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.

October 2018 Columns

Savvy Senior – October Columns

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

Free Resources That Can Help with Your Medicare Decisions

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

September 2018 Columns

Savvy Senior – September Columns

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

Financial Aid for Family Caregivers

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

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

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

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

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

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

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

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

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

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

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

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

Health Insurance Tips for Traveling Abroad

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The CDC recommends that all seniors, 65 or older, get two vaccinations –Prevnar 13 and Pneumovax 23. Both vaccines, which are administered just once at different times, work in different ways to provide maximum protection.

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

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

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

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Choosing a Continuing-Care Retirement Community

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

Approaching 80

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

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

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

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

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

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

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

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

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

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

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

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

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

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

August 2018 Columns

Savvy Senior – August Columns

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

How Medicare Covers Diabetes

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Where Seniors Can Get Help With Home Chores and Small Jobs 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Retirement Planning Tips for Single Women

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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How Older People Can Find Clinical Trials

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

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

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

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

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

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

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

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

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

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

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

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

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

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

July 2018 Columns

Savvy Senior – July Columns

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

Simple Gadgets That Can Help Older Drivers

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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