that 2019 Part B premiums are determined by 2017 income.

So, if your income was $85,001 to $107,000 (or $170,001 to $214,000 if filing jointly), your monthly premium will increase from $187.50 to $189.60.

Monthly premiums for singles with an income of $107,001 to $133,500 (joint filers with income of $214,001 to $267,000) will rise from $267.90 to $270.90. And premiums for singles earning $133,501 to $160,000 ($267,001 to $320,000 for joint filers) will increase from $348.30 to $352.20.

If you had higher income than that, your monthly premium for 2018 was $428.60. In 2019, there will be an extra surcharge tier for people with the highest income.

If your income is between $160,001 and $499,999 ($320,001 to $749,999 for joint filers), you’ll pay $433.40 per month. Single filers with income of $500,000 or more ($750,000 or more for joint filers) will pay $460.50 per month.

If you fall into any of these high-income categories and you’ve experienced certain life-changing events that have reduced your income since 2017, such as retirement, divorce or the death of a spouse, you can contest the surcharge. For more information about contesting or reducing the high-income surcharge, see “Medicare Premiums: Rules for Higher-Income Beneficiaries” at SSA.gov/pubs/EN-05-10536.pdf.

In addition to the Part B premium increases, the annual deductible for Medicare Part B, which covers physician services and other outpatient services, will see a mild bump from $183 to $185 in 2019. The deductible for Medicare Part A, which covers hospital services, will increase from $1,340 in 2018 to $1,364 in 2019.

For more information on all the Medicare costs for 2019 visit Medicare.gov and click on “Find out how much Medicare costs in 2019,” or call 800-633-4227.

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 Capture Your Elder Loved Ones’ Story

Dear Savvy Senior,
I am interested in making a video of my 82-year-old parents’ life story/legacy and how they want to be remembered. With the holidays approaching, I thought this could be a neat gift to my older siblings, but I could use some help. What can you tell me?
Youngest of Five

Dear Youngest,
A personal recording of your parents’ life story could be a wonderful holiday gift and something you and your family could cherish the rest of your lives. Here are a few tips to help you get started.

What You’ll Need
Your first step is to find out if your parents are willing to make a legacy video, which would entail you asking them a number of thoughtful questions about their life in an interview format in front of a video recording device. If they are, all you’ll need is a smartphone or camcorder and a list of questions or prompts to get them talking.

Recording Equipment
If you have a smartphone, making a video of your parents’ story is simple and free. However, you may want to invest a “smartphone tripod” to hold the phone while you conduct the interview, and a “smartphone external microphone,” which would improve the audio quality. You can find these types of products at Amazon.com for under $20.

Most smartphones today have good quality cameras and have the ability to edit/trim out the parts you don’t want. Or you can download a free video-editing app like Magisto or Adobe Premiere Clip that can help you customize your video.

If you want a higher quality video, consider purchasing a HD camcorder. Sony, Panasonic and Canon are the top-rated brands, according to Consumer Reports. These can run anywhere from a few hundred dollars, up to $1,000 or more.

Questions and Prompts
To help you prepare your list of questions for your parents’ video interview, go to “Have the Talk of a Lifetime” website at TalkofaLifetime.org. This resource, created by the Funeral and Memorial Information Council, offers a free workbook that lists dozens of questions in different categories.

Some of these include: earliest memories and childhood; significant people; proudest accomplishments; and most cherished objects. This will help you put together a wide variety of meaningful, open-ended questions.

Old photos of your parents, their family members and friends are also great to have on hand to jog your parents’ memory and stimulate conversations.

After you select your questions and photos, be sure to share them with your parents ahead of time so they can have some time to think about their answers. This will make the interview go much smoother.

Interview Tips
Arrange an interview time when your parents are rested and relaxed, and choose a quiet, comfortable place where you won’t be interrupted. You may need several sessions to cover everything you want.

When you get started, ask your parents to introduce themselves and ask a warm-up question like “When and where were you born?” Then ease into your selected questions, but use them as a guide, not a script.

If your parents go off topic, go with it. You can redirect them to your original question later. Think of it as a conversation; there’s no right or wrong thing to talk about, as long as it’s meaningful to you and your parents.

Also, be prepared to ask follow-up questions or diverge from your question list if you’re curious about something. If you’d like to hear more, try “And then what happened?” or “How did that make you feel?” or “What were you thinking in that moment?”

And end your interview with some reflective questions, such as “What legacy would you like to leave?” or “How do you want to be remembered?”

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.
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When You Need Help Caring for an Aging Parent

Dear Savvy Senior,
Where can I turn for caregiving help? I help take care of my 78-year-old mother and work too, and it’s wearing me to a frazzle.
Exhausted Daughter

Dear Exhausted,
Taking care of an aging parent over a period of time – especially when juggling work and other family obligations – can be physically and mentally exhausting. But help and resources are available.

To help you determine and prioritize the kinds of help you need, a good first step is to make a list of everything you do as a caregiver, big and small. Note the amount of time each one takes every day, week or month. Identify the times when you need help the most and which tasks others might be able to do for you, like making lunch for your mother when you’re at work.

Then list the types of care needed, such as simple companionship or doing active chores, like food shopping. Once you determine this, here are some tips and places you can reach out to for help.

Caregiving Help
If you have siblings or other loved ones close by, schedule a family meeting, in person or by phone, to discuss specific tasks they could provide. See if friends, neighbors or faith group members could help too.

You should also investigate resources in your mom’s town. Many communities offer a range of free or subsidized services that help seniors and caregivers with basic needs such as home delivered meals, transportation, senior companion services and respite services, which offers short-term care so you can take an occasional break. Call your Area Agency on Aging (call 800-677-1116 for contact information) for referrals to services available in your community, or for respite services see ARCHrespite.org/respitelocator.

If you can afford it, you may want to hire someone part-time to help with things like preparing meals, housekeeping or even personal care. Costs can run anywhere from $12 up to $25 per hour. To find someone, ask for referrals through your mom’s doctor or area hospital discharge planners, or try websites like Care.com, CareLinx.com, CareFamily.com or CareSpotter.com.

Financial Aids
If your handling your mom’s financial chores, make things easier by arranging for direct deposit for her income sources, and set up automatic payments for her utilities and other routine bills. You may also want to set up your mom’s online banking service, so you can pay bills and monitor her account anytime.

Or, if you need help, hire a daily money manager (AADMM.com) to do it for you. They charge between $25 and $100 per hour.

BenefitsCheckup.org is another excellent resource to look for financial assistance programs that may help your mom, particularly if she’s lower-income.

Technology Assistance
To help you keep tabs on your mom when you are away at work or if she lives alone, there are affordable technologies that can help.

For example, there are medical alert systems (like Bay Alarm Medical, BayAlarmMedical.com), which provide a wearable “help button” that would allow your mom to call for help anytime she needed it.

Or, you could install a video-monitoring camera (like Lighthouse Al, Light.house/elderly-care) that lets you check in on her anytime via your smartphone or computer. These cameras have built-in motion and sound detection that will let you know when something is detected, and two-way audio that will let you talk and listen to her.

There are even websites (like LotsaHelpingHands.com) that can help you more easily coordinate care with other family members.

Insurance Questions?
If you have questions about Medicare, Medicaid or long-term care, your State Health Insurance Assistance Program (SHIP) offers free counseling and advice on these issues. Call 877-839-2675 or visit ShiptaCenter.org to locate a nearby counselor. You can also get help through the Medicare Rights Center, which staffs a help-line 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 Get Veterans’ Funeral and Burial Benefits

Dear Savvy Senior,
Does the VA provide any special burial benefits to old veterans? My dad, who has late-stage Parkinson’s disease, served during the Vietnam War in the 1960s.
Only Child

Dear Only Child,
Most U.S. veterans are eligible for burial and memorial benefits through the Department of Veterans Affairs (VA) National Cemetery Administration. Veterans who were discharged under conditions other than dishonorable are eligible.

To verify your dad’s discharge, you’ll need a copy of his DD Form 214 “Certificate of Release or Discharge from Active Duty,” which you can request online at Archives.gov/veterans.

Here’s a rundown of some of the different benefits that are available to veterans that die a non-service related death.

National Cemetery Benefits
If your dad is eligible, and would like to be buried in one of the 136 national or 111 grant-funded state and tribal VA cemeteries (see www.cem.va.gov/cem/cems/listcem.asp for a list), the VA provides a host of benefits, at no cost to the family, including a gravesite; opening and closing of the grave; perpetual gravesite care; a government headstone or marker; a United States burial flag that can be used to drape the casket or accompany the urn (after the funeral service; the flag is given to the next-of-kin as a keepsake); and a presidential memorial certificate.

National cemetery burial benefits are also available to spouses and dependents of veterans.

If your dad is cremated, his remains will be buried or inurned in the same manner as casketed remains.

Funeral or cremation arrangements and costs are not, however, taken care of by the VA. They are the responsibility of the veteran’s family, but some veteran’s survivors are eligible for burial allowances, which are explained below.

If you’re interested in this option, the VA offers a pre-need burial eligibility determination program at www.cem.va.gov/pre-need or call the National Cemetery Scheduling Office at 800-535-1117.

Private Cemetery Benefits
If your father is going to be buried in a private cemetery, the benefits available include a free government headstone or marker, or a medallion that can be affixed to an existing privately purchased headstone or marker; a burial flag; and a Presidential memorial certificate.

Funeral or cremation arrangements and costs are again the responsibility of the family (some burial allowances may be available), and there are no benefits offered to spouses and dependents that are buried in private cemeteries.

Military Funeral Honors
Another popular benefit available to all eligible veterans buried in either a national or private cemetery is a military funeral honors ceremony. This includes an honor guard detail of at least two uniformed military persons, folding and presenting the U.S. burial flag to the veteran’s survivors, and the playing of Taps by a bugler or an electronic recording.

The funeral provider you choose will be able to assist you with all VA burial requests. Depending on what you want, certain forms may need to be completed which are always better to be done in advance.

For a complete rundown of burial and memorial benefits, eligibility details and required forms, visit www.cem.va.gov or call 800-827-1000.

Burial Allowances
In addition to the burial benefits, some veteran’s survivors may also qualify for a $300 burial allowance (or $780 if hospitalized by VA at time of death) and $780 for a plot, to those who choose to be buried in a private cemetery. To find out if your dad is eligible, see Benefits.va.gov/benefits/factsheets/burials/burial.pdf.

To apply for burial allowances, you’ll need to fill out VA Form 21P-530 “Application for Burial Benefits.” You need to attach a copy of your dad’s discharge document (DD 214 or equivalent), death certificate, funeral and burial bills. They should show that you have paid them in full. You may download the form at VA.gov/vaforms.

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.

October 2018 Columns

Savvy Senior – October Columns

  1. Free Resources That Can Help with Your Medicare Decisions
  2. How to Recognize and Prevent Elder Financial Abuse
  3. How to Manage Restless Leg Syndrome
  4. The Tax Credit That Lets You Double-Dip on Retirement Savings
  5. Top Dental Care Products for Seniors

Free Resources That Can Help with Your Medicare Decisions

Dear Savvy Senior,
I’m considering making changes in my Medicare coverage during the open-enrollment period. Can you recommend any free resources that can help with my choices?
Swapping Senior

Dear Swapping,
There are a number of good resources you can turn to that can help you choose Medicare coverage that better suites your needs, that’s completely free to use.

As you may already know, each year during Medicare’s open enrollment – Oct. 15 through Dec. 7 – all Medicare beneficiaries can change their coverage without penalty. Doing so, given that insurers are constantly tweaking their plans and offerings, could help lower your premiums and/or give you access to better care. Any changes you make to your coverage will take effect January 1, 2019.

Important Tools
To get help with your Medicare decisions, a good starting point is to get re-familiar with the primary parts – traditional Medicare, Medicare Advantage, supplemental (Medigap) policies and prescription-drug coverage – Medicare publishes an excellent guide called “Medicare & You” that you can access at Medicare.gov/medicare-and-you.

If you are already enrolled in Medicare Advantage or a Medicare Part D prescription-drug plan, it’s very important that you read and understand your “Annual Notice of Changes” and “Evidence of Coverage,” which should have arrived in the mail in September. These documents explain how your existing coverage will change in 2019 and how much you’ll pay for that coverage.

Your next step is to go Medicare’s online “Plan Finder” tool at Medicare.gov/find-a-planHere you can enter some basic information – your Medicare number and prescription drugs (name and dosage) – and it will produce a list of possible health-care plans in your area, the costs involved, drug coverage and customer-satisfaction ratings. Or, if you don’t have Internet access, or don’t feel confident in working through the information on your own, you can also call Medicare at 800-633-4227 and a customer service representative will do the work for you over the phone.

Free Advice
If you want personalized help with a Medicare specialist, contact the Medicare Rights Center or your State Health Insurance Assistance Program.

The Medicare Rights Center is a nonprofit group (MedicareInteractive.org) that offers a national helpline (800-333-4114) where staff members answer questions about Medicare, and can help you choose coverage, at no charge.

And your State Health Insurance Assistance Program (SHIP), which may go by a different name in your state, provides free one-on-one counseling in person or over the phone to beneficiaries, as well as family members and/or caregivers. SHIPs are federally funded programs that are not connected to any insurance company or health plan. To find a SHIP counselor in your area, see ShiptaCenter.org or call the Eldercare Locator at 800-677-1116.

Another good resource, if you’re interested in choosing a new Medicare Advantage plan, is the HealthMetrix Research Cost Share Report at MedicareNewsWatch.com. This free website lists the best Advantage plans by area based on your health status.

Agent Assistance
Another way to get free assistance with your Medicare Advantage, prescription drug or Medigap plans is to use an agent or broker who specializes in Medicare-related insurance in your state. These people get paid a commission to sell you a policy from the insurance providers they represent.

There are federal rules and state laws governing agents or brokers who sell Medicare plans, which include things like barring them from showing up uninvited at your house to pitch a plan or trying to lure you with a cash offer. They also cannot legally charge you a fee to process your enrollment.

It’s also important to understand that commission-based agents and brokers will present only the Medicare plans they represent, rather than all the plans in your market. So, you may miss out on some plans that could benefit 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 Recognize and Prevent Elder Financial Abuse

Dear Savvy Senior,
Can you provide some tips on how to protect seniors from financial scams? My 76-year-old aunt was recently swindled out of $25,000 and I want to make sure my own mother is protected.
Concerned Daughter

Dear Concerned,
Financial scams that target the elderly continue to be a huge problem in the U.S. In fact, it’s estimated that one in five Americans over age 65 are scammed out of roughly $36 billion every year. Here are some tips that can help you spot a scam, and what you can do to protect your mom.

Recognizing a Scam
Spotting a scam or a con artist is not always easy to do. They range from shady financial advisers to slick-talking telemarketers to professional caregivers and relatives who steal from the very people they’re supposed to be looking after.

The most common scams targeting seniors today come in the form of tricky and deceitful telemarketing calls, email and Internet scams, free-lunch seminars selling dubious financial products and endless junk mail peddling free vacation packages, sweepstakes, phony charity fundraisers and more. And, of course, there’s the ongoing problem of identity theft, Medicare and Social Security fraud, door-to-door scams and credit card theft.

The best way to spot a scam is to help your mom manage her finances, or at least monitor her accounts. Reviewing her financial statements each month can alert you to questionable checks, credit card charges or large withdrawals. Or, consider a service like EverSafe.com, which will automatically monitor your mom’s accounts, track suspicious activity and alert you when it detects a problem.

However, if your mom doesn’t want you looking at her financial records, there are other clues. For example: Is she getting a lot of junk mail for contests, free trips, and sweepstakes? Is she receiving calls from strangers offering awards or moneymaking deals? Also, notice if her spending habits have changed, if she has complained about being short of money lately or has suddenly become secretive or defensive about her finances. All these may be signs of trouble.

Protect Your Mom
The most effective way to help protect your mom is to alert her to the different kind of scams going on today. To help you with this, the National Council on Aging has a list of “top 10 financial scams targeting seniors” at NCOA.org. Also see AARP’s Fraud Watch Network at AARP.org/money/scams-fraud and sign up to receive free scam alert emails from the Federal Trade Commission at FTC.gov/scams.

Some other tips to protect her include reminding your mom to never give out her personal information, Social Security number or financial information unless she initiated the contact and knows the institution.

Also, see if your mom would be willing to let you sort her mail before she opens it, so you can weed out the junk. To reduce the junk mail and/or email she gets, use the Direct Marketing Association consumer opt-out service at DMAchoice.org. And to stop credit card and insurance offers, use the Consumer Credit Reporting Industry opt-out service at OptOutPrescreen.com or call 888-567-8688 – they will ask for your mom’s Social Security number and date of birth.

You should also register your mom’s home and cell phone numbers on the National Do Not Call Registry (DoNotCall.gov, 888-382-1222) to reduce telemarketers. To stop robocall scams on her landline phone use Nomorobo (Nomorobo.com), and if she uses a smartphone, use the free app Hiya (Hiya.com). You should also get a free copy of her credit report at AnnualCreditReport.com to make sure she isn’t a victim of identity theft.

Report It
If you suspect your mom has gotten scammed, report it to her local police, her bank (if money has been taken from her account) and her state’s Adult Protective Services agency that investigates reports of elderly financial abuse. Call the Eldercare Locator at 800-677-1116 to get the agency contact number in her area.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.
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How to Manage Restless Leg Syndrome

Dear Savvy Senior,
What can you tell me about restless leg syndrome? I’m 58 years old, and frequently have jerky, uncontrollable urges to move my legs, accompanied by a tingling sensation, and it keeps me awake at night.
Jumpy John

Dear John,
If an irresistible urge to move your legs has you kicking in your sleep, then chances are pretty good you have restless leg syndrome (RLS), a condition that affects 7 to 10 percent of Americans. Here’s what you should know.

RLS, also known as Willis-Ekbom Disease, is a nervous system problem that causes uncomfortable sensations (often described as a creepy-crawly feeling, tingling, itching, throbbing, pulling or aching) and an irresistible urge to move one or both legs while you’re sitting or lying down, and the symptoms usually get worse with age. It typically happens in the evenings or nights while resting. Moving eases the unpleasant feeling temporarily.

While RLS is not a life-threatening condition, the main problem, other than it being uncomfortable and annoying, is that it disrupts sleep, leading to daytime drowsiness, difficulty concentrating and even depression.

What exactly causes RLS is not known, but researchers suspect it could be linked to several things including iron deficiency, an imbalance of the brain chemical dopamine, and genetics – about 60 percent of people with RLS have a family member with the condition.

Treatment Options
While there’s no cure for RLS, there are things you can do to alleviate the symptoms. Depending on the severity of your case, some people turn to RLS medications like gabapentin enacarbil (Horizant), an anticonvulsant, and dopamine agonists ropinirole (Requip), rotigotine (Neupro) and pramipexole (Mirapex). But be aware that these drugs have side effects including nausea, lightheadedness, fatigue and insomnia. And, while these medications can provide short-term relief, they can also make symptoms worse in many people who use them long term.

So before turning to medication, you should consider some of the following natural RLS treatments first, which are very effective for most people.

Check your iron levels. Iron deficiency is believed to be one of the major contributors to RLS, so make an appointment with your doctor and get a blood test to check for this. If you test positive for iron deficiency, your doctor may recommend iron supplements.

Exercise: Getting moderate, regular exercise like walking, cycling, water aerobics and yoga can relieve symptoms, but overdoing it or exercising late in the day may intensify them. Daily leg stretches – include calf, hamstring, quadriceps and hip flexor stretches – are also helpful.

Check your medications: Certain drugs including antinausea drugs, antipsychotic drugs, some antidepressants, and cold and allergy medications containing sedating antihistamines can make RLS worse. If you take any of these, ask your doctor if something else can be prescribed.

Avoid triggers: Alcohol, caffeine, nicotine and refined sugar can all make RLS symptoms worse.

Try these remedies: Soaking in a hot bathtub and massaging your legs can relieve symptoms, as can applying a hot pad and/or ice pack to your legs. Pressure can also help, so consider wearing compression socks or stockings. There’s also a new non-drug FDA approved vibrating pad on the market called Relaxis that interrupts RLS episodes and can provide relief to those who use it.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.
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The Tax Credit That Lets You Double-Dip on Retirement Savings

Dear Savvy Senior,
What can you tell me about the retirement saver’s tax credit? At age 60, I’m looking for ways to boost my retirement savings beyond my 401(k) plan and have heard this may be a smart way to do it. Is this something I’m eligible for?
Need to Save

Dear Need to Save,
If your income is low to moderate and you participate in your employer-sponsored retirement plan or an IRA, the “Saver’s Credit” (also known as the Retirement Savings Contribution Credit) is a frequently overlooked tool that can help boost your retirement savings even more. Here’s how it works.

If you contribute to a retirement-savings account like a traditional or Roth IRA, myRA, 401(k), 403(b), 457, federal employees’ Thrift Savings Plan, Simplified Employee Pension or SIMPLE plan, the Saver’s Credit will allow you to claim 10, 20 or 50 percent of your contribution of up to $2,000 per year for singles or $4,000 for couples.

This valuable tax credit can be claimed in addition to the tax deduction you get for saving in your traditional retirement accounts.

To qualify, you must also be at least 18 years old and not a full-time student and were not claimed as a dependent on someone else’s tax return. And your adjusted gross income (AGI) in 2018 must have been $63,000 or less as a married couple filing jointly, $47,250 or less if filing as head of household, or $31,500 or less if you’re a single filer. These income limits are adjusted annually to keep pace with inflation.

To get the 50 percent credit, you’ll need to have an income below $19,000 if you’re single, $28,500 if you’re filing as head of household, and $38,000 for couples in 2018.

The 20 percent credit rate applies to individuals earning between $19,001 and $20,500; for head of household filers it’s $28,501 to $30,750; and for couples it’s $38,001 to $41,000.

And the 10 percent rate is for individuals with an adjusted gross income between $20,501 and $31,500; for head of household filers $30,751 to $47,250; and couples it’s between $41,001 and $63,000.

Here’s an example of how this works. Let’s say that you file your taxes as head of household and your AGI for 2018 is $30,000. Over the course of the year, you contribute $2,000 to your employer’s 401(k) plan. Since your AGI puts you in the 20 percent credit bracket, and you’ve contributed the $2,000 maximum that can be considered for the credit, you are entitled to a $400 Saver’s Credit on your 2018 tax return.

It’s also worth mentioning that the Saver’s Credit is in addition to any other tax benefits you get for your retirement contributions. So in the previous example, not only would you be entitled to a $400 credit, but you would also be able to exclude the $2,000 401(k) contribution from your taxable income. So, if you’re in the 15 percent tax bracket, this translates to an additional $300 in savings, for a total of $700.

How to Claim
To claim the Saver’s Credit, you will need to fill out Form 8880 (see IRS.gov/pub/irs-pdf/f8880.pdf) and attach it to your 1040, 1040A or 1040NR when you file your tax return. Don’t use the 1040EZ Form.

If you think that you would have qualified for the credit in previous years but didn’t claim it, you can file an amended return as far back as 2015 and still get the credits. A 2014 amended return is due by April 15, 2019. See IRS Form 1040X (IRS.gov/pub/irs-pdf/i1040x.pdf) for instructions on how to file an amended return.

And for more information on the Saver’s Credit, see IRS Publication 590-A “Contributions to Individual Retirement Arrangements” (IRS.gov/pub/irs-pdf/p590a.pdf).

You can also have these forms and publication mailed to you by calling 800-829-3676.

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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Top Dental Care Products for Seniors

Dear Savvy Senior,
I have arthritis in my hands that affects my grip strength and dexterity and makes brushing my teeth difficult. I’ve read that electric powered toothbrushes help make the job easier. Can you make any recommendations on what to get?
Still Smiling

Dear Still Smiling,
For seniors who suffer from arthritis or have other hand weaknesses, an electric toothbrush is a great solution to keep your teeth clean. At the push of a button, an electric toothbrush will do everything but shake, rattle and roll to do the cleaning for you, and most come with a wide handle and rubberized grip that make them easier and more comfortable to hold on to.

How to Choose
With dozens of different electric toothbrushes on the market today, here are several key points you’ll need to consider, to help you choose:

  • Cost: The cost of electric toothbrushes will range from $15 up to around $300. How much are you willing to spend?
  • Brushing action: Brush heads tend to be either “spinning” (they rotate very fast in one direction, then the other, and bristles may pulsate in and out) or “sonic” (they vibrate side to side). Both methods are effective and it is a matter of personal preference.
  • Electric versus battery: Choose a brush with a built-in rechargeable battery and an electric charging station. They’re much more convenient and cost effective than toothbrushes that use replaceable batteries.
  • Brushing timer: Since most dentists recommend brushing for two minutes (and most adults brush less than 60 seconds), get a power toothbrush with a built-in timer. Some brushes will even split the two minutes onto four 30-second intervals and will notify you when it’s time to switch to a different quadrant of your mouth.
  • Extra features: Most higher-priced electric brushes come with various settings such as sensitive (gentler cleaning) or massage (gum stimulation), a charge-level display and more. There are even “smart” toothbrushes on the market that connect to a smartphone or tablet via Bluetooth to track brushing habits. What extra features do you want or need?

Top Electric Toothbrushes
While there are many makes and models of electric toothbrushes to choose from, two of the best-selling, top-rated products to consider are the Oral B Pro 1000 (spinning brush head) and the Philips Sonicare 2 Series (vibrating brush head). Both are simple, very effective at removing plaque, and reasonably priced – around $50. They also both offer two-minute timers, rechargeable batteries and a range of brush heads to meet your needs.

To learn more about these electric toothbrushes and a wide variety of other options, visit OralB.com and Sonicare.com. And for more information on choosing an electric toothbrush, visit Toothbrush.org/best-electric-toothbrush.

Easier Flossing Products
If flossing is difficult too, a good alternative to traditional string floss is floss picks. These are disposable plastic-handle tools that have floss threaded onto them, which makes them easier to hold and use. DenTek, Oral-B and others sell packages for a few dollars, or check out the Reach Access Flosser, which comes with a toothbrush-like handle for a better reach.

Some other flossing devices to consider that are easy on the hands include: The WaterPik power flosser ($7), which gently vibrates to dislodge embedded food particles between your teeth; Philips Sonicare AirFloss water flossers ($50 or $90) that uses burst of water or mouthwash to and clean in-between your teeth; and WaterPik Water Flossers ($50 to $130), which use high-pressured pulsating water to remove food particles and plaque and will stimulate your gums in the process.

All of these dental care products can also be found at your local pharmacy or retailer that sells personal care items or online.

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.

September 2018 Columns

Savvy Senior – September Columns

  1. Financial Aid for Family Caregivers
  2. Health Insurance Tips for Traveling Abroad
  3. Which Flu Shot Is Right for You?
  4. Choosing a Continuing-Care Retirement Community

Financial Aid for Family Caregivers

Dear Savvy Senior,
Do you know of any resources that help family caregivers monetarily? I have to miss a lot of work to take care of my elderly mother and it’s financially stressing me.
Stretched Thin

Dear Stretched,
Caring for an elder parent can be challenging in many ways, but it can be especially difficult financially if you have to miss work or quit your job to provide care. Fortunately, there are a number of government programs, tax breaks, and other tips that may be able to help you monetarily while you care for your mother. Here are some options to explore.

State assistance: Most states have programs that help low-income seniors pay for in-home care services, including paying family members for care. These programs – which go by various names like “cash and counseling” or “consumer-directed”– vary greatly depending on where you live and, in some states, on whether your mom is on Medicaid. To find out what’s available in your state, contact your local Medicaid office.

Veterans benefits: Veterans who need assistance with daily living activities can enroll in the Veteran-Directed Care program. This program, available through VA Medical Centers in 40 states, as well as in Washington, D.C., and Puerto Rico, provides as much as $2,000 a month, which can be used to pay family members for home care. Visit the “Home and Community Based Services” section at VA.gov/geriatrics for information.

Also available to wartime veterans and their surviving spouses is a benefit called Aid and Attendance, which helps pay for in-home care, as well as assisted living and nursing home care. This benefit can also be used to pay family caregivers. To be eligible your mother must need assistance with daily living activities like bathing, dressing or going to the bathroom. And, her annual income must be under $14,133 as a surviving spouse or $21,962 for a single veteran, after medical expenses. Her assets must also be less than $80,000 excluding her home and car. To learn more, go to Vets.gov/pension.

Tax breaks: If you pay at least half of your mom’s yearly expenses, and her gross income is below $4,050 (in 2017) not counting her Social Security or disability, you can claim her as a dependent on your taxes and get a $500 tax credit. For more information, go to IRS.gov/help/ita and click on “Whom May I Claim as a Dependent?”

If you can’t claim her as a dependent, you may still be able to get a tax break if you’re paying more than half her living expenses including medical and long-term care costs, and they exceed 7.5 percent of your adjusted gross income. You can include your own medical expenses in calculating the total. See IRS publication 502, Medical and Dental Expenses (IRS.gov/pub/irs-pdf/p502.pdf) for details.

Long-term care insurance: If your mother has long-term care insurance, check whether it covers in-home care. Some policies permit family members to be paid, although they may exclude people who live in the same household.

Paid caregiver leave: A small but growing number of companies offer paid caregiving leave as a way to recruit and retain their workforce. Additionally, some states provide caregiver benefits or paid leave to take care of ailing family members. Check with your employer to see what, if any, benefits are available to you.

Family funds: If your mother has some savings or other assets, discuss the possibility of her paying you for the care you provide. If she agrees, consult with an elder law attorney about drafting a short-written contract that details the terms of the work and payment arrangements, so everyone involved knows what to expect.

You should also check BenefitsCheckup.org, a free, confidential Web tool that can help you search for financial assistance programs that your mom or you may be eligible 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. ————————————————————————————————————————————————————————

Health Insurance Tips for Traveling Abroad

Dear Savvy Senior,
How does health insurance and Medicare cover health care outside the U.S.? My husband and I have a trip abroad planned this fall and would like to find out if we should buy extra insurance. What can you tell us?
Almost Retired

Dear Almost,
Great question! No one likes to think about health problems while on vacation, but medical emergencies happen, and your regular insurance may not cover your care when you’re traveling abroad. To avoid any expensive surprises, here are some tips to help make sure you’re covered.

Know What’s Covered
Your first step is to contact your health insurer to find out exactly what your plan covers when you’re traveling abroad.

If you have health coverage through an employer, the Health Insurance Marketplace or a private insurance company, the level of coverage can vary widely depending on your policy.

If your plan does provide coverage abroad ask about the specifics, such as whether the plan includes coverage for emergency evacuations to the U.S. and pre-existing medical conditions. You should also find out what your out-of-pocket costs will be if you need medical care while you’re away.

If, however, you or your husband has original Medicare, it does not provide coverage outside the U.S. except in certain circumstances – on a cruise ship within six hours of a U.S., for instance. Some coverage is built in if you have one of the Medigap supplemental plans (C, D, F, G, M, N) that pay 80 percent of bills for emergency care as long as it’s during the first 60 days of the trip abroad. There’s also a $250 annual deductible plus a lifetime limit of $50,000 for foreign travel emergency care.

If you happen to have a Medicare Advantage plan, your coverage outside the U.S. will depend on the plan. Some plans offer emergency care coverage while others don’t. You’ll need to check your plan for details.

Buy Extra Protection
If your policy doesn’t provide health coverage outside the U.S., or if the coverage is limited with high out-of-pocket costs, you can purchase a travel medical insurance policy to cover you, or supplement what your insurer won’t cover.

To shop and compare plans, visit sites like InsureMyTrip.com or SquareMouth.com. To give you a general idea of what travel medical insurance cost. A couple in their sixties planning a two-week trip to Europe, for example, could get a $50,000 medical coverage limit and $100,000 for a medical evacuation for around $100 or higher.

You also need to know that most travel medical plans do not cover costs related to a pre-existing health conditions. So if you or your husband has a pre-existing condition that might require medical care, choose a comprehensive travel policy, which typically covers medical care, medical evacuation, trip cancellation, trip interruption and baggage loss, and then tack on a pre-existing-condition waiver.

Finding Care
If you get sick or injured during your trip, call your travel insurer who can recommend local care options. For extra help, consider joining the International Association for Medical Assistance to Travelers (IAMAT.org), which provides its members access to a worldwide network of physicians who speak English and have agreed to affordable prearranged fees. Membership is free. Also visit Step.State.gov to enroll your trip with nearest U.S. Embassy or Consulate. They too can offer health care referrals.

Reimbursement
If you do have travel medical insurance, and you receive medical care while traveling abroad, you will probably be required to file a claim and show medical records outlining the care you received and receipts. So make sure you get copies of these so you can get reimbursed when you get home.

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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Which Flu Shot Is Right for You?

Dear Savvy Senior,
I’ve been reading that there are a bunch of different flu vaccines for seniors this flu season. Which flu shot is right for me?
Flu-Conscious Carol

Dear Carol,
It wasn’t that long ago that if you wanted to get protected from the flu, you simply got a flu shot. But now days, there are so many flu vaccine options you might feel like you are ordering off a menu. To help you decide which flu shot is right for you, you need to consider your health, age and personal preferences. Here’s what you should know.

Flu Shot Options
Just as they do every year, the Centers for Disease Control and Prevention (CDC) recommends a seasonal flu shot to everyone 6 months of age and older, but it’s especially important for seniors who are at higher risk of developing serious flu-related complications. The flu puts more than 200,000 people in the hospital each year and kills an average of 24,000 – 80 to 90 percent of whom are seniors. Here’s the rundown of the different vaccine options (you only need to get one of these):

Standard flu vaccines: If you want to keep things basic, you can’t go wrong with a “standard (trivalent) flu shot,” which has been around for more than 40 years and protects against three different strains of flu viruses. This year’s version protects against two A strains (H1N1 and H3N2), and one influenza B virus.

Or, for additional protection, you should consider the “quadrivalent flu vaccine” that protects against four types of influenza – the same three strains as the standard trivalent flu shot, plus an additional B-strain virus.

Senior specific vaccines: If you’re age 65 or older and want some extra protection, you should consider the “Fluzone High-Dose” or “FLUAD.”

The Fluzone High-Dose has four times the amount of antigen as a regular flu shot does, while the FLUAD contains an added ingredient called adjuvant MF59. Both vaccines provide a stronger immune response for better protection.

Egg allergy vaccines: If you’re allergic to eggs, your flu shot options are “Flucelvax” or “FluBlok.” Neither of these vaccines uses chicken eggs in their manufacturing process.

Fear of needle vaccines: If you don’t like needles, and you’re between the ages of 18 and 64, your options are the “Fluzone Intradermal” or “AFLURIA” vaccine.

The Fluzone intradermal flu shot uses a tiny 1/16-inch long micro-needle to inject the vaccine just under the skin, rather than deeper in the muscle like standard flu shot. While the AFLURIA vaccine is administered by a jet injector, which is a medical device that uses a high-pressure, narrow stream of fluid to penetrate the skin instead of a needle.

You should also know that if you’re a Medicare beneficiary, Part B covers all flu vaccinations, but if you have private health insurance, you’ll need to check with your plan to see which vaccines they do or don’t cover.

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, work in different ways to provide maximum protection.

If you haven’t yet received any pneumococcal vaccine you should get the Prevnar 13 first, followed by Pneumovax 23 six to 12 months later. Medicare Part B covers both shots, if they are taken at least one year apart.

To locate a vaccination site that offers both flu and pneumonia shots, visit Vaccines.gov and type in your ZIP code.

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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Choosing a Continuing-Care Retirement Community

Dear Savvy Senior,
Can you give me some tips on picking an all-inclusive residential retirement community that offers independent housing along with assisted living and nursing care? My husband and I are looking to downsize and simplify, but we want our next move to be our last.

Approaching 80

Dear Approaching,
If you want your next move to be your final one, an all-inclusive retirement community – also known as a continuing-care retirement community (or CCRC) – is a great option to consider, but they aren’t cheap.

CCRCs are different from other types of senior housing because they provide all levels of housing, services and care in one convenient location.

While they vary greatly in appearance and services, most CCRCs offer apartments or sometimes single-family homes for active independent seniors. In addition, they also offer onsite assisted living for seniors who require help with basic living tasks like bathing, dressing or going to the bathroom, and nursing home care for residents when their health declines.

CCRCs also provide a bevy of resort-style amenities and services that include community dining halls, exercise facilities, housekeeping, and transportation, as well as many social and recreational activities.

But be aware that all these services come at a hefty price. Most communities have entry fees that range from the low to mid-six figures, plus ongoing monthly fees that can range from around $2,000 to over $4,000 depending on the facility, services and the contract option you choose.

With more than 2,000 CCRCs in operation throughout the U.S, finding a facility that fits your lifestyle, needs and budget will require some legwork. Here are some steps that can help you proceed.

Make a list: Start by calling the Area Agency on Aging (call 800-677-1116 for contact information) in the area you want to live for a list of CCRCs, or search websites like Caring.com.

Call the facilities: Once you’ve located a few, call them to find out if they have any vacancies, what they charge and if they provide the types of services you want or need. 

Take a tour: Many CCRCs encourage potential residents to stay overnight and have a few meals in their dining hall. During your visit, notice the upkeep of the facility and talk to the current residents to see how they like living there. Also, check out the assisted living and nursing facilities, and find out how decisions are made to move residents from one level of care to another.

To check-up on a facility, call the state long-term care ombudsman (see LTCombudsman.org) who can tell you if the assisted living and nursing care services within the CCRC have had any complaints or other problems. You can also use Medicare’s nursing home compare tool at Medicare.gov/nursinghomecompare.

Review contracts and fees: Most CCRCs offer three types of contracts: Life-care, or Type A contracts, which have the highest entry fee but covers all levels of long-term care as needed; Type B, or modified contracts that have lower entry fees but limits long-term care services in the initial fee; and Type C, or fee-for-service contracts, which offer the lowest entrance fees but requires you to pay extra for long-term care if you need it.

You also need to find out what yearly price increases you can expect? How much of your entry fee is refundable to you if you move or die? And what happens if you outlive your financial resources?

Research the CCRC: Find out who owns the facility and get a copy of their most recently audited financial statement and review it, along with the copy of the contract with your lawyer or financial advisor. Also get their occupancy rate. Unless it’s a newer community filling up, occupancy below 85 percent can be a red flag that the facility is having financial or management problems.

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.

August 2018 Columns

Savvy Senior – August Columns

  1. How Medicare Covers Diabetes
  2. Where Seniors Can Get Help With Home Chores and Small Jobs
  3. Retirement Planning Tips for Single Women
  4. How Older People Can Find Clinical Trials

How Medicare Covers Diabetes

Dear Savvy Senior,
How well does Medicare cover diabetes? I’m 66 years old and was recently told by my doctor that I have pre-diabetes. If it progresses to full-fledged diabetes what can I expect from Medicare.
Recently Retired 

Dear Recently Retired,
Medicare actually provides a wide range of coverage to help beneficiaries who have diabetes, as well as those who are at risk of getting it – but they don’t cover everything. Here’s a breakdown of what Medicare covers when it comes to diabetes services and supplies along with some other tips that can help you save.

Screenings: If you have pre-diabetes or some other health conditions that put you at risk of getting diabetes – such as high blood pressure, high cholesterol and triglycerides, are overweight, or have a family history of diabetes – Medicare Part B (medical insurance) will pay 100 percent of the cost of up to two diabetes screenings every year. 

Doctor’s services: If you’re a Medicare beneficiary, Medicare will pay 80 percent of the cost of all doctor’s office visits that are related to diabetes. You are responsible for paying the remaining 20 percent after you’ve met this year’s $183 (for 2018) Part B deductible.

Prevention program: Just launched in April, the Medicare Diabetes Prevention Program provides lifestyle change programs offered by health professionals to help you prevent diabetes. This is available for free to all Part B beneficiaries who have pre-diabetes.

Self-management: If you have diabetes, Medicare covers 80 percent of the cost of self-management training to teach you how to successfully manage your diabetes.

Supplies and medications: Medicare Part B covers 80 percent of the cost of glucose monitors, test strips (100 per month if you use insulin, or 33 per month if you don’t), lancets, external insulin pumps and insulin (if you use a pump), after you’ve met your deductible.

But if you inject insulin with a syringe, Medicare’s Part D prescription drug benefit will help pay your insulin costs and the supplies needed to inject it – if you have a plan. Part D plans also cover most other diabetic medications too. You’ll need to check your plan for coverage details.

Nutrition therapyMedicare will pick up the entire tab for medical nutrition therapy, which teaches you how to adjust your diet so you can better manage your condition. You’ll need a doctor’s referral to get this service.

Foot care: Since foot problems are common among diabetics, Medicare covers 80 percent of foot exams every six months for diabetics with diabetes-related nerve damage. They will also help pay for therapeutic shoes or inserts as long as your podiatrist prescribes them.

Eye exams: Because diabetes increases the risks of getting glaucoma and diabetic retinopathy, 80 percent of dilated medical eye exams are covered each year, but eye refractions for glasses are not.

For more information, see “Medicare’s Coverage of Diabetes Supplies & Services” online booklet at Medicare.gov/Pubs/pdf/11022-Medicare-Diabetes-Coverage.pdf. 

Other Insurance
If you have a Medicare supplemental (Medigap) policy, it may pay some of the costs that Medicare doesn’t cover. Call your plan’s benefits administrator for more information.

Or, if you’re in a Medicare Advantage plan (like an HMO or PPO), your plan must give you at least the same diabetes coverage as original Medicare does, but it may have different rules. You’ll need to check your policy for details.

Financial Assistance
If you’re income is low, and you can’t afford your Medicare out-of-pocket costs, you may be able to get help through Medicare Savings Programs. To find out if you qualify or to apply, contact your state Medicaid program.

Also, find out if you are eligible for “Extra Help” which helps Medicare Part D beneficiaries with their medication expenses. Visit SSA.gov/prescriptionhelp or call Social Security (800-772-1213) to learn more.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.

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Where Seniors Can Get Help With Home Chores and Small Jobs 

Dear Savvy Senior,
What’s the best way to find good, trustworthy, qualified people who can help seniors with home chores or small jobs?
Looking for Mom

Dear Looking,
Getting help at home for any number of household tasks is a lot easier than it use to be thanks to a number of web-based tools that can quickly and easily connect you and your mom to a wide variety of skilled, carefully vetted workers. Here’s what you should know.

Finding Qualified Help
One of the best ways to find qualified, reliable, trustworthy people that can help with home chores and other small jobs is throughreferrals from people you trust. But if your friends or family don’t have any recommendations, there are a number of online companies you can turn to now like TaskRabbit.com and Takl.com.

These are on-demand service companies that can quickly and easily connect you to skilled workers to handle a wide variety of household chores and small jobs, like cleaning and housekeeping, moving and packing, lawn and yard cleanup, handyman tasks, grocery shopping, running errands, furniture assembly, picture hanging, closet organizing, and much more.

TaskRabbit currently has more than 60,000 Taskers (workers) in 47 U.S. cities, while Takl currently serves 75 U.S. cities with around 35,000 workers.

All you need to do is download their app, or go to their website, and select the service your mom wants done and set a time when she would like the worker to show up. The software then matches your request and provides you a list of qualified, feedback rated workers (including their hourly rate) from which to choose. Once the job is complete, payment is done through the company’s app.

You should also know that all TaskerRabbit and Takl workers have to go through a thorough vetting process before they can join their respective company including extensive background checks.

But if you can’t find a skilled worker through TaskRabbit or Takl, or if they don’t serve your area, another option is Amazon Home Services at Amazon.com/services. Like TaskRabbit and Takl, Amazon will connect you to qualified workers that handle dozens of household chores and other small jobs.

Amazon also screens all workers through media searches, online interviews, reference checks, and background checks. And all experts need to have licenses and insurance.

To purchase and book a service, you can either buy a pre-packaged service with a fixed price (like two hours of cleaning) or you can submit a custom request and receive estimates. When booking, you select three different dates and time frames and the pro confirms an appointment. All payment is done through your Amazon account. 

Need a Tradesman
If your mom primarily needs of a tradesman like a plumber, electrician, painter, roofer or carpenter for home repairs or remodel projects, you should also check HomeAdvisor.com and AngiesList.com. Both of these sites can connect you with prescreened, customer-rated service professionals in your area for free.

Senior Specific
Another option you should know about is AskUmbrella.com, which is a fee-based membership service for seniors 60-plus that provides qualified, vetted workers to do small jobs in and around the house for only $16 per hour. Currently available in New York, they are expanding nationally over the next year.

Lower-Income Option
If your mom is on a tight budget, you should also contact her nearby Area Aging Agency (call 800-677-1116), who can refer you to services in her area, if they are available.

For example, some communities have volunteer programs that provide chore and handyman services to help seniors in need. And some local non-profit’s offer residential repair services that offer seniors minor upgrades and adaptations to their homes.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today showand author of “The Savvy Senior” book.

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Retirement Planning Tips for Single Women

Dear Savvy Senior,
What retirement planning tips can you recommend to single women? I’m 54 and divorced with a teenage daughter and very little saved for retirement.
Financially Behind

Dear Behind,
It’s an unfortunate reality, but most single women – whether they’re divorced, widowed or never married – face much greater financial challenges in retirement than men. Why?

Because women earn less money – about 80 cents for every dollar that men make, on average, and they have shorter working careers than men due to raising children and/or caring for aging parents. And less money earned usually translates into less money saved and a lower Social Security benefit when you retire.

In addition, women live an average of five years longer than men, which requires their retirement income to stretch farther for living expenses and healthcare costs. And according to some studies, women tend to be less knowledgeable and more intimidated about financial issues than men, which means they don’t always handle their money as well as they should.

Because of these issues, it’s very important that women educate themselves on financial matters and learn how to save more effectively. Listed below are some tips and resources that may help you.

Start Saving
If your employer offers a retirement plan, such as a 401K, you should contribute enough to at least capitalize on a company match, if available. And if you can swing it, contribute even more. By law, you can save as much as $18,500 in a 401(k) in 2018, or $24,500 to those 50 and older, due to the catch-up rule.

If you don’t have a workplace plan, consider opening a Traditional or Roth IRA. Both are powerful tax-advantaged retirement savings accounts that let you contribute up to $5,500 annually, or $6,500 when you’re over 50.

And if you’re self-employed, consider a SEP-IRA, SIMPLE-IRA and/or a solo 401(k), all of which can help reduce your taxable income while putting money away for retirement.

Also, if you have a high-deductible health insurance policy, you should consider opening a health savings account (see HSAsearch.com). This is an excellent tool that can be used to sock away funds pre-tax and use them before or after retirement to pay for medical expenses.

Find Your Number
It’s also important to get a handle on how much you need to save for a comfortable retirement. You can do this through a number of free online calculators like ChooseToSave.org or FinancialMentor.com/calculator. 

Pay Off Debt
If you have debt, you need to get it under control. If you need some help with this, consider a nonprofit credit-counseling agency that provides free or low cost advice and solutions, and can help you set up a debt management plan. To locate an agency, use the National Foundation for Credit Counseling website at NFCC.org or call 800-388-2227.

Find Help
To help you educate yourself on financial matters like retirement planning, saving and investing, health care, annuities and more, a top resource is the Women’s Institute for a Secure Retirement at WiserWomen.org.

And to help you get up to speed on Social Security, visit SSA.gov/people/women. This web page, dedicated to women, provides helpful publications like “What Every Women Should Know,” along with links to benefit calculators and your personal Social Security account to help you figure out your future earnings at different retirement ages.

You should also consider getting a financial assessment with a fee-only financial advisor. Costs for these services will vary from around $150 to $300 per hour, but this can be very beneficial to help you set-up a retirement plan you can follow. See NAPFA.org or GarrettPlanningNetwork.com to locate an advisor in your area.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBCToday showand author of “The Savvy Senior” book.

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How Older People Can Find Clinical Trials

Dear Savvy Senior,
What can you tell me about clinical trials and how to go about finding one?
Old and Ill

Dear Old,
Each year, hundreds of thousands of Americans participate in clinical trials in hopes of gaining access to the latest, and possibly greatest, but not yet on the market treatments for all types of illnesses.

But you need to be aware that clinical trials can vary greatly in what they’re designed to do, so be careful to choose one that can actually benefits you. Here’s what you should know along with some tips for locating one. 

Clinical Trials
A clinical trial is the scientific term for a test or research study of a drug, device or medical procedure using people. These trials – sponsored by drug companies, doctors, hospitals and the federal government – are conducted to learn whether a new treatment is safe and if it works. But, keep in mind that these new treatments are also unproven, so there may be risks too.

Also be aware that all clinical trials have certain eligibility criteria (age, gender, health status, etc.) that you must meet in order to be accepted. And before taking part in a trial, you’ll be asked to sign an informed consent agreement. You can also leave a study at any time.

Find a Trial
Every year, there are more than 100,000 clinical trials conducted in the U.S. You can find them by asking your doctor who may be monitoring trials in his or her specialty.

Or you can look for them on your own at ClinicalTrials.gov. This website, sponsored by the National Institutes of Heath, contains a comprehensive database of federally and privately supported clinical studies in the U.S. and abroad on a wide range of diseases and conditions, including information about each trial’s purpose, who may participate, locations, and phone numbers for more details.

If you want some help finding the right trial, try ResearchMatch.org, a web-based resource created by Vanderbilt University that connects willing patients with researchers of clinical trial. Or, use the Center for Information and Study on Clinical Research Participation at CISCRP.org.

This is a non-profit organization that will take your information online or over the phone and do a thorough clinical trials search for you, and mail or email you the results within a week or two. Call 877-633-4376 for assistance.

Those with dementia and their caregivers can also locate clinical trials at the Alzheimer’s Association TrialMatch at TrialMatch.alz.org.

Things to Know
Before deciding to participate in a trial, you need to first discuss it with your doctor to make sure it is appropriate for you. Then, schedule an appointment with the study’s medical team and ask lots of questions, such as:

  • What’s the purpose of the study and can it improve my condition?
  • What are the risks?
  • What kinds of tests and treatments does the study involve, and how often and where they are performed?
  • Is the experimental treatment in the study being compared with a standard treatment or a placebo?
  • Who’s paying for the study? Will I have any costs, and if so, will my insurance plan or Medicare cover the rest?
  • What if something goes wrong during or after the trial and I need extra medical care? Who pays?

For more information on clinical trials for older adults visit the National Institute on Aging (nia.nih.gov/health/clinical-trials), which has many informative articles including one on “questions to ask before participating in a clinical trial.”

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBCToday showand author of “The Savvy Senior”book.

July 2018 Columns

Savvy Senior – July Columns

  1. Simple Gadgets That Can Help Older Drivers
  2. What’s the Difference Between Alzheimer’s and Dementia?
  3. Can a Debt Collector Take My Social Security Benefits?
  4. How to Make the Most of Your Doctor’s Visit
  5. Choosing an Executor for Your Will

Simple Gadgets That Can Help Older Drivers

Dear Savvy Senior,
Are there any specific auto gadgets you can recommend that can help senior drivers? Both of my parents are in there eighties and still pretty good drivers, but due to arthritis and age they’re very stiff, which causes them some driving problems.
Researching Daughter

Dear Researching,
To help keep senior drivers safe and prolong their driving years, there’s a plethora of inexpensive, aftermarket vehicle adaptions you can purchase that can easily be added to your parent’s vehicles to help with many different needs. Here are some good options.

Entry and Exit Aids
To help arthritic/mobility challenged seniors with getting into and out of their vehicle, there are a variety of portable support handles you can buy, like the “Emson Car Cane Portable Handle” ($12), which inserts into the U-shaped striker plate on the doorframe. And the “Standers CarCaddie” ($13) nylon support handle that hooks around the top of the door window frame.

Another useful product is the “DMI Deluxe Swivel Seat Cushion” ($22), which is a round portable cushion that turns 360 degrees to help drivers and passengers rotate their body into and out of their vehicle.

Enhanced Rear Vision
To help seniors with limited upper body range of motion, which makes looking over their shoulder to back-up or merge into traffic difficult, there are special mirrors you can add as well as back-up cameras.

For starters, to widen rear visibility, eliminate blind spots and even help with parallel parking, get an oversized rear view mirror like the “Allview Rearview Mirror” ($50) that clips on to the existing mirror. You should also purchase some “Ampper Blind Spot Mirrors” ($7.50), which are 2-inch adjustable convex mirrors that stick to the corner of the side view mirrors.

Another helpful device is the “Auto-vox M1W Wireless Backup Camera Kit” ($110). This comes with a night vision camera that attaches to the rear license plate, and a small monitor that mounts to the dash or windshield. When the vehicle is in reverse, it sends live images wirelessly to the monitor so you can see what’s behind you.

Seat Belt Extenders
To make buckling up a little easier, there are a variety of seat belt extension products offered by Seat Belt Extender Pros like the “Seat Belt Grabber Handle” ($8), which is a rubber extension handle that attaches to the seat belt strap to make it easier to reach. And the “7-inch Rigid Seat Belt Extender” ($20) that fit into the seat belt buckle receiver to add a few inches of length, making them easier to fasten.

Gripping Devices
If your parents have hand arthritis that makes gripping the steering wheel, turning the ignition key or twisting open the gas cap difficult or painful, consider these products.

The “SEG Direct Steering Wheel Cover” ($15) that fits over the steering wheel to make it larger and easier to grip. The “Ableware Hole-In-One Key Holder” ($9), which is a small plastic handle that attaches to the car key to provide additional leverage to turn the key in the ignition or door. And for help at the pump, the “Gas Cap & Oil Cap Opener by Gascapoff” ($12) is a long handled device that works like a wrench to loosen and tighten the gas cap.

All of these products can be found online at Amazon.com. Just type the product name in the search bar to find them.

Safety and Security
To help ensure your parents safety, and provide you and them peace of mind, they should also consider an in-car medical alert system like “splitsecnd.” Offered through Bay Alarm Medical (BayAlarmMedical.com, $30/month), his small device plugs into the vehicle’s cigarette lighter to provide 24/7 roadside and emergency assistance at the push of a button, automatic crash detection and response, and GPS vehicle location and monitoring capabilities.

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’s the Difference Between Alzheimer’s and Dementia?

Dear Savvy Senior,
What’s the difference between Alzheimer’s disease and dementia? My aunt has dementia, but they don’t know if she has Alzheimer’s disease, which is very confusing to me.
Trying To Understand

Dear Trying,
Many people use the words “Alzheimer’s disease” and “dementia” interchangeably, but they are not the same thing. In fact, you can have a form of dementia that is completely unrelated to Alzheimer’s disease. Here’s what you should know.

Dementia versus Alzheimer’s
Dementia is a general term for a set of symptoms that includes memory loss, impaired communication skills, a decline in reasoning and changes in behavior. It most commonly strikes elderly people and used to be referred to as senility.

Alzheimer’s disease is a specific illness that is the most common cause of dementia. Though many diseases can cause dementia, Alzheimer’s – which affects 5.7 million Americans today – accounts for 60 percent to 80 percent of dementia cases, which is why you often hear the terms used interchangeably.

But there are many other conditions that can cause symptoms of dementia like vascular dementia, which is the second most common cause, accounting for about 10 percent of dementia cases. Vascular dementia is caused by a stroke or poor blood flow to the brain.

Other degenerative disorders that can cause dementia include Lewy body dementia, Parkinson’s disease, Frontotemporal dementia, Creutzfeldt-Jakob disease, Chronic Traumatic Encephalopathy (CTE), Huntington’s disease and Korsakoff Syndrome. Some patients may also have more than one form of dementia known as mixed dementia.

Dementia is caused by damage to brain cells, but the symptoms can vary depending on the cause. In the case of Alzheimer’s disease, protein fragments or plaques that accumulate in the space between nerve cells and twisted tangles of another protein that build up inside cells cause the damage.

In Alzheimer’s disease, dementia gets progressively worse to the point where patients cannot carry out daily activities and cannot speak, respond to their environment, swallow or walk. Although some treatments may temporarily ease symptoms, the downward progression of disease continues and it is not curable.

But some forms of dementia are reversible, which is why it’s important to be evaluated by a physician early on. Vitamin deficiencies, thyroid problems, brain tumors, depression, excessive alcohol use, medication side effects and certain infectious diseases can cause reversible forms of dementia.

Another treatable form of dementia is a condition known as normal pressure hydrocephalus, which is caused by a buildup of cerebrospinal fluid in the brain that can be relieved by surgically implanting a shunt to drain off excess fluid. This type of dementia is often preceded or accompanied by difficulty walking and incontinence.

To learn more about the different types of dementia, including the symptoms, risks, causes and treatments visit the Alzheimer’s Association at ALZ.org/dementia.

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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Can a Debt Collector Take My Social Security Benefits?

Dear Savvy Senior,
Can my Social Security benefits be garnished if I have some outstanding debts? I just turned 62 and would like to start collecting my retirement benefits, but want to find this out before I apply.
Worried Retiree

Dear Worried,
Whether your Social Security benefits are garnishable or not depends on whom you owe. Banks and other financial creditors, for example, can’t touch your Social Security checks. But if Uncle Sam is collecting on a debt, some of your benefits are fair game. Here’s what you should know.

Creditor Protections
If you have credit card debts, medical bills, unpaid personal loans or pay day loans, you’ll be happy to know that your Social Security benefits are safe from your creditors. Section 207 of the Social Security Act prohibits debt collectors or a bankruptcy court from dipping into your bank account to take Social Security money for purposes of paying off what you owe.

Supplemental Security Income (SSI), veterans benefits, federal employee and civil service retirement benefits, and benefits administered by the Railroad Retirement Board Administration can’t be touched either.

But be aware that your creditors can still take legal action against you to recover what you owe them, and depending on your state’s law, they may be able to garnish your wages and tap into other allowable assets, if you have any.

Government Garnishment
If, however, you owe money to Uncle Sam, it’s a very different story. The federal government can garnish a portion of your Social Security benefits for repayment of several types of debts, including federal income taxes, federal student loans, state-ordered child support and alimony, nontax debt owed to other federal agencies, defaulted federal home loans and certain civil penalties. (If you receive SSI, those benefits cannot be garnished under any circumstance.)

How much can actually be taken depends on the type of debt you owe. In most situations, the government can pull 15 percent of your benefits to cover your debt, but under the Debt Collection Improvement Act of 1996, it must leave you at least $750 each month. That is, unless the levy is for federal income taxes. In that case, the government isn’t required to leave $750 behind.

The other exception is for child support or alimony payments. Depending on your state laws, the court may be able to take half of your benefits or more to pay your obligations to your children or ex-spouse.

If you think your Social Security benefits might be raided to pay overdue bills, you need to address the problem – don’t ignore it. Most government agencies are happy to work with you so long as you’re willing to work with them.

The government typically sends several letters about a debt before it takes action. The final letter will inform you of the intent to levy Social Security payments, and after that, you have 30 days to contact the agency and work out a payment plan.

Get Help
To get a handle on your debt problems, consider contacting a nonprofit financial counseling agency, which offers free and low-cost services on managing financial problems. To locate a credible agency in your area, use the National Foundation for Credit Counseling website at NFCC.org or call 800-388-2227.

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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How to Make the Most of Your Doctor’s Visit

Dear Savvy Senior,
I manage a large health clinic that treats thousands of seniors each year, and we’ve have found that patients that come prepared when they visit our doctors are much more satisfied with the care they receive. Can you write a column educating patients on how to prepare for doctor’s appointments?
Healthcare Helper

Dear Helper,
There’s no doubt about it. Studies have shown that patients who help their doctors by providing important health information and preparing themselves for appointments tend to get better care than patients who don’t. Here are some simple things we can all do to help maximize our next visit to the doctor.

Before Appointments
Gathering your health information and getting organized before your appointment are the key steps to ensuring a productive meeting with your doctor. This is especially important if you’re seeing multiple doctors or are meeting with a new physician. Specifically, you need to:

Get your test results: If you’re seeing a new doctor for the first time, make sure he or she has copies of your latest X-ray, MRI or any other test or lab results you’ve recently had, including reports from other doctors that you’ve seen. In most cases, you’ll need to do the leg work yourself which may only require a phone call to your previous doctor asking them to send it, or you may need to go pick it up and take it yourself.

List your medications: Make a list of all the medications you’re taking including prescription and over-the-counter drugs, supplements and herbs, along with the dosages and take it with you to your appointment. Or, just put all your pill bottles in a bag so you can take them with you.

Know your health history: Being able to talk to your doctor about any previous medical problems and procedures, even if they’re not the reason you are going to the doctor this time, can make an office visit much more efficient. Write it down if it’s complicated. Genetics matter too, so knowing your family’s health history can also be helpful.

Prepare a list of questions: Make a written list of the top three or four issues you want to discuss with your doctor. Since most appointments last around 15 to 20 minutes, this can help you stay on track and ensure you address your most pressing concerns first. If you’re in for a diagnostic visit, you should prepare a detailed description of your symptoms.

During Appointments
The best advice when you meet with your doctor is to speak up and get to the point. So right away, concisely explain why you’re there. Don’t wait to be asked. Be direct, honest and as specific when recounting your symptoms or expressing your concerns.

Many patients are reluctant or embarrassed to talk about their symptoms, which makes the doctor’s job a lot harder to do. It’s also a good idea to bringing along a family member or friend to your appointment. They can help you ask questions, listen to what the doctor is telling you and give you support.

Also consider taking some notes or ask the doctor if you can record the session for later review. If you don’t understand what the doctor is telling you, ask him or her to explain it in simple terms so you can understand. And if you run out of time and don’t get your questions answered, ask if you can follow up by phone or email, make another appointment, or seek help from the doctor’s nurse.

For more information, the National Institute on Aging offers an excellent booklet called “Talking With Your Doctor: A Guide for Older People” that can help you prepare for an appointment and become a more informed patient. To get a free copy mailed to you, call 800-222-2225 or visit order.nia.nih.gov.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.
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Choosing an Executor for Your Will

Dear Savvy Senior,
What options can you recommend for finding a good executor for my will? At one time I thought one of my two kids could do it, but they are both financially inept and would probably make a mess of things.
Looking for Options

Dear Looking,
Choosing an executor – the person or institution you put in charge of administering your estate and carrying out your final wishes – is one of the most important decisions in preparing a will.

A good executor can help ensure the prompt, accurate distribution of your possessions with minimal problems. Some of the duties required include: filing court papers to start the probate process; managing your estate’s assets; using your estate’s funds to pay debts, taxes and bills; handling details like terminating credit cards, and notifying banks and government agencies like Social Security and the post office of the death; preparing and filing final income tax returns; and distributing assets to the beneficiaries named in the will.

Given all the responsibility, the ideal candidate should be someone who is honest, dependable, well organized, good with paperwork and vigilant about meeting deadlines.

Who to Choose
Most people think first of naming a family member, especially a spouse or child, as executor. But if you don’t have an obvious family member to choose, you may want to ask a trusted friend, but be sure to choose someone in good health or younger than you who will likely be around after you’re gone.

Also, if your executor of choice happens to live in another state, you’ll need to check your state’s law to see if it imposes any special requirements. Some states require an out-of-state executor to be a family member or a beneficiary, some require a bond to protect your heirs in case of mismanagement, and some require the appointment of an in-state agent.

Also keep in mind that if the person you choose needs help settling your estate they can always call on an expert like an attorney or tax account to guide them through the process, with your estate picking up the cost.

If, you don’t have a friend or relative you feel comfortable with, you could name a third party executor like a bank, trust company or a professional who has experience dealing with estates. If you need help locating a pro, the National Association of Estate Planners and Councils (NAEPC.org) and the National Academy of Elder Law Attorneys (NAELA.org) are great resources that provide directories on their websites to help you find someone.

Executor Fees
Most family members and close friends, especially if they’re beneficiaries, serve for free because inherited money isn’t taxable. But if you opt for a third party executor it will cost your estate. Each state has laws that govern how an executor is paid – either based on a percentage of the estate, a flat fee or an hourly rate.

Get Approval
Whoever you choose to serve as your executor, be sure you get their OK first before naming him or her in your will. And once you’ve made your choice, go over your financial details in your will with that person, and let him or her know where you keep all your important documents and financial information. This will make it easier on them after you’re gone.

For more information on the duties of an executor, get a copy of the book “The Executor’s Guide: Settling A Loved One’s Estate or Trust” for $28 at NOLO.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 2018 Columns

Savvy Senior – June Columns

  1. How to Find Retiree Travel Perks
  2. How to Make a Living Will
  3. Cheap Cell Phone Plans for Seldom Calling Seniors
  4. Tips for Living with Low Vision

How to Find Retiree Travel Perks

Dear Savvy Senior,
What types of travel discounts are available to older travelers? I just retired and am interested in learning about travel deals for people over 60.
Ready To Go

Dear Ready,
There are literally thousands of different travel-related discounts available to retirees that usually start anywhere between the ages 50 and 65. These discounts – typically ranging between 5 and 25 percent off – can add up to save you hundreds of dollars on your next trip. Here’s how you can find them.

Ways to Save
The first thing to know is that most businesses don’t advertise them, but many give senior discounts just for the asking, so don’t be shy.

You also need to be aware that when it comes to senior travel bargains, the “senior discount,” if available, may not always be the best deal. Hotels, resorts, airlines and cruise lines, for example, offer advanced bookings along with special deals and promotions from time to time that may be a lower rate than what the senior discount is. Before you book, always ask about the lowest possible rate and the best deal available.

Another way retirees with flexible schedules can save is to be flexible when you travel. Last minute travel deals can offer huge savings, as well as traveling during off-season or off-peak times, and avoiding holidays.

Club memberships can also garner you a wide variety of travel bargains. AARP, for example has dozens of travel discounts available on hotels, rental cars, cruises and vacation packages – see AARPadvantages.com. Annual AARP membership fees are $16 or less if you join for multiple years.

Or, if you don’t agree with AARP, there are alternative organizations you can join like the Seniors Coalition or the American Seniors Association that offer discounts on hotels and rental cars.

Types of Discounts
Here’s an abbreviated rundown of some of the different travel discounts you can expect to find.

Transportation: For airline travel, Southwest has fully refundable senior fares to passengers 65 and older, and British Airways offers AARP members $65 off economy travel and $200 off business club travel. American, United and Delta also offer senior fares in certain markets but are extremely limited.

For traveling by train, Amtrak provides a 10 percent discount to travelers 65-plus, and a 10 percent discount to passengers over age 60 on cross-border services operated jointly by Amtrak and VIA Rail Canada.

Greyhound bus lines also offers a 5 percent discount to passengers 62 and older. And most car rental companies offer 10 to 25 percent discounts to customers who belong to membership organizations like AARP or AAA.

Hotels: Many U.S. hotels offer senior discounts (at varying ages) usually ranging between 5 and 15 percent off. For example, Marriott offers a 15 percent discount to travelers 62 and older at over 4,000 locations worldwide. And Wyndham hotel group offers 60-plus guests best available rate discounts.

Restaurants: Some restaurant chains offer senior discounts, ranging from free drinks, to senior menus, to discounts off your total order. National chains that offer these deals include Burger King, Chili’s, Chick-fil-A, Dunkin Donuts, Golden Corral, IHOP and Wendy’s. Offers can vary by location.

Cruses: Royal Caribbean and Carnival Cruise lines offer discount rates to cruisers 55 and over.

Entertainment and Attractions: Most movie theaters, museums, zoos, aquariums, public golf courses and even ski slopes provide reduced admission to seniors over 60 or 65. If you’re 62-plus, you’re also eligible for the “Senior Pass,” which provides a lifetime entry to 2,000 national parks and recreation sites. You can obtain this pass in person at one of the federal recreation sites for $80, or online for $90 at Store.usgs.gov/senior-pass.

To look for other travel discounts on the go, download the Sciddy app at Sciddy.com. This app lets you search for senior discounts and can send you alerts when you’re at an establishment that offers them.

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 Make a Living Will

Dear Savvy Senior,
What’s the best way to go about making a living will? I recently retired and would like to start getting my affairs in order, just in case.
Approaching 70

Dear Approaching,
Preparing a living will now is a smart decision that gives you say in how you want to be treated at the end of your life. Here’s what you should know, along with some resources to help you create one.

Advance Directive
To adequately spell out your wishes regarding your end-of-life medical treatment you need two legal documents: A “living will” which tells your doctor what kind of care you want to receive if you become incapacitated, and a “health care power of attorney” (or health care proxy), which names a person you authorize to make medical decisions on your behalf if you become unable to.

These two documents are known as an “advance directive,” and will only be utilized if you are too ill to make medical decisions yourself. You can also change or update it whenever you please.

Do-It-Yourself
It isn’t necessary to hire a lawyer to complete an advance directive. There are free or low-cost resources available today to help you write your advance directive, and it takes only a few minutes from start to finish.

One that’s completely free to use is Caring Connections, a resource created by the National Hospice and Palliative Care Organization. They provide state-specific advance directive forms with instructions on their website (CaringInfo.org) that you can download and print for free. Or you can call 800-658-8898 and they will mail them to you and answer any questions you may have.

Or, for only $5, an even better tool is the Five Wishes living will. Created by Aging with Dignity, a nonprofit advocacy organization, Five Wishes is a simple do-it-yourself document that covers all facets of an advance directive that will help you create a more detailed customized document. It is legally valid in 42 states and the District of Columbia. To learn more or to receive a copy, visit AgingWithDignity.org or call 888-594-7437.

Want Legal Help
If you would rather use a lawyer, look for one who specializes in estate planning and health care related matters. The National Academy of Elder Law Attorneys (NAELA.org) and the National Association of Estate Planners and Councils (NAEPC.org) websites have directories to help you find someone. Costs will vary depending on the state you reside in, but you can expect to pay somewhere between $200 and $500 to get one made.

Do Not Resuscitate
You should also consider including a do-not-resuscitate order (DNR) as part of your advance directive, since advanced directives do little to protect you from unwanted emergency care like CPR. Doctors and hospitals in all states accept them. To create a DNR, ask your doctor to fill out a state appropriate form and sign it.

Another tool you should know about that will compliment your advance directive is the Physician Orders for Life-Sustaining Treatment (POLST). Currently endorsed in 22 states with 24 more in some phase of development, a POLST translates your end-of-life wishes into medical orders to be honored by your doctors. To learn more or set one up, see POLST.org.

Tell Your Family
To insure your final wishes are followed, be sure you tell your family members, health care proxy and doctor so they all know what you want. You should also provide copies of your advanced directive to everyone involved to help prevent stress and arguments later.

For convenience, there are even resources – like DocuBank.com and MyDirectives.com – that will let you and your family members store your advanced directive online, so you can have immediate access to them when you need them.

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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Cheap Cell Phone Plans for Seldom Calling Seniors

Dear Savvy Senior
What are the cheapest cell phone plans available to seniors today? I’m 78-years-old and want it primarily for emergency purposes.
Infrequent Caller

Dear Infrequent,
While unlimited high-speed data, video streaming and mobile hot spot are now standard for most cell phone plans today, there are still a number of low-cost wireless plans designed with seniors in mind.

These plans offer limited talk time and text, which is ideal for seniors who want to stay connected without spending much money each month. Here are some super cheap plans to consider.

Cheapest Plans
Prepaid plans are the best deal for seniors who only want a cell phone for emergency purposes or occasional calls. The very cheapest prepaid plan available today is T-Mobile’s Pay As You Go plan, which includes any combination of 30 minutes or 30 text messages for only $3 per month. After that, additional minutes and texts cost 10 cents each.

Phone prices start at $75, but if you have a compatible device, you can use it rather than buying a new one. You will, however, need to pay for a $10 SIM Starter Kit fee, whether you bring your own phone or buy a new one. Visit T-Mobile.com or call 844-361-2792 for more information.

Two other companies that offer low-cost prepaid deals are TracFone and AT&T.

TracFone (TracFone.com, 800-867-7183) has a 30 minute talk/text plan for $10 per month, or an even cheaper a 60 minute talk/text plan for $20 for three months, which averages out to only $6.66 per month.

And AT&T (ATT.com, 800-331-0500) has two low-cost prepaid plans including the 25 cent per minute call plan, and a $2 daily plan that charges only when you place or receive a call or send a text that day. The fees are deducted from the prepaid balance on your account. But to use AT&T Prepaid, you must prepay into your account either $10 per month, $25 for three months or $100 per year.

Best Emergency Phone
If you’re interested in a senior-friendly cell phone that provides top-notched emergency assistance, consider the Jitterbug Flip (GreatCall.com, 800-918-8543).

This is a nifty flip phone that has big buttons, enhanced sound, a simplified menu, and a 5Star urgent response button that connects you to a trained agent that will know your locations, and will be able to assist you whether you need emergency services, directions, roadside assistance or a locksmith, or to contact family. GreatCall’s service runs on Verizon’s network.

The Flip phone costs $100, with monthly service plans that start at $15 for 200 minutes. Or, you can get the 5Star service with 50 minutes of monthly talk time for $25.

Free Phones
If your income is low enough, another option you should check into is the federal Lifeline program, which provides free or low-cost cell phones and plans through numerous wireless providers.

To qualify, your annual household income must at or below 135 percent of the Federal Poverty Guidelines – which is $16,389 for one person, or $22,221 for two. Or, you must be receiving Medicaid, food stamps/SNAP, SSI, public housing assistance, veterans pension or survivor’s pension benefit, or live on federally recognized Tribal lands.

To find out if you’re eligible, or to locate wireless companies in your area that participates in the program, visit LifelineSupport.org or call 800-234-9473.

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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Tips for Living with Low Vision

Dear Savvy Senior,
What resources can you recommend to help seniors with vision loss? My husband, who’s 76, has macular degeneration that has progressed to the point that he can’t do a lot of his routine activities anymore, and has become very discouraged.
Looking for Help

Dear Looking,
Unfortunately, there are around 15 million Americans, like your husband, living with macular degeneration today. Over time, this progressive disease can rob people of their central vision, making everyday tasks like driving a car, reading the newspaper or watching television extremely challenging. Here are some resources that can help.

Low Vision Help
The best place to get help living and coping with macular degeneration is at a vision rehabilitation agency or clinic. Typically run by state or nonprofit organizations, or private eye care clinics, there are more than 1,500 of these services scattered across the country that help people who are living with all types of uncorrectable vision impairments. Most state and nonprofit vision rehabilitation services are free or low-cost, while private clinics typically charge a fee or may accept Medicare.

While vision rehabilitation does not restore lost sight, it does help people maximize their existing sight, or, if they have no vision, it can equip them with techniques and tools to help them maintain an independent lifestyle.

Services include counseling, along with training on how to perform daily living tasks with low vision, and how to use visual and adaptive devices and assistive technologies that can help improve quality of life.

They also offer guidance for adapting your home that will make it safer and easier for your husband to maneuver, and can help him locate low-vision support groups. Some agencies will even send their specialist out to work with him in the comfort of your own home.

To find a vision rehabilitation service in your area, call the American Foundation for the Blind referral line at 800-232-5463 or visit VisionAware.org/directory. Or, if you use a smartphone or tablet, download their VisionConnect app (see AFB.org/VisionConnect), which connects you to all types of low-vision resources in your area.

But if you don’t live near a vision rehabilitation service, you can also get help from an occupational therapist (OT), who can provide low vision training in your home. Medicare, if prescribed by your eye doctor or healthcare provider, covers this.

Online Help
Another convenient place to find help for your husband is online at VisionAware.org. This free website, created by the American Foundation for the Blind and the Reader’s Digest Partners for Sight Foundation, is designed to help older adults who are losing their sight.

It provides information on eye conditions, along with dozens of practical tips and instructional videos on living with vision loss, including concepts for adapting your home to make it easier to navigate, techniques for traveling safely outside the home, and various tips on how to manage things like finances, medications, and other tasks like cooking, cleaning, grooming, reading, writing and more.

It also offers a comprehensive list of low vision products and technologies that can help your husband stay active and independent, including product reviews that are published in their online magazine called AccessWorld that you can access at AFB.org/aw.

Other Resources
Some other good resources that can help include: the Hadley Institute (Hadley.edu, 800-323-4238), which offers dozens of free online instructional videos to help the blind or visually impaired live independently. Ears for Eyes (EarsForEyes.info, 800-843-6816) that provides free audio lessons that teach low-vision adaptive daily living skills. And Living Well with Low Vision (LowVision.PreventBlindness.org, 800-331-2020), which offers up-to-date information and free materials for people living with sever vision impairment.

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 2018 Columns

Savvy Senior – May Columns

  1. New Shingles Vaccine Provides Better Protection for Seniors
  2. What You Need to Know About Reverse Mortgages
  3. ‘Extra Help’ Program Helps Seniors With Their Medication Costs
  4. How to Choose a Good Estate Sale Company

New Shingles Vaccine Provides Better Protection for Seniors

Dear Savvy Senior,
A good friend of mine got a bad case of shingles last year and has been urging me to get vaccinated. Should I?
Suspicious Susan

Dear Susan,
Yes! If you’re 50 or older, there’s a new shingles vaccine on the market that’s far superior to the older vaccine, so now is a great time to get inoculated. Here’s what you should know.

Shingles, also known as herpes zoster, is a burning, blistering, often excruciating skin rash that affects around 1 million Americans each year. The same virus that causes chickenpox causes shingles.

What happens is the chicken pox virus that most people get as kids never leaves the body. It hides in the nerve cells near the spinal cord and, for some people, emerges later in the form of shingles. 

In the U.S., almost one out of every three people will develop shingles during their lifetime. While anyone who’s had chickenpox can get shingles, it most commonly occurs in people over age 50, along with people who have weakened immune systems. But you can’t catch shingles from someone else.

Early signs of the disease include pain, itching or tingling before a blistering rash appears several days later, and can last up to four weeks. The rash typically occurs on one side of the body, often as a band of blisters that extends from the middle of your back around to the breastbone. It can also appear above an eye or on the side of the face or neck.

In addition to the rash, about 20 to 25 percent of those who get shingles go on to develop severe nerve pain (postherpetic neuralgia, or PHN) that can last for months or even years. And in rare cases, shingles can also cause strokes, encephalitis, spinal cord damage and vision loss.

New Shingles Vaccine
The Food and Drug Administration recently approved a new vaccine for shingles called Shingrix (see Shingrix.com), which provides much better protection than the older vaccine, Zostavax.

Manufactured by GlaxoSmithKline, Shingrix is 97 percent effective in preventing shingles in people 50 to 69 years old, and 91 percent effective in those 70 and older.

By comparison, Zostavax is 70 percent effective in your 50s; 64 percent effective in your 60s; 41 percent effective in your 70s; and 18 percent effective in your 80s.

Shingrix is also better that Zostavax in preventing nerve pain that continues after a shingles rash has cleared – about 90 percent effective versus 65 percent effective.

Because of this enhanced protection, the Center for Disease Control and Prevention recommends that everyone age 50 and older, receive the Shingrix vaccine, which is given in two doses, two to six months apart.

Even if you’ve already had shingles, you still need these vaccinations because reoccurring cases are possible. The CDC also recommends that anyone previously vaccinated with Zostavax be revaccinated with Shingrix.

You should also know that Shingrix can cause some adverse side effects for some people, including muscle pain, fatigue, headache, fever and upset stomach.

Shingrix – which costs around $280 for both doses – is (or will soon be) covered by insurance including Medicare Part D prescription drug plans, but be aware that the shingles vaccines are not always well covered. So before getting vaccinated, call your plan to find out if it’s covered, and if so, which pharmacies and doctors in your area you should use to insure the best coverage.

Or, if you don’t have health insurance or you’re experiencing medical or financial hardship, you might qualify for GlaxoSmithKline’s Patient Assistance Program, which provides free vaccinations to those who are eligible. For details, go to GSKforyou.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 NBCToday showand author of “The Savvy Senior” book.
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What You Need to Know About Reverse Mortgages

Dear Savvy Senior,
What can you tell me about reverse mortgages for retirees? My wife and I are contemplating getting one but want to make sure we know what we’re getting into.
Running Short

Dear Running,
For retirees who own their home and want to stay living there, but could use some extra cash, a reverse mortgage is a viable financial tool, but there’s a lot to know and consider to be sure it’s a good option for you.

Let’s start with the basics.

A reverse mortgage is a unique type of loan that allows older homeowners to borrow money against the equity in their house (or condo) that doesn’t have to be repaid until the homeowner dies, sells the house or moves out for at least 12 months.

At that point, you or your heirs will have to pay back the loan plus accrued interest and fees, but you will never owe more than the value of your home.

It’s also important to understand that with a reverse mortgage, you, not the bank, own the house, so you’re still required to pay your property taxes and homeowners insurance. Not paying them can result in foreclosure.

To be eligible, you must be 62 years of age or older, own your own home (or owe only a small balance) and currently be living there.

You will also need to undergo a financial assessment to determine whether you can afford to continue paying your property taxes and insurance.

Depending on your financial situation, you may be required to put part of your loan into an escrow account to pay future bills. If the financial assessment finds that you cannot pay your insurance and taxes and have enough cash left to live on, you’ll be denied.

Loan Details
Around 95 percent of all reverse mortgages offered today are Home Equity Conversion Mortgages (HECM), which are FHA insured and offered through private mortgage lenders and banks. HECM’s also have home value limits that vary by county, but cannot exceed $679,650. 

How much you can actually get through a reverse mortgage depends on your age (the older you are the more you can get), your home’s value and the prevailing interest rates.

Generally, most people can borrow somewhere between 50 and 65 percentof the home’s value. To estimate how much you can borrow, use the reverse mortgage calculator at ReverseMortgage.org.

You also need to know that reverse mortgages have recently become more expensive with a number of fees, including: a 2 percent lender origination fee for the first $200,000 of the home’s value and 1 percent of the remaining value, with a cap of $6,000; an upfront 2 percent mortgage insurance premium (MIP) fee on the maximum loan amount, plus an annual MIP fee that’s equal to 0.5 percent of the outstanding loan balance; along with an appraisal fee, closing costs and other miscellaneous expenses.

Most fees can be deducted for the loan amount to reduce your out-of-pocket cost at closing.

To receive your money, you can opt for a lump sum, a line of credit, regular monthly checks or a combination of these.

More Information
To learn more, read the National Council on Aging’s online booklet “Use Your Home to Stay at Home” at NCOA.org/home-equity. And see the National Reverse Mortgage Lenders Association self-evaluation checklist atReverseMortgage.org/consumerguides.

Also note that because reverse mortgages are complex loans, all borrowers are required to get face-to-face or telephone counseling through a HUD approved independent counseling agency before taking one out. Most agencies typically charge around $125. To locate one near you, visit Go.usa.gov/v2H, or call 800-569-4287.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBCToday showand author of “The Savvy Senior” book.
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“Extra Help” Program Helps Seniors With Their Medication Costs

Dear Savvy Senior,
Are there any special Medicare programs that help seniors with their medication costs? My 74-year-old mother, who lives primarily on her Social Security, takes several high-priced drugs that sap her income even with her Medicare drug plan.
Looking for Assistance

Dear Looking,
Yes, there’s a low-income subsidy program called Extra Help that can assist seniors on a tight budget with paying for their premiums, deductible and co-payments in their Medicare (Part D) prescription drug plan.

Currently around 10 million people are receiving this subsidy, but another two million may qualify for it and don’t even realize it. They’re missing out on hundreds, maybe thousands, of dollars in savings each year.

Changes in the law make it easier than ever to qualify for the Extra Help program. Even if your mom applied and didn’t qualify before, she may be eligible now.

The amount of additional assistance she would receive depends on her income and assets. If she qualifies for help, she’ll pay no more than $3.35 for a generic drug and $8.35 for a brand-name drug in 2018.

To get the subsidy, your mom’s assets can’t be more than $14,100 (or $28,150 for married couples living together). Bank accounts, stocks and bonds count as assets, but her home, vehicle, personal belongings, life insurance and burial plots do not.

Also, your mom’s monthly income can’t be more than $1,538 (or $2,078 for married couples). If your mom supports a family member who lives with her, or lives in Alaska or Hawaii, her income can be higher.

In addition, the government won’t count any money if your mom receives help for household expenses like food, rent, mortgage payments, utilities and property taxes.

How To Apply
There are three ways to apply for Extra Help: online at SSA.gov/prescriptionhelp; by calling Social Security at 800-772-1213; or by visiting her local Social Security office.

The application form is easy to complete, but you’ll need your mom’s Social Security number and information about her bank balances, pensions and investments. Social Security will review her application and send her a letter within a few weeks letting you know whether she qualifies.

If your mom doesn’t qualify for Extra Help, she may still be able to get help from a state pharmacy assistance program or a patient assistance program. Visit BenefitsCheckUp.organd click on “Medications” to search for these programs.

Other Medicare Assistance
If your mom is eligible for Extra Help, she may also qualify for help with her other Medicare expenses through her state’s Medicare Savings Program.

State Medicaid programs partner with the federal government, so income and asset qualifications vary depending on where she lives. Medicare Savings Programs will pay her entire Medicare Part B premium each month.

Some also pay for Part B coinsurance and copayments, depending on her income. Contact your mom’s state Medicaid office to determine if she qualifies for benefits in her state.

You can also get help through her State Health Insurance Assistance Program (SHIP), which provides free one-on-one Medicare counseling in person or over the phone. To locate a SHIP counselor in your area, visit ShiptaCenter.orgor call the eldercare locator at 800-677-1116.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBCToday showand author of “The Savvy Senior” book.
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How to Choose a Good Estate Sale Company

Dear Savvy Senior,
Can you provide some tips on how to choose a good estate sale company who can sell all the leftover items in my mother’s house?
Inquiring Daughter

Dear Inquiring,
The estate sale business has become a huge industry over the past decade. There are roughly 22,000 estate sale companies that currently operate in the U.S., up nearly 60 percent from just 10 years ago. But not all estate sale companies are alike.

Unlike appraisal, auction and real estate companies, estate sale operators are largely unregulated, with no licensing or standard educational requirements.

That leaves the door open for inexperienced, unethical or even illegal operators. Therefore, it’s up to you to decipher a good reputable company from a bad one. Here are some tips to help you choose.

Make a list: Start by asking friends, your real estate agent or attorney for recommendations. You can also search online. Websites like EstateSales.netand EstateSales.orglet you find estate sale companies in your area.

Check their reviews:After you find a few companies, check them out on the Better Business Bureau (BBB.org), Angie’s List (AngiesList.com), Yelp (Yelp.com) and other online review sites to eliminate ones with legitimately negative reviews.

Call some companies:Once you identify some estate sale companies, select a few to interview over the phone. Ask them how long they’ve been in business and how many estate sales they conduct each month. Also find out about their staff, the services they provide, if they are insured and bonded and if they charge a flat fee or commission.

The national average commission for an estate sale is around 35 percent, but commissions vary by city and region.

You may also want to ask them about visiting their next sale to get a better feel for how they operate. And be sure to get a list of references of their past clients and call them.

Schedule appointments: Set up two or three face-to-face interviews with the companies you felt provided you with satisfactory answers during the phone interviews.

During their visit, show the estate liquidator through the property. Point out any items that will not be included in the sale, and if you have any items where price is a concern, discuss it with them at that time. Many estate companies will give you a quote, after a quick walk through the home.

You also need to ask about their pricing (how do they research prices and is every item priced), how they track what items sell for, what credit cards do they accept, and how and where will they promote and market your sale. EstateSales.net is a leading site used to advertise sales, so check advertising approaches there.

Additionally, ask how many days will it take them to set up for the sale, how long will the sale last, and will they take care of getting any necessary permits to have the sale.

You also need to find out how and when you will be paid, and what types of services they provide when the sale is over. Will they clean up the house and dispose of the unsold items, and is there’s an extra charge for that? Also, make sure you get a copy of their contract and review it carefully before you sign it.

For more information on choosing an estate sale company, see National Estate Sales Association online guide at NESA-USA.com, and click on “Consumer Education” then on “Find the Right Company.”

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBCToday showand author of “The Savvy Senior” book.

 

April 2018 Columns

Savvy Senior – April Columns

  1. How to Write a Will
  2. What to Know About the New Medicare Cards
  3. Simple Video Calling Devices for Tech-Challenged Seniors
  4. Is Your Blood Pressure Too High?
  5. How to Find Great Volunteer Vacations

How to Write a Will

Dear Savvy Senior,
Though it may seem hard to believe, at age 65, I never have gotten around to making a will, but I’d like to now. My question is: Do I need to hire a lawyer to write my will, or can I do it myself? I want to get my affairs in order, but I hate paying an attorney fee if I don’t have to.
Getting Organized

Dear Getting,
It’s not hard to believe at all. Fewer than half of American adults have a will, mainly because they either haven’t thought about it or gotten around to it, or they’ve put it off because they don’t want to think about dying.

But having a will is important because it ensures that your money and property are distributed to the people you want to receive it after your death.

If you die without a will, your estate will be settled in accordance with state law. Details vary by state, but assets typically are distributed using a hierarchy of survivors. Assets go to first to a spouse, then to children, then your siblings, and so on.

You also need to be aware that certain accounts take precedence over a will. If you jointly own a home or a bank account, for example, the house, and the funds in the account, will go to the joint holder, even if your will directs otherwise. Similarly, retirement accounts and life insurance policies are distributed to the beneficiaries you designate, so it is important to keep them up-to-date too.

Do You Need a Lawyer?
Not necessarily. Creating a will with a do-it-yourself software program may be acceptable in some cases, particularly if you’re single and have a modest bank account.

But if you have significant financial assets or a complex family situation, like a blended family or child with special needs, it’s best to seek professional advice. An experienced lawyer can make sure you cover all your bases, which can help avoid family confusion and squabbles after you’re gone.

The National Academy of Elder Law Attorneys (NAELA.org) and the American College of Trust and Estate Counsel (ACTEC.org) websites are good resources that have directories to help you find someone in your area.

Costs will vary depending on your location and the complexity of your situation, but you can expect to pay somewhere between $200 and $1,500 to get your will made. To help you save, shop around and get price quotes from several different firms. And before you meet with an attorney, make a detailed list of your assets and accounts to help make your visit more efficient.

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

If you are interested in a do-it-yourself will, one of the best options is the Quicken WillMaker Plus 2018 software (available at NOLO.com) that costs $70, works with Windows personal computers and Macs, and is valid in every state except Louisiana.

It’s also recommend that if you do create your own will, it’s wise to have a lawyer review it to make sure it covers all the important bases.

Where to Store It?
Once your will is written, the best place to keep it is either in a fireproof safe or file cabinet at home, or in a safe deposit box in your bank. But make sure your executor knows where it is and has access to it. Or, if a professional prepares your will, keep the original document at your lawyer’s office. Also, be sure to update your will if your family or financial circumstances change, or if you move to another state.

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 Know About the New Medicare Cards

Dear Savvy Senior,
What can you tell me about the new Medicare cards? I’ve heard there are a lot of scams associated with these new cards and I want to make sure I protect myself.
Leery Senior

Dear Leery,
The government will soon be sending out brand new Medicare cards to 59 million Medicare beneficiaries. Here’s what you should know about your new card along with some tips to help you guard against potential scams.

New Medicare Cards
Starting this month (April 2018), Medicare will be removing Social Security numbers from their new Medicare cards, and begin mailing them out to everyone who gets Medicare benefits.

The reason for this change is to help protect your identity and reduce medical and financial fraud. The new cards will have a randomly generated 11-character Medicare Number.

This will happen automatically. You don’t need to do anything or pay anyone to get your new card.

Medicare will mail your card, at no cost, to the address you have on file with the Social Security Administration. If you need to update your official mailing address, visit your online Social Security account at SSA.gov/myaccount, or call 800-772-1213. When you get your new card, your Medicare coverage and benefits will stay the same.

If you have a relative or friend who lives in another state and gets their card before you, don’t fret. The cards will be mailed in waves, to various parts of the country over a 12-month period starting in April 2018, and ending next April 2019.

Medicare beneficiaries in Alaska, California, Delaware, the District of Columbia, Hawaii, Oregon, Pennsylvania, Virginia and West Virginia will be the first to receive the mailings, between April and June.

The last wave of states will be Kentucky, Louisiana, Michigan, Mississippi, Missouri, Ohio and Tennessee, along with Puerto Rico and the Virgin Islands.

When you get your new Medicare card, don’t throw your old one in the trash. Instead, put it through a shredder or cut it up with a pair of scissors and make sure the part showing your Social Security number is destroyed.

If you have a separate Medicare Advantage card, keep it because you’ll still need it for treatment.

Watch Out For Scams
As the new Medicare cards start being mailed, be on the lookout for Medicare scams. Here are some tips:

  • Don’t pay for your new card. It’s yours for free. If anyone calls and says you need to pay for it, that’s a scam.
  • Don’t give personal information to get your card. If someone calls claiming to be from Medicare, asking for your Social Security number or bank information, that’s a scam. Hang up. Medicare will never ask you to give personal information to get your new number and card.
  • Guard your card. When you get your new card, safeguard it like you would any other health insurance or credit card. While removing the Social Security number cuts down on many types of identity theft, you’ll still want to protect your new card because identity thieves could use it to get medical services.

For more information about changes to your Medicare card go to Go.medicare.gov/newcard. And if you suspect fraud, report it to the FTC (FTCcomplaintassistant.gov), AARP’s fraud help line, 877-908-3360, or your local Senior Medicare Patrol program. Go to SMPresource.org for contact information.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.

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Simple Video Calling Devices for Tech-Challenged Seniors

Dear Savvy Senior,
Are there any senior-friendly devices that you can recommend for video calling? I live about a day’s drive from my 83-year-old father and would like to see him more often but he doesn’t use a computer, tablet or a smartphone.
Searching Susan

Dear Susan,
Video chatting is a great way to stay connected and keep tabs on an elder parent when you can’t be there. To help you and your dad achieve this, there are various products on the market today that offer simple video calling for seniors who are unfamiliar or uncomfortable with technology. Here are three unique devices to consider.

ViewClix
If you’re interested in a device that requires no input from your dad, check out the ViewClix Smart Frame. This is a 15-inch digital picture frame with video calling capabilities designed specifically for seniors.

Ready to use right out of the box, this device lets family and friends make video calls and send photos (displayed as a slideshow) directly to your dad’s ViewClix Smart Frame anytime from their smartphone, tablet or computer. To do this, you simply download the free ViewClix app to your devices.

All photos sent and video calls made to your dad’s ViewClix are received automatically. But, it is worth noting that this is a receiving device only. Your dad cannot initiate video calls from his ViewClix.

This device is available at ViewClix.com or 800-304-4281 for $299 (Wi-Fi is required), or you can purchase their 4G Broadband model that works with T-Mobile if Wi-Fi is not available for $299, plus a $20 monthly broadband fee.

GrandPad
Another nifty product that offers simple video calling, and much more, is the grandPad. This is an 8-inch touchscreen custom tablet designed for seniors, ages 75 and older. It comes with a stylus, charging stand and Verizon 4G LTE built-in so it works anywhere within the Verizon network – home Wi-Fi is not necessary.

This unique tablet provides a simplified menu of big colorful icons and large text to only essential features, giving your dad clutter-free, one-touch access to make and receive video calls and phone calls, send voice emails, view photos and videos, listen to personalized music, check the weather, play games and more.

But to simplify usage and avoid confusion, it does not offer Web browsing.

GrandPad also has a “Help” button that offers 24/7 phone/tablet remote assistance to help your dad with any facet of his tablet, and it provides damage and theft insurance so if your dad breaks or loses his tablet it will be replaced at no additional cost. Available at grandPad.net or call 800-704-9412, a grandPad leases for $66 per month, or $49/month if you pay one year in advance.

Echo Show
If you don’t think your dad would mind talking to a machine, the voice activated Amazon Echo Show is another senior-friendly device for video chatting (Wi-Fi is required).

Available at Amazon.com for $230, the Echo Show has a 7-inch color touchscreen that would let your dad make and receive video calls to those who have their own device, or who have the free Amazon Alexa app installed on their smartphone or tablet.

Once you set up his contacts, to make a call your dad would simply say, “Alexa, call Susan.” And when a call comes in, he would ask Alexa to answer or ignore the call. There’s also a feature called “drop-in,” which could allow you and other pre-selected  relatives or friends to video in to your dad’s device at any time without his input.

The Echo Show also offers a bevy of other features your dad might enjoy like voice-activated access to news, weather, his favorite music and more.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.

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Is Your Blood Pressure Too High?

Dear Savvy Senior,
What numbers constitute high blood pressure? I use to be pre-hypertensive, but they keep changing the guidelines, so I’m not sure where I fit in now.
Approaching 60

Dear Approaching,
If you’re unsure what your blood pressure levels should be, you’re not alone. Recent changes in the hypertension guidelines made by the American Heart Association and the American College Cardiology mean that roughly 30 million more Americans than previously thought are now considered to have high blood pressure (hypertension).

According to the new guidelines, anyone with a blood pressure reading above 130/80 is considered to have high blood pressure.

Previously, those with a blood pressure reading between 120/80 and 139/89 would have been put in the prehypertension category and wouldn’t have been considered hypertensive until they got to 140/90.

But the new guidelines eliminate the prehypertension category, putting everyone with systolic pressure readings (top number) between 120 and 129 and a diastolic reading (bottom number) below 80 in a new “elevated” category.

And those with a reading of 130/80 or higher fall in some stage of hypertension. Here’s a complete rundown of the new five category blood pressure ranges:

  • Normal: A top number less than 120 and a bottom number less than 80.
  • Elevated: A top number between 120 and 129, and a bottom number less than 80.
  • Stage 1: A top number between 130 and 139, or a bottom number between 80 and 89.
  • Stage 2: A top number of 140 or higher, or a bottom number of 90 or higher.
  • Hypertensive crisis: A top number over 180 or a bottom number over 120.

Get Checked
Millions of Americans with high blood pressure don’t know they have it because it usually has no outward signs or symptoms. But high blood pressure, over time, can damage your arteries and increase your risk for heart disease, stroke, kidney damage and even dementia.

To guard against this, everyone over the age of 40, as well as those younger with risk factors for hypertension should get their blood pressure checked at least once a year.

If you find that your blood pressure numbers fall in the “elevated” category, you should take steps now to get it under control. Lifestyle changes like eating a healthy diet, losing weight, exercising, watching your salt intake, quitting smoking, and cutting back on alcohol is often all you need to get it back to normal.

Even if your blood pressure numbers are in the “stage 1” category, lifestyle changes are recommended first, unless you’ve had a heart attack or stroke, or you’re at high risk for cardiovascular problems because you smoke, have high cholesterol or type 2 diabetes. Then medications may be prescribed.

But if your blood pressure falls in the “stage 2” or higher category, the new guidelines suggest medication, regardless of age, plus lifestyle changes.

There are several different kinds of drugs used to lower blood pressure. It usually makes sense to start with the oldest, safest, and least expensive drug: diuretics, or water pills, such as chlorthalidone or hydrochlorothiazide.

But these meds can drive up blood sugar levels, so if you have type 2 diabetes or are at risk of it, your doctor may prescribe another drug, such as an ACE inhibitor, ARB or calcium channel blocker.

You should also be aware that blood pressure drugs could cause side effects including dizziness, gastrointestinal problems, fatigue and headaches. They can also cause a decline in kidney function so make sure your doctor periodically monitors your potassium levels.

For more information, see the American Heart Association comprehensive Web page on high blood pressure at 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.

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How to Find Great Volunteer Vacations

Dear Savvy Senior,
My husband and I are approaching retirement and are interested in learning more about volunteer vacations. Can you give us some information on this travel option, and refer us to some good organizations that offer these types of trips.
Love to Travel

Dear Love,
If you’re looking to do more on your next vacation than relax in the sun or go sightseeing, volunteer vacations – also known as voluntourism – which combine travel and volunteer work, are a great alternative and a growing trend among retirees.

Volunteer Vacations
There are many organizations today that offer short-term volunteer vacation projects in the U.S. and abroad, lasting anywhere from a few days to a few weeks.

Common program themes include teaching English, working with children and teens, building and repairing homes and schools, and assisting with community or environmental projects.

In addition, volunteer vacations also give travelers the opportunity to experience the culture more fully and connect with the local people — much different than your run-of-the-mill sightseeing vacation.

Most volunteer vacation groups accept singles, couples and families and you don’t need to speak a foreign language. Costs usually range from around $1,000 to $3,000 per week, not including transportation to the country your site is in.

Fees typically cover pre-trip orientation information, room and board, on-site training, ground transportation once you get there, the services of a project leader, and a contribution to the local community that covers material and services related to the project.

And, if the organization running your trip is a nonprofit, the cost of your trip, including airfare, is probably tax-deductible.

Where to Look
While there are many organizations that offer volunteer vacations, here are some good ones that attract a lot of retirees.

  • Global Volunteers (org): A pioneer in global travel, this group tackles hunger, poverty and educational needs. It offers a variety of one, two and three-week service programs in 17 countries, including the U.S.
  • Earthwatch Institute (org): With an emphasis in environmental conservation and research, they offer dozens of one and two-week expeditions in countries all over the world.
  • Cross-Cultural Solutions (org): Based in New Rochelle, NY, they focus on health, education, and economic volunteer opportunities in Central and South America, Europe, Asia and Africa.
  • Biosphere Expeditions (Biosphere-expeditions.org): Offers wildlife conservation expeditions in 13 countries.
  • Habitat for Humanity (org): Offers international house-building trips through its Global Village Program in more than 40 countries.
  • Sierra Club (org): This venerable environmental group sponsors dozens of service trips in the U.S. each year, with more projects offered through local chapters.

How to Choose
With so many different volunteer vacations to choose from, selecting one can be difficult. To help you decide, you need to think specifically about what you want.

For example: Where you want to go and for how long? What types of work are you interested in doing? What kind of living situation and accommodations do you want? Do you want to volunteer alone or with a group?

Do you want a rural or urban placement? Also consider your age and health. Are you up to the task, or do you have any special needs that will need to be met?

Once you figure out what you want and spot a few volunteer vacations that interest you, ask the organization to send you information that describes the accommodations, the fees and what they cover including their refund policy, the work schedule and work details, and anything else you have questions about.

Also, get a list of previous volunteers and call them.

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.

March 2018 Columns

Savvy Senior – March Columns

  1. How to Get Cash For Your Life Insurance Policy
  2. Could You Have Diabetes?
  3. Tips and Resources for Older Job Seekers
  4. How to Choose a Memory Care Unit

How to Get Cash For Your Life Insurance Policy

Dear Savvy Senior,
I have a life insurance policy that I’ve been paying on for years that I really don’t need any longer. I’ve been thinking about letting it lapse, but I’ve heard that I can actually sell it for a nice payout. What can you tell me about this?
Interested In Selling

Dear Interested,
Selling a life insurance policy, even a term life policy that you don’t want or need any longer – a transaction known as a “life settlement” – has become a popular option among retirees in recent years that could use some extra cash. Here’s how it works.

A life settlement is the sale of an existing life insurance policy to a third party company for cash. Life settlements are typically best suited for people over age 65 who own a policy with a face value of $100,000 or more or someone younger who has experienced a significant change in health.

Historically, if an owner of a life insurance policy decided they no longer needed it, they would either let the policy lapse or turn it in for a meager cash surrender value. But now, with the life settlement option, you can actually sell your policy for more than the cash surrender value would be, but less than its net death benefit.

Once you sell it, the life settlement company then becomes the new owner of the policy, pays the future premiums and collects the death benefit.

How much money you can expect to get with a life settlement will depend on your age, health and life expectancy, the type of insurance policy, the premium costs and the cash value of your policy. You may be able to receive four to eight times more than the policy cash surrender value.

If you’re interested in a life settlement here are some things you should know:

Shop around: Because payout can vary, to ensure you get the best price for your policy get quotes from several companies. Also, find out what broker and transaction fees you’ll be required to pay. Coventry, the nation’s first and largest provider of life settlements, offers some of the highest cash payouts for life insurance policies. To get started, visit CoventryDirect.com or call 888-858-9344. To search for other providers or brokers, the Life Insurance Settlement Association provides a directory at LISA.org.

Be prudent: Life settlements are regulated in most states. Find out from your state insurance commissioner (see NAIC.org for contact information) if the life settlement company you’re interested in is properly licensed.

Protect your privacy: When you sell your life insurance policy, you will have to sign a waiver authorizing the release of medical and other personal information so that the buyer can determine how much to offer for your policy. Before accepting any offer, make sure that the company has procedures in place to protect the confidentiality of your information.

Understand the tax implications: The Tax Cuts and Jobs Act recently updated the tax treatment of a life settlement to be treated the same as the surrender of a policy back to the insurance company. This can be complicated, so be sure to consult a tax advisor.

Other Options
If you want to keep your life insurance policy but could use some extra cash, you may have some other options. For example, some life settlement companies may allow you to keep part of the policy’s death benefit while eliminating your premium obligations. You can also ask your life insurer if you can borrow against your policy, or if you’re in poor health, see if you’re eligible for accelerated death benefits. You should also find out if you’re able to convert the cash value of your policy into an immediate annuity (through a 1035 Exchange), which would make regular payments to you for a set number of years or for the rest of your life.

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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Could You Have Diabetes?

Dear Savvy Senior,
My brother and his wife, who are ages 60 and 56, were recently diagnosed with type 2 diabetes, and prediabetes, and neither one had a clue. Could I have it too?
Concerned Sibling

Dear Concerned,
According to the Centers for Disease Control and Prevention nearly 115 million Americans have diabetes or prediabetes today, but most of them don’t even know they have it. Here’s how to know if you’re at risk.

The problem with diabetes is that most people don’t start thinking about it until they’re diagnosed, and that’s too late. Diabetes is a disease that develops over decades. Most people have prediabetes for a long time before the disease becomes full-blown type 2 diabetes, and even then it progresses gradually. That leaves a big window in which to stop, slow or reverse the disease.

Diabetes occurs when the pancreas doesn’t produce enough insulin to remove sugar from the bloodstream. Excess blood sugar damages blood vessels and affects circulation, putting you at risk for a host of ailments, from heart attack and stroke to blindness, kidney failure and nerve damage.

Are You At Risk?
If you answer “yes” to any of the following questions, your odds of developing diabetes increases.

  • Are you over age 45?
  • Are you overweight?
  • Do you have high blood pressure – 140/90 or higher?
  • Do you have a parent or sibling with diabetes?
  • Are you sedentary?
  • Are you African American, Hispanic/Latino American, Native American, Asian American, Pacific Islander, or Alaska native?
  • Did you develop gestational diabetes during pregnancy?

To help you determine your risk of developing diabetes, take the free online quiz at Diabetes.org/risk-test.jsp.

Get Tested
If you find that you’re at risk for diabetes, there are three different tests your doctor can give you to diagnosis it. The most common is the “fasting plasma glucose test,” which requires an eight-hour fast before you take it. There’s also the “oral glucose tolerance test” to see how your body processes sugar, and the “hemoglobin A1C test” that measures your average blood sugar over the past three months. It can be taken anytime regardless of when you ate.

Most private health insurance plans and Medicare cover diabetes tests, however, if you’re reluctant to visit your doctor to get tested, an alternative is to go to the drug store, buy a blood glucose meter and test yourself at home.

Some top options, recommended by Consumer Reports, include FreeStyle Freedom Lite, Bayer Contour Next, True Metrix Blood Glucose Meter, OneTouch UltraMini, and the ReliOn (Wal-Mart) Micro, which all cost under $25.

If you find that you are prediabetic or diabetic, you need to see your doctor to develop a plan to get it under control.

In many cases lifestyle changes like losing weight, exercising, eating a healthy diet and cutting back on carbohydrates may be all you need to do to get your diabetes under control. For others who need more help, many medications are available.

For more information on diabetes or to find help, join a lifestyle change program recognized by the CDC (see CDC.gov/diabetes/prevention) that offers in-person and online programs in more than 1,400 locations throughout the U.S. Over the course of a year, a coach will help you eat healthy, increase your physical activity and develop new habits.

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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Tips and Resources for Older Job Seekers

Dear Savvy Senior,
What resources can you recommend to help older job seekers? I’m 60 and have been out of work for nearly a year now and need some help.
Seeking Employment

Dear Seeking,
While the U.S. job market has improved dramatically over the past few years, challenges still persist for many older workers. To help you find employment, there are job resource centers and a wide variety of online tools specifically created for older job seekers. Here’s where you can find help.

Job Centers
Depending on where you live, there are career service centers located throughout the U.S. that can help you find a job. One of the best is the American Job Center (AJC) that has around 2,500 centers nationwide. Funded by the U.S. Department of Labor’s Employment and Training Administration, AJCs are free-to-use resource centers that can help you explore your career options, search for jobs, find training, write a resume, prepare for an interview and much more. To find a center near you, call 877-872-5627 or go to CareerOneStop.org.

Some other good programs for older workers include the Senior Community Service Employment Program (SCSEP), and AARP’s Back To Work 50+ program.

The SCSEP – sponsored by the Department of Labor – helps place income-eligible workers over age 55 in part-time, temporary community service positions where they can learn job skills. To learn more or locate a program in your area visit DOLETA.gov/seniors or call 877-872-5627.

AARP’s Back To Work 50+ program currently offers workshops in 19 locations around the U.S. that provide career counseling, job coaching and skills development for 50-plus job seekers. Or, if you can’t attend their workshop, they also offer an excellent guide called “7 Smart Strategies for 50+ Jobseekers.” To get a free copy, or see if there’s a workshop in your area call 855-850-2525.

If none of the above programs are available in your area, check with your local public library or nearby community college to see if they provide career services. 

Job Search Sites
There are also a number of online job search sites that can help you connect with companies that are looking for mature, experienced workers.

Some good sites for 50 and older job seekers include: WhatsNext.com, which offers a job search site and has online assessment tools, calculators, career guides and career coaches to help you; RetiredBrains.com that provides information on finding temporary or seasonal jobs, as well as starting your own business, working from home, writing your resume, finding full-time work, and continuing your education; RetirementJobs.com that lets you post your resume and search for full-time or part-time jobs online; and Workforce50.com, which has job search functions and a list of favorite age-friendly employers by industry. It also gives you the ability to sign up for job alerts.

Work at Home
If you’re interested in working at home, there are many opportunities depending on your skills, but be careful of work-at-home scams that offer big paydays without much effort.

Some popular work-at-home jobs include sales and marketing, customer service, teaching and tutoring, writing and editing, Web development and design, consulting, interpreting and medical coding just to name a few.

To find these types of jobs, a good place to start is FlexJobs.com, which filters out the job scams and lists thousands of legitimate work-at-home jobs in dozens of categories. You can gain access to their listings for $15 for one month, $30 for three months or $50 for a year.  

Start a Business
If you’re interested in starting a small business but could use some help getting started, the U.S. Small Business Administration offers tips, tools and free online courses that you can access at SBA.gov.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.

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How to Choose a Memory Care Unit

Dear Savvy Senior,
My mom has Alzheimer’s disease and has gotten to the point that she can’t live at home any longer. I need to find a good memory care residential unit for her but could use some help. Any suggestions?
Exhausted Daughter

Dear Exhausted,
Choosing a good memory care residential unit for a loved one with Alzheimer’s disease is a very important decision that requires careful evaluation and some homework.

Most memory care units, sometimes called special care units, are housed within assisted living or nursing home facilities. At their best, they offer staff extensively trained in caring for people with dementia, individualized care that minimizes the use of dangerous psychotropic drugs, a home-like environment and activities that improve residents quality of life. But at their worst, they can offer little more than a locked door. Here are some steps that can help you find a good facility and avoid a bad one.

Make a list: To identify some good memory care residential units in your area ask your mom’s doctor for a referral, and use the Alzheimer’s Association online tool at CommunityResourceFinder.org. Make sure the facilities on your list are close to family members and friends who can visit often, because residents with frequent visitors usually get better care.

Research your options: Once you’ve made a list, contact your local long-term care ombudsman (see LTCombudsman.org). This is a government official who investigates assisted living and nursing home complaints and can tell you which facilities have had problems in the past.

If you’re looking at a memory care unit within a nursing home facility, use Medicare’s nursing home compare tool (Medicare.gov/nursinghomecompare), which provides a 5-star rating system.

Call the facilities: Once you’ve identified a few facilities, call them to find out if they have any vacancies, if they provide the types of services your mother needs, what they charge and if they accept Medicaid.

Tour your top choices: During your tour, notice the cleanness and smell of the facility. Is it homey and inviting? Does the staff seem responsive and kind to its residents? Also be sure to taste the food, and talk to the current resident’s family members, if available.

Also, find out about staff screening and training procedures, their turnover rate, and the staff-to-resident ratio. They should have at least one staff member for every five residents.

Make sure the facility offers quality activities that can keep your mom engaged, even at night when she may be awake. Ask how they respond to residents who may wander or become aggressive. If the answer is locked doors and antipsychotic drugs, that’s a red flag.

Because transitions can be unsettling for dementia suffers, make sure that your mom will be able to remain at the facility for the foreseeable future. And find out what, if any, health conditions might require your mom to leave the facility or move to a higher and more expansive level of care.

It’s also a good idea to make multiple visits to the facility including an unscheduled visit at night or on weekends when the staff is more likely to be stretched thin.

To help you evaluate your visit, the Alzheimer’s Association offers a checklist that you can access at ALZ.org/residentialfacilities.

Paying for care: The national average costs for memory care within an assisted living facility is over $5,000 per month, and over $7,500/month for nursing home care, but costs can vary widely depending on your location. Since Medicare does not cover long-term care, most residents pay for care from either personal savings, a long-term care insurance policy, or through Medicaid (if available) once their savings are depleted.

To help you research your financial options, visit the National Clearinghouse for Long-Term Care Information website at LongTermCare.gov.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.