Savvy Senior August 2019 Columns

Savvy Senior – August Columns

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

How Medicare Covers Ambulance Services

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.
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Is Pet Insurance a Good Idea for Seniors on a Budget?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Savvy Senior July 2019 Columns

Savvy Senior – July Columns

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

Hiring an In-Home Caregiver

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

June 2019 Savvy Senior Columns

Savvy Senior – June Columns

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

How a Government Pension Might Reduce Your Social Security Benefits

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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How to Protect Yourself from the Social Security Imposter Scam

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Home Monitors

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

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

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

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

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

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

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

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

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

May 2019 Savvy Senior Columns

Savvy Senior – May Columns

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

2020 Census Offers Temporary Jobs Ideally Suited for Retirees

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Understanding Medicare’s Enrollment Periods

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Adaptive Gardening: Tips and Tools for Older Gardeners

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Savvy Senior — April 2019 Columns

Savvy Senior – April Columns

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

 

Finding Health Insurance Before Medicare Kicks In

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Air Travel Tips for Older Passengers

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Savvy Senior — March Columns

Savvy Senior – March Columns

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

How to Choose a Good Home Stair Lift

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

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

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

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

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

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

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

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

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

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

Unfortunately, original Medicare does not cover stair lifts nor do Medicare supplemental (Medigap) policies, but some Medicare Advantage plans may help pay. There are also many states that offer Medicaid waivers that will pay for lifts to those that qualify, and the VA offers cash grants to veterans with disabilities for home safety improvements.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Savvy Senior — February Columns

Savvy Senior – February 2019 Columns

  1. How to Save Money on Your Medication
  2. Helping Seniors Extend Their Driving Years
  3. Do I Need to File a Tax Return This Year?
  4. How to Slow Down Cognitive Aging

How to Save Money on Your Medication

Dear Savvy Senior,
I take several medications for multiple health conditions and the prices keep going up, even with insurance. Can you recommend any tips that can help me save?
Price-Gouged Patty

Dear Patty,
The rising cost of prescription drugs is a problem that stings millions of Americans. While there’s no one solution, there are some different strategies and resources that can help reduce your drug costs, so you can afford what you need. Here are several to consider.

If you have insurance, know your drug formulary: Most drug plans today have formularies (a list of medications they cover) that place drugs into different “tiers.” Drugs in each tier have a different cost. A drug in a lower tier will generally cost you less than a drug in a higher tier, and higher tier drugs may require you to get permission or try another medication first before you can use it.

To get a copy of your plan’s formulary, visit your drug plan’s website or call the 800 number on the back of your insurance card. Once you have this information, share it with your doctor so, if possible, he or she can prescribe you medications in the lower-cost tiers. Or, they can help you get coverage approval from your insurer if you need a more expensive drug.

You also need to find out if your drug plan offers preferred pharmacies or offers a mail-order service. Buying your meds from these sources can save you some money too.

Talk to your doctor: Ask your doctor if any of the medications you’re currently taking can be reduced or stopped. And, find out if the ones you are taking are available in generic form. About 80 percent of all premium drugs on the market today have a lower-cost alternative. Switching could save you between 20 and 90 percent.

Ask for a three-month prescription: This can be significantly cheaper for drugs you take long-term. If you use insurance, you’ll pay one co-pay rather than three.

Split your pills: Ask your doctor if the pills you’re taking can be cut in half. Pill splitting allows you to get two months’ worth of medicine for the price of one. If you do this, you’ll need to get a prescription from your doctor for twice the dosage you need.

Find and use online discounts: Start by trying GoodRx.com, BlinkHealth.com or WeRx.org. They will ask for the name of the drug, the dose, the number of pills, and where you live. Then they will show you what you can expect to pay at various pharmacies if you use their discount coupons or vouchers, which you can print out or download to your phone to show a pharmacist.

Pay cash: Most generic medications cost less if you don’t use your insurance. For example, chains like Target and Walmart offer discount-drug programs that sell generics for as little as $4 for a 30-day supply and $10 for a 90-day supply if you pay out-of-pocket. While some insurance companies charge a $10 copay for a 30-day supply.

Also ask your pharmacy if they offer a drug discount card program and compare costs with your insurance plan. You can also find free drug discount cards online at sites like NeedyMeds.org, which can be used at most U.S. pharmacies.

Shop online: You can also save by using an online pharmacy like HealthWarehouse.com but be sure to use an online retailer that operates within the U.S. and is licensed. The site should display the VIPPS symbol, which shows it’s a Verified Internet Pharmacy Practice Site.

Search for drug assistance programs: If your income is limited, you can probably get help through drug assistance programs offered through pharmaceutical companies, government agencies and charitable organizations. To find these types of programs use sites like BenefitsCheckUp.org, PatientAdvocate.org, RxAssist.org and NeedyMeds.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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Helping Seniors Extend Their Driving Years

Dear Savvy Senior,
What tips or resources can you recommend to help elderly seniors extend their driving years? My dad, who’s 82, is still a decent driver, but I worry about his safety going forward.
Inquiring Daughter

Dear Inquiring,
With more than 40 million licensed drivers in the U.S. over the age of 65, there are lots of resources available today to help keep older drivers safe and behind the wheel longer. Here are some simple steps you can take to help keep your dad driving safely.

Get his eyes checked: Because about 90 percent of the information necessary to drive is received through our eyes, getting your dad’s eyes checked every year to be sure his vision and eyewear is up to par is an important first step.

Check his meds: Does your dad take any medicine or combination of medicines that make him sleepy, light-headed or loopy? If so, make a list of all his medications (prescription and over-the-counter) and dietary supplements, and take it to his doctor or pharmacist for a review. You can also get help with this online at RoadwiseRX.com.

Evaluate his driving: To stay on top of any potential driving issues, you should take a ride with your dad from time-to-time watching for problem areas, such as: Does he drive at inappropriate speeds, tailgate or drift between lanes? Does he have difficulty seeing, backing up or changing lanes? Does he react slowly, get confused easily or make poor driving decisions? For more tips, see the National Caregivers Library driving assessment checklist at SeniorDriverChecklist.org.

If your dad needs a more thorough evaluation, you can turn to a driver rehabilitation specialist who’s trained to evaluate older drivers. This type of assessment typically costs between $100 and $200. To locate a professional in your area, visit AOTA.org/older-driver or ADED.net.

Take a refresher course: AAA and AARP both have older driver refresher courses that can help your dad tune-up his driving skills, and learn how to adjust for slower reflexes, weaker vision and other age-related changes that affect driving. Taking a class may also earn him a discount on his auto insurance. To locate a class, contact your local AAA (AAA.com), or AARP (AARP.org/drive, 888-227-7669). Most courses cost around $15 to $30 and can be taken in the classroom or online.

Another good resource to look into is CarFit. This is a free assessment program that will help your dad adjust his vehicle for a better fit, making it easier and safer to drive. CarFit events are held around the country in select locations. See Car-Fit.org to look for one near you.

Make some adjustments: Recognizing your dad’s driving vulnerabilities and making small changes on when and where he drives can go a long way in helping keep him safe and driving longer. Adjustments may include not driving after dark or during rush hour traffic, avoiding major highways or other busy roads, and not driving in poor weather conditions.

You can find more tips at AAA Senior Driving at SeniorDriving.AAA.com.

And finally, when it gets to the point that your dad’s driving isn’t safe anymore and he needs to quit, The Hartford Financial Services Group and MIT AgeLab offers two helpful resources. Go to TheHartford.com/lifetime – click on “Publications” on the menu bar – and download or order the “At the Crossroads” and/or “We Need to Talk” guides.

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 I Need to File a Tax Return This Year?

Dear Savvy Senior,
What are the IRS income tax filing requirements for retirees this tax season? My income dropped way down when I had to retire last year, so I’m wondering if I need to file a tax return this year.
Retired Ron

Dear Ron,
Whether or not you are required to file a federal income tax return this year actually depends on several factors: how much you earned last year (in 2018); the source of that income; 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 2018 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: $12,000 ($13,600 if you’re 65 or older by Jan. 1, 2019).
  • Married filing jointly: $24,000 ($25,300 if you or your spouse is 65 or older; or $26,600 if you’re both over 65).
  • Married filing separately: $5 at any age.
  • Head of household: $18,000 ($19,600 if age 65 or older).
  • Qualifying widow(er) with dependent child: $24,000 ($25,300 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 2018, 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/filing – click on “Do I Need to File?” 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 around 5,000 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 Slow Down Cognitive Aging

Dear Savvy Senior
Are there any proven strategies to preventing cognitive decline? I have a family history of dementia and worry about my own memory and cognitive abilities as I grow older. What can you tell me?
Almost 60

Dear Almost 60,
For most people, starting in their fifties and sixties, the brain’s ability to remember names, multi-task or learn something new starts declining. While our genes (which we can’t control) play a key role in determining our cognitive aging, our general health (which we do have some control over) plays a big factor too.

Here are some healthy lifestyle strategies – recommended by medical experts – that you can employ that can help stave off cognitive loss and maybe even build a stronger brain.

Manage health problems: Studies have shown that cognitive problems are related to health conditions, like diabetes, heart disease and even depression. So, if you have high blood pressure, high cholesterol or diabetes you need to treat them with lifestyle changes and medication (if necessary) and get them under control. And if you have a history of depression, you need to talk to your doctor about treatment options.

Exercise: Aerobic exercise increases blood flow to all parts of your body, including your brain, to keep the brain cells well nourished. So, choose an aerobic activity you enjoy like walking, cycling, dancing, swimming, etc., that elevates your heart rate and do it for at least 30 to 40 minutes three times a week.

Eat healthy: A heart-healthy diet, like the Mediterranean diet, will also help protect the brain. A Mediterranean diet includes relatively little red meat and emphasizes whole grains, fruits and vegetables, fish and shellfish, and nuts, olive oil and other healthy fats. Also keep processed foods and sweets to a minimum.

Get some sleep: Quality, restful sleep contributes to brain health too. Typically, adults should get between seven and nine hours of sleep daily. If you have persistent problems sleeping, you need to identify and address the problem. Medications, late-night exercise and alcohol can interfere with sleep quality and length, as can arthritis pain, sleep apnea and restless leg syndrome.

If you need help, make an appointment with a sleep specialist who will probably recommend an overnight diagnostic sleep test.

Challenge your mind: Some research suggests that mind challenging activities can help improve memory, and slow age-related mental decline. But, be aware that these activities consist of things you aren’t accustomed to doing. In other words, crossword puzzles aren’t enough to challenge your brain, if you’re already a regular puzzle-doer. Instead, you need to pick up a new skill like learning to dance, play a musical instrument, study a new language or do math problems – something that’s challenging and a little outside your comfort zone.

Brain-training websites like Lumosity.com and BrainHQ.com are good mind exercising tools because they continually adapt to your skill level to keep you challenged.

Socializing and interacting with other people is another important way to stimulate the brain. So make a point to reach out and stay connected to friends, family and neighbors. Join a club, take a class or even volunteer – anything that enhances your social life.                                                                                       

Don’t smoke or drink excessively: Smoking and excessive alcohol consumption both effect the brain in a negative way, so kick the habit if you smoke and, if you drink, do so only in moderation.

Reduce stress: Some stress is good for the brain, but too much can be toxic. There’s growing evidence that things like mindfulness meditation, yoga and tai chi are all good ways to help reduce stress.

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.

January 2019 Columns

Savvy Senior – January Columns

  1. What You Should Know About Your Aging Parents Finances
  2. Smart Home Devices That Can Help Seniors Age-In-Place
  3. Can You Deduct Medicare Costs on Your Income Taxes?
  4. Could You Have Glaucoma?
  5. How to Fight Age Discrimination in the Workplace

 

What You Should Know About Your Aging Parents’ Finances

Dear Savvy Senior,
My siblings and I don’t know much about our elderly parent’s financial situation or their wishes if something happens to them. When mom broke her hip last year, it got me thinking we need to be better prepared. What’s the best way to handle this, and what all should we know?
Tentative Daughter

Dear Tentative,
Many adult children don’t know much about their elderly parent’s financial situation or end-of-life plans, but they need to. Getting up to speed on their finances, insurance policies, long-term care plans and other information is important because some day you might have to help them handle their financial affairs or care, or execute their estate plan after they die. Without this information, your job becomes much more difficult. Here are some tips that can help.

Have the Conversation
If you’re uncomfortable talking to your parents about this topic, use this column as a prompt or start by talking about your own finances or estate plan as a way to ease into it.

Also see TheConversationProject.org, which offers free kits that can help you kick-start these discussions.

It’s also a good idea to get your siblings involved too. This can help you head off possible hard feelings, plus, with others involved, your parents will know everyone is concerned.

When you talk with your parents, you’ll need to collect some information, find out where they keep key documents and how they want certain things handled when they die or if they become incapacitated. Here’s a checklist of areas to focus on.

PERSONAL & HEALTH INFORMATION

  • Contacts: Make a list of names and phone numbers of their doctors, lawyer, accountant, broker, tax preparer, insurance agent, etc.
  • Medical information: Make a copy of their medical history (any drug allergies, past surgeries, etc.) and a list of medications they take.
  • Personal documents: Find out where they keep their Social Security card, marriage license, military discharge papers, etc.
  • Secured places: Make a list of places they keep under lock and key or protected by password, such as online accounts, safe deposit boxes, safe combination, security alarms, etc.
  • Pets: If they have a pet, what are their instructions for the animal’s care?
  • End of life: What are their wishes for organ or body donation, and their funeral instructions? If they’ve made pre-arrangements with a funeral home, get a copy of the agreement.

LEGAL DOCUMENTS

  • Will: Do they have an updated will or trust, and where is it located?
  • Power of attorney: Do they have a power of attorney document that names someone to handle their financial matters if they become incapacitated?
  • Advance directives: Do they have a living will and a medical power of attorney that spells out their wishes regarding their end-of-life medical treatment? If they don’t have these documents prepared, now’s the time to make them.

FINANCIAL RECORDS

  • Debts and liabilities: Make a list of any loans, leases or debt they have – mortgages owed, car loans, medical bills, credit card debts. Also, make a list of all their credit and charge cards, including the card numbers and contact information.
  • Financial accounts: Make a list of the banks and brokerage accounts they use (checking, savings, stocks, bonds, mutual funds, IRAs, etc.) and their contact information.
  • Company benefits: Make a list of any retirement plans, pensions or benefits from their former employers including the contact information of the benefits administrator.
  • Insurance: Make a list of the insurance policies they have (life, long-term care, home, auto, Medicare, etc.) including the policy numbers, agents and phone numbers.
  • Property: Make a list of the real estate, vehicles or other properties they own, rent or lease and where they keep the deeds, titles and loan or lease agreements.
  • Taxes: Find out where they keep copies of past year’s tax returns.

For more tips, see the Eldercare Locator publication “Let’s Talk: Starting the Conversation about Health, Legal, Financial and End-of-Life Issues” at N4A.org/files/Conversations.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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Smart Home Devices That Can Help Seniors Age-In-Place

Dear Savvy Senior,
I recently read an article about how “smart home” devices can help seniors with aging-in-place. What types of smart home products can you recommend that can help with this?
Inquiring Senior

Dear Inquiring,
There are actually a wide variety of affordable smart home devices you can add to your home that can help make it safer and easier to live in as you age. Here’s what you should know.

Smart Home Technologies
While most Americans today use technology and enjoy the conveniences they provide, there are millions of seniors who still don’t have much use for it. But you don’t have to like technology or be tech savvy to benefit from the many different smart home automation devices that can help seniors age-in-place.

Smart home devices can also give family members and caregivers the ability to electronically keep tabs on their elder loved one when they can’t be there, which provides peace-of-mind.

If you’re interested in adding some smart home products to your house, you need to know that these devices require home Wi-Fi, and for many of the products, you’ll need either a smartphone, tablet or voice-enabled assistant to operate them. Here are some popular aging-in-place smart home products to help you get started.

Voice-enabled assistant: Popular products like the Amazon Echo (Amazon.com/echo), Google Assistant (Assistant.google.com) or Apple HomePod (Apple.com/homepod) will let you operate compatible smart home products with simple voice commands.

These devices can also play your favorite music, read audiobooks, make calls, set timers and alarms, provide reminders for medications, appointments and other things, check traffic and weather, ask questions, and much more – all done by voice commands.

Smart lights: Falls are common concerns among elderly seniors, which are often caused by fumbling around a dark room looking for a light switch. Smart light bulbs like the Philips Hue (MeetHue.com) can turn on and off the lights by voice command, smartphone or tablet. These bulbs can also dim the lights and you can program them to turn on and off whenever you want.

There are also smart electric plugs like the Wemo Mini (Wemo.com) that offer remote control automation for lamps, fans, or other electrical devices.

Video doorbell: Safety is also a concern for seniors who live alone. Smart doorbells like the Ring video doorbell (Ring.com) would allow you to see, hear and speak to someone at her door (via smartphone, tablet, Google smart displays, Amazon Echo Show or Spot) without having to open it.

Stovetop shut-off: To help seniors prevent home cooking fires, stovetop shut-off devices like the IGuardStove (IGuardFire.com) uses motion sensors to turn off electric and gas stovetops when left unattended for a predetermined amount of time. It will also alert family members via text.

Medication management: Seniors on a complex medication schedule can benefit from a smart medication tracking system like the PillDrill (PillDrill.com) that reminds you when pills are due, tracks that you’ve taken them, and notifies loves ones.

Home monitoring: Family members can keep tabs on older loved ones from afar with smart home video cameras like Lighthouse Al (Light.house/elderly-care) or a smart home sensor system like TruSense (MyTruSense.com).

Other options: Some other helpful smart home products to consider include smart door locks like Kwikset Kevo (Kwikset.com), smart thermostats such as the Nest (Nest.com), and smart nightlights like Aladin (Domalys.com), which detects falls and alerts caregivers.

The costs for most smart home products range anywhere from a few dollars to several hundred dollars and can be found in many local home improvement stores as well as online.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.
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Can You Deduct Medicare Costs on Your Income Taxes?

Dear Savvy Senior,
Can I deduct my Medicare premiums, deductibles and co-payments on my income taxes? I had a knee replacement surgery last year and spent quite a bit on medical care out-of-pocket and would like to know what all I can write off.
Frugal Dave

Dear Dave,
The short answer is yes, you can deduct your Medicare costs but only if you meet certain conditions required by the IRS. Here’s how it works.

As a taxpayer, you’re allowed to deduct many medical and dental expenses as well as your Medicare out-of-pocket costs. But you can deduct only those expenses that exceed 7.5 percent of your 2018 adjusted gross income (AGI), and you’ll also need to itemize your deductions. Next year, (2019 tax season) the threshold will rise to 10 percent.

Here’s an example. Let’s say that your AGI in 2018 was $50,000. Of that, 7.5 percent is $3,750. If your total allowable medical expenses last year were $8,000, you’d be able to deduct $4,250 ($8,000 minus $3,750). But, if your medical expenses were less than $3,750, you couldn’t claim any as a deduction.

You also need to understand that when taking a medical expense deduction, you don’t actually get back every dollar you claim. While a tax credit reduces your taxes dollar-for-dollar, tax deductions simply reduce your taxable income, and your savings ultimately depend on the effective rate at which you’re taxed. So, for example, if you qualify for a $4,250 deduction and your effective tax rate is 22 percent, you would get $935 in savings from that particular deduction.

To get this deduction you will need to file an itemized Schedule A (1040) tax return. You cannot claim medical expenses on Form 1040A or Form 1040EZ.

Allowable Medical Expenses
The list of allowable medical expenses, as defined by the IRS, is long and fairly flexible. As a Medicare beneficiary, you can deduct your monthly premiums for Part B, Part C (Medicare Advantage plans), Part D drug plans, and any supplemental (Medigap) insurance you have. If you have to pay a premium for Part A, that’s allowed too. You can also deduct the cost of all your deductibles, coinsurance, and c-opayments under Medicare.

In addition, you’re also allowed to deduct the cost of medical services not covered by Medicare, including dental treatment, vision care, prescription eyeglasses, hearing aids, and even long-term care. They also allow transportation to and from medical treatment to count as an eligible medical expense. And if necessary, you may even be able to deduct home alterations and equipment, like entrance ramps, grab bars, stair lifts etc., that can help you age in place.

Some things, however, you cannot deduct like vitamins and supplements unless recommended by a physician to treat a specific medical condition. And Medicare late penalties added to Part B or Part D premiums. Medicare beneficiaries who fail to sign up during their initial enrollment period are typically hit with a penalty that gets added to their monthly premiums, but these additional costs won’t count for tax purposes.

For more information, including a detailed rundown of allowable and unallowable medical expenses, see IRS Publication 502 “Medical and Dental Expenses” at IRS.gov/pub/irs-pdf/p502.pdf or call the IRS at 800-829-3676 and ask them to mail you a copy.

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

Dear Savvy Senior,
What are the warning signs for glaucoma? My 65-year-old brother lost some of his vision because of it but never had a clue anything was wrong. Could I be at risk too?
Concerned Sister

Dear Concerned,
It’s called the “silent thief of sight” for a reason. With no early warning signs or pain, most people that have glaucoma don’t realize it until their vision begins to deteriorate. Here’s what you should know.

Glaucoma is a group of eye diseases that can damage the optic nerve and cause vision loss and blindness if it’s not treated. This typically happens because the fluids in the eye don’t drain properly, causing increased pressure in the eyeball.

There are two main types of glaucoma, but the most common form that typically affects older people is called open-angle glaucoma. This disease develops very slowly when the eye’s drainage canals become clogged over time, leading to blind spots in the peripheral or side vision. By the time you notice it, the permanent damage is already done.

Are You at Risk?
It’s estimated that more than 3 million Americans have glaucoma today, but that number is expected to surge to more than 4 million by 2030. If you answer “yes” to any of the following questions, you’re at increased risk of developing it.

  • Are you African American, Hispanic/Latino American or Asian American?
  • Are you over age 60?
  • Do you have an immediate family member with glaucoma?
  • Do you have diabetes, heart disease, high blood pressure, migraines or extreme nearsightedness?
  • Have you had a past eye injury?
  • Have you used corticosteroids (for example, eye drops, pills, inhalers, and creams) for long periods of time?

What to Do
Early detection is the key to guarding against glaucoma. So if you’re age 40 or older and have any of the previously listed risk factors (especially if you’re African American), you need to get a comprehensive eye examination every year or two. Or, if you notice some loss of peripheral vision, get to the eye doctor right away.

If you are a Medicare beneficiary, annual eye examinations are covered for those at high risk for glaucoma. Or if you don’t have vision coverage, check into EyeCare America, a national program that provides free glaucoma eye exams and there are no income requirements. Visit EyeCareAmerica.org or call 877-887-6327 to learn more.

While there’s currently no cure for glaucoma, most cases can be treated with prescription eye drops, which reduce eye pressure and can prevent further vision loss. It cannot, however, restore vision already lost from glaucoma. If eye drops don’t work, your doctor may recommend oral medication, laser treatments, incisional surgery or a combination of these methods.

For more information on glaucoma, visit the National Eye Institute at NEI.nih.gov, and the Glaucoma Research Foundation at Glaucoma.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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How to Fight Age Discrimination in the Workplace

Dear Savvy Senior,
How does one fight against workplace age discrimination, and where can I turn to for help if I think I’ve got a case?
Discouraged Donna

Dear Donna,
Age discrimination can happen to anybody over age 40, but it’s difficult to prove. With that said, here are the steps you’ll need to take to fight this growing problem if you think you’ve been treated unlawfully in the workplace.

ADEA Protection

The Age Discrimination in Employment Act (ADEA) is your first defense against age discrimination. This is a federal law that says an employer cannot fire you, refuse to hire you, or treat you differently than other employees because of your age. Some examples of age discrimination include:

  • You were fired because your boss wanted to keep younger workers who are paid less.
  • You were turned down for a promotion, which went to someone younger hired from outside the company, because the boss says the company “needs new blood.”
  • When company layoffs are announced, most of the persons laid off were older, while younger workers with less seniority and less on-the-job experience were kept on board.
  • Before you were fired, your supervisor made age-related remarks about you.
  • You didn’t get hired because the employer wanted a younger-looking person to do the job.

The ADEA protects all workers and job applicants age 40 and over who work for employers that have 20 or more employees – including federal, state and local governments as well as employment agencies and labor unions.

If your workplace has fewer than 20 employees, you may still be protected under your state’s anti-age discrimination law.

What to Do
If you think you are a victim of employment age discrimination, you may first want to talk to, or file a grievance with your company’s human resources department, but it’s important to remember that HR work for your employer, not for you.

If that doesn’t resolve the problem, you should file a charge with the Equal Employment Opportunity Commission (EEOC) within 300 days from the date of the alleged violation. In some states, it’s 180 days. You can do this by mail or in person at your nearest EEOC office (see EEOC.gov/field/index.cfm) or call 800-669-4000. They will help you through the filing process and let you know if you should also file a charge with your state anti-discrimination agency.

If you do file, be prepared to provide the names of potential witnesses, your notes about age-related comments and other episodes.

Once the charge is filed, the EEOC will investigate your complaint and find either reasonable cause to believe that age discrimination has occurred, or no cause and no basis for a claim. After the investigation, the EEOC will then send you their findings along with a “notice-of-right-to-sue,” which gives you permission to file a lawsuit in a court of law.

If you decide to sue, you’ll need to hire a lawyer who specializes in employee discharge suits. To find one, see the National Employment Lawyers Association at NELA.org, or your state bar association at FindLegalHelp.org.

If you lose your job in a group termination or layoff, you should consider joining forces with other colleagues. There are advantages to proceeding as a group, including sharing costs of the litigation and strengthening your negotiating position.

Another option you may want to consider is mediation, which is a fair and efficient way to help you resolve your employment disputes and reach an agreement. The EEOC offers mediation at no cost if your current or former employer agrees to participate. At mediation, you show up with your evidence, your employer presents theirs and the mediator makes a determination within a day or less.

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.

December 2018 Columns

Savvy Senior – December Columns

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

The Retirement Benefits of a Health Savings Account

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Does Medicare Cover Dental Care?

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

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

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

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

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

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

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

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

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

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

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

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Have You Checked Your Social Security Statement for Errors?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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How to Cope with Seasonal Affective Disorder

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

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

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

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

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

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

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

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

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

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

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

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

November 2018 Columns

Savvy Senior – November Columns

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

What You’ll Pay for Medicare in 2019

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Insurance Questions?
If you have questions about Medicare, Medicaid or long-term care, your State Health Insurance Assistance Program (SHIP) offers free counseling and advice on these issues. Call 877-839-2675 or visit ShiptaCenter.org to locate a nearby counselor. You can also get help through the Medicare Rights Center, which staffs a help-line at 800-333-4114.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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