Savvy Senior Columns for September 2020

Savvy Senior – September Columns

  1. How to Prevent Falls During a Pandemic
  2. Should Seniors Consider a Reverse Mortgage Now?
  3. Is There an Age Limit for Organ Donation?
  4. Should I Buy Long-Term Care Insurance?

How to Prevent Falls During a Pandemic

Dear Savvy Senior,
My 80-year-old mother, who lives alone and is self-isolating during the coronavirus pandemic, has fallen several times. Are there any extra precautions you recommend that can help prevent this?
Concerned Daughter

Dear Concerned,
Falls are a common concern for many elderly adults and their families, especially during the coronavirus pandemic when many seniors are sheltering at home alone.

Each year, more than 1-in-4 older Americans fall, making it the leading cause of both fatal and nonfatal injuries for those age 65 and older. But many falls can be prevented. Depending on what’s causing your mom to fall, here are some different tips that can help prevent it.

Encourage exercise: Weak leg muscles and poor balance are two of the biggest risk factors that cause seniors to fall. Walking, strength training and tai chi are all good for improving balance and strength, as are a number of balance exercises your mom can do anytime like standing on one foot for 30 seconds then switching to the other foot, and walking heel-to-toe across the room.

For additional balance and leg strengthening exercises, see AgeBold.com.

Review her medications: Does your mom take any medicine, or combination of medicines, that make her dizzy, sleepy or lightheaded? If so, make a list or gather up all the drugs she takes – prescriptions and over the counter – and contact her doctor or pharmacist for a drug review and adjustment.

Get a vision test: Poor vision can be another contributor to falls, so your mom should get her eyes checked once a year and be sure to update her eyeglasses if needed. Also be aware that if your mom wears bifocal or progressive lenses, they too can cause falls, especially when walking outside or going down steps. These lenses can affect depth perception, so she may want to get a pair of glasses with only her distance prescription for outdoor activities.

If your mom is concerned about a trip into her eye doctor during the pandemic, she can get her vision tested online. Put a call her eye doctor about this option, or consider some online vision testing sites likeEssilor.com or 6over6.com. And to buy eyeglasses online, some popular options include WarbyParker.com and ZenniOptical.com.

Fall-proof her home: There are a number of simple household modifications you can do to make your mom’s living area safer. Start by helping her arrange or move the furniture so there are clear pathways to walk through and pick up items on the floor that could cause her to trip like newspapers, shoes, clothes, electrical or phone cords.

If she has throw rugs, remove them or use double-sided tape to secure them.

In the bathroom buy some non-skid rugs for the floors and a rubber suction-grip mat or adhesive non-skid tape for the floor of the tub or shower, and have a carpenter install grab bars in and around the tub/shower for support.

Also, make sure the lighting throughout the house is good, purchase some inexpensive plug-in nightlights for the bathrooms and hallways, and if she has stairs, put handrails on both sides.

For more tips, see the NIA “fall-proofing your home” web page at NIA.NIH.gov/health/fall-proofing-your-home.

Choose safe footwear: Going barefoot or wearing slippers or socks at home can also cause falls, as can wearing backless shoes, high heels, and shoes with smooth leather soles. The safest option for your mom is rubber-sole, low-heel shoes.

Purchase some helpful aids: If your mom needs some additional help getting around, get her a cane or walker. Also, to help ensure your mom’s safety, and provide you some peace of mind, consider getting her a medical alert device that comes with a wearable emergency button that would allow her to call for help if she were to fall or need assistance.

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

Dear Savvy Senior,
What can you tell me about reverse mortgages? The coronavirus damage to my retirement account has me considering it but want to make sure I know what I’m getting into.
Cash-Strapped Senior

Dear Cash-Strapped,
Massive job losses, a volatile stock market and low interest rates caused by the coronavirus pandemic has caused many cash-strapped retirees to consider a reverse mortgage. But there’s a lot to consider to be sure it’s a good option for you now.

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 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 $765,600.

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 60 percent of the home’s value. To estimate how much you can borrow, use the reverse mortgage calculator at ReverseMortgage.org.

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

But be aware the reverse mortgages aren’t cheap. HECM loans require a 2 percent upfront mortgage insurance payment, plus an additional 0.5 percent annual charge, on top of origination costs and lenders’ fees. Any amount you borrow, including these fees and insurance, accrues interest, which means your debt grows over time.

To learn more, read the National Council on Aging’s online booklet “Use Your Home to Stay at Home” at NCOA.org/home-equity.

Also note that because reverse mortgages are complex loans, all borrowers are required to get counseling through a HUD approved independent counseling agency before taking one out. Most agencies charge between $125 and $250. To locate one near you, visit Go.usa.gov/v2H, or call 800-569-4287.

Other Options
If you have a short-term need for cash, there are other options you should look into. For example, many low-income seniors don’t realize they qualify for the earned income tax credit, a refundable tax break that can put cash in your pocket. You also could use BenefitsCheckUp.org to search for financial assistant programs you may be eligible for.

Another possibility is a regular home equity loan or line of credit. This type of borrowing requires you to make payments, and lenders can freeze or lower limits on lines of credit, but the borrowing costs are much lower.

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 There an Age Limit for Organ Donation?

Dear Savvy Senior,
I never thought about becoming an organ donor until my brother died of kidney failure last year. But at age 78, I would like to know if I’m too old to be a donor, or if they would even use my organs if I were to die from COVID-19. What can you tell me?
Potential Donor

Dear Potential,
There’s no cutoff age for being an organ donor. Anyone, regardless of age or medical history, can sign up. In fact, there are many people well up into their 80’s that donate. The decision to use your organs is based on health of the organ, not age. So, don’t disqualify yourself prematurely. Let the doctors decide at your time of death whether your organs and tissues are suitable for transplantation.

Regarding the COVID-19 part of your question, as of right now, the Organ Procurement and Transplantation Network (OPTN) does not recommend transplantation of organs from donors known to have the virus. So, if you were to contract the coronavirus and die, your organs would probably not be used, however, this may change as treatments are developed.

Here’s what else you should know about becoming a donor.

Donating Facts
In the United States alone, more than 112,000 people are on the waiting list for organ transplants. But because the demand is so much greater than the supply, those on the list routinely wait three to seven years for an organ, and more than 7,000 of them die each year.

Organs that can be donated include the kidneys, liver, lungs, heart, pancreas and intestines. Tissue is also needed to replace bone, tendons and ligaments. Corneas are needed to restore sight. Skin grafts help burn patients heal and often mean the difference between life and death. And heart valves repair cardiac defects and damage.

By donating your organs after you die, you can save or improve as many as 50 lives. The United Network for Organ Sharing maintains the OPTN, a national computer registry that matches donors to waiting recipients.

Some other things you should know about being an organ donor are that it does not in any way compromise the medical care you would receive in a hospital if you are sick or injured, nor does it interfere with having an open-casket funeral if you want that option. And, most major religions in the United States support organ donation and consider it as the final act of love and generosity toward others.

How to Donate
If you would like to become a donor, there are several steps you should take to ensure your wishes are carried out, including:

Registering: Add your name to your state or regional organ and tissue donor registry. You can do this online at either OrganDonor.gov or DonateLife.net. If you don’t have Internet access, call Donate Life America at 804-377-3580 and they can sign you up over the phone.

Identify yourself: Designate your decision to become an organ donor on your driver’s license, which you can do when you go in to renew it. If, however, you don’t drive anymore or if your renewal isn’t due for a while, consider getting a state ID card – this also lets you indicate you want to be a donor. You can get an ID card for a few dollars at your nearby driver’s license office.

Tell your family: Even if you are a registered donor, in many states, family members have the ultimate say whether your organs may be donated after you die. So, clarify your wishes to family. Also tell your doctors and indicate your wishes in your advance directives. These are legal documents that spell out your wishes regarding your end-of-life medical treatment when you can no longer make decisions for yourself. If you don’t have an advance directive, go to MyDirectives.com where you can create one for free.

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

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Should I Buy Long-Term Care Insurance?

Dear Savvy Senior,
My wife and I have thought about purchasing a long-term care insurance policy, but we hate the idea of paying expensive monthly premiums for a policy we may never use. Is there a good rule of thumb on who should or shouldn’t buy long-term care insurance?
Getting Old

Dear Getting Old,
There are two key factors you need to consider that can help you determine if purchasing a long-term care (LTC) insurance policy is a smart decision for you and your wife. One factor is your financial situation and second is your health history. Currently, around 8 million Americans own a policy.

Who Needs LTC Insurance?
As the cost of LTC – which includes nursing home, assisted living and in-home care – continues to rise, it’s important to know that most people pay for LTC either from personal savings or Medicaid when their savings is depleted, or through a LTC insurance policy. National median average costs for nursing home care today is around $92,000 per year, while assisted living averages around $50,000/year.

While national statistics show that about 70 percent of Americans 65 and older will need some kind of LTC, the fact is, many people don’t need to purchase a LTC insurance policy.

The reasons stem from a range of factors, including the fact that relatively few people have enough wealth to protect to make purchasing a policy worthwhile. Seniors with limited financial resources who need LTC turn to Medicaid to pick up the tab after they run out of money.

Another important factor is that most seniors who need LTC only need it for a short period of time, for example, when they’re recovering from surgery. For those people, Medicare covers in-home health care and nursing home stays of 100 days or less following a hospital stay of more than 3 consecutive days.

So, who should consider buying a policy?

LTC insurance policies make the most sense for people who can afford the monthly premiums, and who have assets of at least $150,000 to $200,000 or more that they want to protect, not counting their home and vehicles.

Another factor to weigh is your personal health and family health history. The two most common reasons seniors need extended long-term care is because of dementia and/or disability. And, almost half of all people who live in nursing homes are 85 years or older. So, what’s your family history for Alzheimer’s, stroke or some other disabling health condition, and do you have a family history of longevity?

You also need to factor in gender too. Because women tend to live longer than men, they are at greater risk of needing extended LTC.

Choosing LTC Insurance
After evaluating your situation, if you’re leaning towards buying a LTC policy, be sure to do your homework. The cost of premiums can vary greatly ranging anywhere between $2,500 and $8,000 per year for a couple depending on your age, the insurer, and the policy’s provisions.

Also note that because of coronavirus, it may be more difficult to qualify for coverage now if you’re age 70 or older, in a high-risk group or have had a positive COVID-19 test.

To find a policy, get a LTC insurance specialist who works with a variety of companies. See the American Association of Long-Term Care Insurance website (AALTCI.org) to locate one. Also shop insurers like Northwestern Mutual and New York Life, who work only with their own agents.

Another option you may want to consider are Hybrid policies that combine long-term care coverage with life-insurance benefits. These policies promise that if you don’t end up needing long-term care, your beneficiaries will receive a death benefit.

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

Savvy Senior Columns for August 2020

Savvy Senior – August Columns

  1. Financial Help for Retirees Affected by COVID-19
  2. How to Keep a Watchful Eye on an Aging Parent
  3. How Medicare and Other Tools Can Help Older Smokers Kick the Habit
  4. An Executor’s Guide to Settling A Loved One’s Estate

 

Financial Help for Retirees Affected by COVID-19

Dear Savvy Senior,
Are there any financial assistance programs you can refer me to? The coronavirus pandemic has cost me my part-time retirement job and has shrunk my measly IRA account.
Needy Retiree

Dear Needy,
Absolutely! In addition to the $1,200 federal coronavirus stimulus check that was distributed in April and May, there are many other financial-assistance programs (both public and private) that can help struggling retirees, as well as give relief to family members who help provide financial support for their loved ones.

To find out what types of assistance you may be eligible for, just go to BenefitsCheckUp.org, a free, confidential Web tool designed for adults 55 and older and their families. It will help you locate federal, state and private benefits programs that can assist with paying for food, medications, utilities, health care, housing and other needs. This site – created by the National Council on Aging – contains more than 2,500 programs across the country.

To identify benefits, you’ll first need to fill out an online questionnaire that asks a series of questions like your date of birth, ZIP code, expenses, income, assets, veteran status, the medications you take and a few other factors. It takes about 15 minutes.

Once completed, you’ll get a report detailing all the programs and services you may qualify for, along with detailed information on how to apply.

Some programs can be applied for online; some have downloadable application forms that you can print and mail in; and some require that you contact the program’s administrative office directly (they provide the necessary contact information).

If you don’t have Internet access, you can also get help in-person at any of the 84 Benefit Enrollment Centers located throughout the U.S. Call 888-268-6706 or visit NCOA.org/centerforbenefits/becs to locate a center in your area. Some centers also offer assistance over the phone.

Types of Benefits
Depending on your income level and where you live, here are some benefits you may be eligible for:

Food assistance: Programs like the Supplemental Nutrition Assistance Program (SNAP) can help pay for groceries. The average SNAP benefit for 60-and-older households is around $125 per month. Other programs that may be available include the Emergency Food Assistance Program, Commodity Supplemental Food Program, and the Senior Farmers Market Nutrition Program.

Healthcare: Medicaid and Medicare Savings Programs can help or completely pay for out-of-pocket health care costs. And, there are special Medicaid waiver programs that provide in-home care and assistance too.

Prescription drugs: There are hundreds of programs offered through pharmaceutical companies, government agencies and charitable organizations that help lower or eliminate prescription drug costs, including the federal Low-Income Subsidy known as “Extra Help” that pays premiums, deductibles and prescription copayments for Medicare Part D beneficiaries.

Utility assistance: There’s the Low-Income Home Energy Assistance Program (LIHEAP), as well as local utility companies and charitable organizations that provide assistance in lowering home heating and cooling costs.

Supplemental Security Income (SSI): Administered by the Social Security Administration, SSI provides monthly payments to very low-income seniors, age 65 and older, as well as to those who are blind and disabled. In 2020, SSI pays up to $783 per month for a single person and up to $1,175 for couples.

In addition to these programs, there are numerous other benefits they can help you locate such as HUD housing, home weatherization assistance, tax relief, veteran’s benefits, senior transportation, respite care, free legal assistance, job training and employment and debt counseling.

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 Keep a Watchful Eye on an Aging Parent

Dear Savvy Senior,
Can you recommend any services or technology that help me monitor my elderly mother who lives alone? Since the coronavirus pandemic started last March, my sister and I have noticed that my mom’s health has slipped a bit, so we would like to find something that helps us keep tabs on her when we’re not around.
Concerned Daughter

Dear Concerned
Depending on how closely you want to monitor your mother, and what she’s comfortable with as well, there are check-in call services along with some new monitoring technology devices you can turn to for help. Here are several to consider.

Check-In Calls
If you just want a simple check to make sure your mom is OK every day, consider signing her up with a daily check-in call service program. These are telephone reassurance programs run by police or sheriff’s departments in hundreds of counties across the country and are usually provided free of charge.

Here’s how they work. A computer automated phone system would call your mom at a designated time each day to check-in. If she answers, the system would assume everything is OK. But if she didn’t pick up or if the call goes to voice mail after repeated tries, you (or her other designee) would get a notification call. If you are not reachable, calls are then made to backup people who’ve also agreed to check on your mom if necessary.

The fallback is if no one can be reached, the police or other emergency services personnel will be dispatched to her home.

To find out if this service is available in your mom’s community, call her local police department’s nonemergency number. If it’s not offered, there are other organizations or companies you can turn to that provide similar services.

One that I love that’s completely free to use is Mon Ani (monami.io, 650-267-2474), which offers a volunteer phone bank that provides phone or video calls daily, weekly or anything in between. The volunteer will connect with your mom, provide companionship and make sure everything is OK. And, they’ll let you know if they detect a problem.

Monitoring Technology
Technology also offers a variety of new ways to help you keep an eye on your mom when you can’t be there.

One nifty new option is the Electronic Caregiver’s (electroniccaregiver.com) “Premier” product, which is a wearable wrist device that provides activity monitoring, a 24/7 emergency help button, medication reminders and a GPS locator so you can determine your mom’s whereabouts when she’s away from home.

It’s also linked to a family caregiver app to keep you and other loved ones in the loop. The device is free with a monthly subscription that costs $40 to $60 a month, depending on the level of monitoring.

If your mom is primarily homebound, another option to consider is a sensor-monitoring system like Caregiver Smart Solutions (caregiversmartsolutions.com). This uses small sensors (not cameras) placed in key areas of your mom’s home to track her activities – everything from whether she used the coffee pot to how much she’s watching TV – and will let you know if something out of the ordinary is happening. For instance, if she went to the bathroom and didn’t leave, it could indicate a fall or other emergency.

You can also check up on her patterns anytime you want through the system’s website or app. And for additional protection, it offers emergency call buttons that can be placed around the house. Caregiver Smart Solutions starts at $99 for their activity sensors, plus a $29 monthly service fee.

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 Medicare and Other Tools Can Help Older Smokers Kick the Habit

Dear Savvy Senior,
I understand that COVID-19 hits smokers a lot harder than nonsmokers but quitting at my age is very difficult. Does Medicare offer any coverage that helps beneficiaries quit smoking?
Must Quit

Dear Must,
It’s true. Smokers and vapers have a higher risk of severe COVID-19 infection as the coronavirus attacks the lungs. That’s why quitting now is more important than ever before.

If you are a Medicare beneficiary, you’ll be happy to know that Medicare Part B covers up to eight face-to-face counseling sessions a year to help you quit smoking. And, if you have a Medicare Part D prescription drug plan, certain smoking-cessation medications are covered too. Here are some other tips that can help you kick the habit.

It’s Never Too Late
According to the Center of Disease Control and Prevention (CDC) 12.5 percent of Medicare beneficiaries smoke. Many older smokers, like yourself, indicate that they would like to quit, but because of the nicotine, which is extremely addictive, it’s very difficult to do.

Tobacco use is the leading cause of preventable illness, responsible for an estimated one-fifth of deaths in the United States each year.

But research shows that quitting, even after age 65, greatly reduces your risk of heart disease, stroke, cancer, osteoporosis and many other diseases including COVID-19. It also helps you breathe easier, smell and taste food better, not to mention saves you quite a bit of money. A $6 pack-a-day smoker, for example, saves about $180 after one month without cigarettes, and nearly $2,200 after one year.

How to Quit
The first step you need to take is to set a “quit date,” but give yourself a few weeks to get ready. During that time, you may want to start by reducing the number or the strength of cigarettes you smoke to begin weaning yourself.

Also check out over-the-counter nicotine replacement products – patches, gum and lozenges – to help curb your cravings (these are not covered by Medicare). And just prior to your quit day get rid of all cigarettes and ashtrays in your home, car, and place of work, and try to clean up and even spray air freshener. The smell of smoke can be a powerful trigger.

Get Help
Studies have shown that you have a much better chance of quitting if you have help. So, tell your friends, family, and coworkers of your plan to quit. Others knowing can be a helpful reminder and motivator.

Then get some counseling. Don’t go it alone. Start by contacting your doctor about smoking cessation counseling covered by Medicare and find out about the prescription antismoking drugs that can help reduce your nicotine craving.

You can also get free one-on-one telephone counseling and referrals to local smoking cessation programs through your state quit line at 800-QUIT-NOW or call the National Cancer Institute free smoking quit line at 877-44U-QUIT.

It’s also important to identify and write down the times and situations you’re most likely to smoke and make a list of things you can do to replace it or distract yourself. Some helpful suggestions when the smoking urge arises are to call a friend or one of the free quit lines, keep your mouth occupied with some sugar-free gum, sunflower seeds, carrots, fruit or hard candy, go for a walk, read a magazine, listen to music or take a hot bath.

The intense urge to smoke lasts about three to five minutes, so do what you can to wait it out. It’s also wise to avoid drinking alcohol and steer clear of other smokers while you’re trying to quit. Both can trigger powerful urges to smoke.

For more tips on how to quit, including managing your cravings, withdrawal symptoms and what to do if you relapse, visit 60plus.SmokeFree.gov. There are also a variety of helpful quit smoking apps you can download like SmokeFreeApp.com and QuitGenius.com.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of The Savvy Senior book.
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An Executor’s Guide to Settling A Loved One’s Estate

Dear Savvy Senior,
My aunt recently asked me to be the executor of her will when she dies. I’m flattered that she asked, but I’m not sure what exactly the job entails. What can you tell me about this?
Inquiring Niece

Dear Inquiring,
Serving as the executor of your aunt’s estate may seem like an honor, but it can also be a lot of work. Here’s what you should know to help you prepare for this job.

As the executor of your aunt’s will, you’re essentially responsible for winding up her affairs after she dies. While this may sound simple enough, you need to be aware that the job can be time consuming and difficult depending on the complexity of her financial and family situation. Some of the duties required include:

  • Filing court papers to start the probate process (this is generally required by law to determine the will’s validity).
  • Taking an inventory of everything in her estate.
  • Using her estate’s funds to pay bills, including taxes, funeral costs, etc.
  • Handling details like terminating her credit cards and notifying banks and government agencies like Social Security and the post office of her death.
  • Preparing and filing her final income tax returns.
  • Distributing assets to the beneficiaries named in her will.

Be aware that each state has specific laws and timetables on an executor’s responsibilities. Your state or local bar association may have an online law library that details the rules and requirements. The American Bar Association website also offers guidance on how to settle an estate. Go to AmericanBar.org and type in “guidelines for individual executors and trustees” in the search bar to find it.

Get Organized
If you agree to take on the responsibility as executor of your aunt’s estate, your first step is to make sure she has an updated will and find out where all her important documents and financial information is located. Being able to quickly put your hands on deeds, brokerage statements and insurance policies after she dies will save you a lot of time and hassle.

If she has a complex estate, you may want to hire an attorney or tax accountant to guide you through the process, with the estate picking up the cost. 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 good resources that provide directories on their websites to help you find someone.

Avoid Conflicts
Find out if there are any conflicts between the beneficiaries of your aunt’s estate. If there are some potential problems, you can make your job as executor much easier if everyone knows in advance who’s getting what, and why. So, ask your aunt to tell her beneficiaries what they can expect. This includes the personal items too, because wills often leave it up to the executor to dole out heirlooms. If there’s no distribution plan for personal property, suggest she make one and put it in writing.

Executor Fees
As the executor, you’re entitled to a fee paid by the estate. In most states, executors are entitled to take a percentage of the estate’s value, which often ranges anywhere from 1 to 5 percent depending on the size of the estate. But, if you’re a beneficiary, it may make sense for you to forgo the fee. That’s because fees are taxable, but Uncle Sam in most states doesn’t tax inheritances.

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” 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.

Savvy Senior Columns — July 2020

Savvy Senior – July Columns

  1. RV Travel Tips in the Summer of COVID-19
  2. Can I Stop Social Security if I Go Back to Work?
  3. Video Calling Solutions for Tech-Challenged Seniors
  4. What Happens if You Die Without a Will?
  5. Stretching Tips to Help Seniors Gain Flexibility and Reduce Pain

RV Travel Tips in the Summer of COVID-19

Dear Savvy Senior,
Can you write a column on RV travel for novices? My husband and I have been cooped up all spring and summer because of the coronavirus and would like to take a trip using a rented RV but could use some tips and want to be safe.
Recently Retired

Dear Recently,
Recreational-vehicle (or RV) travel has become a very popular option among U.S. retirees over the past few decades and is probably one of the safest and most convenient ways to get away this summer.

Because it’s a small home on wheels, RV travel will allow you to distance yourself from crowds of people and reduce your risk of COVID exposure that comes with other forms of travel, i.e. air/train travel, hotel/Airbnb lodging and eating in restaurants. But there are still risks – especially in public places like gas stations, shared restrooms and picnic areas – so exercise caution. If you’ve never traveled by motor home or RV, here are a few tips to consider.

Renting an RV
To help you determine the RV size and model you need for your trip, consider your budget, destination and the number of travelers. If it’s just you and your husband, and you’re visiting several locations and driving lots of miles you may want a smaller motor home with better fuel economy. But if you’re taking other family members or friends, you may want a larger RV with slide outs and more sleeping areas. See GoRVing.com for a breakdown of all the different types of RVs available today.

To locate an RV rental dealer near you visit CruiseAmerica.com, one of the largest RV rental companies in the world or search the Recreation Vehicle Rental Association at RVRA.org. Or use peer-to-peer RV rental sites like RVshare.com or Outdoorsy.com, which are usually a little cheaper.

Rental costs will vary greatly depending on what you choose and how far you drive, ranging anywhere from $50 up to $500 per day.

When renting a rig, be sure you get detailed instructions from the owner or rental company on how to use the RV’s systems, including the generator, air-conditioning, leveling, slide outs, electric and entertainment, as well as how to empty waste tanks and refill fresh water.

You should also know that because of COVID-19, most RV rental companies are vigilant about cleaning and disinfecting their units. But if you want to be extra safe, the CDC offers tips at CDC.gov/COVID19 – type “Cleaning and Disinfecting Your Home” in the search bar.

Trip Planning Tips
It’s always wise to map out your trip route and reserve your campgrounds in advance, especially now during the pandemic, because some campgrounds and RV parks, as well as local, state, and national public parks may be closed or operating with restrictions.

A free tool that can help you plan your trip is Roadtrippers.com, which lets you plot out routes, calculate mileage and travel time, and will identify RV campgrounds, points of interest and restaurants along the way.

You should also consider becoming a Good Sam Club member (GoodSam.com/club, $29/year), which provides access to its web-based trip planner, camping and fuel discounts, and a copy of the Good Sam Guide Series that features detailed information on more than 12,000 private RV parks and public campgrounds.

Most RV parks rent spaces on a nightly or weekly basis with rates typically ranging from $30 to $50 per night, however some in city and country parks may be $10 or even free.

RV parks can also range from rustic facilities with limited or no utility hookups, as are more often found in state and national parks, to luxury resorts with amenities that rival fine hotels.

For first-time RV renters, staying at a fully loaded RV park or campground with full hookups, a dump station, and staff on site is highly recommended. Look at Kampgrounds of America (KOA.com) or ReserveAmerica.com to browse the accommodations.

And for more safe travel tips this summer, visit Coronavirus.gov – click on “specific resources for travelers.”

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 I Stop Social Security if I Go Back to Work?

Dear Savvy Senior,
I lost my job last month because of the coronavirus crisis. With little savings, I’ve been thinking about starting my Social Security benefits early to help me get by. But my question is, if I find a new job can I stop my Social Security benefits and restart them at a later date so they can continue to grow?
Almost 63

Dear Almost,
Yes, there are actually two ways you can stop your Social Security retirement benefits (once you’ve started collecting them) and restart them at a later date, which would boost your benefits. But in order to do this certain rules and conditions must be met. Here are your options.

Withdraw your benefits: One way to pause your Social Security benefits is to simply withdraw your Social Security application. But this must be done within 12 months of starting your benefits and you’ll also have to repay what you’ve received so far. If you choose this option, Social Security will treat your application for early benefits as if it never happened.

To withdraw your benefits, you’ll need to complete Form SSA-521 (SSA.gov/forms/ssa-521.pdf) and send it to your local Social Security office. Also be aware that you can only withdraw benefits once in a lifetime.

Suspend your benefits: If you aren’t eligible for withdrawal, but you’ve reached your full retirement age and have not yet reached age 70, another option is to voluntarily suspend your retirement benefits. With the suspension option you don’t have to repay the benefits you’ve received, and you can restart them anytime you wish, or they will be automatically be reinstated at age 70. (See SSA.gov/planners/retire/ageincrease.html to find your full retirement age.)

By suspending your benefits you’ll earn delayed retirement credits, which means your benefit amount increases for every month of the suspension. Your payment will go up by two-thirds of 1 percent monthly or 8 percent annually. A benefit of $1,500 monthly, for example, increases by $10 for each month you have benefits suspended.

You can request a suspension by phone (800-772-1213) or in person at your local Social Security office.

Working and Collecting Benefits
If you start collecting Social Security and you do go back to work, but your income is modest, you may want to continue drawing your benefits while working at the same time. But if your earnings are higher, it makes sense to stop your benefits.

Social Security has a “retirement earnings test” that says if you’re under your full retirement age and you earn more than $18,240 in 2020, Social Security will deduct $1 from your benefits for every $2 you earn over that amount. Those who reach full retirement age in 2020 a less stringent rule applies. In this case, $1 gets taken out for every $3 you make above $48,600 until you reach the month of your birthday.

It’s also important to know that if you were to lose some or all of your Social Security benefits because of the earning limits, they aren’t lost forever. When you reach full retirement age, your benefits will be recalculated to a higher amount to make up for what was withheld.

Also, if you do decide to work and collect Social Security benefits at the same time, you need to factor in Uncle Sam too. Because working increases your income, it might make your Social Security benefits taxable.

Here’s how this works. If your combined income is between $25,000 and $34,000 as an individual or between $32,000 and $44,000 as joint filers, you will pay tax on up to 50 percent of your Social Security benefits. If you earn above the upper limit of these ranges, you will pay tax on up to 85 percent of your benefits. To help you calculate this see the IRS publication 915 at IRS.gov/pub/irs-pdf/p915.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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Video Calling Solutions for Tech-Challenged Seniors

Dear Savvy Senior,
Can you recommend some simple devices that can help tech-challenged seniors with video calls? My 80-year-old mother has been isolating herself for months now in fear of the coronavirus and I haven’t been able to see her face-to-face in quite a while.
Concerned Daughter

Dear Concerned,
Video chatting is a great way to stay connected and keep tabs on an elder parent when you can’t be there, but it’s even more important now during this pandemic as many isolated seniors are also suffering from chronic loneliness.

To help connect you and your mom virtually, there are various products on the market that offer simple video calling for seniors who have limited ability or experience with technology. Here are four devices to consider.

GrandPad: This is a top option for simple video calling, and much more. The GrandPad is an 8-inch tablet specifically designed for seniors, ages 75 and older. It comes with a stylus, a charging cradle and 4G LTE built-in so it works anywhere within the Consumer Cellular network – home Wi-Fi is not required.

Ready to go right out of the box, GrandPad provides a simplified menu of big icons and large text for only essential features, providing clutter-free, one-touch access to make and receive video calls, send voice emails, view photos and videos, listen to personalized music, check the weather, play games, browse the Internet and more.

A GrandPad tablet costs $250 plus $40 monthly service fee and is sold through Consumer Cellular at GrandPad.net or call 888-545-1425.

Amazon’s Echo Show: With its built-in camera and screen, the voice-command Echo Show also provides a simple way to have face-to-face chats with your mom, but she’ll need home Wi-Fi installed.

Echo Shows, which come in three screen sizes – 5-inch ($90), 8-inch ($130) and 10-inch ($230) – will let your mom make and receive video calls to those who have their own device, or who have the Alexa app installed on their smartphone or tablet.

Once you set up her contacts, to make a call your mom could simply say, “Alexa, call my daughter” And when you call her, she would ask Alexa to answer the call (or ignore it). There’s also a feature called “drop-in” that would let you video call your mom’s device anytime without her having to answer it.

Available at Amazon.com, the Echo Show also offers thousands of other features your mom would enjoy like voice-activated access to news, weather, her favorite music and much more.

If you decide to order an Echo Show device for mom, be sure your ask Amazon to mark it as a gift so it doesn’t get tied to your Amazon account. For instructions to help your mom set it up, or if she doesn’t have a smartphone, go to Amazon.com/gp/help/customer/display.html, and type in “Help Loved Ones Set Up Their Echo Show Remotely” in the “find more solutions” bar.

ViewClix: This is a smart picture frame specifically designed for elderly seniors that lets family members make video calls, send photos and post virtual sticky notes with messages to their loved ones ViewClix from their smartphone, tablet or computer. Seniors, however, cannot initiate video calls from their ViewClix. Home Wi-Fi is also required.  Available in two sizes – 10-inch for $199, and 15-inch for $299 – you can learn more about this product at ViewClix.com.

Facebook Portal: If your mom is a Facebook user, a voice-command Facebook portal (see portal.facebook.com) is another simple way to stay connected – home Wi-Fi is needed.

Portals, which come in three sizes – the original 10-inch Portal ($179), the 8-inch Mini ($129) and the massive 15-and-a-half-inch Portal Plus ($279) – are like Echo Shows, except they connect through Facebook. With a Portal, your mom can video call your smartphone or tablet (and vice versa) using Facebook Messenger or WhatsApp.

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 Happens if You Die Without a Will?

Dear Savvy Senior,
What happens to a person’s possessions if they die without a will? I’m almost 60 years old and have never gotten around to making one, but the coronavirus crisis has made it a priority.
Will-less Willie

Dear Willie,
The coronavirus crisis has lit a fire under many Americans when it comes to getting their affairs in older. Currently, fewer than half of American adults have prepared a will or living trust.

If you die without a will, the state you reside in will determine what happens to your assets. Every state has intestacy laws in place that parcel out property and assets to a deceased person’s closest living relatives when there’s no will or trust in place. But these laws vary from state-to-state.

Here is a general breakdown of what can happen to a person’s assets, depending on whom they leave behind.

Married with children: When a married person with children dies without a will, all property, investments and financial accounts that are “jointly owned” automatically goes to the surviving co-owner without going through probate, which is the legal process that distributes a deceased person’s assets.  But for all other separately owned property or individual financial accounts, the laws of most states award one-third to one-half to the surviving spouse, while the rest goes to the children.

Married with no children or grandchildren: Some states award the entire estate to the surviving spouse, or everything up to a certain amount (for example the first $100,000). But many other states award only one-third to one-half of the decedent’s separately owned assets to the surviving spouse, with the remainder generally going to the deceased person’s parents, or if the parents are dead, to brothers and sisters.  Jointly owned property, investments, financial accounts, or community property automatically goes to the surviving co-owner.

Single with children: All state laws provide that the entire estate goes to the children, in equal shares. If an adult child of the decedent has died, then that child’s children (the decedent’s grandchildren) split their parent’s share.

Single with no children or grandchildren: In this situation, most state laws favor the deceased person’s parents. If both parents are deceased, many states divide the property among the brothers and sisters, or if they are not living, their children (your nieces and nephews). If there are none of them, it goes to the next of kin, and if there is no living family, the state takes it.

Make a Will
To ensure your assets go to those you want to receive them, you need to create a will or trust. If you have a simple estate and an uncomplicated family situation, there are do-it-yourself resources that can help you create all these documents for very little money.

Some top-rated options include the Quicken WillMaker & Trust 2020 downloadable software (available at nolo.com) that costs $90 and works with Windows and Macs and is valid in every state except Louisiana; LegalZoom (legalzoom.com), which offers basic wills for $89 or $99 if you’d like assistance from an independent attorney; and Trust & Will (trustandwill.com) which charges $89 for a basic will.

If, however, you want or need assistance or if you have a complicated financial situation, blended family or have considerable assets, you should hire an attorney. An experienced attorney can make sure you cover all your bases, which can help avoid family confusion and squabbles after you’re gone.

Costs will vary depending on where you live, but you can expect to pay anywhere between $200 and $1,000 for a will.

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.

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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Stretching Tips to Help Seniors Gain Flexibility and Reduce Pain

Dear Savvy Senior,
Can you offer some good stretching tips for seniors who are staying home during the pandemic? I’ve gotten so stiff and achy in recent years that I have a hard time doing basic activities like bending over to tie my shoes.
Stiff as a Board

Dear Stiff,
Of all possible exercises, stretching tends to be the most neglected, yet nothing is more vital to keeping an aging body limber and injury free.  As we age, our muscles naturally lose their elasticity if you’re not active, which can make common day-to-day activities like reaching down to tie your shoes or looking over your shoulder to back your car out of the driveway, difficult.

But the good news is, by incorporating some simple stretching exercises into your routine (at least three times a week) you can greatly improve your flexibility, as well as enhance your balance, posture and circulation, relieve pain and stress, and prevent injuries. In addition, stretching is also important as a warm-up and cool-down for more vigorous activities, and leg stretching is an excellent way to prevent nighttime leg cramps too.

Simple Stretches
Stretching exercises should focus on the muscles in your neck, shoulders, arms, chest, back, hips, thighs, hamstrings and calves. If you’ve had hip or back surgery, you should talk to your doctor before doing lower-back flexibility exercises.

While stretching, it’s very important to listen to your body. You want to stretch each muscle group to the point where the muscle feels tight. If it hurts, you’ve gone too far. Back off to the point where you don’t feel any pain, then hold the stretch for 10 to 20 seconds. Relax, then repeat it three to five times, trying to stretch a little farther, but don’t bounce. Bouncing greatly increases your chance of injury.

It’s also a good idea to warm up a little before you start stretching by walking in place and pumping your arms. And remember to breathe when you stretch. Also, keep in mind that muscles that have not been stretched in a while take time to regain their flexibility. So be patient and go slow.

If you don’t have much experience with stretching, the National Institute on Aging offers a free guide that provides illustrated examples of flexibility exercises to help you get started. Go to order.nia.nih.gov, and type in “Exercise & Physical Activity: Your Everyday Guide from The National Institute on Aging” to view it online.

There are also senior fitness programs, like SilverSneakers (silversneakers.com) and Silver&Fit (silverandfit.com), that are currently offering online flexibility and balance videos that can guide you through a series of stretching exercises you can do at home during the pandemic.

There are also a wide variety of stretching exercise DVDs or videos you could purchase at sites like CollageVideo.com or Amazon.com.

Yoga and Tai Chi
Another great way to improve your flexibility is through gentle yoga or chair yoga. In chair yoga you replace the yoga mat with a chair where most poses can be duplicated. This is much easier on tight, inflexible muscles. Tai chi and qi gong are also great exercise options for improving balance and flexibility.

To get started, there are many DVDs and videos that offer instructions and routines for seniors you can do at home. The YMCA has also launched a new series of free, online health and fitness videos at YMCA360.org that includes gentle yoga, chair yoga and tai chi videos.

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

Savvy Senior Columns — June 2020

Savvy Senior – June Columns

  1. How to Find Health Insurance After a Job Loss
  2. How to Make the Most of Your Telehealth Appointment
  3. What to Know About Advance Care Planning in the Age of Coronavirus
  4. Why High Blood Pressure is Even More Dangerous in the COVID-19 Era

How to Find Health Insurance After a Job Loss

Dear Savvy Senior,
Because of the coronavirus pandemic, I just got laid off from my job of 22 years and need to find health insurance until I can get another job or enroll in Medicare at age 65. What are my options?
Scared to Death                                                                                   

Dear Scared,
I’m very sorry about your job loss. It’s estimated that as many as 45 million Americans could lose their health insurance as businesses continue to lay off workers due to repercussions of the coronavirus pandemic. Here’s where you can find health insurance coverage while you’re looking for new employment or waiting for Medicare.

The Affordable Care Act Marketplace
Your best option for getting affordable health insurance is through Affordable Care Act (ACA) Marketplaces, also known as Obamacare. Or, if your income is very low you may qualify for Medicaid.

Normally, enrollment in an ACA Marketplace is limited to the short window for Open Enrollment, which is between Nov. 1 and Dec. 15 each year. But there’s an exception for people who’ve lost their jobs, known as the Special Enrollment Period, which allows you to apply because your layoff meant a loss of health insurance. To do so, you must enroll within 60 days of when your coverage stopped and prove that you lost your health insurance.

There is no limited enrollment period for Medicaid.

Eleven of the states with their own health-insurance marketplaces (California, Colorado, Connecticut, Maryland, Massachusetts, Minnesota, Nevada, New York, Rhode Island, Vermont and Washington), plus the District of Columbia, are also offering special enrollment periods, allowing anyone who is eligible under the ACA rules to sign up.

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

You also need to know that if your annual income will fall below the 400 percent poverty level, the ACA provides premium subsidies, which will reduce the amount you’ll have to pay for a policy.

To qualify for subsidies your household’s estimated income for 2020 must be under $49,960 for an individual, $67,640 for a couple, or $103,000 for a family of four. The lower your income is under these limits the higher your subsidy will be. Unemployment benefits count toward income.

To see how much subsidy you may qualify for, use Kaiser Family Foundation health insurance marketplace calculator at KFF.org/interactive/subsidy-calculator.  Or, if your income is very low – below the 138 percent poverty level – you may qualify for free, or low-cost health coverage through expanded Medicaid services, which is available in many states.

To apply for ACA Marketplace health plans or Medicaid, go to HealthCare.gov. Or, you can call their toll-free number at 800-318-2596 and get help over the phone.

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

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

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

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How to Make the Most of Your Telehealth Appointment

Dear Savvy Senior,
I manage a large doctor’s clinic that treats hundreds of seniors each month. We are moving to more telehealth visits to help keep our patients safe at home during the coronavirus pandemic, but this new way of seeing a doctor is befuddling to many of our elder patients. Can you write a column educating patients on how to prepare for a telehealth appointment?
Regular Reader

Dear Reader,
I’d be happy to help! To help keep patients safe and at home during the coronavirus crisis more and more doctors and other health care providers are turning to telehealth (a.k.a. telemedicine) appointments, which are remote e-visits using a digital communication device like a smartphone, tablet or computer.

Although telehealth has been around for a few years now, recent updates to regulations and a surge in demand has made it the easiest way to get many different types of medical care. Most telehealth appointments today tend to be primary care or follow-up visits that can assess symptoms or check on people who have had a medical procedure. Telehealth also works well for some specialties like dermatology or mental health care (counseling/therapy) services.

So, what can patients expect from a telehealth visit, and how should they prepare?

The first step is to call your doctor’s office to find out whether telemedicine visits are available and whether you will need to set up an account or install special software on your computer, phone or tablet.

Until recently, doctors were required to conduct telehealth visits through platforms such as Doxy, Thera-Link or MyChart that were compliant with the Health Insurance Portability and Accountability Act, or HIPAA. But some of those requirements have been relaxed in the current crisis, so many providers are using popular apps such as FaceTime, Skype and Zoom to conduct visits.

Once you know what technology you will be using, get familiar with it. You don’t want to spend the first 10 minutes of your visit trying to figure out how to unmute the audio.

For older patients that aren’t familiar or comfortable with technology, ask a relative or friend with a smartphone, tablet or laptop to assist you.

Take the time to clarify the purpose of the televisit before it begins. Prioritize a written list of three or four issues you want to discuss with your doctor and make a list of the medicines you’re taking, along with the dosages.  Also, have relevant medical devices or logs on hand, such as a penlight or smartphone flashlight for viewing a sore throat, a blood-pressure cuff and thermometer (or recent readings), blood-sugar logs if you’re diabetic or a food log if you have gastrointestinal problems.

If you’ve received medical care at different places, such as an urgent care facility or another doctor’s office, have your latest medical records with you during the telemedicine visit.

Wear loose clothing that will allow you to show your medical provider what is concerning you.

The length of the appointment may depend on the problem. A routine visit could be very quick, while others, such as a physical-therapy appointment, may last as long as a session at a clinic. Waiting rooms are sometimes replaced by virtual waiting rooms.

Before the visit ends, make sure you know the follow-up plan. Do you need to schedule an in-office visit, fill a prescription or get a referral to a specialist?

Right now, Medicare and Medicaid are covering the cost of telehealth visits (see medicare.gov/coverage/telehealth for details), and most private insurers are following suit.

If you don’t have a primary care physician or need urgent care, you can get help through virtual health care service like Doctor on Demand (doctorondemand.com) or TeleDoc (teladoc.com). These services currently do not accept original Medicare, but they may be covered by private insurers including some Medicare Advantage plans – be sure you check.

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 Advance Care Planning in the Age of Coronavirus

Dear Savvy Senior,
All this horrible coronavirus carnage got me thinking about my own end-of-life decisions if I were to get sick. Can you recommend some good resources that can help me create a living will or advance directive, or other pertinent documents? I’ve put it off long enough.
Almost 70

Dear Almost,
Creating a living will (also known as an advance directive) is one of those things most people plan to do, but rarely get around to actually doing. Only about one-third of Americans currently have one. But the cold hard reality of the novel coronavirus may be changing that. Here’s what you should know along with some resources to help you create an advance directive.

Advance Directives
To adequately spell out your wishes regarding your end-of-life medical treatment are two key 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.

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

One that I highly recommend that’s completely free to use is My Directives (MyDirectives.com). This is an online tool and mobile app that will help you create, store and share a detailed, customized digital advance directive. Their easy-to-use platform combines eight thoughtful questions to guide you through the process. If you’re not computer savvy, ask a family member or trusted friend to help you.

The advantage of having a digital advance directive versus a paper document is being able to access it quickly and easily via smartphone, which is crucial in emergency situations when they’re most often needed.

However, if you’d rather have a paper document, one of the best do-it-yourself options is the Five Wishes advance directive (they offer online forms too). Created by Aging with Dignity, a nonprofit advocacy organization, Five Wishes costs $5, and is available in many languages. To learn more or to receive a copy, visit FiveWishes.org or call 850-681-2010.

Another tool you should know about that will compliment your advance directive is the Physician Orders for Life-Sustaining Treatment, or POLST (sometimes called Medical Orders for Life-Sustaining Treatment, or MOLST). A POLST form translates your end-of-life wishes into medical orders to be honored by your doctors. To learn more about your state’s program or set one up, see POLST.org.

Readers should also know that if you’ve already prepared an advanced directive paper document, a POLST form or the VA advance directive form 10-0137, you can upload, store and share these documents too at MyDirectives.com.

And finally, to ensure your final wishes are followed, make sure to tell your family members, health care proxy and doctors. If you make a digital advance directive or have uploaded your existing forms, you can easily share them electronically to everyone involved. Or, if you make a paper advance directive that isn’t uploaded, you should provide everyone copies to help prevent stress and arguments later.

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

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Why High Blood Pressure is Even More Dangerous in the COVID-19 Era

Dear Savvy Senior,
Are people with high blood pressure at increased risk of getting coronavirus?
Hypertensive Helen

Dear Helen,
If you have high blood pressure, you definitely need to take extra care to protect yourself during the coronavirus (COVID-19) pandemic. Research shows that people with hypertension are more susceptible to getting COVID-19, are more likely to develop severe symptoms if they do get sick, and are more likely to die from the infection, especially if they’re older.

High Risk Links
A weaker immune system is the key reason people with high blood pressure and other health problems are at higher risk for coronavirus. Long-term health conditions and aging weaken the immune system so it’s less able to fight off the virus. Nearly two-thirds of Americans over 60 have high blood pressure.

Another concern that has been circulating, but was put to rest last month, were theories that the medications that are commonly prescribed to treat high blood pressure – ACE inhibitors and angiotensin receptor blockers (ARBs) – could make patients more vulnerable to contracting COVID-19, and more susceptible to severe illness if they did become infected.

But new research published in The New England Journal of Medicine last month found no risk linked to these medications.

COVID Complications
While pneumonia is the most common complication of the virus, it can also damage the cardiovascular system. That’s why people with high blood pressure, heart disease, and heart failure are at risk.

High blood pressure damages arteries and reduces the flow of blood to your heart. That means your heart has to work harder to pump enough blood. Over time, this extra work can weaken your heart to the point where it can’t pump as much oxygen-rich blood to your body.

Coronavirus can also damage the heart directly, which can be especially risky if your heart is already weakened by the effects of high blood pressure. The virus may cause inflammation of the heart muscle, which makes it harder for the heart to pump.

If you also have plaque buildup in your arteries, the virus may make those plaques more likely to break apart and cause a heart attack. Studies have shown that people with heart disease who get a respiratory illness like the flu or earlier types of coronavirus are at higher risk for a heart attack.

What to Do?
While everyone needs to take precautions to prevent coronavirus, people with high blood pressure and other health conditions need to be extra careful.

The best way to avoid getting sick is to stay home as much as you can. If you have to go out, wear a mask and keep at least 6 feet away from other people. And every time you come home, wash your hands with warm water and soap for at least 20 seconds. Also, clean and disinfect all frequently touched surfaces like cell phones, countertops and doorknobs.

The CDC also recommends that you have enough medicine on hand to treat high blood pressure and other health conditions. And stock up on over-the-counter medicines to treat a fever and other symptoms if you get sick.

While a coronavirus vaccine isn’t available yet, you should stay up to date on your other important vaccines. The pneumococcal vaccines – Prevnar 13 and Pneumovax 23 – will prevent you from catching pneumonia on top of coronavirus. Also get a flu shot in September or early October. Its symptoms are easy to confuse with coronavirus, which could make it harder for doctors to diagnose you if you do get sick.

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

Savvy Senior Columns for May

Below are the four”Savvy Senior” columns from May.  Again this month, the columns largely deal with the ongoing coronavirus crisis. 

Savvy Senior – May Columns
1.    How the Coronavirus Relief Law Helps Retirement Savers and Retirees
2.    Do Pneumonia Vaccines Protect Seniors from Coronavirus?
3.    Grocery and Meal Service Delivery Options for Seniors Sheltering in Place
4.    What Older Diabetics Should Know About Coronavirus
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How the Coronavirus Relief Law Helps Retirement Savers and Retirees

Dear Savvy Senior,
What can you tell me about the retirement account changes that Congress recently passed in response to the coronavirus crisis?
Seeking Answers

Dear Seeking,
Tucked into the Coronavirus Aid, Relief, and Economic Security Act, or CARES Act, that President Trump signed into law in late March were a series of changes that can help retirement savers in need of cash, as well as help preserve the retirement savings accounts of current retirees while the stock market is down. Here’s a rundown to how three provisions in the CARES Act might help you, or someone you know.

Hardship Withdrawals
Normally, if you took money out of an employer-sponsored retirement plan or IRA before 59 ½, you’d be hit with taxes and a 10 percent tax penalty on that amount. But the CARES Act waives the early distribution penalty on up to $100,000 of such distributions in 2020 for what the law calls “affected individuals.” You are, however, still on the hook for income taxes on any amounts withdrawn, but the new law allows you to pay them over three years.

To qualify for this penalty-free hardship withdrawal, you must either have been diagnosed with coronavirus (COVID-19), have a spouse or dependent diagnosed with it or experienced adverse financial consequences as a result of being quarantined, furloughed, laid off, having work hours reduced, being unable to work due to a lack of child care due to COVID-19, or closing or reducing hours of a business you owned or operated if you had COVID-19.

Bigger Loans
The CARES Act will also allow you to take larger loans against the money you’ve saved in your 401(k) or 403(b) during the six-month period after the law was implemented, which was March 27. IRAs do not allow loans.

Normally, you can borrow only up to $50,000 or 50 percent of your vested account balance, whichever is less. The CARES Act will double that: up to $100,000 against the amount you’ve saved in your plan.

Borrowers typically have five years to repay a loan or the amount will be treated as a distribution and taxed. But you also need to know that if you leave or lose your job, you may be required to pay back the balance early, or owe taxes and, possibly, an early-withdrawal penalty.

This prevision also helps those with an existing 401(k) loan by allowing them to delay repayments that are due in 2020 for one year.

Suspended RMDs
Starting in 2020, individuals who turn 72 are required to take annual mandatory distributions from their tax-deferred 401(k)s and IRAs. In prior years, this requirement kicked in after savers turned 70½ years of age.

This is known as the required minimum distribution or RMDs.

The CARES Act suspends RMDs for 2020, including those for inherited IRAs, which means you can skip taking your required distributions this year if you wish.

The one-year waiver of RMDs will help retirees, who would otherwise have been forced to base their minimum withdrawals for 2020 on their account balances as of Dec. 31, 2019, when the stock market was near record levels. It will also give the market time to recover before resuming distributions in 2021.

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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Do Pneumonia Vaccines Protect Seniors from Coronavirus?

Dear Savvy Senior,
Do currently offered vaccines against pneumonia provide seniors any protection against the coronavirus disease? I’ve always been bad about getting vaccinated, but this coronavirus pandemic is causing me to change my thinking.
Pro-Vax Patty

Dear Patty,
This is a great question. Because the coronavirus (COVID-19) attacks the lungs and respiratory system, many readers have asked whether the pneumonia vaccines, which are administered to millions of patients each year, might protect someone if they contract the coronavirus.

But unfortunately, the answer is no. Vaccines against pneumonia, such as pneumococcal vaccine and Haemophilus influenza type B vaccine, do not provide protection against the new coronavirus.

This virus is so new and different that it needs its own vaccine. Researchers are in the process of rapidly developing a vaccine against COVID-19, but it is expected to take at least a year before it’s ready.

Having said that, you should also know that there are several other important vaccines the Centers for Disease Control and Prevention (CDC) recommends that all seniors should get up to date on after the coronavirus pandemic dies down. Here’s a rundown of what they are, when you should get them, and how they’re covered by Medicare.

Flu vaccine: While annual flu shots are recommended each fall to everyone, they are very important for older adults to get because seniors have a much greater risk of developing dangerous flu complications. According to the CDC, last year up to 647,000 people were hospitalized and 61,200 died because of the flu – most of whom were age 65 and older.

To improve your chances of escaping the seasonal flu, this September or October consider a vaccine specifically designed for people 65 and older. The Fluzone High Dose or FLUAD are the two options that provide extra protection beyond what a standard flu shot offers. And all flu shots are covered under Medicare Part B.

Pneumococcal vaccine: As previously stated, this vaccine protects against pneumonia, which hospitalizes around 250,000 Americans and kills about 50,000 each year. It’s recommended that all seniors, 65 or older, get two separate vaccines – PCV13 (Prevnar 13) and PPSV23 (Pneumovax 23). Both vaccines, which are administered one year apart, protect against different strains of the bacteria to provide maximum protection. Medicare Part B covers both shots if they are taken at least a year apart.

Shingles vaccine: Caused by the same virus that causes chicken pox, shingles is a painful, blistering skin rash that affects more than 1 million Americans every year. All people over age 50 should get the new Shingrix vaccine, which is given in two doses, two to six months apart. Even if you’ve already had shingles, you should still get this vaccination because reoccurring cases are possible. The CDC also recommends that anyone previously vaccinated with Zostavax be revaccinated with Shingrix because it’s significantly more effective.

All Medicare Part D prescription drug plans cover shingles vaccinations, but coverage amounts, and reimbursement rules vary depending on where the shot is given. Check your plan.

Tdap vaccine: A one-time dose of the Tdap vaccine, which covers tetanus, diphtheria and pertussis (whooping cough) is recommended to all adults. If you’ve already had a Tdap shot, you should get a tetanus-diphtheria (Td) booster shot every 10 years. All Medicare Part D prescription drug plans cover these vaccinations.

Other Vaccinations
Depending on your health conditions, preferences, age and future travel schedule, the CDC offers a “What Vaccines Do You Need?” quiz at www2.CDC.gov/nip/adultimmsched to help you determine what additional vaccines may be appropriate for you. You should also talk to your doctor during your next visit about which vaccinations you should get.

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

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.
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Grocery and Meal Service Delivery Options for Seniors Sheltering in Place

Dear Savvy Senior,
Can you recommend some good grocery and/or meal service delivery options for seniors? My 78-year-old mother has always shopped for herself, but since the coronavirus pandemic hit the grocery store shelves are always half empty, and she’s getting more fearful of leaving the house.
Parent Helper

Dear Helper,
There are numerous grocery and meal service delivery options available to help seniors stay safe at home during this pandemic, but what’s available to your mom will depend on her location and budget. You should also be aware that because of demand, many grocery and meal delivery services are overwhelmed right now, so some services in your mom’s area may be greatly delayed or temporarily unavailable. That said, here are some good options to look into.

Grocery Delivery Services
Today, there are a variety of websites and apps that allow you or your mom to shop for groceries and other household goods without having to step foot inside a store.

Most of these services offer memberships (fees usually run around $100/year), which will get you or your mom free deliveries on orders over $30 or $35. Or, they’ll charge a flat delivery fee, which typically cost around $8 to $10.

Depending on where your mom lives there are numerous grocery delivery services like Instacart (instacart.com) and Shipt (shipt.com), which work with a wide variety of grocery retailers, including national and local chains and are widely available throughout the U.S. They use independent-contractor shopper/drivers to pick up orders in stores and deliver them to you.

You should also check into Walmart’s online grocery delivery or pick-up service (grocery.walmart.com), which is available in hundreds of locations across the U.S.; Amazon Prime Now (primenow.amazon.com), which is offered in many U.S. cities; Peapod (peapod.com) that’s available in 24 metro markets; and FreshDirect (freshdirect.com) which serves the New York, Philadelphia and Washington D.C. areas and a few other select cities in the northeast.

Meal Delivery Services
If your mom still enjoys cooking, another convenient option to consider is meal kit delivery services like Home Chef (homechef.com), Sun Basket (sunbasket.com) or HelloFresh (hellofresh.com).

Meal kits are subscription-based services that will send your mom a box containing fresh, pre-portioned ingredient items for that kit’s recipe. All she’ll need to do is combine the ingredients (some chopping, and slicing may be required) and cook it. Most meal kit services run between $8 and $12 per meal.

Or, if your mom wants a break from cooking, a great alternative is to set her up with a ready-made meal delivery service like Mom’s Meals (momsmeals.com) or Silver Cuisine (silvercuisine.com). Both of these companies, which cater to older adults, offer a wide variety of healthy, fully prepared meal choices (just heat and eat), that accommodate a host of dietary needs for those managing diabetes or needing heart-friendly and/or lower-sodium meal options.

Mom’s Meals, which run $7 per meal plus delivery, arrive fresh and will last up to 14 days in the refrigerator. Silver Cuisine meals are delivered frozen and cost $12 or $13 per meal.

You should also find out if there’s a senior home delivery meal program in your mom’s area. Meals on Wheels is the largest program that most people are familiar with, but many communities offer similar programs sponsored by other organizations that go by different names.

To find services available in your mom’s area, visit MealsOnWheelsAmerica.org, which offers a comprehensive directory on their website.

Most home delivered meal programs across the U.S. deliver hot meals daily or several times a week, usually around the lunch hour, to seniors over age 60. Weekend meals, usually frozen, may also be available, along with special diets (diabetic, low-sodium, kosher, etc.). Most of these programs typically charge a small fee (usually between $2 and $6) or request a donation, while some may be free to low-income seniors.

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 Older Diabetics Should Know About Coronavirus

Dear Savvy Senior,
My husband and I are both in our late sixties and have diabetes. We would like to find out if our diabetes increases our risk of getting the coronavirus.
Concerned Diabetics

Dear Concerned,
Currently, there’s not enough data to show that people with diabetes are more likely to get coronavirus (COVID-19) than the general population. But the problem for diabetics is, if you do happen to contract the virus, your chance of developing serious complications are much higher. This is especially true if your diabetes isn’t well-controlled. Here’s what you should know.

Diabetic Risks
Health data is showing that about 25 percent of people who go to the hospital with severe COVID-19 infections have diabetes. One reason is that high blood sugar weakens the immune system and makes it less able to fight off infections. Your risk of severe coronavirus infection is even higher if you also have another condition, like heart or lung disease.

If you do get COVID-19, the infection could also put you at greater risk for diabetes complications like diabetic ketoacidosis (DKA), which happens when high levels of acids called ketones build up in your blood.

Some people who catch the new coronavirus have a dangerous body-wide response to it, called sepsis. To treat sepsis, doctors need to manage your body’s fluid and electrolyte levels. DKA causes you to lose electrolytes, which can make sepsis harder to control.

How to Avoid COVID-19
The best way to avoid getting sick is to stay home as much as you can. If you have to go out, keep at least 6 feet away from other people. And every time you come back from the supermarket, pharmacy or another public place, wash your hands with warm water and soap for at least 20 seconds.

Also wash your hands before you give yourself a finger stick or insulin shot. Clean each site first with soap and water or rubbing alcohol.

To protect you, everyone in your house should wash their hands often, especially before they cook for the family. Don’t share any utensils or other personal items. And if anyone in your house is sick, they should stay in their own room, as far as possible from you.

The CDC also recommends that you stock up on medications and diabetes testing supplies to last for at least a month. The same goes for grocery supplies and other household necessities.

Also know that Medicare is now covering the cost of telehealth visits, so if you have questions for your doctor, you can ask by video chat or phone instead of going into the office.

If You Get Sick
The most common symptoms of COVID-19 are a dry cough, fever, or shortness of breath. If you develop any symptoms that are concerning, call your doctor about getting tested.

If you find that you have contracted COVID-19, the first level of care is to stay home and check your blood sugar more often than usual and check your ketones too. COVID-19 can reduce your appetite and cause you to eat less, which could affect your levels. You also need more fluids than usual when you’re sick, so keep water close by, and drink it often.

You should also know that many over-the-counter medicines that relieve virus symptoms like fever or cough can affect your blood sugar levels one way or the other. So, before you take anything check with your doctor.

And be aware that if you start experiencing severe shortness of breath, high levels of ketones or DKA symptoms like severe weakness, body aches, vomiting or belly pain, you need to see your doctor or get to an emergency room right away.

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

Savvy Senior Columns — April 2020

Savvy Senior – April Columns

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

How to Protect Your Elderly Parents from Coronavirus

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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How to Get Help from Social Security During the Coronavirus Pandemic

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Medicare Expands Telehealth Services to Help Keep Seniors Safe at Home

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Beware of Coronavirus Scams

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Social Security Offers Lump Sum Payouts to Retirees

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

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

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

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

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

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

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

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

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

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

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

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

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

Savvy Senior Columns — March 2020

Savvy Senior – March Columns

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

Beware of Potential 2020 Census Scams

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Important Legal Documents All Seniors Should Have

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

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

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

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

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

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

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

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

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

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

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

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

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

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How to Prevent the Silent Epidemic of Kidney Disease

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Travel Tips for Grandparents and Grandchildren

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Savvy Senior — February 2020 Columns

Savvy Senior – February Columns

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

Do I Have to File Taxes?

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

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

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

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

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

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

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

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

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

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

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

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

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

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How to Detect Parkinson’s Disease

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

For more information, visit the Parkinson’s Foundation at Parkinson.org.

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

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When Should Dementia Patients Stop Driving?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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10 Things Medicare Doesn’t Cover

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Savvy Senior — January Columns

Savvy Senior – January 2020 Columns

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

IRS Introduces a Tax Form Created for Older Taxpayers

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Savvy Senior — December 2019 Columns

Savvy Senior – December Columns

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

How Seniors Can Get Free Legal Assistance

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

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

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

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

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

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

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

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

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

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

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

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

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What to Do When Medicare Tells You No

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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How to Manage a Loved One’s Social Media Afterlife

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Why the Risk of Heart Attack Rises in Winter

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

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

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

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

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

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

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

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

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

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