The Savvy Senior

Savvy Senior – November Columns

  1. When Will Medicaid Pay for Nursing Home Care?
  2. Assistance Dogs Provide Help and Love
  3. Social Security Options for Divorced Spouses
  4. How to Protect Yourself from Peripheral Artery Disease

When Will Medicaid Pay for Nursing Home Care?

Dear Savvy Senior,
What are the eligibility requirements to get Medicaid coverage for nursing home care?
Caregiving Daughter

Dear Caregiving,
The rules and requirements for Medicaid eligibility for nursing home care are complicated and will vary according to the state where your parent lives. With that said, here’s a general, simplified rundown of what it takes to qualify.

Medicaid Eligibility
Medicaid, the joint federal and state program that covers health care for the poor, is also the largest single payer of America’s nursing home bills for seniors who don’t have the resources to pay for their own care.

Most people who enter nursing homes don’t qualify for Medicaid at first, but pay for care either through long-term care insurance or out-of-pocket until they deplete their savings and become eligible for Medicaid.

To qualify for Medicaid, your parent’s income and assets will need to be under a certain level that’s determined by their state. Most states require that a person have no more than about $2,000 in countable assets that includes cash, savings, investments or other financial resources that can be turned into cash.

Assets that aren’t counted for eligibility include their home if it’s valued under $560,000 (this limit is higher – up to $840,000 – in some states), their personal possessions and household goods, one vehicle, prepaid funeral plans and a small amount of life insurance.

But be aware that while your parent’s home is not considered a countable asset to determine their eligibility, if he or she can’t return home, Medicaid can go after the proceeds of their house to help reimburse their nursing home costs, unless a spouse or other dependent relative lives there. (There are some other exceptions to this rule.)

After qualifying, all sources of your parent’s income such as Social Security and pension checks must be turned over to Medicaid to pay for their care, except for a small personal needs allowance – usually between $30 and $90.

You also need to be aware that your parent can’t give away their assets to qualify for Medicaid faster. Medicaid officials will look at their financial records going back five years to root out suspicious asset transfers. If they find one, their Medicaid coverage will be delayed a certain length of time, according to a formula that divides the transfer amount by the average monthly cost of nursing home care in their state.

So if, for example, your parent lives in a state where the average monthly nursing home cost is $5,000 and they gave away cash or other assets worth $50,000, they would be ineligible for benefits for 10 months ($50,000 divided by $5,000 = 10).

Spousal Protection
Medicaid also has special rules for married couples when one spouse enters a nursing home and the other spouse remains at home. In these cases, the healthy spouse can keep one half of the couple’s assets up to $120,900 (this amount varies by state), the family home, all the furniture and household goods and one automobile. The healthy spouse is also entitled to keep a portion of the couple’s monthly income – between $2,030 and $3,022. Any income above that goes toward the cost of the nursing home recipient’s care.

What about Medicare?
Medicare, the federal health insurance program for seniors 65 and older, and some younger people with disabilities, does not pay for long-term care. It only helps pay up to 100 days of rehabilitative nursing home care, which must occur after a hospital stay.

Find Help
For more detailed information, contact your state Medicaid office (see Medicaid.gov for contact information). You can also get help from your State Health Insurance Assistance Program (see ShiptaCenter.org), which provides free counseling on all Medicare and Medicaid issues.

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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Assistance Dogs Provide Help and Love

Dear Savvy Senior
What can you tell me about assistance dogs for people with disabilities? My sister, who’s 58, has multiple sclerosis and I’m wondering if an assistance dog could help make her life a little easier
.
Inquiring Sister

Dear Inquiring
For people with disabilities and even medical conditions, assistant dogs can be fantastic help, not to mention they provide great companionship and an invaluable sense of security. Here’s what you and your sister should know.

While most people are familiar with guide dogs that help people who are blind or visually impaired, there are also a variety of assistance dogs trained to help people with physical disabilities, hearing loss and various medical conditions.

Unlike most pets, assistance dogs are highly trained canine specialists – often Golden and Labrador Retrievers, and German Shepherds – that know approximately 40 to 50 commands, are amazingly well-behaved and calm, and are permitted to go anywhere the public is allowed. Here’s a breakdown of the different types of assistance dogs and what they can help with.

Service dogs: These dogs are specially trained to help people with physical disabilities due to multiple sclerosis, spinal cord injuries, Parkinson’s disease, chronic arthritis and many other disabling conditions. They help by performing tasks their owner cannot do or has trouble doing, like carrying or retrieving items, picking up dropped items, opening and closing doors, turning lights on and off, assisting with dressing and undressing, helping with balance, household chores and more.

Guide dogs: For the blind and visually impaired, guide dogs help their owner get around safely by avoiding obstacles, stopping at curbs and steps, negotiating traffic and more.

Hearing dogs: For those who are deaf or hearing impaired, hearing dogs can alert their owner to specific sounds such as ringing telephones, doorbells, alarm clocks, microwave or oven timers, smoke alarms, approaching sirens, crying babies or when someone calls out their name.

Seizure alert/response dogs: For people with epilepsy or other seizure disorders, these dogs can recognize the signs that their owner is going to have a seizure, and provide them with advance warning, so he or she can get to a safe place or take medication to prevent the seizure or lessen its severity. They are also trained to retrieve medications and use a pre-programmed phone to call for help. These dogs can also be trained to help people with diabetes, panic attacks and various other conditions.

Finding a Dog
If your sister is interested in getting a service dog, contact some assistance dog training programs. To find them, Assistance Dogs International provides a listing of around 65 U.S. programs on their website that you can access at AssistanceDogsInternational.org.

After you locate a few, you’ll need to either visit their website or call them to find out the types of training dogs they offer, the areas they serve, if they have a waiting list, and what upfront costs will be involved. Some groups offer dogs for free, some ask for donations and some charge thousands of dollars.

To get an assistance dog, your sister will need to show proof of her disability, which her physician can provide, and she’ll have to complete an application and go through an interview process. She will also need to go and stay at the training facility for a week or two so she can get familiar with her dog and get training on how to handle it.

It’s also important to understand that assistance dogs are not for everybody. They require time, money, and care that your sister or some other friend or family member must be able and willing to provide.

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

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Social Security Options for Divorced Spouses

Dear Savvy Senior,
As a divorced woman, am I entitled to my ex-husband’s Social Security benefits? I was married for 14 years and would like to know how this works.
Happily Divorced

Dear Divorced,
Yes, you may very well be eligible for divorced spouses Social Security benefits if you meet certain criteria. Here’s how it works.

A divorced spouse can collect a Social Security retirement benefit on the earnings record of their ex-husband (or ex-wife) if you are at least age 62, were married for at least 10 years, are unmarried, and are not eligible for a higher benefit based on your own earnings record.

In order to collect, your former spouse must also be at least 62 and eligible for Social Security benefits. But, he doesn’t have to be receiving them in order for you to collect divorced spouse’s benefits, as long as you’ve been divorced for at least two years.

Even if your ex is remarried, it won’t affect your right to divorcee benefits, nor will it affect your ex’s retirement benefits or his current spouse’s benefits.

Benefit Amount
A divorced spouse can receive up to 50 percent of their ex’s full Social Security benefit, or less if they take benefits before their full retirement age – which is 66 if you were born between 1943 and 1954. To find out your full retirement age and see how much your benefits will be reduced by taking them early see SSA.gov/planners/retire/retirechart.html.

Keep in mind though, that if you qualify for benefits based on your own work history, you’ll receive the larger of the two benefits. You cannot receive benefits on both your record, and your ex’s work record too.

To find out how much your retirement benefits will be, see your Social Security statement at SSA.gov/myaccount. And to get an estimate of your ex’s benefits, call Social Security at 800-772-1213. You’ll need his Social Security Number to get it.

Divorced Survivor
You also need to know that if your ex-spouse dies, and you were married for 10 or more years, you become eligible for divorced survivor benefits, which is worth up to 100 percent of what your ex-spouse was due.

Survivor’s benefits are available to divorced spouses as early as age 60 (50 if you’re disabled). But, if you remarry before 60 you become ineligible unless the marriage ends. Remarrying after age 60 will not affect your eligibility.

Also note that if you are receiving divorced spouses benefits when you ex-spouse dies, you will automatically be switched over to the higher paying survivor benefit.

Switching Strategies
Being divorced also offers a switching strategy that can help boost your benefits if you were born on or before Jan. 1, 1954. Here’s how it works. If you worked and are eligible for benefits on your own earnings record, you could file a “restricted application” with Social Security at age 66 to collect a divorced spousal benefit, which is half of what your ex gets. Then, once you reach 70, you stop receiving the ex-spousal benefit and switch to your own benefit, which will be 32 percent higher than it would have been at your full retirement age.

Unfortunately, as a result of the Bipartisan Budget Act of 2015, this option is not available if your birthday is Jan. 2, 1954 or later.

Divorced widows (and widowers) also have switching options regardless of your birthday. If, for example, you are currently collecting Social Security retirement benefits on your own record, and your ex-spouse dies, you can switch to survivor’s benefits if the payment is larger. Or, if you’re collecting survivor’s benefits, you can switch to your own retirement benefits – between 62 and 70 – if it offers a larger payment.

For more information visit SSA.gov/planners/retire/divspouse.html, or call 800-772-1213.

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

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How to Protect Yourself from Peripheral Artery Disease

Dear Savvy Senior
For the last six months or so, I’ve been having problems with my hips and legs cramping when I walk, although they feel better once I stop. I thought it was just because I’m getting old, but my friend was telling me about a leg vein disease called PAD and thinks I may have it. What can you tell me about this condition?
Limping at 60

Dear Limping,
The health condition your friend is telling you about is known as “peripheral arterial disease” (or PAD), which is an under the radar disease that affects up to 12 million Americans.

It happens when the arteries that carry blood to the legs and feet become narrowed or clogged over the years with fatty deposits or plaque, causing poor circulation.

But you also need to be aware that because PAD is a systemic disease, people that have it are also much more likely to have clogged arteries in other areas of the body like the heart, neck and brain, which greatly increase the risks of heart attack or stroke.

Few Symptoms
Unfortunately, PAD goes undiagnosed and untreated way too often because most people that have it experience few, if any symptoms. The most common symptom, however, is similar to what you’re experiencing: pain and cramping in the hip, thigh or calf muscles, especially when walking or exercising but usually disappears after resting for a few minutes.

Another reason PAD is under-diagnosed is because many people assume that aches and pains go along with aging and simply live with it instead of reporting it to their doctor.

Other possible symptoms to be aware of include leg numbness or weakness, coldness or skin color changes in the lower legs and feet, or ulcers or sores on the legs or feet that don’t heal.

Are You at Risk?
Like most other health conditions, the risk of developing PAD increases with age. Those most vulnerable are people over the age of 50 who smoke or used to smoke, have elevated cholesterol, high blood pressure, diabetes, are over weight, or have a family history of PAD, heart attack or stroke. African Americans are also twice as likely to have PAD as Caucasians.

If you’re experiencing any symptoms or if you’re at increased risk of PAD, you need to be tested by your doctor or a vascular specialist. He or she will probably perform a quick and painless ankle-brachial index test, which is done by measuring your blood pressure in your ankle as well as your arm and compare the two numbers.

With early detection, many cases of PAD can be treated with lifestyle modifications including an improved diet, increased physical activity and smoking cessation.

If lifestyle changes aren’t enough, your doctor may also prescribe medicine to prevent blood clots, lower blood pressure and cholesterol, and control pain and other symptoms. And for severe PAD, the treatment options are angioplasty (inflating a tiny balloon in the artery to restore blood flow then removed), the insertion or a stent to reopen the artery, or a graft bypass to reroute blood around the blockage.

To learn more about PAD, visit the National Heart, Lung and Blood Institute at www.nhlbi.nih.gov/health/educational/pad.

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

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Savvy Senior – October Columns

  1. A Cheap Death: How to Donate Your Body to Science
  2. Getting a Handle on Prescription Medications
  3. How to Search for Forgotten 401(k) Money
  4. Flu Shots for Seniors
  5. Solo Travel Savings Tips for Retirees

A Cheap Death: How to Donate Your Body to Science

Dear Savvy Senior,
What can you tell me about body donation programs? With little to no savings, I’m looking for a free or cheap way to dispose of my body after I die.
Old and Broke

Dear Broke,
If you’re looking to eliminate your funeral and burial costs, as well as help advance medical research, donating your body to science is a great option to consider. Here’s what you should know.

Body Donations
It’s estimated that each year, at least 20,000 people donate their whole body, after death, to medical facilities throughout the country to be used in medical research projects, anatomy lessons and surgical practice.

After using your body, these facilities will then provide free cremation – which typically costs $600 to $4,000 – and will either bury or scatter your ashes in a local cemetery or return them to your family, usually within a year or two.

And just in case you’re wondering, your family will not be paid for the use of your body. Federal and state laws prohibit it.

Here are a few other things you need to know and check into, to help you determine whether whole-body donation is right for you:

  • Acceptance rules: Most body donation programs will not accept bodies that are extremely obese, or those that have infectious diseases like hepatitis, tuberculosis, H.I.V. or MRSA. Bodies that suffered extensive trauma won’t be accepted either.
  • Organ donation: Most programs require that you donate your whole body in its entirety. So if you want to be an organ donor (with the exception of your eyes), you won’t qualify to be a whole body donor too.
  • Special requests: Most programs will not allow you to donate your body for a specific purpose. You give them the body and they decide how to use it.
  • Memorial options: Most programs require almost immediate transport of the body after death, so there’s no funeral. If your family wants a memorial service they can have one without the body. Or, some programs offer memorial services at their facility at a later date without the remains.
  • Body transporting: Most programs will cover transporting your body to their facility within a certain distance. However, some may charge.

What To Do
If you think you want to donate your body, it’s best to make arrangements in advance with a body donation program in your area. Most programs are offered through university-affiliated medical schools. To find one near you, the University of Florida maintains a list of U.S. programs and their contact information at Anatbd.acb.med.ufl.edu/usprograms.

In addition to the medical schools, there are also private organizations like BioGift (BioGift.org) and Science Care (ScienceCare.com) that accept whole body donations too. Some of these organizations will even allow organ donation because they deal in body parts as well as whole cadavers.

If you don’t have Internet access, you can get help by calling the National Family Service Desk, which operates a free body donation referral service during business hours at 800-727-0700.

Once you locate a program in your area, call and ask them to mail you an information/registration packet that will explain exactly how their program works.

To sign up, you’ll simply need to fill out a couple of forms and return them. But, you can always change your mind by contacting the program and removing your name from their registration list. Some programs may ask that you make your withdrawal in writing.

After you’ve made arrangements, you’ll need to tell your family members so they will know what to do and who to contact after your death. It’s also a good idea to tell your doctors, so they know your final wishes too.

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

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Getting a Handle on Prescription Medications

Dear Savvy Senior,
I’m concerned that my 80-year-old mother is taking too many medications. She currently takes 10 different drugs prescribed by three different doctors, which I think is causing her some problems. She also struggles to keep up with all the drug costs. Any suggestions?
Concerned Daughter

Dear Concerned,
There’s no doubt that older Americans are taking more prescription medications than ever before. According to the Journal of the American Medical Association, around 40 percent of seniors, age 65 and older, take five or more medications. And the more drugs a person takes, the higher their risk for medication problems, and the more likely they are to take something they don’t need.

Brown Bag Review
To help you get a better handle on the medications your mom is taking, gather up all her pill bottles – include all prescription drugs, over-the-counter medications, vitamins, minerals and herbal supplements – and put them in a bag and take them to her primary doctor or pharmacist for a thorough drug checkup. This “brown-bag review’ will give you a chance to check for duplicate meds, excessive doses, and dangerous interactions, and for you to ask questions.

Medicare Part B covers free yearly medication reviews with a doctor through their annual wellness visits, and many Medicare Part D plans cover medication reviews with a pharmacist too.

You should also note that October 21, is “National Check Your Meds Day.” A number of pharmacies – Albertsons, Costco, CVS, Sam’s Club, Target, Walmart and many independents – have agreed to support the effort. Some may even have extra staff on hand to help you review your meds. Ask your local pharmacy whether it is participating.

When you get your mom’s review, go over the basics for each medication or supplement, such as what it’s for, how long she should take it, what it costs, and any side effects and potential interactions. Also ask if there are any meds she can stop taking, and find out if there are any non-drug options that might be safer, and whether she can switch to a lower dose.

To help your mom avoid future medication problems, make sure her primary doctor is aware of all the medications, over-the-counter drugs and supplements she takes. You should also keep an up-dated list of everything she takes and share it with every doctor she sees. And, be sure that your mom fills all her prescriptions at the same pharmacy and informs her pharmacist of any over-the counter, herbal or mail order prescriptions she’s taking so that there is complete oversight of her medications.

How To Save
To help cut your mom’s medication costs, there are a number of cost savings tips you can try. For starters, find out if there are any generic alternatives to the drugs she currently takes. Switching to generics saves anywhere between 20 and 90 percent.

You should also ask your mom’s prescribing doctors if any of the pills she takes could be cut in half. Pill splitting allows you to get two months worth of medicine for the price of one. And for the drugs she takes long-term, ask for a three-month prescription, which is usually cheaper than buying month-to-month.

Because drug prices can vary depending on where you buy them, another way to save is by shopping around (GoodRX.com will help you compare drug prices at U.S. pharmacies), and find out if your mom’s drug insurance plan offers cheaper deals through preferred pharmacies or a mail-order service.

And finally, if your mom’s income is limited, she can probably get help through drug assistance programs offered through pharmaceutical companies, government agencies and charitable organizations. To find these types of programs use BenefitsCheckUp.org.

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

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How to Search for Forgotten 401(k) Money

Dear Savvy Senior,
How do I find an old 401(k) that I think I contributed money to at a former employer?
Approaching Retirement

Dear Approaching,
If you think you may have lost track of a 401(k) retirement account, you aren’t alone. As Americans jump from job to job, many leave scraps of their company sponsored 401(k) plans behind, believing they’ll deal with it later, but never do. To help you look for an old 401(k), here are some suggestions along with some free resources that can help you search.

Contact Employer
The first way to find a previous 401(k) account is to contact your old employer’s human resources department. Ask them to check their plan records to see if you ever participated in their 401(k) plan, and if so, how much it’s worth. You’ll need to provide them your Social Security number and the dates you worked for them.

They should be able to either get you the forms necessary to roll over your retirement money to a different 401(k) or to an IRA, or to give you contact information for any outside financial institution overseeing the plan on your employer’s behalf. By following the appropriate instructions you get, you’ll be able to move your retirement money where you want.

If you don’t have contact information for your old employer, check your old records to see if you kept an old 401(k) statement. Statements will typically have the information you need to get in contact with either your employer or a plan administrator.

If you need help tracking down your former employer because it may have moved, changed owners or merged with another firm, free help is available from sources like the Labor Department (AskEBSA.dol.gov, 866-444-3272) and the Pension Rights Center and Pension Action Center (PensionRights.org/find-help).

These services can tap into public databases that list incorporations and bankruptcies and may be able to help you dig up a plan’s most recently filed Form 5500, the annual report that must be filed with the IRS, PBGC and the Labor Department. This form contains the plan’s contact information and the employer’s identification number, which can be used to locate any plan that inherited the assets in a merger, acquisition or sale.

You can also find recently filed 5500s yourself at websites like FreeERISA.com.

Search Tools
Finding a lost 401(k) account can be trickier if it’s worth less than $5,000, because your former employer can transfer the money to a default individual retirement account without consent. Your cash may go into an interest-bearing, federally insured bank account or to your state’s unclaimed property fund.

To search for a lost plan, use the National Registry of Unclaimed Retirement Benefits at UnclaimedRetirementBenefits.com. This website matches former employers with past employees who have unclaimed retirement funds. This is a secure and free service, but you’ll need to provide your Social Security number to search.

It can also be challenging to track down a lost 401(k) account if your former employer goes bankrupt and abandons the plan. In this case, use the U.S. Department of Labor’s Abandoned Plan Database at AskEBSA.dol.gov/abandonedplansearch.

Starting in 2018, the Pension Benefit Guaranty Corporation (PBGC.gov) will start accepting transfers of missing participants’ accounts from terminating 401(k) plans. When the participants are found, it will pay them that money plus interest. The agency also plans to launch a registry of terminated 401(k) plans that sent money elsewhere, so missing participants can more easily find their accounts.

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

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Flu Shots for Seniors

Dear Savvy Senior,
What can you tell me about the flu shots made for seniors? I got sick last winter after getting a standard flu shot, and am wandering if the flu vaccine for older adults would provide me better protection this year.
Almost 70

Dear Almost 70,
There are actually two different flu shots – the Fluzone High Dose and FLUAD – that are designed specifically for people age 65 and older (you only need to get one of them).

These FDA approved vaccines are designed to offer extra protection beyond what a standard flu shot provides, which is important for older adults who have weaker immune defenses and have a great risk of developing dangerous flu complications.

The Center for Disease Control and Prevention (CDC) estimates that the flu puts more than 200,000 people in the hospital each year and kills, on average, about 24,000 – 80 percent of whom are seniors.

You also need to be aware that these senior-specific flu shots cannot guarantee that you won’t get the flu this season, but they will lower your risk. And if you do happen to get sick, you probably won’t get as sick as you would without it. Here’s more information on the two vaccines:

Fluzone High-Dose: Approved for U.S. use in 2009, the Fluzone High-Dose (see Fluzone.com) is a high-potency vaccine that contains four times the amount of antigen as a regular flu shot does, which creates a stronger immune response for better protection. This vaccine, according to a 2013 clinical trial, was 24 percent more effective than the regular-dose shot at preventing flu in seniors.

FLUAD: Available in the U.S. since last year, the FLUAD vaccine (FLUAD.com) contains an added ingredient called adjuvant MF59 that also helps create a stronger immune response. In a 2012 Canadian observational study, FLUAD was 63 percent more effective than a regular flu shot.

The CDC, however, does not recommend one vaccination over the other, and to date, there have been no studies comparing the two vaccines.

You should also know that both the Fluzone High-Dose and FLUAD can cause more of the mild side effects that can occur with a standard-dose flu shot, like pain or tenderness where you got the shot, muscle aches, headache or fatigue. And neither vaccine is recommended for seniors who are allergic to chicken eggs, or those who have had a severe reaction to a flu vaccine in the past.

Both vaccines are also covered 100 percent by Medicare Part B, as long as your doctor, health clinic or pharmacy agrees not to charge you more than Medicare pays.

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

The CDC is now recommending 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. But if you’ve already been vaccinated with Pneumovax 23, wait at least one year before getting the Prevnar 13.

Medicare Part B covers both shots, if they are taken at least one year apart.

To locate a vaccination site that offers any of these shots, visit 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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Solo Travel Savings Tips for Retirees

Dear Savvy Senior,
Can you recommend some good travel companies that offer good deals for single travelers? I’ve taken a couple tours since I retired a few years ago, but the single-supplement fee really cuts into my budget.
Solo Sally

Dear Sally,
Solo traveling is a growing trend among baby boomers and retirees. Nearly 1-in-4 who travel today, go it alone according to a recent Visa Global Intentions Study. But one of the biggest drawbacks among solo travelers is the single supplemental fee – which is an extra fee charged to single travelers who stay in a double occupancy room alone.

To help you avoid this extra charge, more and more travel companies and cruise lines are making adjustments to accommodate the growing solo-traveler market. Here are several to check into.

Singles Travel
There are a variety of travel companies today that specialize in vacations for solo travelers, including Singles Travel International (SinglesTravelIntl.com) and Singles Travel Getaways (SinglesTravelGetaways.com). Both companies offer tours, cruises and adventures in the U.S. and overseas, and will match you with a roommate to avoid the single supplement, or won’t charge you if a match can’t be arranged.

General Tour Operators
Some big operators in this category that have lots of solo travelers include Intrepid Travel (IntrepidTravel.com), which handles more than 100,000 travelers each year, sending them to more than 100 countries. And G Adventures (Gadventures.com), which has more than 700 tours around the globe, and offers a variety of travel styles. Both of these companies can pair you with a roommate, and some tours offer your own room option for an additional fee.

And for higher-end luxury travel check out Abercrombie & Kent (AbercrombieKent.com), which offers a 50 percent single supplement discount on their select small group solo travel trips and cruises, and Tauck (Tauck.com), which has no single supplement on their European river cruises.

50-Plus Travel
If you’re interested in trips designed for adults 50 and older consider ElderTreks (ElderTreks.com), Road Scholar (RoadScholar.org) and Overseas Adventure Travel (OATtravel.com).

ElderTreks specializes in exotic adventures worldwide, and will match single travelers with roommates on most of its trips, and doesn’t charge if a match can’t be arranged.

Road Scholar specializes in worldwide learning adventures, and has designated trips that offer the same price for solo travelers as for those traveling in pairs.

And Overseas Adventure Travel, which operates in Asia, Africa, Europe, South America, the Middle East, Cuba, Australia and New Zealand, has free single supplements on all its land tours and either free or low-cost single supplements on its small-ship adventures.

Cruise Lines
If cruising is your thing, there are a number of cruise lines that have some ships with single-occupancy cabins, including Norwegian Cruise Line (NCL.com), Royal Caribbean (RoyalCaribbean.com) and Vantage Deluxe World Travel’s river ships (VantageTravel.com).

Or you can consider booking a cruise at SinglesCruise.com, which uses a variety of different cruise lines for their single customers. They provide roommate matching.

Solo Women
For solo women travelers, there are a host of tour companies and clubs, like GutsyWomenTravel.com, Women-Traveling.com, SerenDipityTraveler.com, TheWomensTravelGroup.com and Womens-Travel-Club.com that will either match you up with a roommate, or reduce their single supplement fee.

Travel Partner
If you’d rather find a suitable travel partner before you book your next trip, there are a number of free websites that can help you here too. See Travbuddy.com, TravelFriend.us and TravelersMeeting.com. Or, to find a cruise buddy try CruiseMates.com, which has a message board where users can post roommate requests.

For more information on solo travel, check out SoloTravelerWorld.com, which offers solo travel tips, destinations and stories, and also publishes a monthly list of solo travel deals.

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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Savvy Senior – September Columns

1.    Check-In Services That Can Help Seniors Stay Put
2.    Top New Cars for Older Drivers
3.    How to Find a Better Medicare Prescription Drug Plan
4.    Exercises that Help Ease Arthritis Pain and Stiffness

Check-In Services That Can Help Seniors Stay Put

Dear Savvy Senior,
Are there any services you know of that check in on elderly seniors who live alone. I worry about my 84-year-old father falling or having a medical emergency, and not being able to get to the phone to call for help. And he won’t wear a lifeline help-button.
Desperate Daughter

Dear Desperate,
Depending on where your dad lives, there are check-in call services, volunteer visiting programs, and a variety of technology options you can turn to that can help you keep tabs on him. Here are several to check into.

Daily Check-in Calls
To make sure your dad is OK every day, consider signing him up with a daily check-in call service program. These are telephone reassurance programs run by police or sheriff’s departments in hundreds of counties across the country and are usually provided free of charge.

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

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

To find out if this service is available in your dad’s community, call his local police department’s nonemergency number.

However, if the police or sheriff’s department in your dad’s community doesn’t provide a daily check-in call program, there are a number of companies you can turn to that offer similar services offered directly to consumers for under $15 per month. Some to check into include the CARE senior calling program (Call-Reassurance.com), CareCheckers (CareCheckers.com) and IAmFine (Iamfine.com).

Volunteer Visiting Programs
Another option you may also want to investigate is volunteer visiting programs, which are usually run by churches, community groups, or social service agencies.

These programs provide volunteers who will visit an older adult in their home usually for an hour or two once a week, providing companionship as well as the reassurance that someone is checking in on a regular basis. They can also alert you if they notice your dad’s health or living conditions start to decline.

To find out if these services are available, check with local churches or the area agency on aging near your dad – call the Eldercare Locator at 800-677-1116 for contact information.

Technology Solutions
Technology also offers a number of ways to help keep your dad safe at home, and help you keep an eye on him from afar. For example, for safety and peace of mind there are medical alert systems, which provide a wearable “help button” that would allow him to call for help anytime he needed it. Some of these systems (like Bay Alarm Medical, BayAlarmMedical.com) also offer wall-mounted buttons that can be placed near the floor in high fall risk areas like the bathroom or kitchen, if he didn’t wear a help button.

And to help you keep daily tabs on your dad, there are wireless sensor-monitoring systems (like Silver Mother, Sen.se/silvermother) you could put in his home that will notify you if something out of the ordinary is happening; and video monitoring cameras (like the Nest Cam, Nest.com/camera) that 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 him.

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 New Cars for Older Drivers

Dear Savvy Senior,
My wife and I are both in our late sixties and are looking to buy a new car. Can you recommend some good resources that can help us evaluate and choose a good car for older drivers?
Car Shoppers

Dear Shoppers,
With more than 40 million licensed drivers in the United States age 65 and older, many automakers today are designing certain vehicles that are friendlier for older drivers. But what makes a good car for seniors? For many, top priorities include a vehicle that’s easy to get into and out of, easy to adjust for fit and comfort, easy to operate and see out of, as well as reliable, safe and a good value.

To help you narrow your vehicle choices, Consumer Reports and the American Automobile Association (AAA) offer some great information and tools to assist you.

CR Best Cars
Consumer Reports recently put out a top 25 ranking of new cars for senior drivers. Each vehicle on their list offers excellent or very good ratings on reliability, safety, road-test performance and owner satisfaction. And, they offer a variety of senior-friendly features that are extremely important to older divers, like:

  • Easy front-seat access:Vehicles with low door thresholds, wider door openings, and step-in heights that reduce the need for ducking or climbing, make getting into and out of a car easier for those with physical limitations.
  • Good visibility: Being able to see well out of the front, sides, and back of a vehicle for tall, medium, and shorter drivers.
  • Simplified controls:Easy-to-read gauges and simplified/intuitive controls for changing the radio, shifting gears, and adjusting the heating and cooling is a high priority among older drivers.
  • Bright headlights:Powerful headlights can make driving at night easier for people with decreasing or compromised vision.

They also weighed in extra safety features (standard or optional) like a backup camera, automatic emergency braking, forward-collision warning and blind-spot warning.

Their picks include a variety of compact and midsized sedans and SUVs, two minivans and a station wagon from seven different automakers. Here’s their top 25 ranking, starting with one through 25: Subaru Forester; Subaru Outback; Kia Soul; Subaru Legacy; Kia Sportage; Toyota Highlander; Toyota Prius V; Toyota RAV4; Honda Odyssey; Nissan Rogue; Honda Accord; Ford C-Max Hybrid; Hyundai Sonata; Toyota Camry; Subaru Crosstrek; Toyota Sienna; Honda CR-V; Honda Pilot; Kia Forte; Ford Escape; Toyota Corolla; Kia Sorento; Ford Flex; Hyundai Santa Fe; Hyundai Tucson.

For more information on their top 25 list, see ConsumerReports.org/elderly-driving/top-25-new-cars-for-senior-drivers.

AAA Tool
Another great resource that can help you evaluate and chose a vehicle that meets your needs is the AAA online tool “Smart Features for Older Drivers.”

At SeniorDriving.AAA.com/SmartFeatures you can check the areas you have problems with – like diminished vision, cognitive decline, limited upper body range of motion, decreased leg strength, arthritic hands, short stature or overweight – and the tool will identify vehicles that have the features that will best accommodate your needs. Although this tool looks at model-year 2016 vehicles, in many cases the features shown are carried over for 2017 models.

They also have a Smart Features brochure you can download that will tell you what to look for in a vehicle to best accommodate your needs.

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

Dear Savvy Senior,
I think I’m paying too much for the medications I take. I have a Medicare Part D prescription drug plan and my out-of-pocket spending is over $4,000 thus far in 2017. When and how can I change my Medicare drug plan?
Inquiring Carol

Dear Carol,
You can change your Part D prescription drug plan during Medicare’s open enrollment period, which runs from October 15 through December 7. During this time, beneficiaries can switch drug plans or join a drug plan if you didn’t have one before. They can also switch from Original Medicare to a Medicare Advantage plan, or vice versa if they wish. Any changes to coverage will take effect January 1, 2018.

In September, you should also keep your eyes peeled for your “annual notice of change” from your drug plan. It will outline any changes in coverage, costs or service that will take effect in January.

If you take no action during open enrollment, your current coverage will continue next year. Yet even those who are happy with their coverage should review their plan for any changes to come.

Change Medicare Plans
If you have Internet access and are comfortable using a computer, you can easily shop for and compare all Medicare drug plans in your area, and enroll in a new plan online.

Just go to Medicare’s Plan Finder Tool at Medicare.gov/find-a-plan, and type in your ZIP code or your personal information, enter in how you currently receive your Medicare coverage, select the drugs you take and their dosages, and choose the pharmacies you use. You’ll get a cost comparison breakdown for every plan available in your area so you can compare it to your current plan.

This tool also provides a five-star rating system that evaluates each plan based on past customer service records, and suggests generics or older brand name drugs that can reduce your costs.

When you’re comparing drug plans, look at the “estimated annual drug costs” that shows how much you can expect to pay over a year in total out-of-pocket costs, including premiums, deductibles and co-pays.

Also, be sure the plan you’re considering covers all of the drugs you take with no restrictions. Most drug plans today place the drugs they cover into price tiers. A drug placed in a higher tier may require you to get prior authorization or try another medication first before you can use it.

Need Help?
If you need some help choosing a new plan, you can call 1-800-MEDICARE and they can help you out over the phone. Or, contact your State Health Insurance Assistance Program (SHIP), which provides free one-on-one Medicare counseling. They also conduct seminars during the open enrollment period at various locations throughout each state. To find the contact information for your local SHIP visit Shiptacenter.org, or call the eldercare locator at 800-677-1116.

Low-Income Assistance
If you find yourself struggling to pay your medication costs, check out Medicare’s “Extra Help” program. This is a federal low-income subsidy that helps pays Part D premiums, deductibles and co-payments. To be eligible, your income must be under $18,090 or $24,360 for married couples living together, and your assets must be below $13,820 or $27,600 for married couples. For more information or to apply, call Social Security at 800-772-1213 or visit SSA.gov/medicare/prescriptionhelp.

Other resources that can help include RxAssist.org, which maintains a comprehensive database of patient assistance programs, set up by drug companies for those who have trouble affording their medications. And NeedyMeds.org, a national nonprofit organization that maintains a website of free information on programs that help people who can’t afford their medications or other health-care costs.

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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Exercises that Help Ease Arthritis Pain and Stiffness

Dear Savvy Senior,
What exercises are best suited for seniors with arthritis? I have osteoarthritis in my neck, back, hip and knee and have read that exercises can help ease the pain and stiffness, but I don’t know where to start, and I certainly don’t want to aggravate it.
Stiff and Achy

Dear Stiff,
Many people who have arthritis believe that exercise will worsen their condition, but that’s not true. Exercise is actually one of the best treatments for osteoarthritis.

Proper and careful exercises can help reduce joint pain and stiffness, strengthen muscles around the joints and increase flexibility. It also helps manage other chronic conditions that are common among seniors with arthritis, such as diabetes, heart disease and obesity. Here are some tips to help you get started.

Recommended Exercises

Determining exactly which types of exercises that are best for you depends on the form and severity of your arthritis, and which joints are involved. It’s best to work with your doctor or a physical therapist to help you develop a personalized exercise program. The different types of exercises that are most often recommended to seniors with arthritis include:

  • Range-of-motion exercises: These are gentle stretching exercises that can relieve stiffness as well as improve your ability to move your joints through their normal range of motion. These exercises should be done daily.
  • Strengthening exercise: Calisthenics, weight training and working with resistance bands are recommended (two or more days a week) to maintain and improve your muscle strength, which helps support and protect your joints.
  • Aerobic exercises: Low-impact activities like walking, cycling, swimming or water aerobics are all recommended three to five times per week to help improve cardiovascular health, control weight, and improve your overall function.

It’s also important to keep in mind that when you first start exercising, you need to go slow to give your body time to adjust. If you push yourself too hard you can aggravate your joint pain. However, some muscle soreness or joint achiness in the beginning is normal.

To help you manage your pain start by warming up with some simple stretches or range of motion exercises for five to 10 minutes before you move on to strengthening or aerobic exercises. Another tip is to apply heat to the joints you’ll be working before you exercise, and use cold packs after exercising to reduce inflammation.

If you’re experiencing a lot of pain while you exercise, you may need to modify the frequency, duration, or intensity of your exercises until the pain improves. Or you may need to try a different activity, for example, switching from walking to water aerobics. But it you’re having severe, sharp or constant pain, or large increases in swelling or your joints feel hot or red, you need to stop and see your doctor.

Exercising Aids
To help you exercise at home, the Arthritis Foundation offers a variety of free online videos (see Arthritis.org/living-with-arthritis/exercise/videos) to guide you through a variety of exercises. Or there are arthritis exercise DVDs you can purchase for a few dollars through Collage Video (CollageVideo.com, 800-819-7111) or the Arthritis Foundation Store (AFstore.org).

Also see Go4life.nia.nih.gov (or call 800-222-2225), a National Institute on Aging resource that offers a free exercise guide that provides illustrated examples of different exercises.

If you need some motivation or don’t like exercising alone, ask your doctor about exercise programs in your area for people with arthritis. Hospitals and clinics sometimes offer special programs, as do local health clubs and senior centers.

The Arthritis Foundation also conducts exercise and aquatic programs for people with arthritis in many communities throughout the U.S. Contact your local branch (see Arthritis.org/local-offices, or call 800-283-7800 for contact information) to find out what may be available 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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Savvy Senior – August Columns

  1. Finding Help for Seniors Addicted to Opioids
  2. Low-Cost Wireless Plans for Seniors Who Use Smartphones
  3. Finding Money for Long-Term Care
  4. How to Stop Unwanted Junk Mail and Guard Against Mail Fraud

Finding Help for Seniors Addicted to Opioids

Dear Savvy Senior,
I’m worried about my 72-year-old mother who has been taking the opioid medication Vicodin for her hip and back pain for more than a year. I fear she’s becoming addicted to the drug but I don’t know what to do.
Concerned Daughter

Dear Concerned,
The opioid epidemic is a national problem that is hitting people of all ages, including millions of older Americans. Here’s what you should know and do to help your mother.

The Cause
The main reason opioid addiction has become such a problem for people over age 50 is because over the past two decades, opioids have become a commonly prescribed (and often over-prescribed) medication by doctors for all different types of pain like arthritis, cancer, neurological diseases and other illnesses that become more common in later life.

Nearly one-third of all Medicare patients – almost 12 million people – were prescribed opioid painkillers by their physicians in 2015. That same year, 2.7 million Americans over age 50 abused painkillers.

Taken as directed, opioids can manage pain effectively when used for a short amount of time. But with long-term use, people need to be screened and monitored because around 5 percent of those treated will develop an addiction disorder and abuse the drugs.

Signs of Addiction
Your mother may be addicted to opioids if she can’t stop herself from taking the drug, and her tolerance continues to go up. She may also be addicted if she keeps using opioids without her doctor’s consent, even if it’s causing her problems with her health, money, family or friends.

If you think your mom’s addicted, ask her to see a doctor for an evaluation. Go to the family or prescribing physician, or find a specialist through the American Society of Addiction Medicine (see ASAM.org) or the American Academy of Addiction Psychiatry (AAAP.org). It’s also important to be positive and encouraging. Addiction is a medical matter, not a character flaw. Repeated use of opioids actually changes the brain.

Treatments
Treatment for opioid addiction is different for each person, but the main goal is to help your mom stop using the drug and avoid using it again in the future.

To help her stop using the drug, her doctor can prescribe certain medicines to help relieve her withdrawal symptoms and control her cravings. These medicines include methadone (often used to treat heroin addiction), buprenorphine, and naltrexone.

After detox, behavioral treatments such as individual counseling, group or family counseling, and cognitive therapy can help her learn how to manage depression, avoid the drug, deal with cravings, and heal damaged relationships.

For assistance, call the Substance Abuse and Mental Health Services Administration confidential help line at 800-662-4357, or see SAMHSA.gov. They can connect you with treatment services in your state that can help your mom.

Also, if you find that your mom has a doctor who prescribes opioids in excess or without legitimate reason, you should report him or her to your state medical board, which licenses physicians. For contact information visit FSMB.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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Low-Cost Wireless Plans for Seniors Who Use Smartphones

Dear Savvy Senior,
I’m interested in downsizing my smartphone wireless plan, and am looking for the best low cost options. I use my phone primarily for talking and texting, but also need some cellular data for checking my email and other functions when I’m away from WiFi. What can you tell me?
Senior Saver

Dear Saver,
There are several great low-cost deals I can recommend for older smartphone users who are looking to save some money by paring down their bloated cell phone plan. Here are three good options to consider.

Republic Wireless
If you’re an Android smartphone user, Republic Wireless (RepublicWireless.com) offers one of the cheapest deals available for light data users. Republic uses a mixture of Wi-Fi and cellular networks – Sprint and T-Mobile specifically – to transmit calls, texts and data. This patented technology automatically offloads as much as possible to WiFi when available, so you’ll consume less data than you would with traditional carriers.

Republic’s no contract service plans with cellular data start at only $20 per month for unlimited talk, text and 1 gigabyte (GB) of data. If you need more data, their $30 per month plan gets you 2GB, and $45/month buys you 4GB.

How much data do you need? The best way to find out is to check your current phone bills. The average smartphone owner uses between 2GB to 3GB of data each month, but most older smartphone users use less than 1GB.

To use Republic you’ll need a compatible Android phone (you can’t currently use Apple iPhones), or you can buy a new phone through the company. It currently offers eight Android phones with prices starting at $99.

Consumer Cellular
Another excellent low-cost option for lighter data users, and one that caters to older adults is Consumer Cellular (ConsumerCellular.com, 888-532-5366). Rated the number one wireless service by Consumer Reports seven years running, Consumer Cellular offers a variety of “pay for what you need” talk and connect plans that let’s you choose exactly what you want.

Their talk plans start at $10 per month plus 25 cents per minute used for infrequent callers, or $15/month for 250 minutes, $20/month for 1,500 minutes, and $30/month for unlimited minutes.

And their connect plans for text messages and cellular data run $2.50 per month for 300 texts and 30 megabytes (MB) of data, $5/month for 2,000 text and 200MB data, $10/month for unlimited texts and 500MB, $20/month for unlimited texts and 1.5GB, $30/month unlimited texts and 3GB, and $40/month for unlimited texts and 5GB.

Consumer Cellular, which offers 5 percent monthly fee discounts to AARP members, also lets you bring your own smartphone by offering free SIM cards. Or, you can purchase a wide variety of Android and Apple iPhones along with the senior-friendly Doro 824 SmartEasy for $100.

Lifeline Program
If your income is low enough, another option to check into is the Lifeline Assistance Program. This is a federal program that provides a $9.25 monthly subsidy that could go towards your smartphone service.

To qualify, you’ll need to show that your annual household income is at or below 135 percent of the Federal Poverty Guidelines – which is $16,281 for one person, or $21,924 for two. Or that you’re receiving certain types of government benefits, such as Medicaid, food stamps, SSI, public housing assistance, veterans pension or survivor’s pension benefit, or live on federally recognized Tribal lands.

To apply, contact a wireless provider in your area that participates in the Lifeline program (see LifelineSupport.org or call 800-234-9473) and ask for an application form. Be sure to check all wireless providers in your state because some offer better services – like a free smartphone, monthly talk time minutes, unlimited texting and some cellular data – than others.

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

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Finding Money for Long-Term Care

Dear Savvy Senior,
What resources can you refer me to for long-term care financial help? My 84-year-old mother needs assisted living or nursing home care, but we don’t have a lot of money and she doesn’t have long-term care insurance.
Searching Daughter

Dear Searching,
If your mother does not have a long-term care insurance policy, depending on her circumstances, here are several other sources you should check into that can help pay for her care.

Medicaid: The first thing you need to understand is that Medicare (the government health insurance program for seniors 65 and older and those with disabilities) does not cover long-term care, which includes nursing home care, the costs of assisted living facilities and home aide services, unless your mom is receiving skilled nursing or therapy services too. It only provides limited short-term coverage, up to 100 days for skilled nursing or rehabilitation services after a hospital stay.

However, Medicaid (the joint federal and state program that covers health care for the poor) as it currently stands, does cover long-term care facilities and it covers in-home care too. But to be eligible for coverage, your mother must be very low-income. Her countable assets can’t be more than around $2,000, including investments.

Note that most people who enter a nursing home don’t qualify for Medicaid at first, but pay for care out-of-pocket until they deplete their savings enough to qualify. Contact your state Medicaid office (see Medicaid.gov) for eligibility details.

 Veterans aid: If your mom is a wartime veteran, or a spouse or surviving spouse of a wartime veteran, there is a benefit called Aid and Attendance that can help pay between $1,153 and $2,127 a month toward her long-term care.

To be eligible, your mom must need assistance with daily living activities like bathing, dressing or going to the bathroom. And her yearly income must be under $13,836 as a surviving spouse, $21,531 for a single veteran, or $25,525 as a married veteran – after her medical and long-term care expenses. Her assets must also be less than $80,000 excluding her home and car.

To learn more see Benefits.VA.gov/pension, or contact your regional VA office, or your local veterans service organization. Call 800-827-1000 for contact information.

Life insurance: If your mom has a life insurance policy, find out if it offers an accelerated death benefit that would allow you to get a tax-free advance to help pay for her care.

Or consider selling her policy to a life settlement company. These are companies that buy life insurance policies for cash, continue to pay the premiums and collect the death benefit when she dies. Most sellers generally get four to eight times more than the policy cash surrender value.

If you own a policy with a face value of $100,000 or more and are interested in this option, there are various companies you can turn to like GWG Life (GWGLife.com), which offers some of the highest cash payouts for life insurance policies.

 Tax breaks: If you’re helping out your mom financially, you may also be able to claim her as a dependent on your taxes and reduce your taxable income by $4,050, which you could use for her care. To qualify, you must pay at least half of your mom’s yearly expenses, and her annual income must be below $4,050, not counting Social Security. For more information, see IRS Publication 501 at IRS.gov/pub/irs-pdf/p501.pdf.

If you can’t claim your mom as a dependent because her income is too high, you may still be able to get a tax break if you’re paying at least half her living expenses including her medical, dental 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 the IRS publication 502 (IRS.gov/pub/irs-pdf/p502.pdf) for details.

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

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How to Stop Unwanted Junk Mail and Guard Against Mail Fraud

Dear Savvy Senior,
My elderly father gets over 100 pieces of junk mail every week, and I just discovered that he’s given away nearly $5,000 over the past few months to many of the solicitors that mail him this junk. Can you offer any tips on how can I stop this?
Irritated Son

Dear Irritated,
Millions of older Americans get bombarded with unwanted junk mail these days, including “mail fraud” schemes that you and your dad need to be particularly careful of. Here’s are some tips that may help.

Mail Fraud Alert
While junk mail comes in many different forms — credit card applications, sweepstakes entries, magazine offers, coupon mailers, donation requests, political fliers, catalogs and more — the most troublesome type is mail fraud, which comes from con artists who are only trying to take your money.

Mail fraud can be tricky to detect because there are many different types of schemes out there that may seem legitimate. Some of the most common mail scams targeting seniors today are phony sweepstakes, foreign lotteries, free prize or vacation scams, fake checks (see FakeChecks.org), donation requests from charities or government agencies that don’t exist, get-rich chain letters, work-at-home schemes, inheritance and investment scams, and many more.

If your dad is getting any type of junk mail that is asking for money in exchange for free gifts or winnings, or if he’s receiving checks that require him to wire money, you need to call the U.S. Postal Inspector Service at 877-876-2455 and report it, and then throw it away.

Unfortunately, once a person gets on these mail fraud lists, also known as “suckers lists,” it’s very difficult to get off. That’s because these criminals regularly trade and sell mailing lists of people who they believe to be susceptible to fraud, and they won’t remove a name when you request it.

Knowing this, a good first step to help protect your dad is to alert him to the different kinds of mail fraud and what to watch for. The U.S. Postal Inspection Service can help you with this. They offer a list of the different mail fraud schemes at PostalInspectors.uspis.gov.

Another option is to see if your dad would be willing to let you sort through his mail before he opens it so you can weed out the junk. You may want to have the post office forward his mail directly to you to ensure this.

If your dad feels compelled to donate to certain charities, ask him to let you check them out first to make sure they’re legitimate. You can do this at charity watchdog sites like CharityNavigator.org and Give.org.

Reduce Junk Mail
While scam artists aren’t likely to take your dad’s name off their mailing lists, most legitimate mail-order businesses will. To do this, start with the Direct Marketing Association, which offers a consumer opt-out service at DMAchoice.org. This won’t eliminate all his junk mail, but it will reduce it. The opt-out service is $2 for 10 years if you register online, or $3 by mail.

Then, to put a stop to the credit card and insurance offers he gets, call the consumer credit reporting industry opt-out service at 888-567-8688, and follow the automated prompts to opt him out for either five years or permanently. Be prepared to give his Social Security number and date of birth. You can also do this online at OptOutPrescreen.com. If you choose the permanent opt-out, you’ll have to send a form in the mail.

You should also make sure your dad’s home and cell phone numbers are registered with the National Do Not Call Registry (DoNotCall.gov, 888-382-1222), to help cut down on telemarketing calls.

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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Savvy Senior – July Columns

  1. Auto Safety Devices That Can Help Seniors with Older Cars 
  2. New Medicare Cards Debut Next Year
  3. The Hidden Dangers of Heartburn 
  4. How to Find and Claim Your Family’s Unclaimed Money 
  5. How to Choose the Right Type of Walker 

Auto Safety Devices That Can Help Seniors with Older Cars 

Dear Savvy Senior,
Do you know of any auto safety products that can help seniors with older cars? My 80-year-old father, who drives his beloved 2004 Toyota Avalon, is still a good pretty driver but he has limited range-of-motion, which makes looking 
over his shoulder to back-up or merge into traffic very difficult.
Inquiring Son

Dear Inquiring,
To help keep your dad safe and extend his driving years, there are a number of auto aids and new safety technology products that can be added to his car to help with various needs. Here are several to consider.

Backup Aids
To help your dad increase his visibility when backing up, a simple product that can be added to his car is an AllView Mirror ($60, AllviewMirror.com). This is an oversized rear view mirror that attaches to his existing mirror to widen his rear visibility and eliminate blind spots so he can see traffic without significant neck or body rotation. It also helps during parking.

Another option is a backup camera. These come with a weatherproof, night vision camera, which attaches to the license plate on the rear of the car. When the car is in reverse, it sends live images wirelessly to a small monitor that mounts to the dash or windshield. The Yada Digital Wireless Backup Camera ($140, Amazon) with 4.3” Dash Monitor is a good option. Or, if your dad doesn’t want a monitor in his car, the Auto Vox Wireless Backup Camera ($140, Amazon.com) is one that displays the images in a rearview mirror.

Blind Spot Helpers
To help your dad see better when switching lanes or merging into traffic, purchase your dad some “blind spot mirrors.” These are small convex mirrors that would stick to the corner of his side view mirrors to improve side and rear vision. They can be purchased in any store that sells auto supplies for a few dollars.

Or, for a high-tech more comprehensive solution, there’s the Goshen Blind Spot Detection System ($239, Goshers.com). This system uses small sensors installed on each side of the rear bumper that monitor the sides of the vehicle, and will alert your dad with a light indicator, installed inside the car, if any object detected within 10 feet.

Safety Products
For extra safety, you may also want to consider a collision warning/lane departure device for your dad’s vehicle like the Mobileye 630. This is a smart camera that attaches to the windshield and will alert your dad if he speeds, drifts out of his lane, gets too close to the car in front of him, or gets too close to a pedestrian or cyclist. Sold only through retailers (see Mobileye.com/en-us/find-a-retailer), this device can be purchased and installed by a Mobileye-certified technician for around $1,100.

If you’re interested in something a little less expensive, there are also dashboard cameras that can double as collision warning systems. Garmin’s Dash Cam 35 ($129, Amazon.com), for example, monitors up to 130 feet in front of the vehicle, so if your dad is going 30 mph or faster, it will issue audio and visual alerts of impending collisions.

Another product that can help keep your dad safe in emergency situations is the Hum (Hum.com). This nifty device will automatically call emergency services if your dad has been in an accident. It also sends alerts to drivers’ phones if there’s a mechanical problem and lets driver’s press a button if they need roadside assistance. Hum works in cars built in 1996 or later, and costs $10 per month with two-year required subscription, and one-time set-up and activation fees totaling $50.

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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New Medicare Cards Debut Next Year

Dear Savvy Senior,
I just received my Medicare card in the mail and was surprised to see that the ID number is the same as my Social Security number. I know it’s a bad idea to carry around anything that displays my Social Security number because it makes me vulnerable to identity theft. Wasn’t the government supposed to stop putting Social Security numbers on Medicare cards?
New Beneficiary 

Dear New Benificiary,
Many people new to Medicare are surprised to learn that the ID number on their Medicare card is still identical to their Social Security number (SSN). After all, we’re constantly warned not to carry our SSN around with us, because if it gets lost or stolen, the result could be identity theft.

But the card itself tells beneficiaries to carry it with you when you are away from home so you can show it at the doctor’s office or hospital when you need medical care. Here’s what you should do to protect yourself.

New Medicare Cards
For starters, you’ll be happy to know that the government is in the process of removing SSNs from Medicare cards, but with 58 million beneficiaries, it’s a huge undertaking that will be implemented gradually. The Centers for Medicare and Medicaid Services will start sending the new cards in April 2018, but it will take until December 2019 before SSNs are removed from all cards.

Under the new system, a randomly generated 11-character Medicare Beneficiary Identifier will replace the SSN-based health claim number on your new Medicare card, but your Medicare benefits will not change.

You will receive information in 2018 letting you know about the new Medicare card, with an explanation of how to use the new card and what to do with your old one. You can start using your new Medicare card with the new number as soon as you receive it, and there should be a transition period in 2018 and 2019 when you can use either the old card or the new card.

Protect Your Identity
Until your new Medicare card is issued, here’s what you can do to protect your SSN on your current card. The Privacy Rights Clearinghouse, a national consumer resource on identity theft, recommends that you carry your Medicare card only when you visit a health care provider for the first time, so the provider can make a copy for their files. Otherwise, make a photocopy of your card and cut it down to wallet size. Then take a black marker and black out the last four digits of your SSN, and carry that instead in case of an emergency.

 If your Medicare card does happen to get lost or stolen, you can replace it by calling Social Security at 800-772-1213 or contact your local Social Security office. You can also request a card online at SSA.gov/MyAccount. Your card will arrive in the mail in about 30 days.

If your Medicare card that contains your SSN gets lost or stolen, you’ll need to watch out for Medicare fraud. You can do this by checking your quarterly Medicare summary notices for services or supplies you did not receive. You can also check your Medicare claims early online at MyMedicare.gov (you’ll need to create an account first), or by calling Medicare at 800-633-4227. If you spot anything suspicious or wrong, call the Inspector General’s fraud hotline at 800-447-8477.

Also, watch for other signs of identity theft. For example, if someone uses your Social Security number to obtain credit, loans, telephone accounts, or other goods and services, report it immediately to the Federal Trade Commission at IdentityTheft.gov (or 877-438-4338). This site will also give you specific steps you’ll need to take to handle this problem.

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 Hidden Dangers of Heartburn 

Dear Savvy Senior,
Is regular heartburn or indigestion anything to worry about? My 60-year-old husband eats a lot of Tums or Rolaids throughout the day to help him manage it, but it keeps him up at night too. What can you tell us?
Inquiring Spouse

Dear Inquiring,
Almost everyone experiences heartburn or acid indigestion from time to time, but frequent episodes can signal a much more serious problem. Here’s what you should know, along with some tips and treatments to help relieve your husbands symptoms.

It’s estimated that more than 60 million Americans experience heartburn at least once a month, with around 15 million people who suffer from it daily. If your husband is plagued by heartburn two or more times a week, and it’s not responding well to over-the-counter antacids, he needs to see a doctor. Frequent bouts may mean he has gastroesophageal reflux disease (GERD), which can severely irritate and damage the lining of his esophagus, putting him at risk of Barrett’s esophagus and esophageal cancer if it’s not treated.

Lifestyle Adjustments

Depending on the frequency and severity of his heartburn, there are a number of lifestyle adjustments he can make that can help provide relief and avoid a more serious problem down the road. Consider these tips:

  • Avoid problem foods: Certain foods can trigger heartburn symptoms like citrus fruits, tomatoes, fatty foods, chocolate, garlic, onions, spicy foods, mints, alcohol, coffee and sodas. Your husband should keep a food diary to track which foods cause him the most problems and avoid them.
  • Eat smaller, slower and earlier: Smaller portions at mealtime and eating slower can help reduce heartburn symptoms. He should also wait at least three hours after eating before lying down or going to bed.
  • Lose weight: Having excess weight around the midsection puts pressure on the abdomen, pushing up the stomach and causing acid to back up into the esophagus.
  • Quit smoking: Smoking can increase stomach acid and weaken the valve that prevents acid from entering the esophagus. If your husband smokes, the National Cancer Institute offers a number of smoking cessation resources at SmokeFree.gov or call 1-800-QUIT-NOW.
  • Sleep elevated: To help keep the acid down while sleeping, get your husband a wedge-shaped pillow to prop him up a few inches. If that’s not enough, try elevating the head of his bed six to eight inches by placing blocks under the bedposts or insert a wedge between his mattress and box spring. Wedges are available at drugstores and medical supply stores. Sleeping on his left side may also help keep the acid down.

Treatment Options
If the lifestyle adjustments don’t solve the problem, or if antacids (Tums, Rolaids, Maalox, Mylanta or Alka-Seltzer) aren’t doing the trick there are a variety of over-the-counter and prescription medications that can help, along with surgery. His doctor can help him determine which one is best for him. Treatment options include:

H-2 Blockers: Available as both over-the-counter and prescription strength, these drugs (Pepcid, Tagamet, Axid and Zantac) reduce how much acid your stomach makes but may not be strong enough for serious symptoms.

Proton-Pump Inhibitors (PPI): If you have frequent and severe heartburn symptoms, PPIs are long-acting prescription medications that block acid production and allow time for damaged esophageal tissue to heal. They include Nexium, Prevacid, Prilosec, Zegerid, Protonix, Aciphex and Dexilant. Prevacid 24 HR, Prilosec and Zegerid OTC are also available over-the-counter. But be aware that long-term use of PPIs can increase your risk for osteoporosis and chronic kidney disease.

Surgery: If the medications don’t do the trick, there are also surgical procedures that can tighten or strengthen the lower esophageal sphincter so gastric fluids can’t wash back up into the esophagus.

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

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How to Find and Claim Your Family’s Unclaimed Money 

Dear Savvy Senior,
I’ve heard that there are free online search tools that can help people look for lost or forgotten money left behind by deceased relatives. Can you refer me? When my father passed away his financial affairs were in such a mess, I’m wondering if there was anything he left behind.
Wondering Daughter

Dear Wondering,
Forgotten or lost money is actually quite common in the United States. According to the National Association of Unclaimed Property Administrators, there is around $42 billion in unclaimed funds sitting in state treasuries and other agencies just waiting to be found.

These unclaimed funds are from accounts that are inactive or whose owners, or their heirs, cannot be located. Unclaimed funds can include things lost or forgotten saving or checking accounts, stocks, utility security deposits, tax refunds, life insurance proceeds, un-cashed dividend checks, contents of safe-deposit boxes and more.

This typically happens because of a change of address (the owner moved), a name change (the owner got married or divorced), or the owner dies and the estate was unaware of the money or the heirs could not be located. By law, companies and financial institutions that can’t find the owner or their next of kin within two to five years must turn the property over to the state where it’s held indefinitely.

Where to Search
It’s very possible that your father, or you, have some unclaimed money out there and you don’t even know it. To start your quest go to Unclaimed.org, which has links to all state programs that will let you to do a state benefits search online for free. Or, you can do a multi-state search in 40 states at MissingMoney.com.

Check every state in which your father or you have lived, worked or conducted business.

Also, if you’re married, make sure to check under your maiden name as well. Using a first initial and your last name is also encouraged to make sure everything comes up. Every state can tell you immediately if you or your dad have some unclaimed money, as well as how to go about collecting it.

Look Here, Too
In addition to state treasuries, here are some other agencies that can help you find unclaimed money.

IRS: Each year thousands of refund checks totaling millions of dollars are returned to the IRS by the post office. To look for lost Federal tax refund checks go to IRS.gov/refunds, or call 800-829-1954.

U.S. Treasury: To find out if there are any savings bonds your dad didn’t claim dating back to 1974, go to TreasuryHunt.gov. For older bonds or those still drawing interest use form 1048, which you can download at TreasuryHunt.gov/forms/sav1048.pdf, or call 844-284-2676 to request a form by mail.

Pension Benefit Guaranty Corporation: If your dad worked for a company that went out of business or ended its defined benefit pension plan, you may be entitled to some of his benefits. To look for lost pensions, use the pension-search tool at PBGC.gov/search/unclaimed-pensions, or you can call 800-400-7242 and get help over the phone.

National Association of Insurance Commissioners: To track down a lost or forgotten life insurance policy, the NAIC, an insurance regulatory support organization, offers a national policy locator service at Locator.NAIC.org.

PenChecks Inc. and Millennium Trust Co.: To search for lost or forgotten retirement benefits or 401(k) funds left behind with an old employer, go to UnclaimedRetirementBenefits.com and MTrustCompany.com/unclaimed-retirement-funds.

Federal Deposit Insurance Corporation: To search for unclaimed bank accounts at firms that were shut down between January 1, 1989 and June 28, 1993 go to ClosedBanks.FDIC.gov/funds. State treasuries hold assets from shutdowns after 1993.

Social Security: To find lost Social Security benefits, including the $255 death benefit, call 800-772-1213.

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

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How to Choose the Right Type of Walker 

Dear Savvy Senior,
How does one go about choosing a walker? I have some balance issues along with arthritis in my knee and could use a little more help than a cane provides.
Unsteady at 70 

Dear Unsteady,
When it comes to choosing a walker, there are various styles and options to consider, but selecting the best one for you will depend on your needs, as well as where you’ll be using it. Here are some tips that can help you choose.

Types of Walkers
There are three basic types of walkers on the market today. To help you choose, consider the type of support you’ll need. Then, pay a visit to a medical equipment store or pharmacy (see Medicare.gov/SupplierDirectory) that sells walkers so you can test-walk a few. Here are the different types you’ll have to choose from.

Standard walker: This is the most basic style of walker that has four legs with rubber-based feet (no wheels), is very lightweight (around 6 pounds) and costs between $50 and $100. This type of walker must be picked up and moved forward as you walk, so it’s best suited for people who need significant weight bearing support, or who are walking very short distances.

Two-wheeled walker: This has the same four-leg style as the standard walker except it has wheels on the two front legs that allow you to easily push the walker forward without lifting, while the back legs glide across the floor providing support while you step forward. These are best for people with balance issues, and are priced at around $60 to $120.

Rollator: This is a rolling walker that has wheels on all four (or three) legs. These work best for people who need assistance with balance or endurance inside or outside the home, but require some upper body strength to prevent them from rolling out from under you. Rollators typically come with a built-in seat, basket and hand-breaks. Or, for those with hand arthritis or gripping problems, there are rollators with pushdown brakes that engage with downward pressure, and will lock if you sit on the seat. Rollators typically run between $75 and $225.

Other Tips
After deciding on a type of walker, there a few additional things you need to double-check to ensure it meets your needs.

First, if you’re a large person, make sure the walker’s weight capacity will support you. And if you choose a rollator, check to see if your body can fit between the handgrips when sitting.

Also, make sure the height of the walker is set appropriately for you. To do this, stand with your arms relaxed at your sides. The handgrips of the walker should line up with the crease on the inside of your wrist.

You also need to check that the walker folds easily for transport and storage, and that it’s light enough to lift into your car. Test the handgrips to make sure they’re comfortable. And, be sure you measure the doorways in your home to ensure your walker will fit through them. If you have narrow doorways consider installing “swing clear” offset door hinges as a simple and affordable way to widen them an extra two inches.

Walkers also have lots of accessories that can be added for your convenience such as food tray attachments, tote bags for carrying personal items, oxygen tank holders, and tennis ball walker glides that go over the feet of a standard walker to help it slide more easily across the floor.

 For more tips on how to choose and use a walker, visit Mayoclinic.com/health/walker/HA00060. It’s also a smart idea to work with your doctor or a physical therapist, and be sure to get a written prescription, as Medicare will cover 80 percent of the cost.

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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Savvy Senior – June Columns

  1. Social Security Advice for Soon-To-Be Retirees 
  2. How to Hire a Home Helper 
  3. Best Bicycles for Aging Baby Boomers
  4. How to Fight Dry Eyes and Protect Your Vision 

Social Security Advice for Soon-To-Be Retirees

Dear Savvy Senior,
Can you recommend any services that help pre-retirees decide when to start drawing their Social Security benefits? My wife and I are approaching retirement age and want to carefully weigh our options to make sure we’re maximizing our benefits.
Approaching Retirement

Dear Approaching,
Deciding when to begin collecting your Social Security benefits could be one of the most important retirement-income decisions you’ll make. The difference between a good decision and a poor one could cost you tens of thousands of dollars over your retirement, so doing your homework and weighing your options now is a wise move. 

What to Consider
As you may already know, you can claim Social Security any time between the ages of 62 and 70, but each year you wait increases your benefit by 5 to 8 percent. But there are other factors you need to take into account to help you make a good decision, like your health and family longevity, whether you plan to work in retirement, along with spousal and survivor benefits.

To help you weigh your claiming strategies, you need to know that Social Security Administration claims specialists are not trained or authorized to give you personal advice on when you should start drawing your benefits. They can only provide you information on how the system works under different circumstances. To get advice you’ll need to turn to other sources.

Web-Based Help
Your first step in getting Social Security claiming strategy advice is to go to SSA.gov/myaccount to get your personalized statement that estimates what your retirement benefits will be at age 62, full retirement age or when you turn 70. These estimates are based on your yearly earnings that are also listed on your report.

Once you get your estimates for both you and your wife, there are many online tools you can turn to that can compare your options so you can make an informed decision.

Some free sites that offer basic calculations include AARP’s Social Security Benefits Calculator (AARP.org/socialsecuritybenefits), the Consumer Financial Protection Bureau’s Planning for Retirement tool (ConsumerFinance.gov/retirement) and SSAnalyze that’s offered by United Capital (BedrockCapital.com/ssanalyze).

But if you want a more thorough analysis check out Maximize My Social Security (MaximizeMySocialSecurity.com) or Social Security Choices (SocialSecurityChoices.com), which both charge $40. These services, which are particularly helpful to married couples as well as divorced or widowed persons, will run scenarios based on your circumstances and show how different filing strategies affect the total payout over the same time frame.

Personal Advice
If you want human help, there are specialized firms and financial advisors that can advise you too.

One such firm is Social Security Solutions (SocialSecuritySolutions.com, 866-762-7526). They offer several levels of web-based and personalized service (ranging from $20 to $500) including their $125 “Advised” plan that runs multiple calculations and comparisons, recommends a best course of action in a detailed report, and gives you a one-on-one session with a Social Security specialist over the phone to discuss the report and ask questions.

Or, you can get help through a financial planner. Look for someone who is a fee-only certified financial planner (CFP) that charges on an hourly basis and has experience in Social Security analysis. To find someone, use the National Association of Personal Financial Advisors online directory at NAPFA.org, or try the Garrett Planning Network (GarrettPlanningNetwork.com), which is a network of fee-only advisers that charge between $150 and $300 per hour.

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 Hire a Home Helper 

Dear Savvy Senior,
I would like to hire a personal assistant/home helper for my mom to assist with some simple household chores like house keeping, errand running, driving her to the doctor, and keeping her company. But mom doesn’t require personal/physical caregiving nor does she require any home medical care. Any tips to help us find someone?Looking for Mom

Dear Looking,
Getting your mom some help at home to handle some of her household chores can make a big difference keeping her independent longer. Here’s what you should know, along with some tips to help you find someone reliable for your mom.

Home Helpers
For seniors who could use some help at home – but don’t need a caregiving aide for personal care – there are a bevy of personal assistance/home helpers out there that can help make life a little easier.

Most home helpers can assist with any number of things like shopping, running errands, transportation, light house keeping, laundry, meal preparation, arranging services (home maintenance, lawn care, etc.) and other household chores, along with providing companionship and support. And, if your mom gets to the point she needs personal/physical care like bathing or dressing, they can usually help with this too.

Most home helpers are part time workers who work a few hours a day or a few days per week. You also need to know that while Medicare does cover home health care services if a doctor orders it, they do not cover home helper/personal assistant services.

 There are two ways in which you can go about hiring someone for your mom; either through a home care agency, or you can hire someone directly on your own.

Home Care Agency
Hiring a home helper through a non-medical home care, or non-medical companion care agency is the easiest, but most expensive option of the two. Costs run anywhere from $12 up to $30 an hour depending on where you live and the qualification of the assistant/aide.

How it works is you pay the company, and they handle everything including assigning appropriately trained and pre-screened staff to care for your mom, and finding a fill-in on days her helper cannot come.

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

To find a home care agency in your area, Google “non-medical home care” followed by the city and state your mom lives in, or you can use Medicare’s home health agencies search tool Medicare.gov/hhcompare. Most home health agencies offer some form of non-medical home care services too. You can also check your local yellow pages under “home healthcare services.” 

Hiring Directly
Hiring a personal assistant/home helper on your own is the other option, and it’s less expensive. Costs typically range between $10 and $20 per hour. Hiring directly also gives you more control over who you hire so you can choose someone who you feel is right for your mom.

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

To find someone, ask for referrals through friends or check online job boards like CraigsList.org, or try Care.com, CareLinx.comCareFamily.com or CareSpotter.com.

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

Dear Savvy Senior,
My husband and I are interested in getting a couple of bicycles for leisurely exercise and fun, and would like to get your recommendation. We’re both approaching 60 and are a little overweight, and it’s been a while since we rode.
Easy Riders

Dear Easy,
If you’re interested in leisurely, recreational riding for fitness and fun, a great option is a “comfort bike,” which is very popular among baby boomers. Here’s what you should know about this option, along with some tips to help you shop and choose.

Comfort Bikes
A comfort bike is a style of bicycle that’s easy on an aging body because it lets you ride in a more comfortable upright position. These bikes have high handlebars so you don’t have to hunch over, which eases lower-back strain and reduces pressure on the wrists and hands. They also come with wide tires for a smooth ride, offer fewer gears, and have soft, wide seats to eliminate saddle soreness.

Most comfort bikes also come with shock-absorbing forks and seat posts for additional comfort. And some offer unique design features like an ultra low step-over bar that makes getting on and off easy for people with limited flexibility (like the Biria Easy Boarding at Biria.com), or the “flat-foot” design offered by many manufacturers where the pedals are moved forward, away from the seat. This allows you to get a full-leg extension when you pedal, but keeps the seat in a lower position so when you’re stopped, you can put your feet down flat on the ground while seated, which is a great safety feature for older riders.

Most major manufacturers including Electra, Sun, Raleigh, GT, Giant, and Trek all make a line of comfort bikes that costs between $300 and $800 or more depending on its features.

Shopping Tips
To find a quality comfort bike, your best option is to find a good bike shop in your area. Bikes from big box stores, like Walmart and Target, are mass-market bikes that may be less expensive, but the quality isn’t as good and they’re typically seven to eight pounds heaver. They also come in only one size, so you’re not likely to get a great fit.

Before you buy any bike, be sure you take it for a test ride first to ensure that the seat and fit of the bike is comfortable, the brakes and shifters are easy to use, the gears can go low enough for climbing hills, and the frame and suspension adequately smooth the bumps. 

Recumbent Bikes
If the comfort bikes don’t meet your needs, another popular style among older riders is a recumbent bike. These are the low-to-the-ground, stretched-out frame bikes with La-Z-Boy style seats that allow you to recline with your legs positioned in front of you.

Recumbent bikes are very comfy, easy on the back, arms and shoulders, and aerodynamic which make them ideal for long rides. The disadvantages, because they are low-to-the-ground, they can be harder to balance and maneuver, and are more difficult for other vehicles to see.

If you worry about falling or want more stability when you ride consider a three-wheel recumbent trike.  See SunSeeker.bike and TerraTrike.com for a nice variety, but be aware that recumbent bikes are more expensive, typically ranging between $1,000 and $2,500.

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 Dry Eyes and Protect Your Vision

Dear Savvy Senior
What all can be done to combat dry eyes? Since I turned 50, my eyes have become increasingly dry and irritated.
Constantly Blinking 

Dear Blinking,
Dry eyes is a common problem that affects more than one-third of middle-aged and older Americans. But you don’t have to just put up with it. There are lifestyle adjustments and multiple treatment options available today to keep your eyes moist and healthy. Here’s what you should know.

Dry Eye Issues
Dry, red, irritated eyes are one of the most common reasons for visits to the eye doctor, but discomfort isn’t the only problem of dry eyes. Light sensitivity and blurred or fluctuating vision are common problems too, and worse yet, dry eyes are more likely to get scratched or infected, which could damage your vision permanently.

The reason people get dry eyes are because they either don’t produce enough tears to keep their eyes properly lubricated, or because they produce poor quality tears.

In some cases dry eyes can be triggered by medical conditions such as diabetes, thyroid diseases, allergies, rheumatoid arthritis, lupus and Sjogren’s syndrome. It can also be brought on by age (tear production tends to diminish as we get older), eye conditions, eyelid problems, certain medications, environmental factors and even LASIK and cataract surgery. Dry eyes are also more common in women, especially after menopause.

Lifestyle Adjustments
The first step experts recommend in dealing with dry eyes is to check your lifestyle and surroundings for factors that might be contributing to the problem and make adjustments:

  • Avoid blowing air: Keep your eyes away from air vents, hair dryers, oscillating and ceiling fans and consider buying a home humidifier.
  • Blink more: When you’re reading, watching television, or using a smartphone, tablet or computer, take frequent breaks because these activities cause you blink less often.
  • Avoid irritants :Avoid smoke-filled places and if you swim, wear goggles to cut down exposure to chemicals.
  • Use protection outside: When you go outdoors, use sunglasses that wrap around the sides of your face to protect yourself from sun, glare, wind, and dust.
  • Check your meds:Dozens of prescription and over-the-counter (OTC) drugs like antihistamines, decongestants, diuretics, beta-blockers, antidepressants, tranquilizers, and Parkinson’s medications can all cause dry eyes. If you’re taking any of these, ask your doctor about alternatives.
  • Get more omega-3s: Studies show that eating more fish and other foods rich in omega-3 fatty acids (or take a supplement) helps some people.

Treatment Options
If adjusting your environment and habits doesn’t do the trick, there are a variety of OTC artificial tears that can help. If you experience a lot of burning, try another product or opt for a preservative-free formula. If your dry-eye is persistent, use gel-containing drops like Refresh, Systane and GenTeal. The gel will keep your eyes lubricated for longer periods. If you need a product that’s even longer lasting, consider OTC lubricating ointments like Refresh PM.

If the lifestyle and OTC treatments don’t help, see an ophthalmologist. He or she can offer additional advice and may prescribe a medication. There are several FDA approved medications for dry eye including Xiidra and Restasis, and one in development called Lacripep.

If your dry eye is severe and does not improve, you doctor might recommend a simple office procedure that plugs the small openings (tear ducts) that drain tears away from the eyes. Blocking these openings with punctual plugs keeps tears in place longer.

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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Savvy Senior – May Columns

  1. Nifty Gadgets That Can Help Seniors with Hearing Loss
  2. Can I Inherit My Parent’s Debt?
  3. Should All Baby Boomers Get Tested for Hepatitis C?
  4. Health Coverage Options for Pre-Medicare-Age Spouses

Nifty Gadgets That Can Help Seniors with Hearing Loss

Dear Savvy Senior,
What types of products can you recommend to help people with hearing problems? My 65-year-old husband has some hearing issues, but doesn’t think he needs a hearing aid, so I’m looking for some alternative devices that can help.
Loud Talker

Dear Loud,
If your husband feels he’s not ready for a hearing aid but needs some hearing help, there are dozens of “assistive listening devices” on the market today that can make a big difference.

Assistive listening devices are over-the-counter electronic products (they are not FDA approved hearing aid devices) that can amplify and improve sound to help your husband in different listening situations. It’s also important to know that these products are best suited for people with mild to moderate hearing impairment, and they usually aren’t covered by insurance or Medicare.

Here’s a breakdown of some of the different devices that can help.

Personal amplifiers: For better hearing, especially in noisy environments, there are personal sound amplification products that can be worn in the ear like a hearing aid, and are designed to amplify sound while reducing background noise. Two top rated products to consider that were recently recommended by Consumer Reports are the SoundWorld Solutions CS50+ and the Etymotic Bean.

The CS50+, which costs $350, looks like a Bluetooth cell phone headset, and has customizable settings that can be programed with a smartphone. The Etymotic Bean, which costs $399 a pair or $214 for one, is ready to use right out of the box and is best suited for those with high-frequency hearing loss.

If these are too pricy, there are also a number of small hand-held or body-worn amplifiers – like the Williams Sound Pocketalker ($139) and Bellman & Symfon Mino Personal Amplifier ($188) – that have a microphone and headphones or earbuds that are very effective too.

TV amplifiers: To hear the television better, there are TV listening devices that will let your husband increase the volume and adjust the tone to meet his needs, without blasting you out of the room.

Some of the best options include wireless infrared, radio frequency or Bluetooth devices that come with standard or stethoscope headphones. Sennheiser makes a variety of quality products with prices running between $130 and $450. Or, for a more affordable solution, consider the Serene Innovations TV Sound Box for $120. This is a wireless amplified TV speaker that would sit near your husband, and provide clear stereo sound from the TV without the need for headsets.

Amplified telephones: To have clearer phone conversations, there are a wide variety of amplified telephones that offer enhanced volume and tone adjustments, and they usually come with extra loud ringers and flashing ring indicators to alert him when a call is coming in.

Some top makers of these products are Clarity, ClearSounds and Serene Innovations, and a top seller today is the Clarity XLC2+ Amplified Phone ($144), which is a cordless phone that provides three tone settings and 50 decibels of amplification.

Alerting devices: There are also a variety of alerting devices that can help people who have trouble hearing the doorbell, phone, alarm clock, smoke detector or even weather radio. These products use flashing lights, multi-tone ringers or vibrating devices as a means to alert you.

Some popular products in this category include: The Bellman & Symfon Care Home Alerting Solution that provides door and phone notification with a flashing alert ($198); the Silent Call Weather Alert Radio with strobe and bed shaker ($165); and the all-in-one Serene Innovations CentralAlert CA-360 Clock/Receiver Notification System, which provides alarm clock, doorbell, phone, motion and storm warning alerts ($180).

To locate these and any other hearing loss products visit Harris Communications (HarrisComm.comor call 866-476-9579), which offers more than 2,000 assistive devices and provides customer support services to assist 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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Can I Inherit My Parents’ Debt?

Dear Savvy Senior,
What happens to a person’s debt after they die? My mother has taken on a lot of medical and credit card over the past few years and I’m worried that my brother and I will be responsible for it when she dies. What can you tell me?
Worried Daughter

Dear Worried,
In most cases when a person with debt dies, it’s their estate, not their kids, that is legally responsible. Here’s how it works.

When your mom dies, her estate – which consists of the stuff she owns while she’s alive (home, car, cash, etc.) – will be responsible for paying her debts. If she doesn’t have enough cash to pay her debts, you’ll have to sell her assets and pay off her creditors with the proceeds.

Whatever is left over is passed along to her heirs as dictated by the terms of her will, if she has one. If she doesn’t have a will, the intestacy laws of the state she resides in will determine how her estate will be distributed.

If, however, she dies broke, or there isn’t enough money left over to pay her “unsecured debts” – credit cards, medical bills, personal loans – then her estate is declared insolvent, and her creditors will have to eat the loss.

“Secured debts” – loans attached to an asset such as a house or a car – are a different story. If she has a mortgage or car loan when she dies, those monthly payments will need to be made by her estate or heirs, or the lender can seize the property.

There are, however, a couple of exceptions that would make you legally responsible for her debt after she passes away. One is if you are a joint holder on a credit card account that she owes on. And the other is if you co-signed a loan with her.

NOTE TO SPOUSES: These same debt inheritance rules apply to surviving spouses too, unless you live in a community property state – Arizona, California, Idaho, Louisiana, Nevada, New Mexico, Texas, Washington or Wisconsin. In these states, any debts that one spouse acquires after the start of a marriage belongs to the other spouse too. Therefore, spouses in community property states are usually responsible for their deceased spouses debts.

Protected Assets
If your mom has any IRAs, 401(k)s, brokerage accounts, life insurance policies or employer-based pension plans, these are assets that creditors usually cannot get access to. That’s because these accounts typically have designated beneficiaries, and the money goes directly to those people without passing through the estate.

Settling Her Estate
You also need to be aware that if your mom dies with debt, and she has no assets, settling her estate should be fairly simple. Her executor will need to send out letters to her creditors explaining the situation, including a copy of her death certificate, and that will probably take care of it. But, you and your brother may still have to deal with aggressive debt collectors who try to guilt you into paying.

If your mom has some assets, but not enough to pay all her debts, her state’s probate court has a distinct list of what bills get priority. The details vary by state, but generally estate administrating fees, funeral expenses, taxes and last illness medical bills get paid first, followed by secured debts and lastly, credit card debts.

Need Help?
If you have questions regarding your situation, you should consult with a consumer law attorney or probate attorney. Or, if you just need a question or two answered, call your state’s legal hotline if available (see LegalHotlines.org), or legal services provider.

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

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Should All Baby Boomers Get Tested for Hepatitis C?

Dear Savvy Senior,
I’ve recently read that all baby boomers should get tested for hepatitis C. Is this really necessary, and if so, what are the testing and treatment procedures?
Healthy Boomer

Dear Healthy,

It’s true. Both the U.S. Preventive Services Task Force and the Centers for Disease Control and Prevention (CDC) recommend that all baby boomers – people born from 1945 through 1965 – get a hepatitis C test.

The reason is because baby boomers account for 75 percent of the 3 million or so hepatitis C cases in the U.S. Those that are infected are at very high risk of eventually developing liver cancer, cirrhosis or other fatal liver diseases.

Most hepatitis C infections occurred in the 1970s and 1980s, before there were tests to detect them and before the nation’s blood supply was routinely screened for the virus.

Hepatitis C is transmitted only through blood, so anyone who received either a blood transfusion or an organ transplant prior to 1992 is at increased risk too. So are health-care workers exposed to blood, and people who injected drugs through shared needles. The virus can also be spread through microscopic amounts of infected blood that could occur during sex, from sharing a razor or toothbrush, or getting a tattoo or body piercing at an unsterile shop.

Most people that have hepatitis C don’t know they’re infected because there are no symptoms until their liver becomes severely damaged. It can actually take 30 years for people to show any signs of the virus, but by then, it may be too late to treat. But if it’s detected in time, new treatments are now available that can cure it.

Testing and Treatment
If you’re between the ages of 52 and 72, or fall into one of the previously listed high risk categories, you should see your primary care doctor for a basic blood test to determine whether you have ever been infected with hepatitis C. This is a relatively inexpensive test and typically covered by health insurance under routine medical care.

If the test is negative, no further tests are needed. But, if the test is positive, you’ll need another test called HCV RNA, which will show whether the virus is still active.

If you test positive, you have chronic hepatitis C and will need to talk to your doctor about treatment options. If you’re infected, but have no liver damage, your doctor should monitor your liver at your annual physical.

The main treatments for chronic hepatitis C today are several new FDA approved antiviral medications that have a 95 percent cure rate. Compared to older treatments, these new medications have minimal side effects. Unfortunately, all the new drugs are very expensive – a 12-week treatment course can cost anywhere from $50,000 to $90,000.

Not all health insurance plans, including Medicare Part D plans, cover all prescribed medications for hepatitis C. And due to the expensive nature of these medications, most insurance plans require that you meet several requirements in order to get coverage.

If your insurance provider doesn’t cover the antiviral therapy your doctor recommends, there are financial assistance options available. To look for help, visit HEPC.liverfoundation.org and put your cursor on “Resources” and click on “What if I need Financial Assistance to Pay for Treatment?”

 And for more hepatitis C information, along with a quick online quiz you can take to determine your risks, see CDC.gov/knowmorehepatitis. You can also get information over the phone by calling the national toll-free HELP-4-HEP helpline at 877-435-7443.

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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Health Coverage Options for Spouses Who Aren’t Medicare-Age

Dear Savvy Senior,
My wife, who is 62, is on my health insurance plan through my employer. When I retire in a few months at 65, and go on Medicare, what are my wife’s options? Is there some kind of Medicare coverage for dependent spouses, or do we have to purchase Obamacare?
Approaching Retirement

Dear Approaching,
Medicare, unfortunately, does not offer family coverage to younger spouses or dependent children when you qualify for Medicare. Nobody can obtain Medicare benefits before age 65, unless eligible at a younger age because of disability. With that said, here are some coverage options, including Obamacare, to consider for your wife.

Keep working: If possible, consider working past age 65. This would allow your wife to continue coverage under your employer health insurance until she becomes eligible for Medicare.

Employer options: If your employer provides retiree health benefits, check with your benefits administrator to find out if they offer any options that would allow your wife to continue coverage under their plan. Or, if your wife works, see if she can she switch to health insurance provided by her own employer.

COBRA: If you work for a company that has 20 or more employees, once you make the switch to Medicare, your wife could stay with your company insurance plan for at least 18 months (but could last up to 36 months) under a federal law called COBRA. You’ll need to sign her up within 60 days after her last day of coverage. But be aware that COBRA isn’t cheap. You’ll pay the full monthly premium yourself, plus a 2 percent administrative fee. To learn more, see DOL.gov/ebsa/publications/cobraemployee.html or call 866-444-3272.

If, however, the company you work for has fewer than 20 employees, you may still be able to get continued coverage through your company if your state has “mini-COBRA.” Contact your state insurance department to see if this is available where you live.

 Individual insurance: Buy your wife an individual health insurance policy through the Health Insurance Marketplace (aka Obamacare) until she turns 65. The Marketplace, as it stands now, offers comprehensive health coverage and they can’t deny her coverage or charge extra for preexisting health conditions.

And, if your income falls below the 400 percent poverty level – anything below $47,520 for an individual or $64,080 for a couple in 2017 – you may be eligible for a tax credit that will reduce the amount you’ll have to pay for a policy. To see how much you can save, 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, however, your wife isn’t eligible for the government subsidy, or you want additional policy options to what the Marketplace offers, you can also buy health coverage outside the government marketplaces directly through a private insurance company, an online insurance seller, or an agent or broker. This option is not available if you live in Washington D.C. or Vermont.

These policies do not offer the federal tax credits, but they are required to offer the same menu of essential benefits as Marketplace policies do, and they can’t deny coverage or charge extra for preexisting health conditions. You might even find slightly lower premiums on outside policies, assuming that you don’t qualify for the tax credits.

To find a local broker or agent that sells insurance plans, check the National Association of Health Underwriters website (NAHU.org) which has an online directory. But keep in mind that agents won’t necessarily show you all available policies, just the ones from insurers they work with.

You can also look for these plans at insurance shopping sites like eHealthInsurance.com or GoHealth.com, which lists plans and providers that may not be listed on Healthcare.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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April Columns

  1. How to Pick a Medical Alert System
  2. How Working in Retirement Can Affect Your Social Security Benefits
  3. Coping with Ringing in Your Ears
  4. What to Do with Cremated Ashes?
  5. How Medicare Covers Therapy Services

Savvy Senior
How to Pick a Medical Alert System

Dear Savvy Senior,
I would like to get my 82-year-old mother, who lives alone, a home medical alert system with a panic button that she can push in case she falls or needs help. Can you recommend some good options to help me choose?
Overwhelmed Daughter

 Dear Overwhelmed,
A good medical alert system is an affordable and effective tool that can help keep your mother safe, but with all the choices available today choosing one can be quite confusing. Here are some tips that can help.

How They Work
Medical alert systems, which have been around for about 40 years, are popular products for elderly seniors who live alone. Leased for about $1 a day, these basic systems provide a wearable help button – usually in the form of a neck pendant or wristband – and a base station that connects to the home phone line, or to a cellular network if no landline is present.

At the press of a button, your mom could call and talk to a trained operator through the system’s base station receiver, which works like a powerful speakerphone. The operator will find out what’s wrong, and will notify family members, a friend, neighbor or emergency services as needed.

In addition to the basic home systems, many companies today (for an additional fee) are also offering motion sensitive pendants that can detect a fall and automatically call for help if your mom is unable to push the button. And mobile medical alerts that work when your mom is away from home. Mobile alerts work like cell phones with GPS tracking capabilities. They allow your mom to talk and listen to the operator directly through the pendant button, and because of the GPS, her general location would be known in order for help to be sent.

What to Consider
When shopping for a home medical alert system, here are some things to look for to help you choose a quality system:

  • Extra help buttons: Most companies offer waterproof neck pendant and wristband help buttons, but some also offer wall-mounted buttons that can be placed near the floor in high fall risk areas like the bathroom or kitchen, in case your mom isn’t wearing her pendant.
  • Range: The base station should have a range of at least 400 feet so it can be activated from anywhere on your mom’s property – even in the yard.
  • Backup: Make sure the system has a battery backup in case of a power failure.
  • Monitoring: Make sure the response center is staffed with trained emergency operators located in the U.S., are available on a 24-hour basis, and responds to calls promptly.
  • Contacts: Choose a company that provides multiple contact choices – from emergency services, to a friend or family member who lives nearby – that they can contact if your mom needs help.
  • Certification: Find out if the monitoring center has been certified by Underwriters Laboratories, a nonprofit safety and consulting company.

Top Rated Companies
While there are dozens of companies that offer medical alert systems, here are some top options that offer both home and mobile alerts: Bay Alarm Medical (fees start at $30 per month for a home landline system, bayalarmmedical.com, 877-522-9633); Life Station ($30/month, lifestation.com, 800-554-4600); Medical Alert ($33/month, medicalalert.com, 800-800-2537); MobileHelp ($30/month, mobilehelpnow.com, 800-992-0616); and Phillips Lifeline ($30/month plus a $50 activation fee, lifelinesys.com, 855-681-5351).

Most of these companies offer discounts if you pay three to 12 months in advance.

For mobile medical alerts only, you should also see GreatCall’s Lively Mobile and Wearable (these cost $50 plus a $20 to $35 monthly service fee, greatcall.com, 866-359-5606) and Consumer Cellular’s Ally ($150 plus $25 per month, consumercellular.com, 888-345-5509).

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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Savvy Senior
How Working in Retirement Can Affect Your Social Security Benefits

Dear Savvy Senior,
I’m considering retiring later this year and starting my Social Security benefits, but would also like to work part time. Will this affect my benefits, and if so, how much?
Ready to Retire

Dear Ready,
You can collect Social Security retirement benefits and work at the same time, but depending on how old you are and how much you earn, some or all of your benefits could be temporarily withheld. Here’s what you should know.

Working Rules
Social Security says that if you’re under your full retirement age – which is 66 if you were born between 1943 and 1954, or 66 and 2 months if you were born in 1955 – and are collecting benefits, then you can earn up to $16,920 in 2017 without jeopardizing any of your Social Security if you don’t reach your full retirement age this year. But if you earn more than the $16,920 limit, you’ll lose $1 in benefits for every $2 over that amount.

In the year you reach your full retirement age, a less stringent rule applies. If that happens in 2017, you can earn up to $44,880 from January to the month of your birthday with no penalty. But if you earn more than $44,880 during that time, you’ll lose $1 in benefits for every $3 over that limit. And once your birthday passes, you can earn any amount by working without your benefits being reduced at all.

Wages, bonuses, commissions, and vacation pay all count toward the income limits, but pensions, annuities, investment earnings, interest, capital gains and government or military retirement benefits do not. To figure out how much your specific earnings will affect your benefits, see the Social Security Retirement Earnings Test Calculator at SSA.gov/OACT/COLA/RTeffect.html.

 It’s also important to know that if you do lose some or all of your Social Security benefits because of the earning limits, they aren’t lost forever. When you reach full retirement age, your benefits will be recalculated to a higher amount to make up for what was withheld. For details and examples of how this is calculated, see SSA.gov/planners/retire/whileworking2.html.

For more information on how working can affect your Social Security benefits see SSA.gov/planners/retire/whileworking.html, or call the Social Security at 410-965-2039 and ask to receive a free copy of publication number 05-10069, “How Work Affects Your Benefits.”

The Tax Factor
In addition to the Social Security rules, you need to factor in Uncle Sam too. Because working increases your income, it might make your Social Security benefits taxable.

Here’s how it works. If the sum of your adjusted gross income, nontaxable interest, and half of your Social Security benefits is between $25,000 and $34,000 for individuals ($32,000 and $44,000 for couples), you have to pay tax on up to 50 percent of your benefits. Above $34,000 ($44,000 for couples), you could pay on up to 85 percent, which is the highest portion of Social Security that is taxable. About a third of all people who get Social Security have to pay income taxes on their benefits.

For information, call the IRS at 800-829-3676 and ask them to mail you a free copy of publication 915 “Social Security and Equivalent Railroad Retirement Benefits,” or you can see it online at IRS.gov/pub/irs-pdf/p915.pdf.

In addition to the federal government, 13 states – Colorado, Connecticut, Kansas, Minnesota, Missouri, Montana, Nebraska, New Mexico, North Dakota, Rhode Island, Utah, Vermont and West Virginia – tax Social Security benefits to some extent, too. If you live in one of these states, you’ll need to check with your state tax agency for details.

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

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Savvy Senior
Coping with Ringing in Your Ears

Dear Savvy Senior,
Are there any new treatments you know of that can help with constant ear ringing syndrome known as tinnitus? I’ve had it for years but it’s gotten worse the older I get.
Ringing Louder at 62

Dear Ringing,
Tinnitus is a common condition that affects around 45 million Americans, but is usually more prevalent in the 60-and-older age group. Here’s what you should know along with some tips and treatments that may help.

What is Tinnitus?
Tinnitus (pronounced tin-NIGHT-us or TIN-a-tus) is the sensation of hearing a ringing, buzzing, roaring, hissing or whistling sound in one or both ears when no external sound is present. The sounds, which can vary in pitch and loudness, are usually worse when background noise is low, so you may be more aware of it at night when you’re trying to fall asleep in a quiet room. For most people tinnitus is merely annoying, but for many others it can be extremely disturbing.

 Tinnitus itself is not a disease, but rather a symptom of some other underlying health condition. The best way to find out what’s causing your tinnitus is to see an audiologist, or an otolaryngologist – a doctor who specializes in ear, nose and throat diseases (commonly called and ENT). The various things that can cause tinnitus are:

  • Age-related and noise-induced hearing loss – this is most common cause.
  • Middle ear obstructions, which are usually caused by a build-up of earwax deep in the ear canal.
  • The side effects of many different prescription and nonprescription medicines like aspirin, ibuprofen, certain blood pressure medicines and diuretics, some antidepressants, cancer medicines and antibiotics.
  • Various medical conditions such as high blood pressure, vascular disease, diabetes, allergies, thyroid problems, ear or sinus infections, Meniere’s disease, Lyme disease, fibromyalgia, otosclerosis, temporomandibular joint (TMJ) disorder, a tumor, an injury to the head or neck, traumatic brain injury, depression, stress and more.

 Treating the Causes
While there’s currently no cure for tinnitus there are some ways to treat it depending on the cause. For example, if your tinnitus is caused by a wax build-up in your ears or a medical condition (high blood pressure, thyroid problem, etc.), treating the problem may reduce or eliminate the noise. Or, if you think a medication you’re taking may be causing the problem, switching to a different drug, or lowering the dosage may provide some relief.

Other Treatments
Another treatment option for tinnitus that can help suppress or mask the sound so its less bothersome are “sound therapies.” These can be as simple as a fan or a white noise machine, or something more sophisticated like a modified-sound or notched-music device like Neuromonics (neuromonics.com) or the Levo System (otoharmonics.com) that actually trains your brain not to hear the tinnitus.

Or, if you have hearing loss, hearing aids can help mask your tinnitus by improving your ability to hear actual sounds. There are even hearing aids today that come with integrated sound generation technology that delivers white noise or customized sounds to the patient on an ongoing basis. Your audiologist or ENT can help you with these options.

There are also certain medications that may help. While currently there’s no FDA approved drugs specifically designed to treat tinnitus, some antianxiety drugs and antidepressants have been effective in reliving symptoms. Behavioral therapies, counseling and support groups can also be helpful.

Other things you can do to help quiet the noise is to avoid things that can aggravate the problem like salt, artificial sweeteners, sugar, alcohol, tonic water, tobacco and caffeine. And protect yourself from loud noises by wearing earplugs.

For more information on tinnitus treatment options, visit the American Tinnitus Association at ata.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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Savvy Senior
What to Do with Cremated Ashes?

Dear Savvy Senior,
When my father passed away a few months ago we had him cremated, but are now wondering what to do with his ashes. My sister and I would like to do something celebratory for his life, but aren’t sure what to do. Any suggestions?
No Instructions Left

Dear No Insurance,
If your dad didn’t leave any final instructions on what to do with his cremated remains (ashes), you have a wide array of choices. They can be kept, buried or scattered in a variety of ways and in many locations. Here are some different options to help you decide.

Keep Close By
For many people, keeping the ashes of their deceased love one close by provides a feeling of comfort. If you fit into this category, you could keep his ashes in an urn on the mantel or in a cabinet, or you could also scatter some of them into your lawn or garden, shake them into a backyard pond or dig a hole and bury them. Another possible option is eco-friendly urns (like UrnaBios.com or EterniTrees.com) that contain a seed that grows into a tree or plant after being buried.

Cemetery Options
If you want your dad’s final resting place to be at a cemetery, you have several choices depending on how much you’re willing to spend. With most cemeteries, you can either bury his ashes in a plot, or place them in cremation monument, a mausoleum, or a cemetery building called a columbarium.

Scatter Them
If you want to scatter his ashes, to help you chose an appropriate location, think about what your dad would have liked. For example, did he have a favorite fishing spot, camping area, golf course, beach or park that held a special meaning? These are all possibilities, but be aware to that if you choose to scatter his ashes in a public location or on private land, you’ll need get permission from the management, local government or the land owner.

National parks, for example, require you to have a permit before you scatter ashes. If you wish to dispose of them at sea, the Environmental Protection Agency asks you be at least three miles from shore. Beach scatterings are also illegal in some states, including California, but this is rarely enforced. And many public areas, like Central Park and Disneyland, prohibit scattering ashes, too.  So do most professional and college sports stadiums.

Non-Traditional Methods
If you want to do something truly unique with his ashes, you have many choices here too, but they can get pricy ranging from a few hundred to several thousand dollars. Here are several to consider.

Scattering by air: This free-spirited option lets you spread your dad’s ashes into the sky so the particles can be taken by the wind. To do this, you could hire a private plane, helicopter or hot air balloon service, or use a balloon scattering service like EternalAscent.com or Mesoloft.com. Or, you could even send his ashes into outer space with ElysiumSpace.com.

Scattering by sea: If your dad loved the water, there are many businesses that offer ash scattering services at sea, especially close to coastal areas, or you could rent a boat and do it yourself. There are also companies like EternalReefs.com that offer reef memorials so your dad’s ashes can rest on the ocean floor.

Ashes to keepsakes: If you want a keepsake of your dad, you can also turn some of his ashes into a wide variety of memorabilia, such as: diamonds (see LifeGem.com or DNA2Diamonds.com); jewelry or other handcrafted glass items (ArtFromAshes.com and Memorials.com); vinyl records (Andvinyly.com); gun ammunition (MyHolySmoke.com); or an hourglass urn (InTheLightUrns.com).

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

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Savvy Senior
How Medicare Covers Therapy Services

Dear Savvy Senior,
Can you explain how Medicare covers physical therapy services? I’m a new beneficiary, and would like to get some treatments for my back.
Need Help

Dear Need,
Medicare covers a variety of outpatient therapy services including physical, occupational and speech therapy, if you meet their coverage criteria. Here’s how it works.

Medicare Coverage
To get Medicare (Part B) to help cover your physical therapy, it must be considered medically reasonable and necessary, and will need to be ordered or prescribed by your doctor.

You can get these services as an outpatient at a number of places like a doctor’s or therapist’s office, rehabilitation facility, medical clinic or a hospital outpatient department.

You also need to know that Medicare limits how much it pays for outpatient therapy services in one calendar year. These limits are called “therapy cap limits.” In 2017, Medicare will cover up to $1,980 for physical and speech therapy combined, and another $1,980 for occupational therapy.

But be aware that just like with other Medicare covered services, Medicare will pay 80 percent (up to $1,584) of your therapy costs, after you meet your $183 Part B deductible. You, or your Medicare supplemental plan (if you have one), will be responsible for the remaining 20 percent until the cap limits are reached. After that, you’ll have to pay the full cost for the services.

Extra Therapy
However, if you reach your cap limits and your doctor or therapist recommends that you continue with the treatment, you can ask your therapist for an exception so that Medicare will continue to pay for your therapy. The therapist must provide documentation that these services are medically necessary for you to continue. If Medicare denies the claim, you can appeal through the Medicare appeals process – see Medicare.gov/claims-and-appeals.

If approved, Medicare has an exception threshold of $3,700 for physical and speech therapy combined, and $3,700 for occupational therapy. If your therapy cost exceeds these thresholds, Medicare will audit your case, which could lead to denial of further services.

No Coverage
If you choose to get physical therapy on your own that’s not considered medically necessary or prescribed by your doctor, your therapist is required to give you a written document called an “Advance Beneficiary Notice of Noncoverage” (ABN). Medicare Part B will not pay for these services, but the ABN lets you decide whether to get them.

Therapy at Home
You should also know that Medicare covers home therapy services too if you are homebound and eligible to receive home health care from a Medicare-approved home healthcare agency. To learn more about this option, see the “Medicare and Home Health Care” online booklet at Medicare.gov/pubs/pdf/10969.pdf.

Medicare Advantage
If you are enrolled in a Medicare Advantage plan (like an HMO or PPO), these plans must cover everything that’s included in original Medicare Part A and Part B coverage. But sometimes these plans cover more, with extra services or an expanded amount of coverage. To find out whether your plan provides extra coverage or requires different co-payments for physical therapy, you’ll need to contact the plan directly.

More Information
If you have other questions, call Medicare at 800-633-4227, or contact your State Health Insurance Assistance Program (SHIP), who provides free Medicare counseling in person or over the phone. To find a local SHIP counselor visit Shiptacenter.org, or call the eldercare locator at 800-677-1116.

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

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March Columns
1. How to Find Affordable High-Speed Home Internet Services
2. The ABCs of Picking a Medicare Supplemental Policy
3. How To Stop Snoring
4. Escort Services That Can Help Seniors With the Rigors of Travel

Savvy Senior
How to Find Affordable High-Speed Home Internet Services

Dear Savvy Senior,
Do you know of any resources that can help me find affordable high-speed home Internet services? I’m retired and live primarily on my Social Security and would like to find something cheaper than the $40 per month that I currently pay.
Searching Senior

Dear Searching,
There are two great resources you can turn to, to help you locate low-cost or discounted Internet services, but’s what’s available to you will depend on where you live and/or your income level. Here’s where to begin.

Low-Cost Internet
Your first step to locate cheaper high-speed Internet is EveryoneOn, a national nonprofit organization dedicated to making affordable Internet services available to all Americans.

Through partnerships with Internet providers like Comcast, Cox, AT&T, T-Mobile, Mediacom and others, EveryoneOn can help you search for services in your area that provide high-speed (4G LTE) Internet at a very low cost. Most participating companies charge around $10 per month, with no contract and no equipment fee. However, for non-income qualifiers, there may be a one-time setup/equipment fee of $62. Data plans will vary too.

To start your search, go to EveryoneOn.org and type in your ZIP code and click on the “Find Offers” button, or you can call 877-947-4321. You’ll then need to answer a few questions regarding you household financial situation so the Internet services you’re eligible for can be located.

Some providers offer their services only to people with limited financial resources, however there are others that offer low-cost deals to everyone regardless of income. What’s available to you will depend on where you live.

Also note that in addition to the low-cost Internet services, EveryoneOn also provides referrals to affordable computers and free computer classes. Most of the companies they work with offer refurbished tablets usually for under $100, and computers for under $160 that are available to everyone. And, they provide referrals to free computer classes, which are typically offered in public libraries across the U.S.

Discounted Internet
If you don’t have any luck finding a low-cost service through EveryoneOn, and your income is low enough, another option is the Lifeline Assistance Program. This is a federal program that provides a $9.25 monthly subsidy to help pay for broadband Internet service, or for a home or wireless phone. Only one benefit is available per household; either phone service (home or wireless) or Internet (home or mobile), but not both.

To qualify, you’ll need to show that your annual household income is at or below 135 percent of the Federal Poverty Guidelines – which is $16,281 for one person, or $21,924 for two. Or, that you’re receiving certain types of government benefits, such as Medicaid, food stamps, SSI, public housing assistance, veterans pension or survivors pension benefit, or live on federally recognized Tribal lands.

To apply, you’ll need to contact an Internet provider in your area that participates in the Lifeline program and ask for an application form. To locate providers in your area, visit LifelineSupport.org or call 888-641-8722. Once the provider verifies your eligibility, they will begin service. (NOTE: The Internet companies that partner with EveryoneOn do not currently accept the lifeline subsidy.)

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 ABCs of Picking a Medicare Supplemental Policy

Dear Savvy Senior,
Can you provide any advice on choosing a Medicare supplemental policy to help cover things outside of Medicare? I’ll be 65 in a few months and could use some assistance.
Looking for Help

Dear Looking,
If you plan to enroll in original Medicare, getting a supplemental policy (also known as Medigap insurance) too is a smart idea because it will help pay for things that aren’t covered by Medicare like co-payments, coinsurance and deductibles. Here are some tips to help you choose an appropriate plan.

Medigap Plans  
In all but three states (Massachusetts, Minnesota, and Wisconsin), Medigap plans, which are sold by private health insurers, come in 10 standardized benefit packages labeled with the letters A, B, C, D, F, G, K, L, M and N.

Plan F is the most popular policy followed by plan C because they provide comprehensive coverage. Plans K and L are high-deductible policies that have lower premiums but impose higher out-of-pocket costs. Plan F also offers a high-deductible version in some states. And a popular middle ground policy that attracts many healthy beneficiaries is plan N.

For more information on the different types of plans and the coverage they provide, including Medigap options in Massachusetts, Minnesota, and Wisconsin, see Medicare’s “Choosing a Medigap Policy” guide at Medicare.gov/pubs/pdf/02110-medicare-medigap.guide.pdf, or call 1-800-MEDICARE and ask them to mail you a copy.

How to Choose
To pick a Medigap policy that works best for you, consider your health, family medical history and your budget. The differences among plans can be small and rather confusing.

To help you choose, visit Medicare.gov, and click on “Supplements & Other Insurance” at the top of the page, then on “Find a Medigap policy” and type in your ZIP code. This will give you a list of the plans available in your area, their price ranges and the names, and contact information of companies that sell them. But it’s up to you to contact the carriers directly to get there specific pricing information.

You can also compare Medigap prices on most state insurance department websites (see NAIC.org/state_web_map.htm for links), or you can order a personalized report from Weiss Ratings for $99 at WeissMedigap.com.

Since all Medigap policies with the same letter must cover the exact same benefits (it’s required by law), you should shop for the cheapest policy.

You’ll get the best price if you sign up within six months after enrolling in Medicare Part B. During this open-enrollment period, an insurer cannot refuse to sell you a policy or charge you more because of your health.

You also need to be aware of the pricing methods, which will affect your costs. Medigap policies are usually sold as either: “community-rated” where everyone in an area is charged the same premium regardless of age; “issue-age-rated” that is based on your age when you buy the policy, but will only increase due to inflation, not age; and  “attained-age-rated,” that starts premiums low but increases as you age. Community-rate and issue-age-rated policies are the best options because they will save you money in the long run.

You can buy the plan directly from an insurance company, or you can work with a reputable local insurance broker.

Drug Coverage
You also need to know that Medigap policies do not cover prescription drugs, so if you don’t have drug coverage, you need to consider buying a separate Medicare Part D drug plan too. See Medicare.gov/find-a-plan to compare plans. Also note that Medigap plans do not cover vision, dental care, hearing aids or long-term care either.

Alternative Option
Instead of getting original Medicare, plus a Medigap policy and a separate Part D drug plan, you could sign up for a Medicare Advantage plan that provides all-in-one coverage. These plans, which are sold by insurance companies, are generally available through HMOs and PPOs. To find and compare Advantage plans visit Medicare.gov/find-a-plan.

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 Stop Snoring

Dear Savvy Senior,
Over the past few years my 57-year-old husband’s snoring has gotten much worse. It’s to the point that I have to either wear earplugs or move to a different room. Any suggestions?
Sleep Deprived Susan

Dear Susan,
Snoring is a very common problem that often gets worse with age. Around 37 million Americans snore on a regular basis according to the National Sleep Center.

Snoring occurs when the airway narrows or is partly blocked during sleep usually due to nasal congestion, floppy tissue, alcohol, or enlarged tonsils. But you and your husband also need to know that snoring can be much more than just an annoyance. It can also be a red flag for obstructive sleep apnea, a serious condition in which the snorer stops and starts breathing during sleep, increasing the risks of cardiovascular disease, stroke, cardiac arrhythmia and hypertension. According to the American Academy of Sleep Medicine, 34 percent of men and 19 percent of women who snore routinely have sleep apnea or are at risk for it.

Self-Help Remedies
Even if you are unsure whether your husband has a primary snoring problem or sleep apnea, sleep experts suggest you start with these steps.

Open a stuffy nose: If nasal congestion is causing your husband to snore, over-the-counter nasal strips such as Breathe Right may help. Or, if allergies are the cause, try saline nasal sprays.

Elevate his head: Buying a foam wedge to elevate his head a few inches can help reduce snoring, or buy him a contoured pillow to lift his chin and keep the tongue from blocking the back of his throat as he sleeps. Also check out Nora (smartnora.com), a wireless snoring device that slides under the pillow and gently moves the head to a different position when snoring is detected. This, they say, stimulates the relaxed throat muscles and opens the airway.

Sleep on your side: To prevent back sleeping, which triggers snoring, place a pillow against your husbands back to keep him from rolling over or sew a tennis ball in the back of his pajama shirt. Or check out the Night Shift Sleep Positioner (nightshifttherapy.com), a device that’s worn around the neck that vibrates when you roll on your back.

Avoid alcohol before bed: Alcoholic beverages can relax the muscles in the throat, and constrict airflow. He should not consume alcohol three to four hours before bedtime.

Lose excess weight: Fat around the neck can compress the upper airway and impede airflow and is often associated with sleep apnea.

Quit smoking: Smoking causes inflammation in the upper airways that can make snoring worse.

Need More Help?
If these lifestyle strategies don’t make a big difference, your husband should see his doctor, a sleep specialist, or an otolaryngologist who may recommend an overnight study to test him for apnea.

For primary snoring or mild to moderate sleep apnea, an oral appliance that fits into the mouth like a retainer may be prescribed. This shifts the lower jaw and tongue forward, keeping the airway open.

Some other options are Theravent snore therapy (theraventsnoring.com) and Provent sleep apnea therapy (proventtherapy.com), which are small nasal devices that attach over the nostrils to improve airflow.

But the gold standard for moderate to severe sleep apnea is a continuous positive airway pressure, or CPAP, device. This involves sleeping with a mask and is hooked up to a machine that gently blows air up your nose to keep the passages open.

If these don’t work or are intolerable, surgery is an option too. There are procedures available today that remove excess tissue in the nose, mouth, or throat. And a newer procedure called hypoglossal nerve stimulation that uses a small device implanted in the chest to help control the movement of the tongue when it blocks the airway.

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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Escort Services That Can Help Seniors With the Rigors of Travel

Dear Savvy Senior,
Do you know of any services that help seniors with the rigors of traveling? My youngest daughter is getting married in a few months and would love to have my 82-year old mother attend, but she needs help flying across the country.
Searching Daughter

Dear Searching,
Traveling can be daunting under the best circumstances but for elderly seniors, those with disabilities, or those recovering or rehabilitating from an illness or injury, it can seem particularly overwhelming or unmanageable.

Fortunately, there are a number of companies that provides traveling companion/escort services to help older adults with the rigors of travel.

Whether it’s seniors going on vacation or grandparents wanting to join their far-off families for weddings and graduations, travel companions help clients who need help moving through airports, managing luggage, navigating busy terminals and hotel lobbies and much more.

Some companion services even provide personal care like medication reminders, dressing, bathing and feeding. And for those with specific medical needs, traveling nurse services are available too.

But be aware that these services aren’t cheap. You will pay for the travel companion’s tickets, the companion’s hotel room if necessary, meals, incidentals and fees for the service. The price to accompany a client on a plane trip within the United States – including the companion fees and travel costs for all parties – can range anywhere from $1,500 to $5,000 or more for coach airfare. Business or first class would cost more.

To locate a travel companion service in your area, search online for “senior travel companion” or “senior travel escort,” followed by your mom’s city or state. Or use an experienced national service like Flying Companions (FlyingCompanions.com) or FirstLight Home Care (FirstLightHomeCare.com), which has a national network of franchises that provides in-home care for seniors, and offers travel companion programs in about one-third of its 130 franchises.

Or, for medical travel companions do a search for “traveling nurse escort” or “medical travel companion,” or checkout Travel Care & Logistics (YourFlightNurse.com), which provides registered nurses as escorts.

If, however, your mom doesn’t require a lot of assistance, or if you can’t afford a travel escort, consider asking a trusted family member or friend that has some air travel experience.

Questions to Ask
If you’re interested in hiring a travel companion service to help your mom, there are a number of things you need to check into to ensure you get the right escort.

First, if you mom requires personal or medical care while traveling, find out if the escort is trained to manage her healthcare needs. What sort of medical certifications do they have? (Nursing credentials? C.P.R. training? etc.)

Also, find out how many trips the companion has taken with clients. Have they completed trips with travelers like your mom? How long has the travel service company been in business? What is the company’s safety record? And what sort of insurance does it carry, and what and who does it cover?

Also, get a quote breaking down exactly what you’ll be required to pay, in addition to the companion’s fees. And, get a list of two or three clients/references who has used their service and call them.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.
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February 2017 columns

  1. How to Help Older Drivers Give Up the Car Keys
  2. Do You Need To File a Tax Return in 2017?
  3. How Medicare Covers Preventive Health Services
  4. Choosing the Best Assisted Living Facility

Savvy Senior
How to Help Older Drivers Give Up the Car Keys

Dear Savvy Senior,
What tips can you recommend that can help me deal with my mom’s bad driving? At age 83, her driving abilities have declined, but I know she’s bound and determined to keep driving as long as she’s alive.
Nervous Nelly

Dear Nelly,
There’s no doubt that giving up driving can be a tough step for many elderly seniors, as well as a difficult conversation for concerned family members. While there’s no one way to handle this sometimes touchy topic, there are a number of tips and resources that can help you evaluate and adjust your mom’s driving, and ease her out from behind the wheel when she can no longer drive safely.

Assess Her Driving
To get a clear picture of your mom’s driving abilities, your first step – if you haven’t already done so – is to take a ride with her and watch for problem areas. For example: Does she drive at inappropriate speeds, tailgate or drift between lanes? Does she have difficulty seeing, backing up or changing lanes? Does she react slowly, get confused easily or make poor driving decisions? Also, has your mom had any fender benders or tickets lately, or have you noticed any dents or scrapes on her vehicle? These, too, are red flags. For more assessment tips see SeniorDriverChecklist.info.

If you need help with this, consider hiring a driver rehabilitation specialist who’s trained to evaluate older drivers. This typically runs between $100 and $200. Visit AOTA.org/older-driver or ADED.net to locate a specialist in your area.

Transitioning and Talking
After your assessment, if you think it’s still safe for your mom to drive, see if she would be willing to take an older driver refresher course.

These courses will show her how aging affects driving skills, and offers tips and adjustments to help ensure her safety. Taking a class may also earn your mom a discount on her auto insurance. To locate a class contact your local AAA (AAA.com) or AARP (AARP.org/drive, 888-227-7669). Most courses cost around $20 to $30 and can be taken online or in a classroom.

If, however, your assessment shows that your mom really does need to stop driving, you need to have a talk with her, but don’t overdo it. If you begin with a dramatic outburst like “mom, you’re going to kill someone!” you’re likely to trigger resistance. Start by simply expressing your concern for her safety.

For more tips on how to talk to your mom about this, the Hartford Financial Services Group and MIT AgeLab offers a variety of resources at TheHartford.com/lifetime – click on “Publications” on the menu bar, then on the “We Need To Talk” guidebook.

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

If she still refuses, contact your local Department of Motor Vehicles to see if they can help. Or, call in an attorney to discuss with your mom the potential financial and legal consequences of a crash or injury. If all else fails, you may just have to take away her keys.

 Alternative Transportation
Once your mom stops driving she’s going to need other ways to get around, so help her create a list of names and phone numbers of family, friends and local transportation services that she can call on.

To find out what transportation services are available in her area, contact the Rides in Sight (RidesInSight.org, 855-607-4337) and the Eldercare Locator (800-677-1116), which will direct you to her area agency on aging for assistance.

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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Savvy Senior
Do You Need To File a Tax Return in 2017?

Dear Savvy Senior,
What are the IRS income tax filing requirements for retirees this tax season? My income dropped way down when I retired last year in 2016, so I’m wondering if I need to even file a tax return this year.
New Retiree

Dear New Retiree,
There are several factors that affect whether or not you need to file a federal income tax return this year including how much you earned last year (in 2016), and the source of that income, as well as your age and filing status.

Here’s a rundown of this tax season’s (2016) IRS tax filing requirement thresholds. For most people, this is pretty straightforward. If your 2016 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 probably won’t have to file. But if it’s over, you will.

  • Single: $10,350 ($11,900 if you’re 65 or older by Jan. 1, 2017).
  • Married filing jointly: $20,700 ($21,950 if you or your spouse is 65 or older; or $23,200 if you’re both over 65).
  • Married filing separately: $4,050 at any age.
  • Head of household: $13,350 ($14,900 if age 65 or older).
  • Qualifying widow(er) with dependent child: $16,650 ($17,900 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.

Special Circumstances
There are, however, some other financial situations that will require you to file a tax return, even if your gross income falls below the IRS filing requirement. For example, if you had earnings from self-employment in 2016 of $400 or more, or if you owe any special taxes to the IRS such as alternative minimum tax or IRA tax penalties, you’ll probably need to file.

To figure 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 about 15 minutes to complete.

You can access this tool at IRS.gov/filing – click on “Do you need to file a return?” under the Get Ready tab. Or, you can get assistance over the phone by calling the IRS helpline at 800-829-1040. You can also get face-to-face help at a Taxpayer Assistance Center. See IRS.gov/localcontacts or call 800-829-1040 to locate a center near you.

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

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

Also check with AARP, a participant in the TCE program that provides free tax preparation at more than 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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Savvy Senior
How Medicare Covers Preventive Health Services

Dear Savvy Senior,
Does Medicare cover 100 percent of all preventive health care screenings? I’m due to get a colonoscopy and a few other tests, but I want to find out if I’ll have to pay anything before I proceed.
New to Medicare

Dear New to Medicare,
Medicare currently covers a wide array of free preventive and screening services to help you stay healthy, but not all services are completely covered.

You also need to be aware that the repeal of the Affordable Care Act (aka Obamacare) – which helps financially support Medicare – may very well cause these free preventive services to be eliminated in the future. But in the meantime, here’s how it works.

Free Preventive Services
Currently, most of Medicare’s preventive services are available to all Part B beneficiaries for free, with no copays or deductibles, as long as you meet basic eligibility standards. Mammograms; colonoscopies; shots against flu, pneumonia, and hepatitis B; screenings for diabetes, depression, and heart conditions; and counseling to combat obesity, alcohol abuse, and smoking are just some of Medicare’s lengthy list of covered services. But to get these services for free, you need to go to a doctor who accepts Medicare “on assignment,” which means he or she has agreed to accept the Medicare approved rate as full payment.

Also, the tests are free only if they’re used at specified intervals. For example, prostate cancer PSA tests, once every 12 months for men over 50; or colonoscopy, once every 10 years, or every two years if you’re at high risk.

Medicare also offers a free “Welcome to Medicare” exam with your doctor in your first year, along with annual wellness visits thereafter. But don’t confuse these with full physical examinations. These are prevention-focused visits that provide only an overview of your health and medical risk factors and serve as a baseline for future care.

For a complete list of services along with their eligibility requirements, visit Medicare.gov and click on the “What Medicare Covers” tab at the top of the page, followed by “Preventive & screening services.”

Hidden Costs
You also need to know that while the previously listed Medicare services are completely free, you can be charged for certain diagnostic services or additional tests or procedures related to the preventive service. For example, if your doctor finds and removes a polyp during your preventive care colonoscopy screening, the removal of the polyp is considered diagnostic and you will likely be charged for it. Or, if during your annual wellness visit, your doctor needs to investigate or to treat a new or existing problem, you will probably be charged here too.

You may also have to pay a facility fee depending on where you receive the service. Certain hospitals, for example, will often charge separate facilities fees when you are receiving a preventive service. And, you can also be charged for a doctor’s visit if you meet with a physician before or after the service.

To eliminate billing surprises, talk to your doctor before any preventive service procedure to find out if you may be subject to a charge and what it would be.

Cost Sharing Services
Medicare also offers several other preventive services that require some out-of-pocket cost sharing. With these tests, you’ll have to pay 20 percent of the cost of the service, after you’ve met your $183 Part B yearly deductible. The services that fall under this category include glaucoma screenings, diabetes self-management trainings, barium enemas to detect colon cancer, and digital rectal exams to detect prostate cancer.

Medicare Advantage Members
If you have a Medicare Advantage plan, your plans are also required to cover the same free preventive services as original Medicare as long as you see in-network providers. If you see providers that are not in your plan’s network, charges will typically 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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Savvy Senior
Choosing the Best Assisted Living Facility

Dear Savvy Senior,
What tips can you offer for choosing a quality assisted living facility for my mom? Her health and mental abilities have declined to the point that she can’t live alone anymore but isn’t ready for a nursing home either.
Looking Around

Dear Looking,
If your mom needs some assistance with daily living activities like bathing or getting dressed, managing her medications, preparing meals, housekeeping, laundry or just getting around, an assisted living facility is definitely a good option to consider.

Assisted living facilities are residential communities that offer different levels of health or personal care services for seniors who want or need help with daily living.

There are around 40,000 assisted living facilities (also called board and care, supportive-care or residential-care facilities) in the U.S. today, some of which are part of a retirement community or nursing home. Most facilities have between 25 and 125 suites, varying in size from a single room to a full apartment. And some even offer special memory care units for residents with dementia. Here are some steps you can take to help you choose a good facility.

Make a list: There are several sources you can turn to for referrals to assisted living facilities in your area including your Area Agency on Aging (call 800-677-1116 to get your local number), family doctors or local senior centers, or online search services like Caring.com.

Call your ombudsman: This is a government official who investigates long-term care facility complaints and advocates for residents and their families. This person can help you find the latest health inspection reports on specific assisted living facilities, and can tell you which ones have had complaints or other problems. To find your local ombudsman, visit LTCombudsman.org.

Call the facilities: Once you’ve narrowed your search, call the facilities you’re interested in to find out if they have any vacancies, what they charge and if they provide the types of services your mother needs.

Tour your top choices: During your visit, notice the cleanness and smell of the facility. Is it homey and inviting? Does the staff seem responsive and kind to its residents? Also be sure to taste the food, and talk to the residents and their family members, if available. It’s also a good idea to visit several times at different times of the day and different days of the week to get a broader perspective.

On your visit, get a copy of the admissions contract and the residence rules that outline the facilities fees, services, and residents’ rights, and explains when a resident might be asked to leave because their condition has worsened and they require more care than the facility can provide.

Also find out about staff screening and training procedures, and what percentage of their staff leaves each year. Less than 30 percent annually is considered good. More than 50 percent is a red flag. To help you rate your visit, Caring.com offers a checklist of questions that you can download and print at Caring.com/static/checklist-AL-tour.pdf.

Paying for care: Monthly costs for assisted living ranges anywhere from $2,500 to $5,000 or more, depending on where you live, the facility you choose and the services provided. Since Medicare does not cover assisted living, most residents pay out-of-pocket from their own personal funds, and some have long-term care insurance policies.

If your mom is lower-income and can’t afford this, there are many states that now have Medicaid waver programs that help pay for assisted living. Or, if she’s a veteran, spouse or surviving spouse of a vet, she may be able to get funds through the VA’s Aid and Attendance benefit. To find out about these programs, ask the assisted living facility director, or contact her local Medicaid office (see Medicaid.gov) or regional VA office (800-827-1000).

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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Savvy Senior columns
January 2017

1. Getting Old Pays Off
2. How to Organize Your Affairs
3. Help for Seniors with Bladder Control Problems
4. Tax Help for Caregiver of Elderly Parents
5. How to Guard Against Medicare Fraud

Getting Old Pays Off

Dear Savvy Senior,
What types of discounts are available to baby boomers, at what age do they kick in, and what’s the best way to go about finding them?
Almost 50

Dear Almost 50,
One of the great perks of growing older in America is the many discounts that are available to boomers and seniors.

There are literally thousands of discounts on a wide variety of products and services including restaurants, grocery stores, travel and lodging, entertainment, retail and apparel, health and beauty, automotive services and much more. These discounts – typically ranging between 5 and 25 percent off – can add up to save you hundreds of dollars each year.

So, if you don’t mind admitting your age, here are some tips and tools to help you find the discounts you may be eligible for.

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

You also need to know that while some discounts are available as soon as you turn 50, many others may not kick in until you turn 55, 60, 62 or 65.

Search Online
Because senior discounts frequently change and can vary depending on where you live and the time of the year, the Internet is the easiest way to help you locate them.

To do a search, start by visiting SeniorDiscounts.com, which lists thousands of discounts that you can search for by city and state, and by the category you’re interested in, for free.

You can also look for discounts at TheSeniorList.com, which provides a large list of national and regional business chains that offer them, or you can Google them individually. Just go to Google.com and type in the business or organization you’re curious about, followed by “senior discount” or “senior discount tickets.”

If you use a smartphone, another tool is the Sciddy app (see Sciddy.com) that lets you search for senior discounts and can send you alerts when you’re at an establishment that offers them.

Join a Club
Another good avenue to senior discounts is through membership organizations like AARP, which offers its 50 and older members a wide variety of discounts through affiliate businesses (see AARPdiscounts.com).

If, however, you’re not the AARP type, there are other alternative organizations you can join that also provide discounts such as The Seniors Coalition or the American Seniors Association. Or, for federal workers, there’s the National Active and Retired Federal Employees Association.

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

Restaurants: Senior discounts are common at restaurants and fast food establishments – like Burger King, Chick-fil-A, Subway, Wendy’s, Applebee’s and Golden Corral – ranging from free/discounted drinks, to discounts off your total order.

Retailers: Many thrift stores like Goodwill, and certain retailers like Banana Republic, Kohl’s, Michaels and Ross stores offer a break to seniors on certain days of the week.

Supermarkets: Many locally owned grocery stores offer senior discount programs, as do some chains like Albertsons, Kroger, Publix and Fry’s Supermarkets, which offer some discounts on certain days of the week but they vary by location.

Travel: Southwest Airlines provide the best senior fares in the U.S. to passengers 65 and older, while Amtrak offers a 15 percent discount and Greyhound offers 5 percent off to travelers over 62. Most car rental companies provide discounts to customers who belong to organizations like AARP. Royal Caribbean, Celebrity and Carnival cruise lines offer discount rates to cruisers 55 and over. And, most hotels offer senior discounts, usually ranging from 10 to 30 percent.

Entertainment: Most movie theaters, museums, golf courses, ski slopes and other public entertainment venues provide reduced admission to seniors over 60 or 65. And the National Park Service offers a lifetime pass for those 62 and up for $10 (see nps.gov/findapark/passes.htm).

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 Organize Your Affairs

Dear Savvy Senior,
My wife and I would like to get our personal and financial affairs in order so our kids will know what’s going on if we get sick or die. What tips can you offer?
Procrastinating Paul

Dear Paul,
Organizing your key information and getting your personal and financial affairs in order is a great gift to your loved ones.

To help you get started, your first step is to gather up all of your important personal, financial and legal information so you can arrange it in a format that will benefit you now, and your loved ones later.

Then you’ll need to sit down and create various lists of important information and instructions of how you want certain things handled when you die or if you become incapacitated. Here’s a checklist of areas you need to focus on.

PERSONAL INFORMATION
* Contacts: Make a master list of names and phone numbers of close friends, clergy, doctors, and professional advisers such as your lawyer, accountant, broker and insurance agent.
* Medical information: Include a list of medications you and your spouse take, along with any allergies and illnesses.
* Personal documents: Include such items as your birth certificates, Social Security cards, marriage license, military discharge papers, etc.
* Secured places: List all the places you keep under lock and key or protected by password, such as safe deposit boxes, safe combination, security alarms, etc.
* Service providers: Provide contact information of the companies or people who provide you regular services such as utility companies, lawn service, etc.
* Pets: If you have a pet, give instructions for the care of the animal.
* End of life: Indicate your wishes for organ and tissue donation (see organdonor.gov), and write out your funeral instructions. If you’ve made pre-arrangements with a funeral home include a copy of agreement, their contact information and whether you’ve prepaid or not.

LEGAL DOCUMENTS
* Will, trust and estate plan: Include the original copy of your will and other estate planning documents you’ve made.
* Financial power of attorney: This document names someone you trust to handle money matters if you’re incapacitated.
* Advance health care directives: These documents (see caringinfo.org) – a living will and medical power of attorney – spell out your wishes regarding your end-of-life medical treatment when you can no longer make decisions for yourself.

FINANCIAL RECORDS
* Financial accounts: Make a list of all your bank accounts, brokerage and mutual fund accounts, and any other financial assets you have.
* Debts and liabilities: Make a list of any loans, leases or debt you have – mortgages owed, car loans, student loans, medical bills, credit card debts. Also, make a list of all credit and charge cards, including the card numbers and contact information.
* Company benefits: List any retirement plans, pensions or health benefits from your current or former employer including the contact information of the benefits administrator.
* Insurance: List the insurance policies you have (life, long-term care, home, auto, Medicare, Medigap, prescription drug, etc.) including the policy numbers, agents and phone numbers.
* Property: List real estate, vehicles and other properties you own, rent or lease and include documents such as deeds, titles, and loan or lease agreements.
* Taxes: Include the location of your tax records and your tax preparer’s contact information.

Keep all your organized information and files together in one convenient location, ideally in a fireproof filing cabinet or safe in your home. Also be sure to review and update it every year, and don’t forget to tell your loved ones where they can find it.

If you need help, get a copy of “12 Critical Things Your Family Needs to Know.” This is an excellent 60-page workbook available at 12criticalthings.com for $15 or $19 for the downloadable versions, or $25 for a printed 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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Help for Seniors with Bladder Control Problems

Dear Savvy Senior,
What are the best treatments recommended to help seniors with bladder control problems?
Leaking Linda

Dear Linda,
Incontinence is very common in older adults. According to the CDC, more than half of women and 30 percent of men ages 65 and older are affected by it. Fortunately, there are a wide variety of treatment options that can help, as well as a number of absorbent pads or underwear you could use for leakage protection. Here’s what you should know.

See A Doctor
If you leak unexpectedly (also known as stress incontinence) or sometimes have such a strong urge to urinate (urge incontinence) that you fear you won’t make it to a bathroom in time, your first step is to make an appointment with your primary care doctor, or see a gynecologist, urologist, or urogynecologist.

A doctor can determine if a medication side effect or a condition like diabetes or a urinary-tract infection might be causing urine leakage. They can also set you up with a treatment plan. Depending on the reason or the type on incontinence you have, here are some common treatment options.

Non-drug therapies
There are a number of exercises, bladder training techniques and lifestyle strategies that should be the first line of treatment.

Kegel exercises (repeatedly tightening and relaxing the muscles that stop urine flow to strengthen them) are especially helpful for women with stress incontinence, or leaking when they laugh, cough, sneeze, lift heavy objects, or exercise.

Bladder training involves keeping a diary of urination and accidents, then slowly increasing the time between bathroom visits. It’s most effective for those with urge incontinence.

There are also a number of lifestyle strategies that can help, such as cutting down on caffeinated and alcoholic drinks, which cause the kidneys to produce more urine. Getting sufficient fiber in your diet to keep yourself regular, because constipation can contribute to incontinence. Losing weight if appropriate, because excess weight puts pressure on the abdomen and bladder, and being overweight can also lead to Type 2 diabetes, which causes damage to the nerves that control the bladder. And if you smoke quit, because smoking leads to excess coughing which can cause urine leakage.

Medications
Several drugs are approved for urge incontinence (or overactive bladder), such as prescription mirabegron (Myrbetriq), oxybutynin (Ditropan XL and generic), solifenacin (Vesicare), and tolterodine (Detrol and generic).

While drug treatments are effective for many people, you also need to know that more than half of those who take incontinence drugs stop within six months because of side effects including constipation, drowsiness, dry mouth, blurry vision, and dizziness.

Injections of Botox into the bladder muscle are also approved for this condition and may reduce the urge to urinate. This is usually prescribed to people only if other first line medications haven’t been successful.

Medications should only be considered for those who continue to have bothersome symptoms despite having tried lifestyle changes and therapy exercises.

Electrical stimulation
Mild electric shocks to nerves in the lower back or the pelvic area can stimulate and strengthen muscles that are involved in urination. This can help with both urge and stress incontinence, but it requires multiple treatments over many weeks.

Surgery
Several surgical procedures are available for stress incontinence. The most common is sling surgery, where strips of synthetic mesh are implanted to support the urethra. This surgery is very effective in most patients, but should be a last resort.

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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Tax Help for Caregivers of Elderly Parents

Dear Savvy Senior,
Are caregiving expenses tax deductible? I provide a lot of financial support to my elderly mother and would like to find out if I can write any of it off on my taxes.
Supporting Son

Dear Supporting Son,
There are actually several tax deductions and credits available to adult children who help look after their aging parents or other relatives. Here are your options along with the IRS requirements to help you determine if you’re eligible to receive them.

Dependency Deduction
If you’re paying for more than 50 percent of your mom’s living costs (housing, food, utilities, medical and dental care, transportation and other necessities), and her 2016 gross income (not counting her Social Security benefits) was under $4,050, you can claim your mom as a dependent on your tax return, and reduce your taxable income by $4,050.

Also note that your mom doesn’t have to live with you to qualify as a dependent, as long as her income was under $4,050 and you provided more than half her financial support.

If your mother does live with you, you can include a percentage of your mortgage, utilities and other expenses in calculating how much you contribute to her support. IRS Publication 501 (see irs.gov/pub/irs-pdf/p501.pdf) has a worksheet that can help you with this. To receive this, or other IRS publications or forms via mail, call 800-829-3676.

Shared Support
If you share the financial responsibility for your mom with other siblings, you may be eligible for the IRS multiple-support declaration. Here’s how this works. If one sibling is providing more than half the parent’s financial support, only that sibling can claim the parent. But if each sibling provides less than 50 percent support, but their combined assistance exceeds half the parent’s support. In that case, any sibling who provides more than 10 percent can claim the parent as a dependent. But only one sibling can claim the tax break in any given year. Siblings can rotate the tax break, with one claiming the parent one year, and another the next. The sibling who claims the parent as a dependent will need to fill out IRS Form 2120 (irs.gov/pub/irs-pdf/f2120.pdf) and file it with his or her tax return.

Medical Deductions
If you can’t claim your mom as a dependent, you may still get a tax break for helping pay her medical costs. The IRS lets taxpayers deduct money spent on a parent’s health care and qualified long-term care services, even if the parent doesn’t qualify as a dependent.

To claim this deduction, you still must provide more than half your mom’s support, but your mom doesn’t have to be under the $4,050 income test. And the deduction is limited to medical, dental and long-term care expenses that exceed 10 percent (or 7.5 percent if you’re 65 by Dec. 31, 2016) of your adjusted gross income. You can include your own medical expenses in calculating the total. See the IRS publication 502 (irs.gov/pub/irs-pdf/p502.pdf) for details.

Dependent Care Credit
If you’re paying for in-home care or adult day care for your mom so you are free to work, you may also be able to claim the Dependent Care Tax Credit, regardless of whether or not your mom qualifies as a dependent on your tax return. This credit can cut up to $1,050 off your tax bill for the year. In order to claim it, you must fill out IRS Form 2441 (irs.gov/pub/irs-pdf/f2441.pdf) when you file your federal return.

Check Your State
In addition to the federal tax breaks, more than 20 states offer tax credits and deductions for caregivers on state income taxes too. Check with your state tax agency to see what’s available. For links to state tax agencies see taxadmin.org/state-tax-agencies.

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 Guard Against Medicare Fraud

Dear Savvy Senior,
What are the steps seniors need to take if they suspect Medicare fraud?
Suspicious Sandy

Dear Sandy,
Medicare fraud costs taxpayers more than $60 billion every year, making it one of the most profitable crimes in America. Here’s what you should know, along with some tips for preventing, detecting and reporting it, if it happens to you.

What is Medicare fraud?
In a nutshell, Medicare fraud happens when Medicare is purposely billed for services or supplies that were never provided or received. Here are a few examples of some different types Medicare fraud that’s out there:
* A healthcare provider bills Medicare for services you never received.
* A supplier bills Medicare for equipment you never got.
* Someone uses your Medicare card to get medical care, supplies, or equipment.
* A company offers a Medicare drug plan that has not been approved by Medicare.
* A company uses false information to mislead you into joining a Medicare plan.

What You Can Do
The best way for you to spot Medicare fraud is to review your quarterly Medicare Summary Notices (MSN) or your Explanation of Benefits (EOB). Be on the lookout for things like charges for medical services, medications or equipment you didn’t get, dates of services and charges that look unfamiliar, or if you were billed for the same thing twice. You can also check your Medicare claims early online at MyMedicare.gov (you’ll need to create an account first), or by calling Medicare at 800-633-4227.

If you do spot any unusual or questionable charges, your first step is to contact your doctor or health care provider. The charge may just be a simple billing error. If, however, you can’t resolve the problem with the provider, your next step is to report the questionable charges to Medicare at 800-633-4227, or to the Department of Health and Human Services Office of Inspector General Fraud hotline at 800-447-8477.

When you call in, have the MSN or EOB with the questionable charges handy because you’ll need to provide them with the following information: your Medicare card number; the physician, supplier, and/or facility name where the service was supposedly provided; the date the service was rendered; the payment amount approved and paid by Medicare; as well as the reason you think Medicare shouldn’t have paid. As an incentive, if the suspicious activity you report turns out to be fraud, you may be eligible for a reward of up to $1,000.

If you need help identifying or reporting Medicare fraud or resolving your Medicare billing errors, contact your state Senior Medicare Patrol program, which provides free assistance. Go to smpresource.org or call 877-808-2468 for contact information.

Protect Yourself
To help you protect yourself from becoming a victim of Medicare fraud, you need to guard your Medicare card like you would your credit cards, and don’t ever give your Medicare or Social Security number to strangers. Also, don’t ever give out your personal information to someone who calls or comes to your home uninvited to get you to join a Medicare plan. Medicare will never call or visit your home to sell you anything.

It’s also a smart idea to keep records of your doctor visits, tests, and procedures so you can compare them with any suspicious charges on your MSN or EOB.

For more tips and information on how to protect yourself from Medicare fraud, visit StopMedicareFraud.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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Savvy Senior – December Columns
1. How Much You’ll Pay for Medicare in 2017
2. Locating Lost Life Insurance Policies
3. How to Create a Safe ‘Aging-in-Place’ Home
4. How to Spot and Fix Medical Billing Mistakes

How Much You’ll Pay for Medicare in 2017

Dear Savvy Senior,
I know there won’t be much of a cost-of-living increase in Social Security benefits next year but what about Medicare? How will the 0.3 percent Social Security raise affect our Part B monthly premiums in 2017?
Inquiring Beneficiary

Dear Inquiring,
Considering the rising cost of health care coverage, the news regarding your Medicare costs for 2017 is not too bad. Here’s what you can expect.

Part B Premiums
Because the Social Security Administration is giving out a measly 0.3 percent cost of living increase starting in January – that equates to about a $4 to $5 monthly increase on average – the 2017 Part B monthly premium for about 70 percent of Medicare recipients will increase only about $4 to $5.

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.

So, if your Medicare Part B monthly premium is currently $104.90, you can expect it to be around $109 (on average) in 2017. Or, if you signed up for Part B for the first time in 2016, your $121.80 monthly premium will rise to around $127 (on average) next year.

Some Will Pay More
Unfortunately, the hold harmless provision does not protect all Medicare recipients. New Medicare enrollees (those who will enroll in 2017), beneficiaries who are directly billed for their Part B premium, and current beneficiaries who have deferred claiming their Social Security will pay more.

If you fit into any of these categories, your Medicare Part B premium will be $134 per month in 2017, up from $121.80.

The hold harmless rule also does not protect high-income Medicare beneficiaries who already pay higher Part B premiums because their annual incomes are above $85,000 for an individual or $170,000 for a couple. If you fit into this category, here’s what you’ll pay for your Part B premium next year, based on your 2015 tax returns.
* Individuals with incomes of $85,000 to $107,000, or married couples filing joint tax returns with incomes of $170,000 to $214,000, will pay $187.50 per month.
* Individuals earning $107,000 to $160,000 (couples $214,000 to $320,000) will pay $267.90.
* Individuals with incomes of $160,000 to $214,000 (couples $320,000 to $428,000) will pay $348.30.
* Individuals with incomes over $214,000 or couples above $428,000 will pay $428.60.

Another increase high-income beneficiaries (those with incomes over $85,000, or $170,000 for joint filers) need to be aware of is the surcharge on Part D premiums. Affluent seniors that have a Medicare Part D prescription drug plan will pay an additional $13.30 to $76.20 per month, depending on their income, on top of their regular Part D premiums.

Deductibles and Co-Pays
Other changes that will affect all Medicare beneficiaries include the Part B deductible, which will increase to $183 in 2017 from $166 in 2016. The Part A (hospital insurance) annual deductible will also go up to $1,316 in 2017 (it’s currently $1,288) for hospital stays up to 60 days. That increases to $329 per day for days 61-90, and to $658 a day for days 91 and beyond. And the skilled nursing facility coinsurance for days 21-100 will also increase to $164.50 per day, up from $161 in 2016.

For more information on all the Medicare costs for 2016 visit Medicare.gov and click on “Find out how much Medicare costs in 2017,” 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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Locating Lost Life Insurance Policies

Dear Savvy Senior,
When my mom passed away we thought she had a life insurance policy, but we have no idea how to track it down. Do you know of any resources that might help?
Searching Susan

Dear Susan,
Lost or forgotten life insurance policies are very common in the U.S. It’s estimated that more than $7 billion in benefits from unclaimed life insurance policies are waiting to be claimed by their rightful beneficiaries.

While unfortunately, there isn’t a national database for tracking down these policies, there are a number of strategies and a few new resources that can help your search. Here are several to get you started.

Search her records: Check your mom’s financial records or storage areas where she kept her important papers for a policy, records of premium payments, or bills from an insurer. Also contact her employer or former employer benefits administrator, insurance agents, financial planner, accountant, attorney or other adviser and ask if they know about a life insurance policy. Also check safe-deposit boxes, monitor the mail for premium invoices or whole-life dividend notices, and review old income-tax returns, looking for interest income from, and interest expenses paid, to life insurance companies.

Contact the insurer: If you suspect that a particular insurer underwrote the policy, contact that carrier’s claim office and ask. The more information you have, like your mom’s date of birth and death, Social Security number and address, the easier it will be to track down. Contact information of some big insurers include: Prudential 800-778-2255; MetLife Metlife.com/policyfinder; AIG 800-888-2452; Nationwide 800-848-6331; John Hancock JohnHancock.com – click on “Contact Us” then on “Account Search Request.”

Get state help: Nineteen state insurance departments have a policy locator service program that can help you locate lost life insurance, and many other states offer resources that can help you with your search. To find direct access to these resources visit the American Council of Life Insurers website at ACLI.com/consumers – click on “Missing Policy Tips.”

Search unclaimed property: If your mom died more than a few years ago, benefits may have already been turned over to the unclaimed property office of the state where the policy was purchased. Go to MissingMoney.com, a website of the National Association of Unclaimed Property Administrators, to search records from 40 states, Puerto Rico and the District of Columbia. The pull-down menu under Links connects you to a map and addresses for unclaimed property agencies. Or, to find links to each state’s unclaimed-property division use Unclaimed.org.

If your mom’s name or a potential benefactor’s name produces a hit, you’ll need to prove your claim. Required documentation, which can vary by state, is detailed in claim forms, and a death certificate might be necessary. If you need a copy of your mom’s death certificate, contact the vital records office in the state where she died, or go to VitalChek.com.

Search fee-based services: There are several businesses that offer policy locator services for a fee. The MIB Group, for example, which is a data-sharing service for life and health insurance companies, offers a policy locator service at PolicyLocator.com for $75. But it only tracks applications for individual policies made since 1996.

You can also get assistance at Policy Inspector (PolicyInspector.com) for $99, and L-LIFE (LostLifeIns.com) for $108.50, who will do the searching for 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 Create a Safe ‘Aging-in-Place’ Home

Dear Savvy Senior,
My husband and I are thinking about making some modifications to our home so we can remain living there for as long as possible. Can you recommend some good resources that can help us with aging in place ideas?
Staying Put

Dear Staying,
Many retirees, like you and your husband, want to stay living in their own house for as long as possible. But being able to do so will depend on how easy it is to maneuver your home as you get older. Here are some helpful resources you can turn to, to get an idea of the different types of features and improvements you can make that will make your house safer and more convenient as you grow older.

Home Evaluation
A good first step in making your home more age-friendly is to do an assessment. Go through your house, room-by-room, looking for problem areas like potential tripping or slipping hazards, as well as areas that are hard to access and difficult to maintain. To help with this, there are several organizations that have aging-in-place checklists that point out potential problems in each area of the home, along with modification and solutions.

Rebuild Together, for example, has a two-page “Safe at Home Checklist” that’s created in partnership with the Administration on Aging and the American Occupational Therapy Association. Go to AOTA.org and search for “Rebuilding Together Safe at Home Checklist.”

The National Association of Home Builders also has an “Aging-in-Place Remodeling Checklist” that offers more than 100 suggestions to can help homeowners age 50-plus live safely, independently and comfortably. Go to NAHB.org and search for “Aging in Place Remodeling Checklist.”

Also check out AARP’s excellent resource called the “HomeFit Guide” that’s filled with 28-pages of tips and diagrams to make your entire home safe and easier to live in as you age. You can access it at AARP.org – search for “HomeFit,” or call 888-687-2277 and ask them to mail you a free copy.

Personalized Advice
If you want more personalized help, consider getting a professional in-home assessment with an occupational therapist.

An occupational therapist, or OT can evaluate the challenges and shortcomings of your home for aging in place, recommend design and modification solutions, and introduce you to products and services to help you make improvements.

To find an OT in your area, check with your physician, health insurance provider or local hospital, or seek recommendations from family and friends. Many health insurance providers, including Medicare, will pay for a home assessment by an OT if prescribed by your doctor. However, they will not cover the physical upgrades to the home.

Another option is to contact a builder who’s a Certified Aging in Place Specialist (CAPS). CAPS are home remodelers and design-build professionals that are knowledgeable about aging in place home modifications, and can suggest ways to modify or remodel your home that will fit your needs and budget. CAPS are generally paid by the hour or receive a flat fee per visit or project.

To find a CAPS in your area visit the National Association of Home Builders website at NAHB.org/capsdirectory where you can search by state and city.

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 Spot and Fix Medical Billing Mistakes

Dear Savvy Senior,
After a recent hospital stay, I have a stack of confusing medical bills at home I need to decipher. I’ve heard these bills frequently contain mistakes. How do I spot them to ensure I’m not paying more than I need to be?
Cautious Carol

Dear Carol,
Medical billing errors and overcharging is not uncommon. According to the American Medical Association, 7 percent of medical bills in 2013 had errors, and other groups estimate that figure to be much higher. Unfortunately, untangling those mistakes is almost always up to you. Here are some tips and tools that can help.

Check For Errors
To help you get a grip on your medical bills and check for errors, you need to familiarize yourself with what your insurance does and doesn’t cover. Then you need to carefully review the explanation of benefits from your insurer, and the invoices you receive from your doctor, hospital and/or outpatient facility providers.

These invoices need to be itemized bills detailing the charges for every procedure, test, service and supply you received. If you didn’t receive an itemized invoice, request it from your health care providers. And if the invoices contain any confusing billing codes or abbreviations that you don’t understand, ask them for an explanation. You can also look up most medical billing codes online by going to any online search engine and typing in “CPT” followed by the code number.

Once you receive and decode the invoices, keep your eyes peeled for these mistakes:
* Typos: Incorrect billing codes, a misspelled name or a wrong policy number.
* Double billing: Being charged twice for the same services, drugs, or supplies.
* Canceled work: Charging for a test your doctor ordered, then canceled.
* Phantom services: Being charged for services, test or treatments that were never received.
* Up-coding: Inflated charges for medications and supplies.
* Incorrect length of stay: Most hospitals will charge for the admission day, but not for day of discharge. Be sure you’re not paying for both.
* Incorrect room charges: Being charged for a private room, even if you stayed in a semi-private room.
* Inflated operating room fees: Being billed for more time than was actually used.  Compare the charge with your anesthesiologist’s records.

To make sure the charges on your bill are reasonably priced, your insurance provider may offer an online price transparency tool, or use the Healthcare Blue Book (healthcarebluebook.com) or Guroo (guroo.com). These are free resources that let you look up the going rate of many procedures, tests or services in your area.

Make Corrections
If you find errors or have questions about charges, contact your insurer and your health care provider’s billing office. When you call, be sure you write down the date, time and name of the person you speak to and a summary of the conversation, in case you need to refer back to it at a later time.

If there’s a billing code error or some other mistake that’s easily correctable, ask your health care provider to resubmit a corrected claim to your insurance company.

Get Help
If you aren’t able to resolve the dispute on your own, you may want to consider hiring a medical billing advocate to work on your behalf. To find someone, try sites like billadvocates.com or claims.org. Most advocates charge an hourly fee – somewhere between $50 and $200 per hour – for their services, or they may work on a contingency basis, earning a commission of 25 percent to 35 percent of the amount they save you.

If you’re a Medicare beneficiary, another resource is your State Health Insurance Assistance Program (SHIP). They provide free counseling and can help you understand your medical bills and Medicare coverage. To find a local SHIP counselor visit shiptacenter.org, 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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Savvy Senior – November Columns
1. Incentive Trusts Can Motivate Your Heirs
2. Automatic Medicare Advantage Enrollment Causes Confusion
3. Caregiving Tips for Long-Distance Caregivers
4. Thyroid Disorders Often Missed in Seniors

Incentive Trusts Can Motivate Your Heirs

Dear Savvy Senior,
What can you tell me about incentive trusts? I have two adult children that are financial disasters. Before I die, I want to put some type of requirements in place that they will need to follow in order to receive their portion of my estate. Otherwise, they’ll blow it all in the first year.
Troubled Parent

Dear Parent,
If you want to influence your family members even after you’re gone, an incentive trust is definitely an option to consider. Here’s how it works, along with some tips to help you create one.

Incentive Trust?
An incentive trust is an estate-planning tool designed to help prod your heirs in a direction you desire when you’re no longer around.

With an incentive trust, some or all of your assets are passed to your trust when you die rather than directly to your heirs. Your trustee is empowered to distribute funds from the trust only if and when your beneficiaries do whatever it is you have specified in the trust.

For example, an incentive trust might encourage a beneficiary to graduate from college, enter a particular profession, get married or even have children. They could also reward beneficiaries who do charitable work, or supplement the incomes of those who choose low-paying, yet meaningful careers like teaching or social work. Or, they could penalize beneficiaries who don’t work by cutting off or decreasing distributions, or placing restrictions on heirs with addictions by requiring that payments go directly to rehab centers.

But be aware that these types of trusts can also have drawbacks. A poorly constructed incentive trust can have a high risk of unintended consequences. For example, if your trust provides a financial incentive for your children to be employed full-time, but one of them gets sick or seriously injured in a car accident and can’t work, they would be punished unfairly.

You also need to know that incentive trusts aren’t cheap. You can expect to pay an attorney $2,500 to $5,000 to draft one.

There are also legal limits on what you can do with an incentive trust. While state laws vary, incentive trusts that encourage a beneficiary to join or leave a particular religion, or leave a spouse or not marry at all, can be challenged in court and possibly struck down.

How To Make One
To create a solid incentive trust that accomplishes what you envision, tell your estate-planning attorney that you want to include precise instructions that clearly spells out your wishes, but you also want to include language granting your trustee the right to use his or her discretion and that the trustee’s decisions should be final and binding.

This allows your trustee to make common sense rulings, which will reduce or eliminate the chances of unintended and unfair consequences. It also makes it very difficult for beneficiaries to successfully challenge the trust or trustee in court. When a trust grants final decision-making authority to its trustee, it becomes almost impossible for beneficiaries to successfully argue that this trustee is not correctly implementing the trust’s terms.

The key is to select a trustee who’s smart enough to interpret your intent and has sufficient backbone to stand up to beneficiaries when necessary. You also need to select a successor trustee too if your first choice can no longer serve. Fees paid to a trustee vary widely depending on the state’s fee schedules, the size and complexity of the trust, and conditions laid out in the trust.

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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Automatic Medicare Advantage Enrollment Causes Confusion

Dear Savvy Senior,
I’ll be 65 in a few months and I recently pre-enrolled in original Medicare. But last week, I received a member card in the mail for a Medicare Advantage plan that I did not enroll in. What’s going on? Medicare is so confusing with all the different choices, and now it seems like I’m getting automatically enrolled in a plan I didn’t even choose. Is this a scam?
New to Medicare

Dear New,
It’s not a scam, but it is a growing problem the Centers for Medicare and Medicaid Services needs to resolve. Here’s what you should know.

Automatic Enrollment?
When Americans first become eligible for Medicare – typically at age 65 – they can choose to enroll either in original Medicare, or they can opt for a Medicare Advantage plan, which is offered by private insurance companies. But some people, like yourself, are being enrolled in a Medicare Advantage plan without your knowledge.

Here’s how it’s happening.

Before becoming eligible for Medicare, many people are covered by a commercial or a Medicaid health care plan run by a private health insurance company. These insurers often operate Medicare Advantage plans too.

Under a little-known rule authorized by the federal government, some insurers can shift their beneficiaries who are turning 65 to their own Medicare Advantage plan. It’s a process called “seamless conversion enrollment,” and all it requires is that the insurance company send a letter to the beneficiary explaining the new coverage, which takes effect unless the member opts out within 60 days.

The idea is to preserve continuity for those who want to stay with the same company. But some seniors are unaware that they’ve been signed up, in part due to the flood of mail they get around their 65th birthday from insurers marketing their Medicare plans. This makes it easy to miss a notice of seamless conversion or fail to understand the letter.

It can also have serious financial consequences. Medicare Advantage plans tend to be HMOs and PPOs with limited provider networks. If you unknowingly get enrolled in a Medicare Advantage plan and receive treatment from a doctor who’s not in the network your medical bills may go uncovered.

Consumer advocate groups like the Medicare Rights Center is pushing for a change in the rules. They want it set up so beneficiaries must respond to the letter/invitation before they’re enrolled, versus having to opt out of automatic enrollment. In the meantime, here are some things you can do to protect yourself from unrequested Medicare enrollment.

Self Protection
Every one approaching age 65 should carefully read all mail received from your current health insurance provider. If you come across anything suggesting that the insurance company intends to enroll you in a Medicare Advantage plan that you do not wish to have, contact the insurer and decline to be enrolled.

Also, to be safe, about a month prior to Medicare eligibility, call your current insurer to confirm that you are not being automatically enrolled in a Medicare Advantage plan.

If you are enrolled in a Medicare Advantage plan against your wishes, call Medicare at 800-633-4227. People in this situation have been allowed to convert to traditional Medicare without having to wait until the next open-enrollment period, or enroll in a different Medicare Advantage plan that they choose. It even might be possible to be retroactively enrolled in Medicare so that out-of-network expenses already incurred are covered.

If you need help with your Medicare enrollment, contact your State Health Insurance Assistance Program (SHIP), which provides free one-on-one Medicare counseling in person or over the phone. For contact information visit Shiptacenter.org, or call the eldercare locator at 800-677-1116.

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

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Caregiving Tips for Long-Distance Caregivers

Dear Savvy Senior,
Can you recommend any long-distance caregiving tips that can help me help my elderly father who lives in another state? He has physically declined over the past year, but is determined to stay living in his own house.
Worried Daughter

Dear Worried,
Providing care and support for an aging parent who lives far away can be very difficult and stressful. Here are some tips and resources that can help.

When it comes to monitoring and caring for an aging parent from afar, you have a couple options. You can either hire a professional to oversee your dad’s needs, or you can manage things yourself by building a support system, tapping into available resources, and utilizing technology devices that can help you keep tabs on him.

Professional Help
If your dad needs a lot of help, you should consider hiring an “aging life care professional” who will give him a thorough assessment to identify his needs, and will set up and manage all aspects of his care. These professionals typically charge between $100 and $200 per hour, and are not covered by Medicare.

To find a professional in your dad’s area, ask his doctor for a referral or visit the Aging Life Care Association website at AgingLifeCare.org.

Do-It-Yourself
If your dad only needs occasional help, or if you can’t afford to use a care manager, here are some things you can do yourself to help him.

Assemble a support system: Put together a network of people (nearby friends or family, neighbors, clergy, etc.) who can check on your dad regularly, and who you can call on from time to time for occasional help. Also put together a list of reliable services you can call for household needs like lawn care, handyman services, plumber, etc.

Tap local resources: Most communities offer a range of free or subsidized services that can help seniors with basic needs such as home delivered meals, transportation, senior companion services and more. Contact the Area Aging Agency near your dad – call 800-677-1116 for contact information – to find out what’s available.

Use financial aids: If your dad needs help with his financial chores, arrange for direct deposit for his income sources, and set up automatic payments for his utilities and other routine bills. You may also want to set up your dad’s online banking service, so you can pay bills and monitor his 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 dad, particularly if he’s lower-income.

Hire in-home help: Depending on your dad’s needs, you may need to hire a part-time home-care aide that can help with things like preparing meals, housekeeping or personal care. Costs can run anywhere from $12 up to $25 per hour.

To find someone, ask for referrals through your dad’s doctor or area hospital discharge planners, or try websites like Care.com, CareLinx.com, CareFamily.com or CareSpotter.com.

Utilize technology: To help you keep tabs on your dad and manage his care from afar, there are various technologies that can help.

For example, there are motion sensors (like Silver Mother – sen.se/silvermother) and video cameras (nest.com/camera) that can help you make sure he is moving around the house normally; computerized pillboxes (medminder.com) that will notify you if he forgets to take his medication; simplified computer tablets (grandpad.net) that provide important face-to-face video calls; and a variety of websites that can help you coordinate care (lotsahelpinghands.com) and medical information (reunioncare.com) with other family members.

For more tips, call the National Institute on Aging at 800-222-2225 and order their free booklet “Long-Distance Caregiving: Twenty Questions and Answers.”

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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Thyroid Disorders Are Often Overlooked in Seniors

Dear Savvy Senior,
Can you write a column on the overlooked problem of thyroid disease? After struggling with chronic fatigue, joint pain and memory problems, I was finally diagnosed hypothyroidism. Now, at age 70, I’m on thyroid medication and am doing great. Five years of feeling lousy. I wish I’d have known.
Frustrated Patient

Dear Frustrated,
I’m glad to hear that you’re finally feeling better. Unfortunately, thyroid problems are quite common in older adults but can be tricky to detect because the symptoms often resemble other age related health problems. In fact, as many as 30 million Americans have some form of thyroid disorder, but more than half of them aren’t aware of it.

Here’s a basic overview: The thyroid is a small butterfly-shaped gland located at the base of your neck that has a huge job. It produces hormones (called T3 and T4) that help regulate the rate of many of your body’s activities, from how quickly you burn calories to how fast your heart beats. It also influences the function of the brain, liver, kidneys and skin.

If the gland is underactive and doesn’t produce enough thyroid hormones, it causes body systems to slow down. If it’s overactive, and churns out too much thyroid, it has the opposite effect, speeding up the body’s processes.

The symptoms for an underactive thyroid (also known as hypothyroidism) – the most common thyroid disorder in older adults – will vary but may include fatigue, unexplained weight gain, increased sensitivity to cold, constipation, joint pain, muscle stiffness, dry skin and depression. Some patients may even develop an enlarged thyroid (goiter) at the base of the neck. However, in older adults, it can cause other symptoms like memory impairment, loss of appetite, weight loss, falls or even incontinence.

And the symptoms of an overactive thyroid (or hyperthyroidism), which is more common in people under age 50, may include a rapid heart rate, anxiety, insomnia, increased appetite, weight loss, diarrhea, excessive perspiration, as well as an enlarged thyroid gland. Too much thyroid can also cause atrial fibrillation, affect blood pressure and decrease bone density, which increases the risk of osteoporosis.

Those with the greatest risk of developing thyroid disorders are women who have a family history of the disease. Other factors that can trigger thyroid problems include: autoimmune diseases like Hashimoto’s or Graves disease; thyroid surgery; radiation treatments to the neck or upper chest; and certain medications including interferon alpha and interleukin-2 cancer medications, amiodarone heart medication and lithium for bipolar disorder.

Get Tested
If you have any of the aforementioned symptoms, or if you’ve had previous thyroid problems or notice a lump in the base of your neck, ask your doctor to check your thyroid levels. The TSH (thyroid-stimulating hormone) blood test is used to diagnosis thyroid disorders.

Thyroid disease is easily treated once you’ve been diagnosed. Standard treatment for hypothyroidism involves daily use of the synthetic thyroid hormone levothyroxine (Levothroid, Synthroid and others), which is an oral medication that restores adequate hormone levels.

And treatments for hyperthyroidism may include an anti-thyroid medication such as methimazole (Tapazole), which blocks the production of thyroid hormones. Another option is radioactive iodine, which is taken orally and destroys the overactive thyroid cells and causes the gland to shrink. But this can leave the thyroid unable to produce any hormone and it’s likely that you’ll eventually become hypothyroid and need to start taking thyroid medication.

For more information on thyroid disorders, visit the American Thyroid Association at Thyroid.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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Savvy Senior – October Columns
1. How and When to Apply for Social Security Retirement Benefits
2. Flu Vaccines Designed Specifically for Seniors
3. How Much Does a Funeral Cost?
4. Forgetfulness: What’s Normal & What’s Not
5. How to Find and Hire a Good Handyman or Contractor


How and When to Apply for Social Security Retirement Benefits

Dear Savvy Senior,
What is the easiest way to apply for my Social Security retirement benefits, and how far in advance do I need to apply before I start collecting?
Approaching 62

Dear Approaching,
The Social Security Administration offers three different ways you can apply for your retirement and/or spouses benefits, depending on your preference and how much help you need. Here’s a rundown of the options, along with a list of information you’ll need to apply, and when to fill out the application.

How To Apply?
The easiest and most convenient way to apply for your Social Security benefits is to do it yourself online at SocialSecurity.gov. It takes less than 15 minutes to complete the application, as long as you’ve gathered all of the required information and documentation (more on that at the bottom of the column).

If, however, you’d rather have a Social Security employee assist with the process, you can also apply by phone at 800-772-1213, or at your local Social Security office. If you apply in person, be sure to call ahead and schedule an appointment to cut your office wait time.

Whichever method you feel most comfortable using, your application will be reviewed and processed as soon as all necessary documentation and information is received. And, the Social Security Administration will notify you if it turns out you could qualify for higher benefits on your spouse’s record, or if other family members can receive benefits on your work record.

When To Apply?
While full retirement age is currently 66 (for those born between 1943 and 1954) you can start receiving your Social Security retirement benefits as early as age 62 or as late as age 70, but the longer you wait the larger your monthly check. See ssa.gov/retire/estimator.html to estimate your benefits.

Social Security recommends that you apply for retirement benefits three months before you want your payments to start. So if you want your benefits to begin as soon as you turn 62, you should apply at 61 years and nine months old.

It’s also worth noting that if you start receiving your Social Security retirement benefits before age 65, you will automatically be enrolled in Medicare Part A and Part B, and you’ll receive your Medicare card about three months before your 65th birthday. It will include instructions to return it if you have work coverage that qualifies you for late enrollment.

But if you decide to delay your retirement benefits, you’ll need to sign up just for Medicare at age 65, which you can also do at SocialSecurity.gov, over the phone at 800-772-1213 or through your local Social Security office.

If you do not sign up, in some circumstances your Medicare coverage may be delayed and cost more.

Needed Information
In order to apply for Social Security benefits, you’ll need to be able to document some information about your identity and work history. So before applying, have the following information handy:
* Your Social Security number.
* Your birth certificate (original or certified).
* Proof of U.S. citizenship or lawful alien status if you were not born in the United States.
* A copy of your U.S. military service papers if you had military service before 1968.
* A copy of your W-2 forms and/or self-employment tax return for last year.
* Your bank information (including your account number and the bank routing number) you want your benefits direct deposited to.

For a complete checklist of information you’ll need to complete your application, see ssa.gov/hlp/isba/10/isba-checklist.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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Flu Vaccines Designed Specifically for Seniors

Dear Savvy Senior,
Are there any specific flu shots that are better suited for seniors? I just turned 65 and would like to find out what’s recommended and how Medicare covers it.
Semi-Healthy Senior

Dear Semi-Healthy,
There are actually two different flu vaccines available this year that are designed specifically for seniors age 65 and older. One option is the Fluzone High-Dose, which has been available since 2010, and the other is the new FDA approved FLUAD vaccine (you only need to get one of these).

The Fluzone High-Dose (see Fluzone.com) is a high-potency vaccine that contains four times the amount of antigen as a regular flu shot does, which creates a stronger immune response for better protection. While the new FLUAD vaccine (FLUAD.com) contains an added ingredient called adjuvant MF59 that also helps create a stronger immune response.

The extra protection these vaccines provide is particularly helpful to seniors who have weaker immune defenses and have a great risk of developing dangerous flu complications. The CDC estimates that 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.

But be aware that both the Fluzone High-Dose and FLUAD are not recommended for seniors who are allergic to chicken eggs, or those who have had a severe reaction to a flu vaccine in the past.

You should also know that the Center for Disease Control and Prevention (CDC) does not recommend one vaccination over the other, and to date, there have been no studies comparing the two vaccines.

If you decide you don’t want to get a senior-specific flu shot, there are other options available to people 65 years and older including the standard (trivalent) flu shot, the quadrivalent flu shot which protects against four different flu viruses, and the FluBlok vaccine for those who have egg allergies.

To locate a vaccination site that offers any of these flu shots, visit Vaccines.gov and type in your ZIP code. You’ll also be happy to know that as a Medicare beneficiary, Part B will cover 100 percent of the costs of any flu shot, as long as your doctor, health clinic or pharmacy agrees not to charge you more than Medicare pays.

Pneumonia Vaccines

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

The CDC is now recommending 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. But if you’ve already been vaccinated with Pneumovax 23, wait at least one year before getting the Prevnar 13.

Medicare Part B covers both shots, if they are taken at least 11 months apart.

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 Much Does a Funeral Cost?

Dear Savvy Senior,
How much does an average funeral and body burial cost? I need to make funeral arrangements for my aunt, who’s terminally ill, and would like to have a cost idea going in so I can plan and budget appropriately.
The Executor

Dear Executor,
It definitely pays to know what charges to expect when pre-planning a funeral. Most people don’t have a clue, and can often be upsold thousands of dollars worth of extra services you may not want or need. Here’s a breakdown of what you can expect.

Funeral Prices
The first thing you need to be aware of is that funeral costs will vary considerably depending on your geographic location, the funeral home you choose and the funeral choices you make. With that said, here’s a breakdown of what an average funeral costs, nationwide, according to recent data from the National Funeral Directors Association.

Professional services fee: This is a basic non-declinable fee that covers the funeral provider’s time, expertise and overhead. $2,000

Transfer of the remains: This is for picking up the body and taking it to the funeral home. $310

Embalming and body preparation: Embalming is usually mandatory for open-casket viewing, otherwise it’s not required unless the body is going to be transported across state lines. Embalming costs $695. Other body preparations, which includes hairdressing and cosmetics runs $250.

Funeral viewing and ceremony: If the viewing and funeral ceremony is at the funeral home, you’ll be charged for use of the chapel and any necessary staff. Costs: $420 for viewing, and $495 for funeral ceremony.

Metal casket: This is a big money maker for funeral homes, with markups of up to 300 percent over the wholesale price. $2,395.

Funeral transportation: Use of hearse and driver $318 to transport the body to the cemetery. Use of a service car/van $143.

Memorial printed package: This includes printed programs and memorial guest book.  $155.

In addition to these costs, there are a number of other related expenses such as flowers for the funeral (around $200 to $400), the newspaper obituary fee ($100 to $600 or more), the clergy honorarium ($200 to $300) and extra copies of the death certificate ($5 to $35 per copy depending on the state).

And, a number of large cemetery costs like the plot or mausoleum fee, the vault or grave liner that’s required by most cemeteries, and the opening and closing of the grave, all of which average between $2,000 and $4,000; and the gravestone, which typically costs between $1,000 and $3,000.

All told, the average cost of a total funeral today is around $11,000 or more.

Ways to Save

If you aunt’s estate can’t afford this, there are ways to save. For starters, you should know that prices can vary significantly by funeral provider, so it’s wise to shop around.

If you need some help finding an affordable provider, your area funeral consumers alliance program may be able to refer you. See Funerals.org/local-fca or call 802-865-8300 for contact information.

There are also free websites you can turn to, like Parting.com that lets you compare prices, and FuneralDecisions.com that will provide estimates from local funeral homes based on what you want.

When evaluating funeral providers, be sure you get an itemized price list of services and products so you can accurately compare and choose what you want.

But, the most significant way to save on a funeral is to request a “direct burial” or “direct cremation.” With these options your aunt would be buried or cremated shortly after death, which skips the embalming and viewing. If she wants a memorial service you can have it at the graveside or at her place of worship without the body. These services usually run between $600 and $2,000, not counting cemetery charges.

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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Forgetfulness: What’s Normal & What’s Not

Dear Savvy Senior,
At age 76, my husband has become forgetful lately and is worried he may have Alzheimer’s. What resources can you recommend to help us get a grip on this?
Concerned Wife

Dear Concerned,
Many seniors worry about memory lapses as they get older fearing it may be the first signs of Alzheimer’s disease or some other type of dementia. To get some insight on the seriousness of your husband’s problem, here are some resources you can turn to for help.

Warning Signs
As we grow older, some memory difficulties – such as forgetting names or misplacing items from time to time – are associated with normal aging. But the symptoms of dementia are much more than simple memory lapses.

While symptoms can vary greatly, people with dementia may have problems with short-term memory, keeping track of a purse or wallet, paying bills, planning and preparing meals, remembering appointments or traveling out of the neighborhood.

To help you and your husband recognize the difference between typical age-related memory loss and a more serious problem, the Alzheimer’s Association provides a list of 10 warning signs that you can assess at 10signs.org.

They also provide information including the signs and symptoms on the other conditions that can cause dementia like vascular dementia, Lewy body dementia, frontotemporal dementia, Parkinson’s disease, Huntington’s disease, chronic traumatic encephalopathy and others – see ALZ.org/dementia.

Memory Screening
Another good place to help you get a handle on your husband’s memory problems is through the National Memory Screening Program, which offers free memory screenings throughout National Memory Screening Month in November.

Sponsored by the Alzheimer’s Foundation of America, this free service provides a confidential, face-to-face memory screening that takes about 10 minutes to complete and consists of questions and/or tasks to evaluate his memory status.

Screenings are given by doctors, nurse practitioners, psychologists, social workers or other healthcare professionals in thousands of sites across the country. It’s also important to know that this screening is not a diagnosis. Instead, its goal is to detect problems and refer individuals with these problems for further evaluation.

To find a screening site in your area visit NationalMemoryScreening.org or call 866-232-8484. It’s best to check for a screening location at the end of October, because new sites are constantly being added.

See a Doctor
If you can’t find a screening site in your area, make an appointment with his primary care doctor to get a cognitive checkup. This is covered 100 percent by Medicare as part of their annual wellness visit. If his doctor suspects any problems, he may give him the Memory Impairment Screen, the General Practitioner Assessment of Cognition, or the Mini Cog. Each test can be given in less then five minutes.

Depending on his score, his doctor may order follow-up tests or simply keep it on file so he can see if there are any changes down the road. Or, he may then refer him to a geriatrician or neurologist who specializes in diagnosing and treating memory loss or Alzheimer’s disease.

Keep in mind that even if your husband is experiencing some memory problems, it doesn’t necessarily mean he has dementia. Many memory problems are brought on by other factors like stress, depression, thyroid disease, side effects of medications, sleep disorders, vitamin deficiencies and other medical conditions. And by treating these conditions he can reduce or eliminate the problem.

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

Dear Savvy Senior,
What’s the best way to find a good handyman or tradesman to do some work around the house? I’ve have had some bad luck lately with unprofessional workers who do shoddy work and charge too much.
Frustrated Senior

Dear Frustrated,
Hiring a good home repair handyman can be a bit of a crapshoot. How do you find someone who will return your calls, show up on time, do the job right and finish it, all at a fair price? Here are some tips that can help.

Who to Call
While it may seem obvious, whom you call on for help will depend on what you need done. If, for example, you have a small home repair or improvement project that doesn’t require a lot of technical expertise, a handyman may be all you need. But if you have a job that involves electricity, plumbing, or heating or cooling systems, you’re better off going with a licensed tradesman. Bigger jobs like home renovations or remodeling may require a general contractor.

Whatever type of work you need, the best way to find it is through referrals from people you trust. If your friends or family don’t have any recommendations turn to professionals in the field like local hardware or home improvement stores, or even real estate agents.

The Internet can also help. Websites like HomeAdvisor.com can put you in touch with prescreened, customer-rated service professionals in your area for free. Or try AngiesList.com, a membership service that will connect you with contractors and service companies with various types of expertise for free. They provide ratings and reviews of local professionals who’ve done work for other members in your area, plus details about the type of work they’ve done, prices, professionalism and timeliness. They also offer an upgraded silver or gold membership for $25 or $100 per year, which offers discounts, a magazine, complaint resolutions and more.

Another option for finding handyman services is through a local or national service company like MrHandyman.com, HouseDoctors.com or HandymanConnection.com. You’ll probably pay more going through a company than you would with an independent handyman, but service companies typically promise professional workers who are screened, licensed, bonded and insured.

To find local handyman services in your community check your yellow pages or go to any Internet search engine and type in “handyman” plus your city and state.

Things to Know  
Once you’ve located a few candidates, your next step is to get written estimates that list the materials, costs and details of the project. It’s a good idea to get at least three estimates from different sources to be sure you’re getting a fair deal.

Before hiring someone, check out his or her work history with your state consumer protection agency (go to usa.gov/state-consumer for a list) and the Better Business Bureau (bbb.org/council). You can also search the Web using the company or individual’s name and such words as “reviews” and “complaints.”

You also need to find out if your candidates have an approved contractor or tradesman license. Using an unlicensed worker in a state that requires a license is dangerous – you’ll have little legal recourse if the job goes bad. (To see which states license contractors, visit contractors-license.org.) Contractorcheck.com is another good resource for researching local contractors.

Also, ask to see their proof of insurance, which covers any damages they may cause while working on your home, and ask for several references from past jobs and check them.

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

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Savvy Senior – September Columns
1.    How to Prevent Falls at Home
2.    Cheap Cell Phone Plans for Seldom Calling Seniors
3.    Health Tips and Advice for Senior Travelers
4.    Meal Service Delivery Options for Seniors Who Don’t Cook

How to Prevent Falls at Home
Dear Savvy Senior,
My 79-year-old mother, who lives alone, has fallen several times over the past year. Are there any extra precautions we should take that can help prevent this?
Worried Daughter

Dear Worried,
Falls are a big concern for many elderly seniors and their families. Each year, 1-in-3 older Americans fall, making it the leading cause of both fatal and nonfatal injuries for those age 65 and older. But many falls can be prevented. Depending on what’s causing your mom to fall, here are some different tips that can help protect her.

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

For additional balance and leg strengthening exercises the National Institute on Aging offers free exercise guides and a DVD that you can order at Go4Life.nia.nih.gov.

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

Get her vision checked: Poor vision can be another contributor to falls, so get your mom’s eyes checked every year. She may be wearing the wrong glasses or have developed a condition such as glaucoma or cataracts that make it harder to see obstacles on the floor.

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

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

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

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

For more tips, call the Eldercare Locater at 800-677-1116 and order a free copy of their “Preventing Falls at Home” brochure. Or, get an occupational therapist to come in and assess your mom’s home for fall risks. Medicare will pay for this service if prescribed by a doctor.

Choose safe footwear: Your mom should be aware that going barefoot or wearing slippers or socks at home can also cause falls, as can wearing backless shoes, high heels, and shoes with smooth leather soles. The safest option are rubber-soled, low-heeled shoes.

Purchase some helpful aids: If your mom needs some help, talk to her doctor or a physical therapist about getting her fit for a cane or walker.

Also, to help ensure your mom’s safety, and provide you some peace of mind, get her a medical alert device like Bay Alarm Medical (BayAlarmMedical.com), one of the most reliable and affordable devices available today. For less than $1 per day, this offers an emergency alert button – either in the form of a necklace pendent, wristband or wall-mounted buttons placed in high fall risk areas like the bathroom and kitchen – so she could call for help anytime if she were to fall or need assistance.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.
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Cheap Cell Phone Plans for Seniors Who Seldom Make Calls

Dear Savvy Senior,
What are the cheapest cell phone options available to seniors today who only want one for emergency purposes or occasional calls? I have a cell phone now that cost me $30 per month, but I hate paying for something I hardly ever use.
Infrequent Caller

Dear Infrequent,
For seniors who don’t use their cell phone very often but still want one for emergencies or occasional use, there are a many super-cheap plans available, or depending on your income level you may qualify for a free cell phone. Here’s where to find some of the best deals.

Super Cheap Plans
For seniors who are light/infrequent cell phone users, “prepaid” or “pay as you go” plans are the way to go if you want to save money. With these services, you buy a certain amount of minutes (for talk or text) that must be used within a specified period of time.

While many cell phone providers still offer these lower cost plans, the very best/cheapest deal available today is through T-Mobile’s pay as you go plan (T-Mobile.com, 800-501-0952).

For just $3 per month, this plans provides any combination of 30 minutes of talk or 30 text messages. If you want more, you can pay an additional 10 cents per minute/message when you sign up, or you can make adjustments later. You also don’t have to worry about overage charges with this plan, because once you reach your talk/text limit for the month, the phone stops working. And, if you have a compatible device, you won’t need to purchase a new cell phone.

If you’re looking for a little more talk time or text messages, another low-cost option is Pure Talk USA (PureTalkUSA.com, 877-820-7873), which offers a Senior AddVantage 80 Plan. This plan provides any combination of 80 minutes of talk or 240 text messages for only $5 per month. Pure Talk also accepts unlocked phones and they don’t have overage fees.

Senior-Friendly Cell Phones
If you would rather have a senior-friendly phone with a large keypad and simplified features, and an “SOS” emergency alert button, the Doro PhoneEasy 626 sold through Consumer Cellular (ConsumerCellular.com, 888-532-5366) is the best, low-cost option. It runs $50 for the phone, with calling plans that start at $10 per month.

Free Cell Phones
If your income is low enough, you may qualify for a free cell phone through the Lifeline Assistance Program. This is a government-sponsored program that subsidizes wireless (and landline) companies who in turn provide free cell phones and usually between 250 and 1,000 minutes of free monthly talk time and texts to low-income Americans. (Some programs in some states charge a small monthly fee.)

The free phones and minutes are provided by a number of big prepaid wireless companies like Safelink, Assurance Wireless and Budget Mobile, along with a host of other regional carriers throughout the country.

Most states have several wireless companies that provide the free phones and minutes. If you are eligible, the free cell phone you’ll receive is a basic phone that also offers text messaging, voice mail, call waiting and caller ID.

To qualify, you’ll need to show that you’re receiving certain types of government benefits, such as Medicaid, Food Stamps, SSI, home energy assistance or public housing assistance. Or, that your household income is at or below 135 or 150 percent of the Federal Poverty Guidelines – it varies by state. To find out if you’re eligible, or to locate the wireless companies that provide Lifeline government cell phones in your state, visit LifelineSupport.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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Health Tips and Advice for Senior Travelers

Dear Savvy Senior,
My husband and I are recently retired and would like to do some traveling both in the United States and abroad, but worry about health issues, such as insurance, finding a good hospital if we get sick, etc. What tips can you offer health conscious seniors who want to travel?
Older Travelers

Dear Travelers,
A dream vacation can turn into a real nightmare if you get sick or injured while you’re away and aren’t prepared. Before setting out, here are some simple steps to help ensure a safe and healthy trip.

Talk to your doctor: If you have a medical condition or health concerns, a good first step is to talk with your doctor now about what precautions you need to take before traveling. You should also have your doctor’s contact information with you when you travel, as well as a list of your medical conditions and the medications you’re taking in case you need emergency medical care while you’re away.

If you’re traveling outside the U.S., you need to find out the health conditions of the country you’re visiting and what, if any, vaccinations and/or preventative medications are recommended. See CDC.gov/travel or call 800-232-463 to get this information.

Check your insurance: If you have health insurance or a Medicare Advantage plan through an HMO or PPO that covers in-network doctors only, check your plan to find out what’s covered if you need medical care when traveling outside your geographic area.

Beneficiaries that have original Medicare are covered everywhere in the U.S. But if you’re traveling abroad, you need to know that original Medicare does not cover medical expenses beyond the border except in rare circumstances, although some Medicare Advantage plans and some Medigap supplemental policies do. And, many private health plans don’t pay health care costs outside the U.S. either. Be sure to check.

If you need coverage when traveling abroad, get a comprehensive travel medical insurance policy that covers medical care, medical evacuation and trip cancellation coverage. See InsureMyTrip.com and SquareMouth.com to shop and compare policies.

Locate health care: Before your trip, find out what health and urgent care facilities are near the areas you’re visiting. Your hotel can help you with this, or see UrgentCareLocations.com or USHospitalFinder.com for U.S. facilities.

If you’re traveling abroad, the U.S. consulate or embassy in the countries you’re visiting (go to step.state.gov to enroll your trip) is a good place to get a referral. Or join 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.

Pack your meds: Make sure you have a sufficient supply of medications to last the entire trip.

If traveling by air, you need to pack your medicine in your carry-on bag, so if your checked luggage gets lost or misdirected you won’t be without. It’s best to keep your medications in their original containers to get through airport security without delays. It’s also a good idea to bring along a note from your doctor that explains why you take these medications, especially if syringes or other medical supplies are involved.

For airport security requirements visit TSA.gov – click on “Disabilities and Medical Conditions.” You can also call TSA Cares at 855-787-2227 prior to traveling with questions about screening policies, procedures and what to expect at the security checkpoint.

Seek mobility aids: If mobility is an issue and you’re flying to your destination, call your airline before you leave and ask them to supply you a wheelchair to use while you’re in the airport. And when booking hotel reservations, ask for an accessible room that accommodates wheelchairs and walkers.

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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Meal Service Delivery Options for Seniors Who Don’t Cook

Dear Savvy Senior
What types of healthy meal delivery options can you recommend for seniors who live at home, but don’t cook and don’t get out much. Since mom passed away, my dad’s diet is terrible and I worry about his health.
Long-Distance Daughter

Dear Long-Distance,
There are various healthy meal service delivery options available to non-cooking seniors who live at home, but what’s available to your dad will depend on his location and budget. Here are several to check into.

Senior Meal Programs
A good place to start is to find out if there’s a senior home delivery meal program in your dad’s area. Meals on Wheels is the largest program that most people are familiar with, but many communities offer senior meal delivery programs sponsored by other organizations that go by different names.

To find services available in your dad’s area, visit MealsOnWheelsAmerica.org, which offers a comprehensive directory on their website, or call the area aging agency near your dad. Contact the Eldercare Locator at 800-677-1116 to get the number.

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

Online Meal Delivery
Another option that’s a bit more expensive is to purchase your dad’s meals online and have them delivered to his home. There are a number of companies that offer this type of service like Magic Kitchen (magickitchen.com), Home Bistro (homebistro.com), Personal Chef To Go (personalcheftogo.com), Good Measure Meals (goodmeasuremeals.com), and many others.

These companies offer a wide variety of tasty meal choices, and will usually post the nutrition information for their meals right on their website. Most companies will also cater to a host of dietary and medical needs, such as low-sodium and low-carb meals, diabetic meals, gluten-free, dairy-free, and vegetarian options.

Most of the food arrives frozen, but a few companies ship food fresh. Prices generally start at around $10 to $13 per meal, plus shipping, however most companies provide discounts or free shipping when you order meals in bulk.

Grocery Stores and Restaurants
Depending on where your dad lives, he may also be able to get home delivered meals from local grocery stores or restaurants. Some grocery stores offer a selection of pre-cooked meals and foods, including roasted chicken, mashed potatoes, and fresh soups and salads. Contact the grocery stores in your dad’s area to inquire about this option. Or check with some of his favorite restaurants to see if they offer home delivery.

Personal Chefs
Another option for non-cooking seniors with a bigger budget is to hire a personal chef from time to time. A personal chef can provide your dad with a do-it-all service that will help plan his meals, do the grocery shopping and prepare him several weeks worth (or more) of tasty meals in his home, which he can freeze and eat whenever he wants. Or, they can prepare it in their own kitchen and deliver it. Chef’s fees range between $200 and $300 plus groceries. He may be able to save money by sharing meals with you or another family member, or a friend or neighbor.

To find a personal chef in your dad’s area, check the listings at the American Personal & Private Chef Association (personalchef.com) or the United States Personal Chef Association (hireachef.com).

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

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Savvy Senior – August Columns
1. How to Find Financial Assistance for Elderly Parents
2. Medicare Coverage for Non-Working Spouses
3. How to Track Down Things You Routinely Misplace
4. Donating Old Hearing Aids, Eyeglasses and Mobility Equipment

How to Find Financial Assistance for Elderly Parents

Dear Savvy Senior,
Where can I go to locate financial assistance programs for seniors? I have been helping support my 70-year-old mother the past couple years and really can’t afford to do it any longer.
Feeling Overwhelmed

Dear Overwhelmed,
There are actually a wide variety of financial assistance programs and government benefits that can help seniors in need. But what’s available to your mom will depend on her income level and where she lives.

To find out what types of assistance your mom may be eligible for, just go to BenefitsCheckUp.org, a free, confidential Web tool designed for adults 55 and older and their families. It will help you locate federal, state and private benefits programs that can assist with paying for food, medications, utilities, health care, housing and other needs. This site – created by the National Council on Aging – contains more than 2,000 programs across the country.

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

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

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

If you don’t have Internet access, you can also get help in-person at any of the 47 Benefit Enrollment Centers located throughout the U.S. Call 888-268-6706 or visit NCOA.org/centerforbenefits/becs to locate a center in your area. Some centers also offer assistance over the phone.

Types of Benefits
Depending on your mom’s income level and where she lives, here are some benefits that she may be eligible for:

Food assistance: Programs like the Supplemental Nutrition Assistance Program (SNAP) can help pay for groceries. The average monthly SNAP benefit is currently around $127 per person. Other programs that may be available include the Emergency Food Assistance Program, Commodity Supplemental Food Program, and the Senior Farmers’ Market Nutrition Program.

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

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

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

Supplemental Security Income (SSI): Administered by the Social Security Administration, SSI provides monthly payments to very low-income seniors, age 65 and older, as well as to those who are blind and disabled. SSI pays up to $733 per month for a single person and up to $1,100 for couples.

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

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

Dear Savvy Senior,
Does Medicare cover spouses who have not worked? I have worked all my life, but my spouse worked only for a few years when we first got married but then quit to take care of our children fulltime. Will she be eligible for Medicare?
Inquiring Husband

Dear Inquiring,
There are plenty of couples in your situation when it comes to applying for Medicare. The answer generally is yes, your spouse can qualify for Medicare on your work record. Here’s how it works.

Eligibility Rules
Medicare, the government health insurance program for older adults, covers more than 55 million Americans age 65 and older, as well as those younger that have a qualifying disability or have End-Stage Renal Disease.

To be eligible, you must have worked and paid Medicare taxes for at least 10 years to qualify for premium-free Medicare Part A hospital coverage when you turn 65. If you qualify, then your non-working spouse will qualify too, based on your work record when she turns 65.

Divorced spouses are also eligible if they were married at least 10 years and are single, as are surviving spouses who are single and who were married for at least nine months before their spouse died.

In addition to Part A, both you and your spouse would also qualify for Medicare Part B, which covers doctor’s visits and other outpatient services, but requires a monthly premium, not a work history. The premium for most Part B beneficiaries in 2016 is $104.90 per month, while new beneficiaries pay $121.80/month and higher earning couples – those with incomes over $170,000 per year – pay even more.

There are also a number of other caveats you should know about depending on your wife’s age.

Older Spouse

If your wife is older than you, she can qualify for Medicare on your work record at age 65, even if you’re not getting Medicare yourself, but you must be at least 62 years old. You also must have been married for at least one year for your wife to apply for Medicare on your work record.

If you are still working and your wife is covered by your employer’s health insurance, she may want to enroll only in the premium-free Medicare Part A until you retire or your employer coverage ends. Part B – along with its premium – can be added later without penalty as long as your employer’s group health plan is your “primary coverage.” Check with your employers’ human resources department to find out about this.

If your wife is more than three years older than you and has no health coverage, you can buy her Medicare Part A until you turn 62 and the premium-free benefit kicks in. The Part A monthly premium is $411 in 2016.

Younger Spouse
If your wife is younger than you, she will need health insurance until she turns 65 and becomes eligible for Medicare. This may be through your employer if you are still working, through COBRA (see dol.gov/ebsa/publications/cobraemployee.html), or through the Health Insurance Marketplace (see healthcare.gov) or outside the marketplace through a private insurance company.

Other Medicare Options
In addition to Medicare Part A and B, when you and your wife become Medicare eligible, each of you will also need to enroll in a Part D prescription drug plan if you don’t have credible drug coverage from your employer or union. And, you may want to purchase a Medicare supplemental (Medigap) policy too, to help pay for things that aren’t covered by Medicare like copayments, coinsurance and deductibles. Or, you may want to consider an all-in-one Medicare Advantage plan.

For more information on Medicare choices and enrollment rules visit Medicare.gov or call 800-633-4227. You can also get help through your State Health Insurance Assistance Program (see shiptacenter.org), which provides free Medicare counseling.

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


Dear Savvy Senior,
Can you recommend any products or devices to help seniors track down lost or misplaced items, like car keys, wallet, cell phone, etc. My husband has become forgetful in his old age, so we spend a lot of wasted time looking for things.
Frustrated Spouse

Dear Frustrated,
There are actually a wide variety of tracking devices that can help you and your husband find items that are commonly misplaced or lost. Here are some top options to consider depending on how tech savvy you are.

Smartphone or Tablet Users
If you or your husband uses a smartphone or tablet, you can easily track down lost or misplaced items like keys, a purse, wallet, remote control, smartphone, tablet or laptop with a Bluetooth tracker like TrackR (thetrackr.com, $25 or $30 per tag) or Tile (thetileapp.com, $25 per tag). Both of these products pair with an Apple or Android smartphone or tablet app, which will help you locate the missing item.

All you do is attach a small TrackerR or Tile tag to the items you want to keep track of with an adhesive sticker, a key ring or you can just slip it inside the item.

Then, when a tagged item goes missing, you simply access the app on your smartphone or tablet to see how far away you are from the item or last known location on the map. If you’re within 100 feet, you can make the tracking device ring so you can follow the sound.

Or, if you or your husband loses your phone or tablet, both TrackR and Tile work in reverse, allowing you to press a button on the device to make your phone or tablet ring (even if it’s on silent) as long as it’s nearby. And to help you avoid leaving items behind, TrackR can be set to sound an alarm when there’s too much distance between your phone and device.

Low-Tech Finders
If, however, you or your husband don’t have a smartphone or tablet, there are radio frequency devices like Click ‘N Dig (clickndig.com) that can help you find lost/misplaced items. This device comes with one finder fob/remote and four or six tags for $26 or $39 respectively. Attach a tag to the items you want to keep track of with adhesive or a key ring. Each tag is color-coded and corresponds to a colored button on the finder.

When an item goes missing, you simply press the colored button on the finder fob and the tag will flash and beep. The signal will go through walls and cushions, but you’ll need to be within at least 60 feet of your lost item. Make sure you keep the finder fob in a safe spot, because if you misplace it, you won’t be able to find the tagged items.

Another good option, and one that doesn’t require a finder fob, is Find One Find All or FOFA (findonefindall.com). This device can manage up to six items. It comes in a key-fob finder and/or a flat, credit card sized finder for your wallet, remote, phone, tablet, etc.

These finders can be attached to items you wish to keep track of, and because each finder is also a transmitter, as long as you can find one FOFA tagged item, you can locate the rest.

FOFA finders sound an alarm when signaled so you can follow the sound to locate the missing item, but the range for this device is only 30 feet. Cost: $25 for two finders.

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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Donating Old Hearing Aids, Eyeglasses and Mobility Equipment

Dear Savvy Senior,
Where are some good places to donate old hearing aids, eyeglasses and mobility equipment? My uncle passed away a few months ago and left behind a bunch of useful aids that could surely help someone else.
Searching Nephew

Dear Searching,
Donating old, unused assistive living aids and/or medical equipment is a great way to help those in need who can’t afford it, and in most cases its tax deductible too. Here are some good places to check into.

Hearing Aids
There are several national nonprofit service organizations that offer hearing aid recycling programs. Hearing aids that are donated are usually refurbished and either redistributed to those in need, or resold with the proceeds going to buy new hearing aids for people who can’t afford them.

One of the most popular places to donate old hearing aids, as well as hearing aid parts or other assistive listening devices is the Starkey Hearing Foundation “Hear Now” recycling program (starkeyhearingfoundation.org, 800-328-8602), which collects around 60,000 hearing aids a year. Hearing aids and other listening devices should be sent to: Starkey Hearing Foundation, ATTN: Hearing Aid Recycling, 6700 Washington Avenue South, Eden Prairie, MN 55344.

Some other good nonprofits to donate to are the Lions Club Hearing Aid Recycling Program (go to lionsclubs.org and search for: HARP), and Hearing Charities of America (hearingaiddonations.org, 816-333-8300), which is founded by Sertoma, a civic service organization dedicated to hearing health.

Or, if you’re interested in donating locally, contact your Hearing Loss Association of America state or local chapter (see hearingloss.org for contact information). They can refer you to state agencies or community service programs that also accept hearing aids.

Eyeglasses
One of the best places to donate old eyeglasses is to the Lions Club Recycle for Sight program. They collect nearly 30 million pairs of glasses each year and distribute them to people in need in developing countries.

To donate, look for a Lion’s Club glasses donation drop-off box in your community. You can often find them at libraries, community centers, churches, schools and many local eye doctor offices, or call your local Lions Club for drop-off locations. See directory.lionsclubs.org for contact information.

New Eyes (www.new-eyes.org/recycle) is another not-for-profit organization that collects unused eyeglasses and distributes them abroad to people in need.

Medical Equipment
If you have old wheelchairs, walker, canes, shower chairs or other durable medical equipment, there are many foundations and organizations that would love to receive them. For example, Goodwill and Salvation Army stores are popular donation destinations, as are foundations like the ALS Association (alsa.org) and Muscular Dystrophy Association (mda.org), which accept donations at local chapters.

There are also state agencies and local nonprofit organizations that accept medical equipment donations and redistribute them to people in need. To find what’s available in your area, contact your state assistive technologies program for a referral. See ataporg.org/programs for contact information.

Or, if you’re interested in selling your uncles old medical equipment, you have options here too, including craigslist.com, recycledmedical.com and usedhme.com, which are all free sites that let you list what you want to sell online.

Tax-Deductible

Don’t forget that donations to nonprofits are tax-deductible, so when you drop off your donated items, be sure to ask for a receipt for your tax records. Or, if you’re mailing it in or are using one of the Lions Club drop-off boxes, you’ll need to include a note requesting a letter of acknowledgement of the donation. Your note should include your name and a brief description of what you donated, along with a self-addressed stamped envelope.

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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Savvy Senior – July Columns
1. Who’s Eligible for Social Security Survivor Benefits?
2. Great Gadgets for Aging Golfers
3. How to Choose an Adult Day Care Service
4. 10 Ways Seniors Can Avoid Identity Theft
5. Acupuncture Can Help Relieve Pain and Many Other Ailments

Who’s Eligible for Social Security Survivor Benefits?

Dear Savvy Senior,
Who all is eligible for Social Security survivor benefits? My ex-husband died last year at the age of 59, and I would like to find out if me, or my two kids – ages 13 and 16 – that we had together are eligible for anything?
Divorced Widow

Dear Divorced,
If your ex-husband worked and paid Social Security taxes, both you and your kids may very well be eligible for survivor benefits, but you need to act quickly because benefits are generally retroactive only up to six months. Here’s what you should know.

Under Social Security law, when a person who has worked and paid Social Security taxes dies, certain members of that person’s family may be eligible for survivor benefits including spouses, former spouses and dependents. Here’s a breakdown of who may be eligible.

Widow(er)’s and divorced widow(er)’s: Surviving spouses are eligible to collect a monthly survivor benefit as early as age 60 (50 if disabled). Divorced surviving spouses are also eligible at this same age, if you were married at least 10 years and did not remarry before age 60 (50 if disabled), unless the marriage ends.

How much you’ll receive will depend on how much money (earnings that were subject to Social Security taxes) your spouse or ex-spouse made over their lifetime, and the age in which you apply for survivors benefits.

If you wait until your full retirement age (which is 66 for people born in 1945-1956 and will gradually increase to age 67 for people born in 1962 or later), you’ll receive 100 of your deceased spouses or ex-spouses benefit amount. But if you apply between age 60 and your full retirement age, your benefit will be somewhere between 71.5 – 99 percent of their benefit.

To find out what percentage you can get under full retirement age visit ssa.gov/survivorplan/survivorchartred.htm.

There is, however, one exception. Surviving spouses and ex-spouses that are caring for a child (or children) of the deceased worker, and they are under age 16 or disabled, are eligible to receive 75 percent of the worker’s benefit amount at any age.

Unmarried children: Surviving unmarried children under age 18, or up to age 19 if they’re still attending high school, are eligible for survivor benefits too. Benefits can also be paid to children at any age if they were disabled before age 22 and remain disabled. Both biological and adoptive children are eligible, as well as kids born out of wedlock. Dependent stepchildren and grandchildren may also qualify. Children’s benefits are 75 percent of the workers benefit.

Dependent parents: Benefits can also be paid to dependent parent(s) who are age 62 and older. For parents to qualify as dependents, the deceased worker would have had to provide at least one-half of the parent’s financial support.

But be aware that Social Security has limits on how much a family can receive in monthly survivors benefits – usually 150 to 180 percent of the workers benefit.

You also need to know that in addition to survivor benefits, surviving spouses or children are also eligible to receive a one-time death benefit of $255.

Maximizing Strategies
Social Security also provides surviving spouses and ex-spouses some nice strategies that can help boost your benefits. For example, you could take a reduced survivor benefit at age 60, and could switch to your own retirement benefit based on your earnings – between 62 and 70 – if it offers a higher payment.

Or, if you’re already receiving retirement benefits on your work record, you could switch to survivors benefits if it offers a higher payment. You cannot, however, receive both benefits.

You also need to know that if you collect a survivor benefit while working, and are under full retirement age, your benefits may be reduced depending on your earnings.

For more information, visit ssa.gov/survivorplan or call 800-772-1213.

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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Great Gadgets for Aging Golfers

Dear Savvy Senior,
Can you recommend any products that can help older golfers? I love to play golf, but at age 74, I have hip and back problems that make bending over to tee up or pick up the ball difficult. And I have arthritis in my thumbs that makes griping the club a problem.
Ailing Eddy

Dear Eddy,
There are actually a wide variety of nifty golf accessories and adaptive equipment that can help older golfers who struggle with injuries, arthritis or loss of mobility. Here are several products for different needs.

Bending Substitutes
The game of golf requires a lot of repetitive bending and stooping that comes with teeing up the ball, repairing divots, marking the ball on the green, retrieving a ball or tee on the ground, along with picking up a club, sand rake or flag stick off the ground.

For teeing up the ball without bending over, consider one of the Northcroft Golf Tee-Up devices. These are long-handled tools (1.5 to 3 feet long) that have trigger-style handgrips and a jaw that holds the ball and tee for easy placement. They cost between $69 and $72 and are available at NorthcroftGolf.com. For other tee-up solutions, see the Tee Pal ($55, TeePalPro.com) and Joe’s Original Backtee ($15, UprightGolf.com).

NorthcroftGolf.com and UprightGolf.com also offer a variety of stoop-proof ball pickup accessories, divot repair and magnetic ball marker products ranging between $5 and $12.

Or, if you just want a great all-around golf picker-upper, consider the Graball GrabAll Jaw – sold through Amazon.com for $10 for a package of two. It attaches to the handle end of your putter and chipper and is designed to pick up golf balls, flagsticks, putters and green side chippers.

Gripping Aids
To help alleviate your golf club gripping problem, there are specially designed golf gloves and grips that can make a big difference.

The best gloves are the Bionic Golf Gloves (BionicGloves.com) that have extra padding in the palm and finger joints to improve grip. And the Power Glove (PowerGlove.com) that has a small strap attached to the glove that loops around the club grip to secure it in your hand. These run between $20 and $30.

Another option is to get oversized grips installed on your clubs. This can make gripping the club easier and more comfortable, and are also very good at absorbing shock. Oversized grips are usually either one-sixteenth-inch or one-eighth-inch larger in diameter than a standard grip, and cost around $10 per grip. You can find these grips and have them installed at your local golf store or pro shop.

Or, for a grip-and-glove combination fix, consider the Quantum Grip (QuantumGrip.com) that incorporates Velcro material recessed in the golf club grip and a companion golf glove that has mating Velcro material in the palm. Cost: $20 per grip, plus $35 per glove.

Vision Helper
If vision problems make finding the ball difficult, Chromax golf balls (ChromaxGolf.com) can make a big difference. These are reflective colored golf balls that make them appear larger and brighter. Cost: $10.50 for a three-pack.

Ergonomic Carts

There are also ergonomically designed golf carts that can help you transport your golf clubs around the course. If you like to walk, the Sun Mountain Sports Micro-Cart, V1 Sport Cart or Reflex Cart are great options. These are three and four-wheeled, lightweight push carts that that fold into a compact size for easy transport. Available at SunMountain.com for $200, $210 and $230.

Or, for severe mobility loss, the SoloRider specialized electric golf cart (SoloRider.com) provides the ability to play from a seated or standing-but-supported position. Retailing for $9,450, plus a $550 shipping fee, this cart is lightweight and precisely balanced so it can be driven on tee boxes and greens without causing any damage. Federal ADA laws require that all publically owned golf courses allow them.

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

Dear Savvy Senior,
Can you offer any tips on finding and choosing a good adult day care service for an elderly parent? My 82-year-old mother, who is moving in with me, has Alzheimer’s and needs attention during the day while I’m at work.
Looking for Help

Dear Looking,
Adult day care services can be a great option for caregivers who work, or for those who just need a break during the day. Here’s what you should know, along with some tips to help you find and choose one.

Adult Day Services

The business of adult day care services has grown rapidly in recent years. According to the National Adult Day Services Association, there are around 5,700 programs operating in the United States today.

As the name implies, adult day care provides care for elderly seniors who cannot care for themselves at home. While services will vary from center to center, they typically provide personal care, meals and snacks, various activities and social interaction in a safe supportive environment. Additionally, many centers also provide health services such as medication management, various therapies, exercise and transportation to and from the facility.

Adult day care centers generally operate programs during normal business hours five days a week. However, some centers may offer services in the evenings and on weekends, too.

Costs for care will vary as well, usually between $25 to more than $100 per day (the national average is $65/day), depending on where you live.

Unfortunately, in most cases original Medicare (Part A and B) does not pay for adult day care, but some Medicare Advantage (Part C) plans, and many long-term care insurance policies do. But, most seniors or their families pay for care out-of-pocket.

If your mom is lower income and can’t afford this, many states offer Medicaid waiver programs, and some have PACE programs that provide financial assistance. Contact your state Medicaid office (see Medicaid.gov) for more information. The VA even provides adult day care to eligible veterans enrolled in their Medical Benefits Package. See VA.gov/geriatrics to learn more.

How to Choose
Your first step in shopping for an adult day center is to determine the kinds of services your mother and you need. After you do that, here are some tips to help you locate and choose a good provider.

Start by contacting your Area Agency on Aging (call 800-677-1116 to get your local number) to get referrals to adult day service programs in your area. You can also search online at the National Adult Day Services Association (NADSA) website at NADSA.org/locator, or check your phone book yellow pages under “Adult Day Care” or “Seniors Services.”

Once you have a list of a few centers, call them to find out their eligibility criteria, if they offer the types of services your mother needs, if they are accepting new clients, their hours of operation, if they’re licensed and/or registered with a state agency (this is not required in all states) and what they charge.

After you identify a few good centers, go in for a visit. Find out about the staffing ratio (at least one staff member for every six participants is recommended) and what kind of training they have. While you’re there, notice the cleanness and smell of the facility. Is it homey and inviting? Does the staff seem friendly and knowledgeable? Also be sure to taste the food, and consider making an unannounced visit.

To help you rate your visit, the NADSA offers a helpful checklist of questions to ask at NADSA.org – click on “Choosing a Center.”

Then, after your visit, be sure to check their references. Get names and phone numbers of at least two or three families who have used the center you are considering and call them.

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

Dear Savvy Senior,
What can seniors do to protect themselves from identity theft? My brother-in-law, who’s 77, recently had his identity stolen and I want to make sure it doesn’t happen to me.
Worried Relative

Dear Worried,
Great question! Each year around 17 million people fall victim to identity theft, which happens when someone gets access to your Social Security number, bank or credit card account number, or other identifying information and uses it to steal from you. Here are some free steps you can take to reduce your risks.

Guard your personal information: Never give your Social Security number, credit card number, checking or savings account numbers to anyone unless you initiate the contact. Also, do not carry your Social Security card around in your wallet or purse, and don’t carry around your Medicare card either unless you’re going to the doctor.

Get off mailing lists: Put a stop to pre-approved credit-card offers, which is a gold mine for ID thieves. To do this visit optoutprescreen.com or call 888-567-8688 – they will ask for your Social Security number and date of birth. You can stop other junk mail at dmachoice.org, and reduce telemarketing calls at donotcall.gov.

Use strong passwords: To safeguard your personal data on your smartphone or tablet don’t use a password that’s easy to hack, like 1234 or 0000. Also, make your computer passwords more than 8 characters long, with uppercase and lowercase letters, numbers, and symbols like # and %, and use different passwords on different accounts. If it’s hard to remember them, try a password manager service like dashlane.com, truekey.com or lastpass.com.

Be wary of unknown emails: Never click on links in emails from strangers, or those that claim to be from the Social Security Administration, IRS or other government agencies, or from your bank, phone or credit card company warning of a “problem.” This can result in identity-stealing malware being installed on your computer. To protect your computer from malware, install antivirus software (see avg.com and avast.com for free options) and set up automatic security updates and full weekly scans.

Secure your mail: Empty your home mailbox quickly or buy a locked mailbox to deter thieves. And mail outgoing payments from a U.S. Postal Service mailbox or the post office, not from your more vulnerable home mailbox.

Get safer credit cards: If you don’t already have one, get an EMV chip credit card from your credit card provider. They’re much more difficult for fraudsters to hack than magnetic strip cards.

Shred unneeded documents: Buy a crosscut paper shredder so you can shred all unneeded records, receipts, statements, preapproved credit offers or other papers you throw out that has your financial or personal information.

Monitor your accounts: Review your monthly bank and credit card statements carefully, and see if your bank or credit card issuer offers free alerts that will warn you of suspicious activity as soon as it’s detected. If they do, sign up for them or use eversafe.com, which will do it for you for a small fee.

Watch your credit: Check your credit report at annualcreditreport.com or call 877-322-8228. You can receive one free report a year from each of the three major credit bureaus (Equifax, Experian and TransUnion), so consider staggering your request so you can get one free copy every four months.

Set up security freezes: If you don’t plan to apply for new credit, loans, insurance or utility services, freeze your credit reports so crooks can’t open up new accounts in your name. Rules vary by state, but the $5 to $20 fee is waived if you’re 65 or older, or show proof of past ID theft. Security freezes are set up at all three credit bureaus at equifax.com, experian.com and transunion.com.

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

Dear Savvy Senior,
Is acupuncture a proven treatment for arthritis pain? I have a lot of back and neck pain and am wondering if it’s worth trying. What all can you tell me about acupuncture?
Afraid of Needles

Dear Afraid,
Many well-designed studies over the years – funded by the National Institutes of Health – have found acupuncture to be very effective in easing arthritis pain, and can help with a variety of other ailments too. Here’s what you should know.

First used in China more than 2,000 years ago, acupuncture has become increasingly popular in the United States over the past 40 years.

While acupuncture isn’t a cure-all treatment, it is a safe, drug-free option for relieving many different types of pain including osteoarthritis, low back pain, neck pain, migraine headaches, fibromyalgia, postoperative pain, tennis elbow, carpel tunnel syndrome, dental pain, menstrual cramps and more. Studies have also shown that it can be helpful in treating asthma, depression, digestive disorders, addictions, menopause symptoms like hot flashes, and nausea caused by chemotherapy or anesthesia.

Exactly how or why acupuncture works is still not fully understood, but it’s based on the traditional Eastern theory that vital energy flows through pathways in the body, and when any of these pathways get blocked, pain and illness result. Acupuncture unblocks the pathways to restore health.

However, today most U.S. medical doctors tend to believe that acupuncture works because it stimulates the nerves causing the release of endorphins, which are the body’s natural painkiller hormones. It’s also shown to increase blood circulation, decrease inflammation and stimulate the immune system.

What to Know
If the thought of getting needles stuck into your body makes you a little uneasy, you’ll be happy to know that an acupuncture treatment is nothing like getting a shot. In fact, it’s quite relaxing. Here are some additional points you should know:

The needles: They’re solid, sterile and disposable (used only once), and as thin as a cat’s whisker. The number of needles used for each treatment can vary anywhere from a few, up to a dozen or more. And where the needles are actually stuck depends on the condition being treated, but they are typically inserted about one-quarter to 1-inch deep, and are left in place for about 20 minutes. After placement, the needles are sometimes twirled or manipulated, or stimulated with electricity or heat.

Does it hurt? You may feel a brief, sharp sensation when the needle is inserted, but generally it’s not painful. Once the needle is in place, however, you may feel a tingling sensation, numbness, mild pressure or warmth.

Treatments: How many treatments you’ll need will depend on the severity of your condition – 12 treatments done weekly or biweekly is very common. It’s also important to know that acupuncture can be used in conjunction with other conventional medical treatments, or by itself.

Cost and coverage: The cost per treatment typically runs anywhere from $50 to $100 or more. Unfortunately, most private health plans including Medicare, do not cover acupuncture.

To find an acupuncturist in your area ask your doctor for a referral, or you can do a search online at the National Certification Commission for Acupuncture and Oriental Medicine (nccaom.org) and acufinder.com. Both sites provide a national database of certified and/or licensed practitioners. Or visit the American Academy of Medical Acupuncturists (medicalacupuncture.org), which offers a directory of MDs who are certified to practice acupuncture.

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

June 2016

Savvy Senior – June Columns
1. Simple Smartphones for Seniors
2. The New MIND Diet May Help Prevent Alzheimer’s
3. Deciding What to Do in Retirement
4. How Medicare Handles Second Medical Opinions


Simple Smartphones for Seniors


Dear Savvy Senior,
Can you recommend some smartphones that are specifically designed for seniors? My 75-year-old mother is interested in upgrading from a basic cell phone to a smartphone, but will need one that’s very easy to operate.
Inquiring Daughter

Dear Inquiring,
I wrote about this topic just last year, but in the fast changing world of personal technology devices, there’s a new crop of simplified smartphones that have recently hit the market that are better than ever for tech-shy seniors. Here are my three top options.

Doro 824 SmartEasy: Offered by Consumer Cellular, the new Doro 824 SmartEasy is one of the best, simplified smartphones available today. It starts with a bright, 5-inch high-resolution touch screen display that offers large icons and text, and customizable volume settings. Its simplified design pairs down the options, providing uncluttered, easy access to key contacts and frequently used features – such as the phone, text messages, the camera email and the Internet – right from the home screen. And, it provides help as you go along from the built-in coach.

It also offers a unique pre-installed My Doro Manager app that can also be downloaded by family or friends. This app provides a number of tutorials showing your mom how to enjoy her phone, and gives her trusted contacts the remote ability to help manage and adjust her Doro smartphone from their smartphone no matter where they are.

And for added convenience and safety, the Doro 824 provides three physical buttons on the front of the phone for quick, one-touch access to the home screen, recently used applications, and a back button that returns to the previous screen. And an “Emergency Alert” button on the back of the phone that will automatically dial one, predetermined contact in the event of an emergency.

The Doro 824 is sold online at ConsumerCellular.com, over the phone at 888-532-5366, or at any Target or Sears store for $200 with no contract.

Jitterbug Smart: Offered by GreatCall wireless, the new 4th generation Jitterbug Smart is much bigger than previous GreatCall smartphones. This phone is actually an Alcatel smartphone that’s been rebranded and loaded with GreatCall’s simplified user interface software.

It has a big, bright 5.5-inch high-definition touch screen, and a simple single-list menu on the home page that provides easy access to only frequently used features, along with one-touch access to contacts and other apps.

It also provides convenient voice typing for emails and texts, and offers a variety of optional health and safety features, like MedCoach, that sends medication and prescription refill reminders. Urgent Care, which provides unlimited access to registered nurses and doctors to answer health questions. And a 5Star medical-alert service that lets you speak to a live emergency-alert agent around the clock. These trained agents will confirm your mom’s location via GPS tracking technology and dispatch help as needed.

Available online at GreatCall.com, or at Best Buy, Rite Aid, Sears and Walmart stores for $150 with a onetime $35 activation fee and no contract.

Samsung Galaxy Note5: While this smartphone isn’t designed specifically for seniors, its large size (5.7-inch screen) and unique “Easy” mode setting that boosts the icon and font sizes and simplifies the home-screen layout, makes it a good option.

With the Easy mode turned on, the Note5’s home screen will display only the time, date and local weather, and six frequently used functions. To access your 12 most important contacts, you would simply swipe the home screen to the right. And to access your 12 favorites apps, swipe to the left.

The Note5 (see Samsung.com/galaxynote5) is available with 32 and 64 GB of storage from the major carriers (AT&T, Sprint, ?Verizon, T-Mobile) and some smaller carriers at prices ranging between $615 and $840 without a contract.

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.

The New MIND Diet May Help Prevent Alzheimer’s

Dear Savvy Senior,
I’ve heard that there’s a new diet that can help prevent Alzheimer’s disease. What can you tell me about this? My 80-year-old mother has Alzheimer’s and I want to do everything I can to protect myself.
Concerned Daughter

Dear Concerned,
It’s true! Research has found that a new diet plan – called the MIND diet – can have a profound impact on your brain health as you age, and can even lower your odds of getting Alzheimer’s disease.

The MIND diet takes two proven diets – the heart-healthy Mediterranean diet and the blood-pressure lowering DASH diet – and zeroes in on the foods in each that specifically affect brain health.

The MIND diet, which stands for “Mediterranean-DASH Intervention for Neurodegenerative Delay,” was developed by Martha Clare Morris, a nutritional epidemiologist at Rush University Medical Center, through a study funded by the National Institute on Aging.

The study followed the diets of nearly 1,000 elderly adults, who filled out food questionnaires and underwent repeated neurological testing for an average of 4.5 years.

It found participants whose diets most closely followed the MIND recommendations had brains that functioned as if they were 7.5 years younger, and it lowered their risk of developing Alzheimer’s disease by as much as 53 percent. And even those who didn’t stick to the diet perfectly but followed it moderately well reduced their risk of Alzheimer’s by 35 percent.

The MIND Menu
The MIND diet has 15 dietary components. The emphasis is on eating from 10 brain-healthy food groups, and limiting foods from five unhealthy groups. Here’s a rundown of the healthy foods you should work into your diet:
* Green leafy vegetables (like spinach and salad greens): Eat at least one serving per day.
* Other vegetables: At least one other vegetable a day.
* Whole grains: Three or more servings a day.
* Nuts: Five one-ounce servings a week.
* Beans: At least three servings a week.
* Berries: Two or more servings a week.
* Fish: Once a week.
* Poultry (not fried): Two times a week.
* Olive oil: Use it as your primary cooking oil.
* Wine: One glass a day.

And the five unhealthy food groups you should limit include:
* Red meat: Eat fewer than four servings a week.
* Butter and margarine: Less than a tablespoon daily.
* Cheese: Less than one serving a week.
* Pastries and sweets: Less than five servings a week.
* Fried or fast food: Less than one serving a week.

Other Benefits
One of the best things about the MIND diet is that it’s easer to follow than most other diets and you don’t have to stick to it perfectly to gain the benefits, which makes it more likely you’ll follow it for a long time. And the longer you eat the MIND way, the lower the risk of getting Alzheimer’s disease.

Another advantage is that the MIND diet can help you lose some weight too, if you keep your portions in check and are careful about how the food is prepared.

It’s also important to understand that even though diet plays a big role, it’s only one aspect of Alzheimer’s disease. So get regular exercise, if you smoke, quit, and learn how manage your stress to lower your risk even 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.

Deciding What to Do in Retirement   

Dear Savvy Senior,
I just turned 62 and am financially prepared for retirement, but I’m less certain about how to spend my time after leaving work. Can you recommend some resources or tools that can help me with this?
Feeling Lost

Dear Lost,
This is a great question! Many people, when asked what they want to do when they retire, will say they want a mix of travel, play and meaningful work. Specifics, however, tend to be few and far between. But planning how to fill your time in retirement is just as important as the financial planning aspect. Here are some resources that can help.

Online Tools
A good starting point to figuring out what you want to do in retirement is at LifeReimagined.aarp.org. This is an AARP website (you don’t have to be a member to use it) that can help you rediscover what truly matters to you and focus on what you really want to do. It offers a variety of online exercises and programs that will hopefully spark some ideas and give you inspiration.

Encore.org is another good resource that helps people who are seeking work that matters in the second half of life. Click on “Resources” on the menu bar and download their free Encore Guide, and consider purchasing a copy of their “Encore Career Handbook” (available at Amazon.com or BN.com for $10.50) by Marci Alboher, which is excellent.

Also check out the free E-book called “The Age for Change,” which can help answer the question: “What now?” You can download this at ComingOfAge.org.

And, if you’ve never taken a personality test before, this too can be a good tool to help you figure out what type of activities or work you’d like to do. A good option for this is the Myers-Briggs Type Indicator assessment, which you can take online at MBTIcomplete.com for $50.

Personalized Guidance
If you want personalized help, you can also get one-on-one guidance from a retirement or life planning coach. Some resources that can help you here include LifePlanningForYou.com, which has a free exercise called EVOKE to help identify a path that might suit you best in later life, and provides a directory to registered life planners to help guide you.

Also see: RetirementOptions.com, which will connect you with a retirement coach who will give you an assessment to help reveal your attitudes and opinions about work, family life, relationships, leisure time and more. And the LifePlanningNetwork.org, which is a group of professionals and organizations that help people navigate the second half of life. You can also find life and retirement coaching at the International Coach Federation at CoachFederation.org.

Coaching sessions typically range from $75 to $300 or more, and usually require four to six sessions to get the most out of the process.

Other Resources
If you’re primarily interested in volunteering, finding a retirement job or even starting a business when you retire, there are lots of resources that can help here too.

For volunteering, PointsOfLight.org, VolunteerMatch.org and SeniorCorps.gov and help you search for opportunities, or even create one on your own.

To look for job ideas, sites like RetirementJobs.com, Workforce50.com and RetiredBrains.com list thousands of jobs nationwide from companies that are actively seeking older workers. FlexJobs.com can help you find good work-at-home jobs. CoolWorks.com and BackDoorJobs.com are great for locating seasonal or summer jobs in great places. Or to search for freelance opportunities in a wide variety of areas, there’s Elance.com and Guru.com.

And if you’re interested in starting a new business, the U.S. Small Business Administration offers tips, tools and free online courses to entrepreneurs that are 50 and older at SBA.gov/content/50-entrepreneurs, as does the nonprofit association Score at Score.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.

How Medicare Handles Second Medical Opinions

Dear Savvy Senior,
Does Medicare cover second medical opinions? The doctor I currently see thinks I need back surgery, but I would like to get some other treatment options before I proceed. What can you tell me?
Searching Senior

Dear Searching,
Getting a second medical opinion from another doctor is a smart idea that may offer you a fresh perspective and additional options for treating your back condition so you can make a more informed decision. Or, if the second doctor agrees with your current one, it can give you some reassurance.

Yes, Medicare does pay for second opinions if your current doctor has recommended surgery, or some other major diagnostic or therapeutic procedure.

If you’re enrolled in original Medicare, 80 percent of the costs for second medical opinions are covered under Part B (you or your Medicare supplemental policy are responsible for the other 20 percent), and you don’t need an order or referral from your doctor to get one. Medicare will even pay 80 percent for a third opinion, if the first two differ.

Most Medicare Advantage plans cover second opinions too, but you may need to follow certain steps to get it paid for. For example, some plans will only help pay for a second opinion if you have a referral from your primary care doctor, and/or they may require that you can only use a doctor in their network. If you have a Medicare Advantage plan, you’ll need to call it to find out their rules.

Finding Another Doctor
To find another doctor for a second opinion you can either ask your current doctor for a name or two, or you can ask another doctor you trust for a referral, or you can find one on your own.

Whatever route you choose, it’s best to go with a doctor that’s affiliated with a different practice or hospital than your original doctor. Hospitals and practices can be set in their ways when it comes to treatments and are likely to offer similar advice.

If you choose to find one on your own, use the Physician Compare tool at Medicare.gov/physiciancompare. This will let you find doctors by name, medical specialty or by geographic location that accept original Medicare. You can also get this information by calling Medicare at 800-633-4227. Or, if you’re enrolled in a Medicare Advantage plan, call or visit your plan’s website for a list of candidates.

After you’ve got a few doctors names, there are a number of free online resources to help you research them like HealthGrades.com and Vitals.com. Or, consider AngiesList.com (888-888-5478), which is a membership service that currently offers doctors ratings and reviews from other members in your area for $3.50 for one month, or $11.32 for the year, but will be offering free reviews this summer.

After you find another doctor, before you get a second opinion you’ll need to have your current doctor’s office send your medical records ahead to the second doctor, or you may have to pick them up and deliver them yourself. That way, you won’t have to repeat the tests you already had. But, if the second doctor wants you to have additional tests performed as a result of your visit, Medicare will help pay for these tests too.

For more information, see the Medicare publication “Getting a Second Opinion Before Surgery” at Medicare.gov/pubs/pdf/02173.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.

May 2016

 

Savvy Senior – May Columns
1. How to Replace Vital Documents that are Lost or Stolen
2. Simplified Tablets Designed for Tech-Challenged Seniors
3. How to Pick a Medicare Advantage Plan
4. Simple Steps to Protect Yourself from Melanoma Skin Cancer

How to Replace Vital Documents that are Lost or Stolen

Dear Savvy Senior,
Can you tell me how to go about replacing important lost documents?  My wife and I recently downsized to a retirement community, and somewhere in the move we lost our Social Security and Medicare cards, birth certificates, marriage license and passports.
Worried Ron

Dear Ron,
Replacing important documents that are lost, stolen or damaged is pretty easy if you know where to turn. Here are the replacement resources for each document you mentioned, along with some tips to protect you from identity theft, which can happen if your documents end up in the wrong hands.

Birth certificate: If you were born in the United States, contact the vital records office in the state where you were born (see cdc.gov/nchs/w2w.htm for contact information). This office will give you specific instructions on what you need to do to order a certified copy and what it will cost you. Birth certificate fees range between $9 and $30.

Social Security card: You can replace a lost or stolen Social Security card for free, and if you live in the District of Columbia, Michigan, Nebraska, Washington or Wisconsin, you can do it online at ssa.gov/ssnumber.

If, however, you live outside these areas, you’ll need to fill out Form SS-5 (see ssa.gov/forms/ss-5.pdf to print a copy) and take it in or mail it to your nearby Social Security office, along with your U.S. driver’s license, or a state-issued non-driver ID card or a U.S. passport (photocopies are not accepted). Any documents you mail in will be returned to you. To find the Social Security office that serves your area, call 800-772-1213 or see ssa.gov/locator.

You also need to be aware that losing your Social Security card puts you at risk for identity theft. If you find that someone uses your Social Security number to obtain credit, loans, telephone accounts, or other goods and services, report it immediately to the Federal Trade Commission at IdentityTheft.gov (or 877-438-4338). This site will also give you specific steps you’ll need to take to handle this problem.

Medicare card: To replace your Medicare card for free, just call Social Security 800-772-1213 or contact your local Social Security office. You can also request one online at ssa.gov/myaccount. Your card will arrive in the mail in about 30 days.

By losing your Medicare card, you also need to watch out for Medicare fraud. So check your Medicare Summary Notice for services you did not receive and, if you spot any, call the Inspector General’s fraud hotline at 800-447-8477 to report them.

Marriage certificate: Contact your state’s vital records office to order a copy (see cdc.gov/nchs/w2w.htm). You’ll need to provide your full names for you and your spouse, the date of your wedding, and the city or town where the wedding was performed. Fees range from $10 to $30.

Note: Divorce certificates can also be ordered from your state’s vital records office (fees range from $5 to $30), and divorce decree documents can be obtained from the county clerk’s office for the city or county in which the divorce was granted.

Passport: A lost passport also puts you at risk for identity theft, so you need to report this as soon as possible to the U.S. State Department. Go to travel.state.gov/content/passports/en/passports/lost-stolen.html and fill out Form DS-64. You’ll receive an e-mail acknowledging that your report was received. Within a couple of days, you’ll receive another e-mail (or letter, if you request that option) confirming that your passport has been entered into the Consular Lost or Stolen Database.

You can apply for a replacement passport at a Passport Application Acceptance Facility. Many post offices, public libraries and local government offices serve as such facilities. You can search for the nearest authorized facility at iafdb.travel.state.gov. The fee for a replacement passport is $135.

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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Simplified Tablets Designed for Tech-Challenged Seniors

Dear Savvy Senior,
I’m interested in getting my 78-year-old mother a tablet for video calls and email but want to get one that’s super simple to use. What can you recommend?
Shopping Around

Dear Shopping,
There are several different ways you can go about getting your mom a simplified tablet that’s easy for her to use. Depending on how much help she needs and how much you’re willing to spend, here are some different options to consider.

Simplify a Tablet
If you or your mom already has a tablet, but it’s too difficult for her to use, you can install a free senior-friendly software application on it like Oscar Senior (OscarSenior.com), which works on Apple iPads and Android tablets.

This app will change the appearance and performance of your tablet into a simplified device with big understandable icons to only commonly used features (video calls, photos, instant messages, Internet, news, weather, reminders, contacts, etc.) for easy navigation, with no clutter. It even offers remote access capabilities so you can gain access to your mom’s tablet from your smartphone, so you can see what she sees, and help her if she gets stuck.

Limited Tech Skills
If you’re interested in purchasing your mom a new tablet that’s specifically designed for seniors, you have options here too, depending on how simple it needs to be.

For seniors with some, but limited, computer/tablet skills, there’s AARP’s RealPad, which is an Android Intel tablet with a 7.85-inch touchscreen that provides a simplified home page with large text icons to frequently used functions. It also comes with 24/7 phone support, and a “Real QuickFix” tool that connects users to technology support agents over the Internet who can access the tablet and fix problems. Available at AARPrealpad.org for only $60, AARP recently announced that the RealPad will be discontinued when inventory sells out in a few months, but they will continue offering customer/technical support throughout the life of the product.

No Tech Skills
If your mother is completely unfamiliar with technology, two simpler options are the grandPad and Claris Companion.

GrandPad is a 7-inch touchscreen Android tablet that is designed for seniors, ages 75 and older. It comes with a stylus, charging stand and Verizon 4G LTE built-in so it works anywhere within the Verizon network – home Wi-Fi is not necessary.

This tablet provides a simplified menu of big colorful icons and large text, to only essential features, giving your mom clutter-free, one-touch access to make phone calls and video calls, send voice emails, view photos and videos, listen to personalized music, check the weather, play games and more. But, to simplify usage and avoid confusion, it does not offer Web browsing.

GrandPad also has a “Help” button that offers 24/7 phone/tablet remote assistance to help your mom with any facet of her tablet, and it provides damage and theft insurance so if your mom breaks or loses her tablet it will be replaced at no additional cost. Available at grandPad.net or call 800-704-9412, a grandPad leases for $60 per month, or $53/month if you pay one year in advance.

Another good option to check out is the Claris Companion (ClarisCompanion.com, 866-284-4939), which offers Wi-Fi and 4G tablets that costs $549 and $649 respectively, plus a $29 and $49 monthly subscription fee.

These tablets are designed specifically for elderly seniors living at home so their family can connect with them socially via video calls, email, text messages and photos. It also gives caregivers the ability to receive alerts and monitor compliance with medications, treatments, and important appointments.

Claris Companions are 10-inch Android tablets that have big buttons and text to only essential functions. They come in a thick bamboo frame, with a charging stand that prop them up, and can be customized to fit your mom’s needs and abilities. Claris also offers a lower cost tablet option for $349 and an Android app for $29.

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 Pick a Medicare Advantage Plan

Dear Savvy Senior,
I’m approaching 65 and am interested in a Medicare Advantage plan to cover my health care and medications. What tips can you provide to help me pick a plan?
Medicare Shopper

Dear Shopper,
Medicare Advantage plans have become increasingly popular among retirees over the past 10 years, as more than 30 percent of Medicare participants are now enrolled in an Advantage plan. Here are some tips and tools to help you pick a plan that fits your needs.

First, let’s start with a quick review. Medicare Advantage plans (also known as Medicare Part C) are government approved health plans sold by private insurance companies that you can choose in place of original Medicare. The vast majority of Advantage plans are managed-care policies such as HMOs or PPOs that require you to get your care within a network of doctors.

If you join an Advantage plan, the plan will provide all of your Part A (hospital insurance) and Part B (medical insurance) coverage. Some plans even offer extra benefits like vision, dental and hearing, and most plans include Part D prescription drug coverage too.

You also need to know that the monthly premiums for many Advantage plans are cheaper than if you got original Medicare, plus a separate Part D drug plan and a Medigap policy, but their deductibles and co-pays are usually higher. That makes these plans better suited for healthier retirees.

How to Pick

To help you pick a plan, a good first step is to call the office managers of the doctors you use and find out which Advantage plans they accept, and which ones they recommend. Then go to the Medicare Plan Finder tool at Medicare.gov/find-a-plan and type in your ZIP code or your personal information to compare health plans with drug coverage in your area.

This tool also provides a five-star rating system that evaluates each plan based on past customer satisfaction and quality of care the plan delivers. When comparing, here are some key points to consider:

Total costs: Look at the plan’s entire pricing package, not just the premiums and deductibles. Compare the maximum out-of-pocket costs plus the copays and coinsurance charged for doctor office visits, hospital stays, visits to specialists, prescription drugs and other medical services. This is important because if you choose an Advantage plan, you’re not allowed to purchase a Medigap policy, which means you’ll be responsible for paying these expenses out of your own pocket.

Drug coverage: Check the plan’s formulary – the list of prescription drugs covered – to be sure all the medications you take are covered without excessive co-pays or requirements that you try less expensive drugs first.

Dental, vision and hearing: Some Advantage plans come with dental, vision and hearing benefits, but are often limited. Get the details on what exactly is covered.

Coverage while traveling: Most Advantage plans limit you to using in-network doctors only within a service area or geographic region, so find out what’s covered if you need medical care when you’re away from home.

Out-of-network coverage: Check to see what’s covered if you want to see a specialist in a hospital that is not in a plan’s network. You can get a list of doctors and hospitals that take part in a plan on the plan’s website.

Retiree benefits: If you have employer-based retiree health coverage, be sure you speak with the benefits manager, because signing up for Medicare Advantage may void your coverage.

How to Enroll
Once you’ve selected a plan you can enroll either on the Medicare.gov website, over the phone at 1-800-MEDICARE, directly with your chosen plan or through an insurance broker.

If you need some help choosing a plan contact your State Health Insurance Assistance Program (SHIP) at Shiptacenter.org. Also see the HealthMetrix Research Cost Share Report at MedicareNewsWatch.com that lists the best Advantage plans based on health status.

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

Dear Savvy Senior,
Does skin cancer run in families? My 63-year-old brother died of melanoma last year, and I’m wondering about my risks of getting this. What can you tell me?
Younger Sibling

Dear Sibling,
While long-term sun exposure and sunburns are the biggest risk factors for melanoma – the deadliest form of skin cancer – having a sibling or parent with melanoma does indeed increase your risk of getting it two to three times.

Each year, about 75,000 Americans are diagnosed with melanoma, and around 10,000 people will die from it. While anyone can get it, those most often diagnosed are Caucasians, age 50 and older. And those with the highest risk are people with red or blond hair, blue or green eyes, fair skin, freckles, moles, a family history of skin cancer and those who had blistering sunburns in their youth.

Skin Exams
The best way you can guard against melanoma and other skin cancers (basal and squamous cell carcinomas) is to protect yourself from the sun, and if you’re over age 50, get a full-body skin exam done by a dermatologist every year, especially if you’re high risk.

Self-examinations done every month or so is also a smart way to detect early problems. Using mirrors, check the front and backside of your entire body, including the tops and undersides of your arms and hands, between your toes and the soles of your feet, your neck, scalp and buttocks. Be on the lookout for new growths, moles that have changed, or sores that don’t heal. Follow the ABCDE rule when examining suspicious moles.
* Asymmetry: One half of a mole doesn’t match the other.
* Border: The border is blurred or ragged.
* Color: The mole has uneven colors, often shades of brown, tan or black, with patches of pink, red, white or blue.
* Diameter: The lesion is new or at least a quarter-inch in diameter.
* Evolving: The mole is changing in size, shape or color.

For more self-examination tips and actual pictures of what to look for, see SkinCancer.org or Melanoma.org.

In the spring and summer, there are a variety of places that offer free skin cancer screenings. Check with the American Academy of Dermatology (888-462-3376, aad.org/public/spot-skin-cancer), which offers screenings done by hundreds of volunteer dermatologists across the U.S., and the American Society for Dermatologic Surgery (asds.net/skincancerscreening.aspx).

Sun Protection
Even though you can’t change your skin or family history, there are some proven strategies that can help you protect yourself.

For starters, avoid tanning beds, and when you go outside, slather on broad-spectrum SPF 30, water-resistant sunscreen on both sunny and cloudy days. If you don’t like the rub-on lotions, try the continuous spray-on sunscreens which are easier to apply and re-apply and less messy. Also, seek the shade when rays are most intense – between 10 a.m. and 2 p.m.

You can also protect your skin by wearing a wide-brimmed hat, and long sleeves and pants when possible. The best clothing options are tightly-woven fabric that help prevent the sun’s rays from reaching your skin, or you can wash-in an invisible shield sun protection into your cloths with SunGuard laundry additive (see sunguardsunprotection.com). You can even buy a variety of lightweight clothing and hats that offer maximum UV protection in their fabric. Coolibar.com and SunPrecautions.com are two sites that offer these products.

Treatments

If melanoma is caught and treated early, it’s nearly 100 percent curable. But if it’s not, the cancer can advance and spread to other parts of the body, where it becomes hard to treat and can be fatal. Standard treatment for melanoma is surgical removal. In advanced cases however, chemotherapy or radiation may also be used, along with a variety of new drug treatments.

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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April 2016

Savvy Senior – April Columns

  1. Booster Shots Recommended for Seniors
    2. Auto Insurance Discounts for Older Drivers
    3. When Does it Pay to Take Social Security Early?
    4. How to Downsize Your Stuff for a Move
    5. Choosing an Appropriate Walking Cane
    Booster Shots Recommended for Seniors

Dear Savvy Senior,
I just turned 65 and would like to find out what types of vaccinations are recommended to Medicare beneficiaries, and how they are covered.
Health Conscious

Dear Conscious,
Most people think that vaccinations are just for kids, but adults, especially seniors who tend to have weaker immune systems, need their shots too. Here’s a rundown of what vaccines the Centers for Disease Control and Prevention (CDC) recommend for seniors 65 and older, and how they’re covered by Medicare.

Flu (Influenza): While you probably already know that flu shots are recommended every fall to all seniors, you may not know that those over 65 also have the option of getting a high-dose flu vaccine instead of a regular flu shot. This vaccine – known as the Fluzone High-Dose – has four times the amount of antigen as a regular flu shot does, which creates a stronger immune response for better protection. All annual flu shots are covered under Medicare Part B.

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

Pneumococcal: This vaccine protects against pneumonia, which kills about 50,000 Americans each year. It’s now recommended that all seniors, 65 or older, get two separate vaccines – Prevnar 13 and Pneumovax 23 – at different times. Medicare Part B covers both shots if they are taken at least 11 months apart.

Shingles (zoster): Caused by the same virus that causes chicken pox, shingles is a painful, blistering skin rash that affects more than 1 million Americans each year. All people over age 60 should get the Zostavax vaccine, even if they’ve had shingles before. All Medicare Part D prescription drug plans cover this one-time vaccination, but coverage amounts and reimbursement rules vary depending on where the shot is given. Check your plan.

Varicella (chickenpox): If you’ve never had the chicken pox, this two-dose vaccine (called Varivax) is recommended to adults, and is also covered by Medicare Part D plans.

Hepatitis A: This is a two-dose series of shots recommended to adults that have chronic liver disease, a clotting-factor disorder, have same-sex male partners, illicit injectable drug use, or who have close contact with a hepatitis A-infected individual or who travel to areas with a high incidence of hepatitis A. These shots are covered by Medicare Part D drug plans.

Hepatitis B: This three-dose series is recommended to adults who are on dialysis, have renal disease or liver disease, are sexually active with more than one partner, have a sexually transmitted disease or HIV. These vaccinations are covered under Medicare Part B.

Meningococcal: Adults 56 and older, who have had their spleen removed, have certain blood deficiencies or plan to travel to parts of the world where meningitis is common, should receive the meningococcal polysaccharide vaccine. This is covered by Medicare Part D.

To help you get a handle on which vaccines are appropriate for you, take the CDC’s What Vaccines Do You Need? quiz at www2.cdc.gov/nip/adultimmsched. Also, talk to your doctor during your next visit about what vaccinations you should get.

If you can’t remember which vaccines you’ve already had, check with your past doctors to see if they have any records, or contact your state’s health department. Some agencies have vaccination registries (see vaccineinformation.org/state-immunization-programs) that may help you.

If you can’t locate your records, your doctor can give you blood tests to see if you’re immune to certain vaccine-preventable diseases. Or, they may just give you the shot. It’s safe to repeat vaccines, according to the CDC.

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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Auto Insurance Discounts for Older Drivers

Dear Savvy Senior,
I’ve read that many car insurance companies offer a variety of discounts to older drivers when they retire or reach a certain age. What can you tell me about this?
Discount Seeker

Dear Seeker,
Most auto insurance companies offer policyholders a wide variety of discounts, many of which can benefit retirees. Auto insurers love older drivers because they’re experienced behind the wheel and they drive less than younger age groups, which makes them a lower risk for accidents and a safer bet for insurance companies.

While discounts will vary by insurer, many of these benefits can reduce your overall premium by 15 to 20 percent or more, and you are usually allowed to combine discounts to increase your savings, though total discounts are often capped at around 25 percent.

To find out what discounts may be available to you, contact your auto insurer and inquire about these benefits, and any others that may benefit you.

Age discount:
Many auto insurance companies offer a general “senior” discount that will reduce your premium just because you’ve reached a specific age. The actual name and amount of the discount will vary by insurer.

Allstate, for example, provides a “senior adult discount” of up to 10 percent to drivers who are at least 55 years old and aren’t actively looking for full-time work. And Liberty Mutual offers a “newly retired discount” to drivers who reach that employment milestone, regardless of age.

Low mileage discount: Most insurers offer discounts to customers who drive limited miles each year, which is often beneficial to retirees who drive less because they don’t commute to work every day. The fewer miles you drive, the lower your odds of getting into an accident.

The parameters of low mileage differ by insurer, but generally about a 10 percent discount is available for driving less than 5,000 to 8,000 miles each year, although smaller discounts may also be available to seniors who drive more than this but less than 15,000.

Drivers Ed discount:
Many states require insurance companies to offer “defensive-driving” discounts to drivers who take a refresher course to brush up on their safety skills. The discounts vary usually ranging between 5 and 15 percent.

Driver safety courses are inexpensive, usually costing around $20 to $30 and can often be taken in a classroom or online. To locate a class contact your local AAA (aaa.com), which operates a Driver Improvement Course for seniors, or AARP (aarp.org/driversafety, 888-227-7669), which offers the Smart Driver Course to members and non-members.

Club member discount: Insurers offer discounts to members of clubs and associations with which they have partnered. These could include professional associations, workers’ unions, large employers or membership organizations such as AAA, the National Active and Retired Federal Employees Association, the Seniors Coalition, AARP, etc. You could even qualify for savings based on the college you attended or the fraternity or sorority you belonged to decades ago.

Safe driving discount: Many insurance providers now offer discounts based on how and when you use your car. To do this, they would place a diagnostic device in your car that transmits wireless data on how you drive (including how fast you’re going and how hard you’re braking), when you drive and how much you drive. Drivers are rewarded for safe driving, low mileage and for not driving late at night.

In addition, many insurance providers also offer discounts to drivers who do not have any violations or accidents for three or more years.

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 Does it Pay to Take Social Security Early?

Dear Savvy Senior,
I will turn 62 in a few months and am trying to decide when to start taking my Social Security retirement benefits. Almost everything I read on this topic tells me it’s better to wait until my full retirement age or beyond. Is there ever a good reason to start early?
Ready to Retire

Dear Ready,
You’re right! Most financial planners agree that waiting to take your Social Security retirement benefits is a smart financial move. Why? Because each month you defer, from your 62nd birthday to your 70th, your monthly benefits grow. That adds up to around 6 to 8 percent higher payments for every year you delay.

Yet despite the financial incentive to wait, most people (58 percent of men and 64 percent of women) claim their benefits before full retirement age, which is currently 66 for those born between 1943 and 1954.

But speeding up the clock isn’t always a bad idea. Here are some scenarios where it may make sense for you to collect early.

You need the money: If you’re retired and don’t have enough savings or a pension to cover your living expenses, you’ll probably have to start early. But, if you decide to work, be aware of the earnings test.

If you claim Social Security benefits before full retirement age (and you don’t reach 66 this year), you’ll forfeit $1 for every $2 you earn over the earnings limit of $15,720 in 2016. It usually doesn’t make sense to take benefits early if you’re working, unless your income is below the earnings limit.

You have poor health: Having a serious medical problem that is likely to shorten your life is another reason to start your benefits sooner rather than later.

Consider the “break even point” – the age you need to reach to come out ahead by waiting to claim Social Security – is 78 for someone who claims at 62 versus waiting to 66. If you don’t anticipate making it to 78, go ahead and claim early.

However, if you are married or have other dependents at home that depend on your benefit, you may want to hold off because starting early will reduce their survivor’s benefits.

You’re a lower-earning spouse: If you’re married and your lifetime earnings are much lower than your spouse’s, you could take your benefit early but your higher-earning spouse should delay. This lets you increase your household income now, while the higher-earning spouse’s benefit grows, therefore increasing the survivor benefit.

This strategy is best suited when a lower-earning wife is three to six years younger than her husband and her earnings are 30 to 40 percent of his. She should claim at 62 and he should claim at full retirement age, or better yet wait to age 69 or 70. Because the husband is likely to die earlier, the wife’s reduced benefit will be temporary and she will then qualify for the higher survivor benefit.

You’re skeptical of Social Security: Many people take their retirement benefits early because they fear Social Security will go bankrupt, but this not a good reason to start collecting early.

While it is true that the Social Security trust fund will become insolvent around 2033 – 17 years from now – if no changes are made, that doesn’t mean there will be no more money for benefits. It means that the fund is no longer taking in enough money to cover all promised benefits. Thus payment checks are likely to end up shrinking by about 25 percent.

But, if the thought of losing out on your benefits keeps you up at night, then it may be better to start claiming early instead of holding off for more later.

To see how much your benefits will be affected by your claiming age, use the Consumer Financial Protection Bureau’s new Planning for Retirement tool at consumerfinance.gov/retirement/before-you-claim.

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 Downsize Your Stuff for a Move

Dear Savvy Senior,
Can you offer any helpful tips for downsizing? My husband and I are interested in moving to a condo downtown when we retire, but we need to get rid of a lot of our personal possessions before we can move. We’ve lived in the same house for almost 35 years and have accumulated tons of stuff.
Feeling Overwhelmed

Dear Feeling,
The process of weeding through a house full of stuff and parting with old possessions can be difficult and overwhelming for many people.

A good place to start the downsizing process is to give your unused possessions away to your kids or grandkids. You can give up to $14,000 per person per year before you’re required to file a federal gift tax return, using IRS Form 709. Beyond that, here are a few other tips and services that may help you.

Sell It
Selling your stuff is one way you can downsize and pad your pocketbook at the same time. Some other popular selling options are consignment shops, garage sales and estate sales.

Consignment shops are good for selling old clothing, household furnishings and decorative items. You typically get half of the final sale price. Garage sales are another option, or for large-scale downsizing you could hire an estate sale company to come in and sell your items. Some companies will even pick up your stuff and sell it at their own location – they typically take about 40 percent of the profits.

Or, if you’re willing, online selling at sites like Craigslist, eBay and Amazon are another way to make top dollar for your stuff. Craigslist.org is a huge classified ads site that lets you sell your stuff for free. While eBay.com and Amazon.com takes a cut of your sale – roughly 10 to 15 percent. Or, if you don’t want to do the selling yourself, eBay offers a valet service (sellforme.ebay.com) to do it for you, for 20 to 40 percent of the selling price.

Donate It

If you itemize on your tax returns, donating your belongings is another way to downsize and get a tax deduction. Goodwill (goodwill.org, 800-741-0186) and the Salvation Army (satruck.org, 800-728-7825) are two big charitable organizations that will come to your house and pick up a variety of household items, furnishings and clothing.

If your deduction exceeds $500, you’ll need to file Form 8283, “Noncash Charitable Contributions” (irs.gov/pub/irs-pdf/f8283.pdf). You’ll also need a receipt from the organization for every batch of items you donate, and will need to create an itemized list of the items you donated. To calculate fair market value for your stuff, use the Salvation Army’s donation guide at satruck.org/home/donationvalueguide, or the free program “It’s Deductible” at turbotax.intuit.com/personal-taxes/itsdeductible.

Trash It
If you have a lot of junk you want to get rid of, contact your municipal trash service to see if they provide bulk curbside pickup services. Or, depending on where you live, you could hire a company like 1-800-Got-Junk (1800gotjunk.com, 800-468-5865) or Junk-King (junk-king.com, 888-888-5865) to come in and haul it off for a moderate fee.

Another good disposal option is Bagster (thebagster.com, 877-789-2247) by Waste Management. This is a dumpster bag that you purchase for around $30, fill it to a limit of 3,300 pounds and schedule a pickup, which costs an average of $140 but varies by area.

Hire Someone to Help
You can also hire a professional senior move manager (nasmm.org, 877-606-2766) to do the entire job for you. These are organizers who will sort through your stuff and arrange for the disposal through an estate sale, donations or consignment. Or, you can hire a professional organizer through the National Association of Professional Organizers at napo.net. Organizers may charge $30 to $80 per hour or by the project.

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 Appropriate Walking Cane

Dear Savvy Senior,
I have severe arthritis in my knee and could use a walking cane to help me get around. Is there anything I should know about canes before I buy one?
Limping Linda

Dear Linda,
When it comes to choosing a cane for balance and support most people don’t give it much thought, but they should. Walking canes come in hundreds of different styles, shapes and sizes today, so you need to take into account your needs and preferences to ensure you choose one that’s appropriate for you. Here are some tips that can help.

Types of Canes
The first thing you need to consider is how much support you need. That will help you determine the kind of cane you choose. The three basic types of canes you’ll have to choose from include:

1. Straight canes: These are basic, single point canes that typically incorporate a rounded “crook” handle or “L-shaped” ergonomic handle. Usually made of lightweight aluminum or wood, most of the aluminum models are adjustable in height and some even fold up.

2. Offset-handle canes: These also are single point straight canes, but come with a swan neck curve in the upper part of the shaft that puts the user’s weight directly over the cane tip for added stability. These canes are typically aluminum, adjustable-height and come with a flat, soft grip handle that’s easy on the hands.

Both straight canes and offset-handle canes are best suited for people who have a slight walking impairment.

3. Quad canes: Also called broad based canes, these work best for people who need maximum weight bearing and support. Quad canes comes with four separate tips (some have three tips) at the base, they usually have an offset flat handle, and can remain standing when you let go of it which is very convenient.

Fitting the Cane
Once you decide on the type of cane, you need to make sure it fits. Stand up with your arms hanging straight down at your side. The top of the cane should line up with the crease in your wrist, so your arm is slightly bent at the elbow when you grip the cane.

The cane should also have a rubber tip at the bottom to prevent slipping. A worn or torn rubber tip is dangerous, so check the tip frequently to ensure it’s in good condition and replace it when necessary. Rubber tips come in different sizes depending on the shaft diameter, and can usually be purchased in multipacks at your local pharmacy.

The grip is also very important, so choose one that’s ergonomically designed, or one that has a molded rubber or foam grip that’s comfortable to hold on to.

And if you travel much, consider getting a folding cane that can be packed or stored away easily.

How to Use
When using a cane, it should always be held in the hand opposite of the leg that needs support. For example, if your knee pain is on your left side, you should use the cane in your right hand. The cane should then move forward as you step forward with the bad leg.

If you have to go up stairs, you should lead with the good leg. And when you go down stairs, you should put your cane on the step first and then step down with your bad leg.

The Mayo Clinic offers a slide show at mayoclinic.com/health/canes/HA00064 that will show you how to choose and use a cane. It’s also a smart idea to work with a physical therapist.

Where to Buy

You can buy canes at drugstores, discount retailers, medical supply stores and online, usually between $10 and $50. You’ll also be happy to know that Medicare covers canes with a written prescription from a physician.

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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March 2016

Savvy Senior – March Columns

  1. How to Avoid Medicare Mistakes When You’re Still Working
    2. How Retirees can Save on Prescription Eyeglasses
    3. Elder Mediation Can Help Families Resolve Caregiving Conflicts
    4. The Consequences of Dying Without a Will

    How to Avoid Medicare Mistakes When You’re Still WorkingDear Savvy Senior,
    Should I enroll in Medicare at age 65 if I’m still working and have coverage through my employer?
    Almost 65
    Dear Almost 65,
    The rules for enrolling in Medicare can be very confusing with all the different choices available today. But when you postpone retirement past age 65, as many people are doing, it becomes even more complicated.First, let’s review the basics. Remember that original Medicare has two parts: Part A, which provides hospital coverage and is free for most people. And Part B, which covers doctor’s bills, lab tests and outpatient care. Part B also has a monthly premium of $104.90 in 2016 (though it’s higher for individuals earning $85,000 or more a year).If you are receiving Social Security, you will be enrolled automatically in parts A and B when you turn 65. If you aren’t yet receiving Social Security, you will have to apply, which you can do online at SSA.gov/medicare, over the phone at 800-772-1213 or through your local Social Security office.If you plan to continue working past the age of 65 and have health insurance from your job, your first step is to ask your benefits manager or human resources department how your employer insurance works with Medicare. In most cases, you should at least take Medicare Part A because it’s free. But to decide whether to take Part B or not will depend on the size of your employer.Small employer: If your current employer (or spouse’s employer if it’s providing your coverage) has fewer than 20 employees, Medicare will be your primary insurer and you should enroll in Medicare Part B during your initial enrollment period. This is a seven-month period that includes the three months before, the month of, and the three months after your 65th birthday.If you miss the seven-month sign-up window, you’ll have to wait until the next general enrollment period, which runs from Jan. 1 to March 31 with benefits beginning the following July 1. You’ll also incur a 10 percent penalty for each year you wait beyond your initial enrollment period, which will be tacked on to your monthly Part B premium.Large employer: If your employer has 20 or more employees, your employer’s group health plan will be your primary insurer as long as you (or your spouse if the coverage is from his/her employer) remain an active employee. If this is the case, you don’t need to enroll in Part B when you turn 65 if you’re satisfied with the coverage you are getting through your job. But if you do decide to enroll in Medicare, it will supplement your employer insurance by paying secondary on all of your claims.Once your employment (or group health coverage) ends, you will then have eight months to sign up for Part B without a penalty. This is known as the Special Enrollment Period.Drug coverage: You also need to verify your prescription drug coverage. Call your benefits manager or insurance company to find out if your employer’s prescription drug coverage is considered “creditable.” (Creditable prescription drug coverage is one that is considered to be as good as or better than the Medicare prescription drug benefit.) If it is, you don’t need to enroll in a Medicare Part D prescription drug plan. If it isn’t, you should purchase a plan (see medicare.gov/find-a-plan) during your initial enrollment period or you’ll incur a premium penalty (1 percent of the average national premium for every month you don’t have coverage) if you enroll later.For additional help, visit Medicare.gov or contact your State Health Insurance Assistance Program (SHIP) at Shiptacenter.org. The Medicare Rights Center also offers a free helpline 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 Retirees can Save on Prescription EyeglassesDear Savvy Senior,
    What tips can you recommend for finding affordable prescription eyeglasses? I used to have vision insurance through my work, but lost it when I turned 65, retired, and signed up for Medicare.
    Looking For Eyeglasses
    Dear Looking,
    Prescription eyeglasses today aren’t cheap. You can easily spend $200 for a basic pair, but if you want designer frames or need bifocal or progressive lenses the price can more than double. Here are a few different options that can help you save.Medicare/Insurance Coverage
    If you are a Medicare beneficiary, you already know that original Medicare (Part A and B) and Medigap supplemental policies do not cover routine eye exams or eyeglasses (unless you’ve just had cataract surgery), but there are some Medicare Advantage (Part C) plans that do.Many of these plans, which are sold through private insurance companies, cover vision as well as dental, hearing and prescription drugs, in addition to all of your hospital and medical insurance. To locate Advantage plans in your area that provides vision coverage, visit Medicare.gov/find-a-plan or call 800-633-4227. But before enrolling in a plan, check the benefit details to ensure the plan’s vision coverage includes routine eye exams, eyeglass frames and lenses.You can switch from original Medicare to a Medicare Advantage plan each year during the open enrollment period, which is between Oct. 15 and Dec. 7.If, however, you don’t want a Medicare Advantage plan, you can still get coverage by purchasing an inexpensive vision insurance policy – see eHealthInsurance.com. Policy costs vary depending on where you live, but they usually start at around $6 to $9 per month for an individual. Before signing up, make sure your savings potential is worth the cost of the premiums and copays.Discount Stores
    Purchasing eyeglasses from discount retailers is another way to save. Costco is one of the best discount stores for good eyewear and low prices. Eyeglasses cost an average of around $150, but to shop there you have to pay a $55 annual membership fee. Some other good retail options for low prices include For Eyes Optical, BJ’s Optical, Sam’s Club and Walmart.You also need to find out if you are eligible for any discounts. Many retailers provide discounts to membership groups like AARP and AAA. AARP members, for example, can get 30 percent off a pair of prescription eyeglasses as well as discounts on eye exams at any LensCrafters, most participating Pearle Vision, Sears Optical, Target Optical, JCPenney Optical and thousands of private optometrist offices.Look Online
    Buying eyeglasses online can also offer huge savings. Some online stores like ZenniOptical.com, Goggles4u.com and EyeBuyDirect.com sell prescription eyeglasses for as little as $7 plus shipping. These sites let you upload a photo of your face, so you can see what you’d look like in different frames.Or, for a fancier choice of frames see WarbyParker.com, which offers single-vision glasses for $95. They even offer a free program where you can request up to five pairs to try on at home for five days.To purchase glasses online, you’ll need your eyeglass prescription from a local eye doctor, plus your pupillary distance number, which is the distance, measured in millimeters, between the centers of your pupils in each eye.Low-Income Assistance
    If your income is low, depending on where you live, there may be some local clinics that provide free or discounted eye exams and eyeglasses. Put in a call to your local Lions Club to see what’s available in your area. See directory.lionsclubs.org for contact information.You may also be able to get free eyeglasses through New Eyes (new-eyes.org, 973-376-4903), a nonprofit organization that provides free eyeglasses through a voucher program to people in financial need.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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    Elder Mediation Can Help Families Resolve Caregiving Conflicts Dear Savvy Senior,
    Are there any services that you know of that help families resolve caregiving conflicts? My mother – who just turned 82 – recently had a stroke, and to make matters worse, my two siblings and I have been perpetually arguing about how to handle her caregiving needs and finances.
    Bickering Siblings
    Dear Bickering,
    It’s not unusual when adult children disagree with each other regarding the care of an elder parent. If your siblings are willing, a good possible solution is to hire an “elder care mediator” who can help you work through your disagreements peacefully. Here’s what you should know.Elder Mediation
    While mediators have been used for years to help divorcing couples sort out legal and financial disagreements and avoid court battles, elder care mediation is a relatively new and specialized service designed to help families resolve disputes that are related to aging parents or other elderly relatives.Family disagreements over an ill or elderly parent’s caregiving needs, living arrangements, financial decisions and medical care are some of the many issues that an elder care mediator can help with. But don’t confuse this with family or group therapy. Mediation is only about decision-making, not feelings and emotions.The job of an elder mediator is to step in as a neutral third party to help ease family tensions, listen to everyone’s concerns, hash out disagreements and misunderstandings, and help your family make decisions that are acceptable to everyone.Good mediators can also assist your family in identifying experts such as estate-planners, geriatric care managers, or health care or financial professionals who can supply important information for family decision making.Your family also needs to know that the mediation process is completely confidential and voluntary, and can take anywhere from a few hours to several meetings depending on the complexity of your issues. And if some family members live far away, a conference or video call can be used to bring everyone together.If you’re interested in hiring a private elder care mediator, you can expect to pay anywhere from $100 to more than $500 per hour depending on where you live and who you choose. Or, you may be able to get help through a nonprofit community mediation service which charges little to nothing.Finding a Mediator
    To locate an elder mediator, start by contacting your area aging agency (call 800-677-1116 to get your local number), which may be able to refer you to local resources, or search online at Mediate.com. Another good option is the National Association for Community Mediation website (nafcm.org), which can help you search for free or low-cost community-based mediation programs in your area.Unfortunately, there is currently no formal licensing or national credentialing required for elder mediators, so make sure the person you choose has extensive experience with elder issues that are similar to what your family is dealing with. Also, be sure you ask for references and check them. Most elder mediators are attorneys, social workers, counselors or other professionals who are trained in mediation and conflict resolution.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 Consequences of Dying Without a WillDear Savvy Senior,
    What will happen to my money and possessions if I die without a will?
    Getting Old
    Dear Getting Old,
    If you die without a will, what happens to your assets will be determined by the state you reside in. Every state has intestacy laws in place that parcel out property and assets to a deceased person’s closest relatives when there’s no will or trust. But these laws vary from state-to-state.A good resource to help you find out how your state works is About.com’s Wills and Estate Planning site, which provides a state-by-state breakdown of how your estate would be distributed if you die without a will. See StateIntestacyLaws.com for a direct link to this page.In the meantime, here is a general (not state specific) breakdown of what can happen to a person’s assets, depending on whom they leave behind.Married with children: When a married person with children dies without a will, all property, investments and financial accounts that are “jointly owned” automatically goes to the surviving co-owner (typically the spouse or child), without going through probate, which is the legal process that distributes a deceased person’s assets.But for all other separately owned property or individual financial accounts, the laws of most states award one-third to one-half to the surviving spouse, while the rest goes to the children.

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

    Jointly owned property, investments, financial accounts, or community property automatically goes to the surviving co-owner.

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

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

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

    One of the best is the Quicken WillMaker Plus 2016 software (available at nolo.com) that costs $55, works with Windows personal computers and is valid in every state except Louisiana. If you use a Mac, they offer an online will maker for $35.

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

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

    The National Academy of Elder Law Attorneys (naela.org) and the National Association of Estate Planners and Councils (naepc.org) are good resources that have online directories to help you find someone in your area.

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

    Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.
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Savvy Senior – February Columns
1. How to Calculate Your Retirement Number
2. Choosing a Hospice Care Program
3. 2016 Tax Filing Requirements for Retirees
4. Make Long-Term Care Coverage More Affordable

How to Calculate Your Retirement Number  

Dear Savvy Senior,
Can you help me calculate about how much my wife and I need to save for retirement? We are both in out late-fifties and want to see where we stand.
Looking Ahead

Dear Looking,
Calculating an approximate number of how much you’ll need to save for a comfortable retirement is actually pretty easy, and doesn’t take long to do. It’s a simple, three-step process that includes estimating your future living expenses, tallying up your retirement income and calculating the difference. There are even a host of online calculators that can help you with this too.

Living Expenses
The first step is the most difficult – estimating your living expenses when you retire. If you want a quick ballpark estimate, figure around 75 to 85 percent of your current gross income. That’s what most people find they need to maintain their current lifestyle in retirement.

If you want a more precise estimate, track your current living expenses on a worksheet and deduct any costs you expect to go away or decline when you retire, and add whatever new ones you anticipate.

Costs you can scratch off your list include work-related expenses like commuting or lunches out, as well as the amount you’re socking away for retirement. You may also be able to deduct your mortgage if you expect to have it paid off by retirement, and your kid’s college expenses. Your income taxes should also be less.

On the other hand, some costs will probably go up when you retire, like health care, and depending on your interests you may spend a lot more on travel, golf or other hobbies. And, if you’re going to be retired for 20 or 30 years you also need to factor in the occasional big budget items like a new roof, furnace or car.

Tally Income
Step two is to calculate your retirement income. If you and/or your wife contribute to Social Security, go tossa.gov/myaccount to get your personalized statement that estimates what your retirement benefits will be at age 62, full retirement age and when you turn 70.

In addition to Social Security, if you or your wife has a traditional pension plan from an employer, find out from the plan administrator how much you are likely to get when you retire. And, figure in any other income from other sources you expect to have, such as rental properties, part-time work, etc.

Calculate the Difference

The final step is to do the calculations. Subtract your annual living expenses from your annual retirement income. If your income alone can cover your bills, you’re all set. If not, you’ll need to tap your savings, including your 401(k) plans, IRAs, or other investments to make up the difference.

So, let’s say for example you need around $55,000 a year to meet your living expenses and pay taxes, and you and your wife expect to receive $30,000 a year from Social Security and other income. That leaves a $25,000 shortfall that you’ll need to pull from your nest egg each year ($55,000 – $30,000 = $25,000).

Then, depending on what age you want to retire, you need to multiply your shortfall by at least 25 if you want to retire at 60, 20 to retire at 65, and 17 to retire at 70 – or in this case that would equate to $625,000, $500,000 and $425,000, respectively.

Why 25, 20 and 17? Because that would allow you to pull 4 percent a year from your savings, which is a safe withdrawal strategy that in most cases will let your money last as long as you do.

If you need some help, there’s a bevy of free online retirement calculators to assist you, like the ones offered by T. Rowe Price (troweprice.com/retirement) or Financial Mentor (financialmentor.com/calculator).

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 Hospice Care Program

Dear Savvy Senior,
Can you offer any information on hospice care, how to choose a good provider, and whether Medicare covers it? My grandmother has terminal cancer and wants to die at home, if possible.
Grieving Granddaughter

Dear Grieving,
Hospice can be a wonderful option in the last months of life because it offers a variety of services, not only to those who are dying, but also to those left behind. Here’s what you should know.

What Hospice Offers
Hospice care is a unique service that provides medical care, pain management, and emotional and spiritual support to people who are in the last stages of a terminal illness – it does not speed up or slow down the process of dying. Hospice’s goal is to simply keep the patient as comfortable and pain-free as possible, with loved ones nearby until death.

The various services provided by a hospice program comes from a team of professionals that works together to accommodate all the patients’ end-of-life needs.

The team typically includes hospice doctors that will work with the primary physician and family members to draft up a care plan; nurses who dispense medication for pain control; home care aids that attend to personal needs like eating and bathing; social workers who help the patient and the family prepare for end of life; clergy members who provide spiritual counseling, if desired; and volunteers that fill a variety of niches, from sitting with the patient to helping clean and maintain their property.

Some hospices even offer massage or music therapy, and nearly all provide bereavement services for relatives and short-term inpatient respite care to give family caregivers a break.

Most hospice patients receive care in their own home. However, hospice will go wherever the patient is – hospital, nursing home or assisted living residence. Some even have their own facility to use as an option.

To receive hospice, your grandmother must get a referral from her physician stating that their life expectancy is six months or less.

It’s also important to know that home-based hospice care does not mean that a hospice nurse or volunteer is in the home 24 hours a day. Services are based on need and/or what you request. Hospice care can also be stopped at anytime if your grandmother’s health improves or if she decides to re-enter cure-oriented treatments.

How to Choose
The best time to prepare for hospice and consider your options is before it’s necessary, so you’re not making decisions during a stressful time. There are more than 5,500 hospice programs in the U.S., so depending on where you live, you may have several options from which to choose.

To locate a good hospice in your area, ask your grandmother’s doctor or the discharge planner at your local hospital for a referral, call your state hospice organization (see hospicefoundation.org/hospice-directory for contact information), or search online at sites like the National Hospice and Palliative Care Organization atnhpco.org.

When choosing, look for an established hospice that has been operating for a few years and one that is certified by Medicare. To help you select one, the American Hospice Foundation provides a list of questions to ask at 16HospiceQuestions.us.

Who Pays
Medicare covers all aspects of hospice care and services for its beneficiaries. There is no deductible for hospice services although there may be a very small co-payment – such as $5 for each prescription drug for pain and symptom control, or a 5 percent share for inpatient respite care. Medicaid also covers hospice in most states, as do most private health insurance plans.

For more information, see the “Medicare Hospice Benefits” online booklet atmedicare.gov/pubs/pdf/02154.pdf. And if you have financial questions or concerns, talk to your hospice provider. Most hospices offer financial assistance to help families in need.

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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2016 Tax Filing Requirements for Retirees

Dear Savvy Senior,
What is the IRS income tax filing requirements going to be for this tax season? Due to health problems I stopped working early last year, so I’m wondering if I need to file.
Unintended Retiree

Dear Unintended,
There are a number of factors that affect whether or not you need to file a federal income tax return this year including how much you earned last year (in 2015), and the source of that income, as well as your age and filing status.

Here’s a rundown of this tax season’s IRS filing requirements. For most people, this is pretty straightforward. If your 2015 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 age and filing status, you probably won’t have to file. But if it’s over, you will.

• Single: $10,300 ($11,850 if you’re 65 or older by Jan. 1, 2016).
• Married filing jointly: $20,600 ($21,850 if you or your spouse is 65 or older; or $23,100 if you’re both over 65).
• Married filing separately: $4,000 at any age.
• Head of household: $13,250 ($14,800 if age 65 or older).
• Qualifying widow(er) with dependent child: $16,600 ($17,850 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.

Special Requirements

There are, however, some other financial situations that will require you to file a tax return, even if your gross income falls below the IRS filing requirement. For example, if you had earnings from self-employment in 2015 of $400 or more, or if you owe any special taxes to the IRS such as alternative minimum tax or IRA tax penalties, you’ll probably need to file.

To figure 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.

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

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

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

Also check with AARP, a participant in the TCE program that provides free tax preparation at more than 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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Make Long-Term Care Coverage More Affordable

Dear Savvy Senior,
I have been thinking about getting a long-term care insurance policy, but have found the monthly premiums to be very expensive. How can I find cheaper coverage?
Getting Old    

Dear Getting Old,
Cost is usually the biggest factor that keeps most people from purchasing long-term care insurance – only around 8 million Americans currently have a policy.

Depending on your age, health, and the provisions of the policy, costs can range anywhere from $1,000 up to $5,000 a year for an individual policy that covers nursing home care, assisted living and in-home care. Fortunately, there are various cost-cutting strategies that can help you save and still get adequate coverage. Here are several to consider.

Buy young: The most basic way to get long-term care insurance at a cheaper rate is by purchasing it at a younger age. For example, a typical policy that costs a 55-year-old $1,500 a year in premiums could cost a 65-year-old $3,000. Health is another fact that can affect costs. While good health can lower your monthly payments, having a preexisting medical condition can increase your costs, or you may not be able to get insurance at all.

Sign up as a pair:  Many insurers offer 20 to 30 percent discounts on premiums if you sign-up at the same time as your spouse, partner or sibling.

Choose a shorter benefit period: Most people need long-term care for just under three years on average. So, by choosing a policy that covers you for two or three years, versus five or more years, it can cut your premiums by 20 to 40 percent.

Lengthen the time you pay: Most policies have 30 to 90-day waiting periods that require you to pay out-of-pocket for care before the policy kicks in. By choosing a longer wait period, it can lower your premiums 15 to 20 percent.

Lower the daily benefit: You can get a policy that pays out $100, $150, $200 per day or more, but the higher the benefit, the higher your premium. So consider a plan that covers two-thirds the daily cost, and pay the other third out of savings. That could cut your premiums by about one-third.

Buy lower inflation protection: Inflation coverage protects you from the rising costs of care. Five percent compounded annually has been a common practice in the industry but it’s expensive. Consider a policy that has a 3 percent CPI-adjusted inflation protection. This can save you 50 percent or more.

Get state help:
Currently, 41 states have a long-term care partnership program that can help you save too. Under these programs, if you buy a long-term care policy approved by your state Medicaid agency, you can protect an amount of assets from Medicaid equal to the benefits that your policy pays out. With this program, you can choose a shorter benefit period, which will lower your premiums. See aaltci.org/partnership to learn more.

Buy a hybrid policy: If the thought of paying expensive monthly premiums for long-term care insurance – which you may never use – is keeping you from buying a policy, consider one that combines long-term care insurance with either a life insurance policy or an annuity. Hybrid life insurance policies provide a death benefit for your heirs and a pool of money you can use for long-term care. Any funds you use for care are generally subtracted from the death benefit. While hybrid annuity policies generally allows you to purchase a deferred annuity, which can be used for long-term care or if you don’t need care, it can be redeemed for its accumulated value when it matures, or left to your heirs when you die.

To find a policy that offers the best rates, get a long-term care insurance specialist who works with a variety of companies. See aaltci.org to locate one. Also shop insurers like Northwestern Mutual and New York Life, who work only with their own agents.

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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Savvy Senior – January Columns
1.    Paying Income Tax on Social Security Benefits
2.    How to Keep Tabs On an Elderly Parent with Video Monitoring
3.    How to Find Discounts for People with Disabilities
4.    Could You Have COPD?
5.    Financial Paperwork: What to Keep, What to Toss

Paying Income Tax on Social Security Benefits

Dear Savvy Senior,
Will I have to pay federal income taxes on my Social Security benefits when I retire?
Approaching Retirement

Dear Approaching Retirement,
Whether or not you’ll be required to pay federal income tax on your Social Security benefits will depend on your income and filing status. About 35 percent of Social Security recipients have total incomes high enough to trigger federal income tax on their benefits.

To figure out if your benefits will be taxable, you’ll need to add up all of your “provisional income,” which includes wages, taxable and non-taxable interest, dividends, pensions and taxable retirement-plan distributions, self-employment, and other taxable income, plus half your annual Social Security benefits, minus certain deductions used in figuring your adjusted gross income.

How To Calculate
To help you with the calculations, get a copy of IRS Publication 915 “Social Security and Equivalent Railroad Retirement Benefits,” which provides detailed instructions and worksheets. You can download it at irs.gov/pub/irs-pdf/p915.pdf or call the IRS at 800-829-3676 and ask them to mail you a free copy.

After you do the calculations, the IRS says that if you’re single and your total income from all of the listed sources is:
• Less that $25,000 – Your Social Security will not be subject to federal income tax.
• Between $25,000 and $34,000 – Up to 50 percent of your Social Security benefits will be taxed at your regular income-tax rate.
• More than $34,000 – Up to 85 percent of your benefits will be taxed.

If you’re married and filing jointly and the total from all sources is:
• Less that $32,000 – Your Social Security won’t be taxed.
• Between $32,000 and $44,000 – Up to 50 percent of your Social Security benefits will be taxed.
• More than $44,000 – Up to 85 percent of your benefits will be taxed.

If you’re married and file a separate return, you probably will pay taxes on your benefits.

To limit potential taxes on your benefits, you’ll need to be cautious when taking distributions from retirement accounts or other sources. In addition to triggering ordinary income tax, a distribution that significantly raises your gross income can bump the proportion of your Social Security benefits subject to taxes.

How to File
If you find that part of your Social Security benefits will be taxable, you’ll need to file using Form 1040 or Form 1040A. You cannot use Form 1040EZ. You also need to know that if you do owe taxes, you’ll need to make quarterly estimated tax payments to the IRS or you can choose to have it automatically withheld from your benefits.

To have it withheld, you’ll need to complete IRS Form W-4V, Voluntary Withholding Request (irs.gov/pub/irs-pdf/fw4v.pdf), and file it with your local Social Security office. You can choose to have 7 percent, 10 percent, 15 percent or 25 percent of your total benefit payment withheld. If you subsequently decide you don’t want the taxes withheld, you can file another W-4V to stop the withholding.

State Taxation
In addition to the federal government, 13 states – Colorado, Connecticut, Kansas, Minnesota, Missouri, Montana, Nebraska, New Mexico, North Dakota, Rhode Island, Utah, Vermont and West Virginia – tax Social Security benefits to some extent too. If you live in one of these states, check with your state tax agency for details.

For questions on taxable Social Security benefits call the IRS help line at 800-829-1040, or visit an IRS Taxpayer Assistance Center (see www.irs.gov/localcontacts) where you can get face-to-face help.

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

Dear Savvy Senior,
Can you recommend some good home video monitoring devices that can help my sister and me keep an eye on our elderly mother? Over the holidays, we noticed that her health has slipped a bit, and would like to keep a closer eye on her.
Worried Daughters

Dear Worried Daughters,
There are lot’s of great video monitoring cameras that can help families keep a watchful eye on an elderly parent from afar, but make sure it’s OK with your mom first. Many seniors find this type of “I’m watching you” technology to be an invasion of privacy, while others don’t mind and even welcome the idea. With that said, here are some top monitoring devices for keeping tabs on your mom.

Video Monitoring
As the technology has improved and the costs have come down, video monitoring/surveillance cameras have become very popular for keeping an eye on your home, business, child or pet (via smartphone, tablet or computer), but they also work well for monitoring an elder loved one who lives alone.

Most home video monitoring cameras today are sleek, small and easy to set up, but do require home Wi-Fi.

Although camera capabilities will vary, the best devices all provide wide-view angles, HD quality video, night vision, built-in motion and sound detection that can notify you when something is happening, and two-way audio that let’s you talk and listen.

And, they also offer a video recording option (for an extra fee) that saves past video to a cloud, so you can rewind and review what you missed.

One of the best products available today that does all this and more is the Nest Cam (nest.com), which costs $199, but if you want their video recording option, it’s an extra $100 per year for a 10-day video history, or $300/year for 30 days.

Also check out the Piper NV (getpiper.com), which – at $279 – is more expensive than the Nest Cam but allows free Internet cloud storage. And the Simplicam (simplicam.com), which is the cheapest of the three but the video quality isn’t quite as good. They charge $150 for the camera, or $200 for the camera plus 24-hour video storage for one year.

Sensor Monitoring
If your mom is uncomfortable with video monitoring, and doesn’t want you to be able to peek in on her whenever you want, another less invasive option to consider is a “sensor” monitoring system.

These systems use small wireless sensors (not cameras) placed in key areas of your mom’s home that can detect changes in her activity patterns, and will notify you via text message, email or phone call if something out of the ordinary is happening.

A great company that offers this technology is Silver Mother (sen.se/silvermother), which provides small sensors that you attach to commonly used household objects like her pillbox, refrigerator door, TV remote, front door, etc.

So, for example, if your mom didn’t pick up her pillbox to get her medicine or didn’t open the refrigerator door to make breakfast like she usually does, or if she left the house at a peculiar time you would be notified and could check on her. You can also check up on her anytime you want online or through their mobile app. Silver Mother costs $299 for four sensors, with no ongoing monthly service fees.

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

Dear Savvy Senior,
Are there any worthwhile discounts available to people with disabilities, and if so, how can I find them? My wife – who’s 48 – has Multiple Sclerosis that now requires her to use a wheelchair.
Need to Save

Dear Need to Save,
There are actually a wide variety of discounts and services available to people with disabilities and those living with a chronic illness that can literally save you hundreds and even thousands of dollars each year. Here are some tips to help you find them.

Always Ask
The first thing to know is that most businesses that offer discounts to people with disabilities or their escorts don’t publicize them, so it’s important to always ask.

Also note that most nonprofit organizations and government agencies that provide disabled services or benefits will require proof of disability through a letter from your doctor or some other form of verification before they will accommodate you.

Search Locally
The disabled discounts available to your wife will vary depending on where you live, so a good place to start is to contact the local chapter of the nonprofit organization that specializes in your particular disease or disability – in your wife’s case that would be the National Multiple Sclerosis Society (nationalmssociety.org, 800-344-4867).

Local chapters often know where to find discounts on the medical supplies, mobility equipment and support services. Some organizations have even negotiated special discounted rates with suppliers, and a few even provide subsidized equipment directly.

To search for other disability or disease specific organizations, use any Internet search engine, any type in your disease or disability followed by organizations – for example “Arthritis Organizations” or “Hearing Loss Organizations.”

Search Online
DisabledDiscounts.com is one of the best resources for finding disabled discounts online. This is a free website that lists thousands of discounts in all 50 states. You search by state and county in 30 different categories ranging from assistive technology to federal and state tax discounts, entertainment to education and so much more.

Also visit Benefits.gov and BenefitsCheckUp.org, two great sites that will help you look for financial assistance programs your wife and you may be eligible for, and will tell you how to apply. And see Disability.gov, a site that connects people with disabilities to helpful programs and services in your area.

Types of Discounts
Here are a few examples of the different types of disabled discounts and services that are out there.

Recreation: Most movie theaters, museums, zoos, theme parks and aquariums provide reduced admission to people with disabilities or their escort. And, the National Park Service offers the “America The Beautiful Access Pass” (see nps.gov/findapark/passes.htm) to disabled residents, which provides a lifetime of free access into all national parks and federal recreational lands.

Taxes: There are numerous federal tax deductions and credits available to people with disabilities, and a number of states and counties also offer property tax deductions to disabled homeowners.

Utilities: Many utility companies, including electric, gas, phone, water and trash services offer discounts to customers who are disabled, elderly or low income.

Communication devices: 47 states have equipment distribution programs (see tedpa.org) that offer free amplified telephones to residents with hearing impairment.

Home modifications: There are a number of federal, state, local and nonprofit organizations that help pay for home accessibility improvements like wheelchair ramps, handrails and grab bars for elderly and disabled people in need.

Travel: Amtrak offers a 15 percent rail fare discount to adult passengers with a disability and up to one traveling companion.

Reading services: For those with vision or physical impairments that make it difficult for them to read, the Library of Congress (see loc.gov/nls) offers a “Talking Books” program that provides free audiobooks, magazines and audio equipment. And the National Federation of the Blind offers a free newspaper and magazine reading service at nfbnewslineonline.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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Could You Have COPD?

Dear Savvy Senior,
I have struggled with some shortness of breath for the past five years or so. I just thought I was getting older and out of shape, but a friend recently mentioned I may have COPD.  What can you tell me about this?
Breathless Bob

Dear Bob,
COPD, or chronic obstructive pulmonary disease is a serious lung disease that, over time, makes it hard to breathe. What’s more, an estimated 24 million people have COPD today, but about half of them don’t know it.

Many people mistake shortness of breath as a normal part of aging, or a result of being out of shape, but that’s not necessarily the case. COPD – a term used to describe a variety of lung diseases including emphysema and chronic bronchitis – develops slowly, so symptoms may not be obvious until damage has occurred.

Common symptoms include an ongoing cough or a cough that produces a lot of mucus; shortness of breath, especially during physical activity; wheezing; and chest tightness.

Those most at risk are smokers or former smokers over age 40, and people who have had long-term exposure to other lung irritants like secondhand smoke, air pollution, chemical fumes and dust. There is also a rare genetic condition known as alpha-1-antitrypsin, or AAT deficiency that can increase the risks.

If you’re experiencing any of the aforementioned symptoms, you need to get tested by your doctor. A simple breathing test called spirometry can tell if you have COPD, and if so, how severe it is. Early screening can also identify COPD before major loss of lung function occurs.

If you do indeed have COPD, you need to know that while there’s no cure, there are things you can do to help manage symptoms and protect your lungs from further damage, including:

Quit smoking: If you smoke, the best thing you can do to prevent more damage to your lungs is to quit. To get help, the National Cancer Institute offers a number of smoking cessation resources at smokefree.gov or call 1-800-QUIT-NOW. Or ask your doctor about prescription antismoking drugs that can help reduce your nicotine craving.

Avoid air pollutants: Stay away from things that could irritate your lungs like dust, allergens and strong fumes. Also, to help improve your air quality at home, remove dust-collecting clutter and keep carpets clean; run the exhaust fan when using smelly cleaning products, bug sprays or paint; ban smoking indoors; and keep windows closed when outdoor air pollution is high (see airnow.gov for daily air-quality reports).

Guard against the flu: The flu can cause serious problems for people who have COPD, so get a flu shot every fall and wash and sanitize your hands frequently to avoid getting sick. Also ask your doctor about getting the pneumococcal immunizations for protection against pneumonia.

Take prescribed medications: Bronchodilators (taken with an inhaler) are commonly used for COPD. They help relax the airway muscles to make breathing easier. Depending on how severe your condition, you may need a short-acting version only for when symptoms occur, or a long-acting prescription for daily use. Inhaled steroids may also help reduce inflammation and mucus and prevent flare-ups.

For more information, visit the COPD Foundation at copdfoundation.org or call the COPD information line at 866-316-2673.

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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Financial Paperwork — What to Keep & What to Toss

Dear Savvy Senior,
How long should a person hang on to old receipts, stock records, tax returns and other financial documents? I have accumulated boxes full of such papers over the years and would like to get rid of some of it now that I’m retired.
Getting Organized

Dear Getting Organized,
This is a great time of the year to get rid of unnecessary or outdated paperwork and to organize your records in preparation for filing your tax return in the spring. Here’s a checklist of what to keep and what to toss out, along with some tips to help you reduce your future paper accumulation.

Toss Out
• ATM receipts and bank-deposit slips as soon as you match them up with your monthly statement.
• Credit card receipts after you get your statement, unless you might return the item or need proof of purchase for a warranty.
• Credit card statements that do not have a tax-related expense on them.
• Utility bills when the following month’s bill arrives showing that your prior payment was received. If you wish to track utility usage over time, you may want to keep them for a year, or if you deduct a home office on your taxes keep them for seven years.

To avoid identity theft, be sure you shred anything you throw away that contains your personal information. It’s best to use a crosscut shredder rather than a strip one, which leaves long paper bands that could be reassembled.

Keep for One Year
• Paycheck stubs (until you get your W-2 in January, to check their accuracy).
• Bank statements (savings and checking account) to confirm your 1099s.
• Brokerage, 401(k), IRA and other investment statements until you get your annual summary (keep longer for tax purposes if they show a gain or loss).
• Receipts for health care bills in case you qualify for a medical deduction.

Keep for Seven Years
Supporting documents for your taxes, including W-2s, 1099s, and receipts or canceled checks that substantiate deductions. The IRS usually has up to three years after you file to audit you but may look back up to six years if it suspects you substantially underreported income or committed fraud.

Keep Indefinitely
• Tax returns with proof of filing and payment. You should keep these for at least seven years, but many experts recommend you keep them forever because they provide a record of your financial history.
• IRS forms that you filed when making nondeductible contributions to a traditional IRA or a Roth conversion.
• Receipts for capital improvements that you’ve made to your home until seven years after you sell the house.
• Retirement and brokerage account annual statements as long as you hold those investments.
• Defined-benefit pension plan documents.
• Savings bonds until redeemed.
• Loan documents until the loan is paid off.
• Vehicle titles and registration information as long as you own the car, boat, truck, or other vehicle.
• Insurance policies as long as you have them.
• Warranties or receipts for big-ticket purchases for as long as you own the item, to support warranty and insurance claims.

Keep Forever
Personal and family records like birth certificates, marriage license, divorce papers, Social Security cards, military discharge papers and estate-planning documents (power of attorney, will, trust and advanced directive). Keep these in a fireproof safe or safe-deposit box.

Reduce Your Paper
To reduce your paper clutter, consider digitizing your documents by scanning them and converting them into PDF files so you can store them on your computer and back them up onto a USB flash drive or external hard drive like icloud.com or carbonite.com.

Your can also reduce your future paper load by switching to electronic statements and records whenever possible.

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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2015

Savvy Senior – December Columns
1. How Much You’ll Pay for Medicare in 2016
2. How to Make Your Kitchen Safer and Easier to Use
3. Pill Splitting Dos and Don’ts
4. Helping an Aging Parent with their Finances
5. How To Write Your Own Obituary

How Much You’ll Pay for Medicare in 2016

Dear Savvy Senior,
I know there won’t be a cost-of-living increase in Social Security benefits next year but what about Medicare? I’ve heard some beneficiaries will get hit with a big Part B monthly premium increase in 2016. What can you tell me, and who will this affect?
Planning Ahead

Dear Planning,
All things considered, the news regarding your Medicare costs next year is pretty good. For about 70 percent of the nation’s 52 million Medicare beneficiaries, there will be no Part B premium increase in 2016. And thanks to the 2015 Bipartisan Budget Act that was signed into law by President Obama on Nov. 2, the other 30 percent will pay much less than previously projected. Here’s what you can expect.

Part B Premiums

Because the Social Security Administration will not be giving out a cost of living increase (or COLA) in 2016, the Medicare Part B premiums for most current beneficiaries will not go up either. Thanks to the “hold harmless” provision in the Medicare law, which prohibits Part B premiums from rising in any year that there’s no COLA, the 2016 monthly premium will remain at $104.90 for most current Medicare participants.

However, this provision does not protect new Medicare enrollees (those who enroll in 2016), beneficiaries who are directly billed for their Part B premium, or current beneficiaries who have deferred claiming their Social Security. This includes people 65 or older who are still working but have signed up for Medicare because their employer doesn’t offer health insurance. It also hits people who have filed and suspended Social Security benefits to allow a spouse to claim.

If you fit into any of these categories, your Medicare Part B premium will increase to $121.80 a month in 2016 – which is much lower than the $159.30 that it would have been, had the budget deal fell through.

The hold-harmless rule also does not protect high-income Medicare beneficiaries who already pay higher Part B premiums because their annual incomes are above $85,000 for an individual or $170,000 for a couple. If you fit into this category, here’s what you’ll pay for your Part B premium next year, based on your 2014 tax returns.
* Individuals with incomes of $85,000 to $107,000, or married couples filing joint tax returns with incomes of $170,000 to $214,000, will pay $170.50 per month.
* Individuals earning $107,000 to $160,000 (couples $214,000 to $320,000) will pay $243.60.
* Individuals with incomes of $160,000 to $214,000 (couples $320,000 to $428,000) will pay $316.70.
* Individuals over $214,000 or couples above $428,000 will pay $389.80.

Another increase high-income beneficiaries (those with incomes over $85,000, or $170,000 for joint filers) need to be aware of is the surcharge on Part D premiums. Affluent seniors that have a Medicare Part D prescription drug plan will pay an additional $12.70 to $72.90 per month, depending on their income, on top of their regular Part D premiums.

Deductibles and Co-Pays

Other changes you need to know about that will affect all Medicare beneficiaries include the Part B deductible, which will increase to $166 in 2016 (it’s currently $147); and the Part A (hospital insurance) annual deductible which will go up to $1,288 (it’s currently $1,260) for hospital stays up to 60 days. That increases to $322 per day for days 61-90, and to $644 a day for days 91 and beyond. And the skilled nursing facility coinsurance for days 21-100 will also increase to $161 per day (it’s currently $157.50).

For more information on all the Medicare costs for 2016 visit Medicare.gov and click on “Your Medicare Costs” tab at the top of the page, 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 Make Your Kitchen Safer and Easier to Use

Dear Savvy Senior,
What tips can you recommend for making a kitchen senior-friendly? My wife, who loves to cook, has had several kitchen-related accidents over the past year, which is why we would like to modify to make it safer and more practical.
Hungry Husband

Dear Hungry,
There are a number of simple modifications and inexpensive add-ons that can make a big difference in making your kitchen more age-friendly. Depending on your wife’s needs, here are some tips for each aspect of the kitchen.

Floors: If you have kitchen throw rugs, to reduce tripping or slipping, replace them with non-skid floor mats or consider gel mats, which are cushiony and more comfortable to stand on for long periods. GelPro.com and WellnessMats.com offer a nice selection.

Lights: If the lighting in her kitchen is dim, replace the old overhead fixture with a bright new ceiling light, and add under-cabinet task lighting to brighten up her kitchen countertops.

Cabinets and drawers: To reduce bending or reaching, organize your kitchen cabinets and drawers so that the items you most frequently use are within comfortable reach. You can also make your cabinets and pantry easier to access by installing pullout shelves or lazy susans. And D-shaped pull-handles for the cabinets and drawers are also recommended because they’re more comfortable for arthritic hands to grasp than knobs.

Faucet: If you have a twist-handle kitchen faucet, replace it with an ADA compliant single handle faucet. They’re easier to use, especially for seniors with arthritis or limited hand strength. There are also kitchen faucets on the market today (like the Delta Touch20 faucet and Moen MotionSense) that will turn themselves on and off by simply touching the base or moving your hand over a motion sensor. And, for safety purposes, set your hot water tank at 120 degrees to prevent possible water burns.

Microwave and stove: If your microwave is mounted above the stove, consider moving it to a countertop. This makes it safer and easier to reach. And if you’re concerned about your wife remembering to turn the stove off, there are automatic stove shut-off devices you can purchase and install to prevent a fire. See cookstop.com, stoveguardintl.com and pioneeringtech.com for some different options.

If you’re looking to upgrade some of your appliances too, here are some different senior-friendly features you should look for when shopping.

Refrigerator and freezer: Side-by-side doors work well for seniors because the frequently used items (refrigerated and frozen) can be placed at mid-shelf range for easy access. Pullout adjustable height shelves and a water/ice dispenser on the outside of door are also very convenient.

Stove or cooktop: Look for one with controls in the front so you won’t have to reach over hot burners to turn it off, and make sure the controls are easy to see. Flat surface electric or induction burners, or continuous grates on gas stoves are also great for sliding heavy pots and pans from one burner to the next. And ask about automatic shut off burners.

Oven: Self-cleaning ovens are a plus, and consider a side-swing door model. They’re easier to get into because you don’t have to lean over a hot swing-down door. Also consider a wall-mounted oven, installed at your wife’s preferred height to eliminate bending.

Dishwasher: Consider a dishwasher drawer that slides in and out, and is installed on a 6 to 10-inch raised platform. These require less bending to load and unload.

Washer and dryer: Front-load washers and dryers with pedestals that raise the height 10 to 15 inches are also back-savers and easy to access.

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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Pill Splitting Dos and Don’ts

Dear Savvy Senior,
Is pill splitting safe? I have several friends who cut their pills in half in order to save money, but I have some concerns. What can you tell me?
Cautious Kim

Dear Kim,
Pill splitting – literally cutting them in half – has become a popular way to save on pharmaceutical costs but you need to talk to your doctor or pharmacist first, because not all pills can be split.

The reason pill splitting is such a money saver is because of a quirk in the way drugs are manufactured and priced. A pill that’s twice as strong as another may not be twice the price. In fact, it’s usually about the same price. So, buying a double-strength dose and cutting it in half may allow you to get two months worth of medicine for the price of one. But is it safe? As long as your doctor agrees that splitting your pills is OK for you, you learn how to do it properly, and you split only pills that can be split, there’s really no danger.

Ask Your Doctor
If you’re interested in splitting your pills, talk to your doctor or pharmacist to find out if any of the medicines you use can be safely split. It’s also important to find out whether splitting them will save you enough money to justify the hassle.

The pills that are easiest to split are those with a score down the middle. However, not every pill that’s scored is meant to be split. Pills that are most commonly split include:
* Cholesterol lowering drugs, like Crestor, Lipitor, Mevacor, Pravachol and Zocor.
* Antidepressants, like Lexapro, Celexa, Serzone, Paxil, and Zoloft.
* High blood pressure medicines such as, Accupril, Zestril, Diovan, Avapro, Norvasc, Tenormin, Toprol and Cardura.

Use a Splitter
Having the right equipment is very important too. Don’t use a knife or scissors to cut your pills in half. It can cause you to split them unevenly resulting in two pieces with very different dosages, which can be dangerous. Purchase a proper pill cutter that has a cover and a V-shaped pill grip that holds the pill securely in place. You can find them at most pharmacies for $3 to $10.

For convenience, you might be tempted to split the whole bottle of pills at once. But it’s best to do the splitting on the day you take the first half, and then take the other half on the second day or whenever you are scheduled to take your next dose. That will help keep the drugs from deteriorating due to exposure to heat, moisture, or air. It will also help ensure that any deviation in the size of one dose is compensated in the next. It’s also important to know that pills are only safely split in half, and never into smaller portions such as into thirds or quarters.

Don’t Split These

Some pills should never be split. Drugs that are time-released or long-lasting and tablets that contain a combination of drugs probably shouldn’t be split, because it’s difficult to ensure a proper amount of active ingredient in each half. Pills with a coating to protect your stomach, and pills that crumble easily or irritate your mouth shouldn’t be split either, along with chemotherapy drugs, anti-seizure medicines, birth control pills and capsules containing powders or gels.

Again, your doctor or pharmacist will know which drugs can and cannot be split. If you’re taking a medicine that can be split, you’ll need to get a prescription from your doctor for twice the dosage you need. Then you can start splitting safely, and saving.

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 an Aging Parent with their Finances

Dear Savvy Senior
Can you offer any tips on helping an elderly parent with their finances? My 82-year-old mother is having some trouble keeping up with her bills, and I just found out that she has been making a lot of small contributions to suspicious charities.
Concerned Daughter

Dear Concerned,
Millions of adult children today serve as financial helpers to their elderly or ill parents or other loved ones. They provide services like paying bills, handling deposits and investments, filing insurance claims, preparing taxes and more. Here are some tips and resources that can help you help your mom.

Have a Talk
Taking on some or all of the financial responsibility of an elderly parent or other loved one can sometimes be awkward and difficult.

The first step in helping your mom is to have a thoughtful and respectful talk with her, expressing your concerns, and offering your help in simplifying her financial life. If you have siblings, it can be a good idea to get them involved too. This can help you head off any possible hard feelings, plus, with others involved, your mom will know everyone is concerned.

Get Organized

If your mom is willing to let you help manage her financial affairs your first order of business is to get organized by making a list of her financial accounts, and locate her important legal documents. This will help you get a handle on her overall financial situation and let you know if any key documents are missing. Your list should include her:
* Monthly bills: Phone, cable, water and trash, gas, electric, credit card accounts, etc.
* Financial accounts: Including bank accounts, brokerage and mutual fund accounts, safe-deposit boxes and any other financial assets she has.
* Company benefits: Any retirement plans, pensions or health benefits from your current or former employer.
* Insurance policies: Life, home, auto, long-term care, Medicare, etc.
* Important legal documents: A will, advanced medical directive which includes a living will and health-care proxy, and durable power of attorney which gives one or more people the legal authority to handle her finances if she becomes incapacitated. Make sure these documents are prepared.
* Taxes: Copies of your mom’s income tax returns over the past few years.
* Contact list: Names and phone numbers of key contacts like insurance agents, financial advisor, tax preparer, family attorney, etc.

Seek Advice

If your mom has considerable assets or a complex financial situation, you and your mom should sit down with her financial advisor or attorney to review her situation. If she doesn’t have anyone, consider hiring a reputable fee-only financial planner who can help you figure things out and put a smart plan in place. Fee-only planners do not earn commissions by selling you financial products. They charge only for their services, which can be around $150 to $300 an hour. To locate one in your area, visit napfa.org or garrettplanningnetwork.com.

Simplify Financial Tasks
One of the easiest ways to simplify your mom’s monthly financial chores is to set up automatic payments for her utilities and other routine bills, and arrange for direct deposit of her income sources. You can also make arrangements to have her bank statements mailed directly to you, so you can monitor what’s coming in and going out each month. Or, you could set up your mom’s online banking service (if available), so you can pay bills and monitor her account anytime.

For more tips on financial caregiving, the Consumer Financial Protection Bureau offers four guides on “Managing Someone Else’s Money” that you can read online at consumerfinance.gov/blog/managing-someone-elses-money.

If you need some help or live far away, you may want to consider hiring a daily money manager (aadmm.com, 877-326-5991) who can come in once or twice a month to pay bills, make deposits, decipher health insurance statements and balance her checkbook. Costs range between $50 and $150 per hour.

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 Write Your Own Obituary

Dear Savvy Senior,
Can you provide any tips on how to write your own obituary? At age 80, I am in the process of preplanning my funeral and would also like to take a crack at writing my own newspaper obit too.
Still Alive

Dear Alive,
For many people, writing their own obituary can be a nice way to sum up their life, not to mention avoid any possible mistakes that sometimes occur when obituaries are hurriedly written at the time of death. Here’s what you should know, along with some tips and tools to help you write one.

Obit Tips
Before you start writing your obit, your first step is to check with the newspaper you want it to run in. Some newspapers have specific style guidelines or restrictions on length, some only accept obituaries directly from funeral homes, and some only publish obituaries written by newspaper staff members.

If your newspaper accepts self-written obits, find out if they have a template to guide you, or check with your funeral provider. Most funeral homes provide forms for basic information, and will write the full obituary for you as part of the services they provide.

You also need to be aware that most newspapers charge by the word, line or column inch to publish an obituary, so your cost will vary depending on your newspaper’s rate and length of your obit – most range between 200 and 500 words.

What to Include
Depending on how detailed you want to be, the most basic information in an obituary usually includes your full name (and nickname if relevant), age, date of birth, date of death, where you were living when you died, significant other (alive or dead), and details of the funeral service (public or private). If public, include the date, time, and location of service.

Other relevant information you may also want to include is: cause of death; place of birth and parents names; your other survivors including your children, other relatives, friends and pets and where they live; family members who preceded your death; high school and colleges you attended and degrees earned; your work history and military service; your hobbies, accomplishments and any awards you received; your church or religious affiliations; any clubs, civic and fraternal organizations you were members of; and any charities you feel strongly about that you would like people to donate to either in addition to or in lieu of flowers or other gifts.

You’ll also need to include a photo, and be sure to leave copies with your funeral director and/or immediate family members.

Need Help?
If you need some help writing your obituary there are free online resources you can turn to like legacy.com, obituaryguide.com or caring.com/obituary, which offer tips, templates and sample obits.

Or, if you want your obit to be more memorable, purchase the ObitKit (obitkit.com). This is a $20 workbook that helps you gather the details of your life so you can write an obituary that will reflect your personality and story.

Ethical Will
If you’re interested in writing your own obituary, you may also be interested in writing a legacy letter or ethical will.

A legacy letter is a heartfelt letter that you write to your loved ones sharing with them your feelings, wishes, regrets, gratitude and advice. And an ethical will (which is not a legal document), is like an extension of a legacy letter that many people use to express their feelings as well as explain the elements in their legal will, give information about the money and possessions they’re passing on, and anything else they want to communicate.

For help in creating these, there are lots of resources available like celebrationsoflife.net and personallegacyadvisors.com, which offers practical information, examples and materials you can purchase to help you put it together.

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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November Columns
1.    How to Choose a Good Nursing Home
2.    Required IRA and 401(k) Withdrawal Rules for Retirees
3.    How to Guard Against Deadly Aortic Aneurysms
4.    Senior-Friendly Furniture Aids for Mobility Challenged Seniors

How to Choose a Good Nursing Home

Dear Savvy Senior,
Can you give me some tips on picking a good nursing home for my mother who has Alzheimer’s disease? I’ve been taking care of her at home, but she’s gotten to the point where she’s too much for me to handle.
Overwhelmed Daughter

Dear Overwhelmed,
Choosing a good nursing home for a loved one with Alzheimer’s disease is a very important decision that requires careful evaluation and some homework. Here are some steps that can help you find a good facility and avoid a bad one.

Make a list: There are several sources you can turn to for referrals to nursing homes in your area: Your Area Agency on Aging (call 800-677-1116 for contact information); your mom’s doctor or nearby hospital discharge planner; or friends, family or neighbors who may have had a loved one in a nursing home. Ideally, the nursing homes should be close to family members and friends who can visit often, because residents with frequent visitors usually get better care.

Compare nursing homes: To research and compare the nursing homes on your list, use Medicare’s nursing home compare tool at medicare.gov/nursinghomecompare. This tool provides a 5-star rating system on recent health inspections, staffing, quality of care, and overall rating.

You should also contact your local long-term care ombudsman. This is a government official who investigates nursing home complaints and can tell you which ones have had problems in the past. To find your local ombudsman, call your Area Agency on Aging or see ltcombudsman.org.

Contact the facilities: Once you’ve narrowed your search, call the nursing homes you’re interested in to verify that they have a dementia unit that can facilitate your mom’s needs. Also, find out if they have any vacancies, what they charge, and if they accept Medicaid.

Tour your top choices: During your nursing home visit, notice the cleanness and smell of the facility. Is it homey and inviting? Does the staff seem responsive and kind to its residents? Also be sure to taste the food, and talk to the residents and their family members, if available. It’s also a good idea to visit several times at different times of the day and different days of the week to get a broader perspective.

Also, find out about their staff screening (do they do background checks) and training procedures, staff-to-patient ratio, and the staff turnover rate.

To help you rate your visit, Medicare offers a helpful checklist of questions to ask at medicare.gov/nursinghomecompare/checklist.pdf, as does the Alzheimer’s Association at alz.org/visitinganursinghome.pdf. Print these lists from your computer and take them with you on your visit.

Paying for care: With nursing home costs now averaging $250 per day nationally for a private room, paying for care is another area you may have questions about or need assistance with. Medicare only helps pay up to 100 days of rehabilitative nursing home care, which must occur after a hospital stay.

Most nursing home residents pay for care from either personal savings, a long-term care insurance policy, or through Medicaid once their savings are depleted.

The National Clearinghouse for Long-Term Care Information website (longtermcare.gov) is a good resource that can help you understand and research your financial options. You can also get help from your State Health Insurance Assistance Program (SHIP), which provides free counseling on all Medicare and Medicaid issues. To find a local SHIP counselor visit shiptacenter.org, or call 800-677-1116.

For more information, see Medicare’s online booklet “Your Guide to Choosing a Nursing Home” at medicare.gov/publications/pubs/pdf/02174.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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Required IRA and 401(k) Withdrawal Rules for Retirees

Dear Savvy Senior,
Can you give me the details on required IRA and 401(k) distributions? I turned 70 this year, and want to be clear on what I’m required to do, and when I’ll have to do it.
Planning Ahead

Dear Planning,
The old saying “you can’t take it with you” is definitely true when it comes to Uncle Sam and your tax-deferred retirement accounts. Here’s what you should know about required retirement account distributions along with some tips to help you avoid extra taxes and penalties.

RMD Rules
Beginning at age 701Ž2, the IRS requires all seniors that own tax-deferred retirement accounts – like traditional IRAs, SEP IRAs, SIMPLE IRAs, SARSEPs, 401(k)s, 403(b)s and 457s – must start taking annual required minimum distributions (RMDs), and pay taxes on those withdrawals. The reason: The IRS doesn’t want you hoarding your money in these accounts forever. They want their cut. Distributions are taxed as income at your ordinary income tax rate.

There are, however, two exceptions. Owners of Roth IRAs are not required to take a distribution, unless the Roth is inherited. And if you continue to work beyond age 701Ž2, and you don’t own 5 percent or more of the company you work for, you can delay withdrawals from your employer’s retirement plan until after you retire. But if you have other non-work-related accounts, such as a traditional IRA or a 401(k) from a previous employer, you are still required to take RMDs from them after age 701Ž2, even if you’re still working.

RMD Deadlines
Generally, you must take your distribution every year by Dec. 31. First timers, however, can choose to delay taking their distribution until April 1 of the year following the year you turn 701Ž2. So, for example, if your 70th birthday was in March 2015, you would turn 701Ž2 in September and your required beginning date would be April 1, 2016. But if your 70th birthday occurred later in the year, say in August, you wouldn’t turn 701Ž2 until 2016. In that case, you would be required to take your first distribution by April 1, 2017.

But be careful about delaying, because if you delay your first distribution, it may push you into a higher tax bracket because you must take your next distribution by December 31 of the same year.

Also note that you can always withdraw more than the required amount, but if you don’t take out the minimum, you’ll be hit with a 50 percent penalty on the amount that you failed to withdraw, along with the income tax you owe on it.

Distribution Amounts
Your RMD is calculated by dividing your tax-deferred retirement account balance as of Dec. 31 of the previous year, by an IRS estimate of your life expectancy. A special rule applies if your spouse is the beneficiary and is more than 10 years younger than you.

IRA withdrawals must be calculated for each IRA you own, but you can withdraw the money from any IRA or combination of IRAs. 403(b) accounts also allow you to total the RMDs and take them from any account or combination of accounts.

With 401(k) plans, however, you must calculate the RMD for each plan and withdraw the appropriate amount from each account.

To calculate the size of your RMD, you can use the worksheets on the IRS website – see irs.gov/Retirement-Plans and click on “Required Minimum Distributions.” Or, contact your IRA custodian or retirement-plan administrator who can do the calculations for you.

For more information, call the IRS at 800-829-3676 and ask them to mail you a free copy of the “Distributions from Individual Retirement Arrangements” (publication 590-B), or see irs.gov/pub/irs-pdf/p590b.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 Guard Against Deadly Aortic Aneurysms

Dear Savvy Senior,
My father died several years ago, at the age of 76, from a stomach aneurysm, which now has me wondering. What are my risk factors of getting this, and what can I do to protect myself, as I get older?
Just Turned 60

Dear 60,
Stomach aneurysms, also known as “abdominal aortic aneurysms,” are very dangerous and the third leading cause of death in men over 60. They also tend to run in families, so having had a parent with this condition makes you much more vulnerable yourself.

An abdominal aortic aneurysm (or AAA) is a weak area in the lower portion of the aorta, which is the major artery that carries blood from the heart to the rest of the body. As blood flows through the aorta, the weak area bulges like a balloon and can burst if it gets too big, causing life-threatening internal bleeding. In fact, nearly 80 percent of AAAs that rupture are fatal, but the good news is that more than nine out of 10 that are detected early are treatable.

Who’s At Risk?
Around 200,000 people are diagnosed with AAAs each year, but estimates suggest that another 2 million people may have it but not realize it. The factors that can put you at increased risk are:
Smoking: Ninety percent of people with an AAA smoke or have smoked. This is the number one risk factor and one you can avoid.
Age: Your risk of getting an AAA increases significantly after age 60 in men, and after age 70 in women.
Family history: Having a parent or sibling who has had an AAA can increase your risk to around one in four.
Gender: AAAs are five times more likely in men than in women.
Health factors: Atherosclerosis, also known as hardening of the arteries, high blood pressure and high cholesterol levels also increase your risk.

Detection and Treatment
Because AAAs usually start small and enlarge slowly, they rarely show any symptoms, making them difficult to detect. However, large AAAs can sometimes cause a throbbing or pulsation in the abdomen, or cause abdominal or lower back pain.

The best way to detect an AAA is to get a simple, painless, 10-minute ultrasound screening test. All men over age 65 that have ever smoked, and anyone over 60 with a first-degree relative (father, mother or sibling) who has had an AAA should talk to their doctor getting screened.

You should also know that most health insurance plans cover AAA screenings, as does Medicare to beneficiaries with a family history of AAAs, and to men between the ages of 65 and 75 who have smoked at least 100 cigarettes during their life.

If an AAA is detected during screening, how it’s treated will depend on its size, rate of growth and your general health. If caught in the early stages when the aneurysm is small, it can be monitored and treated with medication. But if it is large or enlarging rapidly, you’ll probably need surgery.

AAA Protection
While some risk factors like your age, gender and family history are uncontrollable, there are a number of things you can do to protect yourself from AAA. For starters, if you smoke, you need to quit – see smokefree.gov or call 1-800-QUIT-NOW for help.

You also need to keep tabs on your blood pressure and cholesterol levels, and if they are high you need to take steps to lower them through diet, exercise and if necessary, medication.

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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Senior-Friendly Furniture Aids for Mobility Challenged Seniors

Dear Savvy Senior,
I am interested in purchasing a recliner that lifts and lowers off the ground, or some other type of senior-friendly furniture that can help my elderly father. He’s arthritic and overweight and struggles mightily with getting up from most of the cushioned furniture in the house. What can you recommend?
Need a Boost

Dear Need,
The task of sitting down and/or getting up from soft cushioned furniture is a problem for many seniors who struggle with excessive weight, arthritis or other mobility issues. Here are some different product solutions that can help.

Lift Recliners
One of the most popular types of cushioned furniture on the market today for mobility challenged seniors is an electric recliner lift chair. While they look just like regular recliners, powerlift recliners come with a built-in motor that raises and lowers the entire chair, which makes sitting down and getting up much easier.

With literally dozens of different types and styles of lift recliners to choose from, here are a few key points that can help you select a good fit for your dad.
Chair size: The recliner needs to fit the person sitting in it, so your dad’s height and weight will determine the size of chair he needs.
Reclining options: Aside from the lifting system, the degree in which the chair reclines is your choice too. Most lift recliners are sold as either two-position, three-position or infinite-position lift chairs. The two-position chairs recline only to about 45 degrees, which makes them ideal for watching TV or reading. But if your dad wants to nap, he’ll probably want a three-position or infinite-position chair that reclines almost completely horizontally.
Style and features: You’ll also need to choose the type of fabric, color and back style you want the chair to be, or if you want any extra features like built-in heating or massage elements, or a wall hugging chair which is great if you’re tight on space.

While there are many companies that make lift recliners – such as Med-Lift, NexIdea, Catnapper, Berkline, Franklin and La-z-boy – Pride Mobility (pridemobility.com) and Golden Technologies (goldentech.com) have been around the longest and have some of the best reputations. With prices typically ranging between $600 and $2,000, you can find lift recliners at many medical supply stores and online.

You’ll also be happy to know that Medicare provides some help purchasing a lift chair. They cover the lift mechanism portion, which equates to around $300 towards your purchase.

Risedale Chairs
If powerlift recliners don’t appeal to your dad, another option to consider is a Risedale chair. These are open-legged, wing back chairs that are different from lift recliners because only the seat cushion lifts instead of the whole chair. Sold by Carex Health Brands (carex.com), the Risedale costs $725.

Furniture Adapters
If you’re looking for something less expensive, or if your dad doesn’t want different furniture, there are also a number of assistive products that can be added to his current furniture that can help too, like the Stander CouchCane or EZ Stand-N-Go (see stander.com).

These products provide support handles that make sitting down and standing up a little easier, and they both work on couches and recliners. Available online at Amazon.com, the CouchCanes sell for around $110, and the EZ Stand-N-Go costs $129.

Another way to make your dad’s furniture more accessible is by increasing its height with furniture risers. These typically range from 2 to 5 inches in height, are made of heavy-duty plastic or wood, and are inserted under the base of the legs or supports of his furniture. Costs typically range from a few dollars up to $50 or more and can be purchased at retail stores like Walmart and Target, or online at Amazon.com.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.
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October columns
1.    Specialized Services That Help Seniors Relocate
2.    How to Find a Better Medicare Prescription Drug Plan
3.    How to Plan an Affordable Funeral
4.    Understanding Reverse Mortgages: Beware of Misleading Ads
5.    A Social Security Benefit for Kids

Specialized Services That Help Seniors Relocate

Dear Savvy Senior,
I need to find some help with selling my elderly mother’s house – where she’s lived for almost 50 years – and relocating her to an apartment or condo closer to where I live. Can you recommend any businesses or services that specialize in helping seniors relocate?
Overwhelmed Daughter

Dear Overwhelmed,
The process of selling a house and moving to a new home, or downsizing to a condo, apartment or senior housing facility is a big job for anyone. But it can be especially overwhelming for seniors who are moving from a long time residence filled with decade’s worth of stuff and a lifetime of memories. Fortunately, there are several specialized services available today that can help make your mom’s move a lot easier.

Real Estate Specialist
To get help selling your mom’s home and/or finding her a new one, you should look into hiring a Seniors Real Estate Specialist (SRES) or a Certified Senior Housing Professional (CSHP). These are realtors that have received special training, making them better equipped to help seniors and their family members through the financial and often complex emotional issues that can come with selling a long time family home and relocating.

SRES and CSHP designees are educated and knowledgeable in such areas as downsizing, aging-in-place, senior housing options, reverse mortgages, as well as ways to use pensions, 401k accounts and IRAs in real estate transactions. And, if you need help from other professionals, a SRES and CSHP can put you in touch with qualified home inspectors, movers, attorneys, CPAs and other experts.

To learn more or to locate a professional in your area, contact the SRES Council (sres.org, 800-500-4564) which also offers a free “Moving On” guide that help seniors and their family members with the decisions and transitions that come with moving. And to find a CSHP see SeniorsRealEstateInstitute.com.

Moving Manager
To help your mom get packed up and move, you should consider hiring a “senior move manager.” These are organizers who assist older people with the challenges of relocating, and can minimize the stress of this major transition by doing most of the work for you.

They can help your mom pare down her belongings, decide what to take and what to dispose of, recommend charities for donations and help sell her unwanted items. They also get estimates from moving companies, oversee the movers, arrange the move date, supervise the packing and unpacking, have the house cleaned and just about anything you need related to her move.

Costs vary depending on the services and size of the move, but you can expect to pay between $1,000 and $5,000, not including the cost of movers.

To locate a senior move manager visit the National Association of Senior Move Managers website at nasmm.org or call 877-606-2766. You can also search at Caring Transitions (caringtransitions.com), the largest senior relocation and transition services franchised company in the U.S.

But, before you hire one, be sure you ask for references from previous clients and check them. Also find out how many moves they have actually managed, and get a written list of services and fees. And make sure they’re insured and bonded.

If you can’t find a senior move manager in your area, another option is to hire a certified professional organizer who specializes in downsizing and relocating. To find one, check the National Association of Professional Organizers who has a searchable database on their website at napo.net.

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

Dear Savvy Senior,
I recently received a letter from my Medicare drug plan provider notifying me that they are increasing my co-pays next year. I’d like to look for a better plan but could use some guidance. What’s the easiest way to do this?
Need a Change

Dear Need a Change,
Cost increases and coverage changes are an annual event for many Medicare Part D prescription drug plans. Fortunately, during the open enrollment period (which is Oct. 15 – Dec. 7), you have the ability to shop and compare plans and choose one that better fits your needs and budget. Your new plan will go into effect Jan.1, 2016. Here are some tips that can help with this process.

Shop Online
If you have Internet access and are comfortable using a computer, you can easily shop for and compare all Medicare drug plans in your area, and enroll in a new plan online.

Just go to Medicare’s Plan Finder Tool at medicare.gov/find-a-plan, and type in your ZIP code or your personal information, enter in how you currently receive your Medicare coverage, select the drugs you take and their dosages, and choose the pharmacies you use. You’ll get a cost comparison breakdown for every plan available in your area so you can compare it to your current plan.

This tool also provides a five-star rating system that evaluates each plan based on past customer service records, and suggests generics or older brand name drugs that can reduce your costs.

It’s also important to keep in mind that when you’re comparing drug plans don’t judge a plan strictly by its monthly premium cost. Low-premium plans are often associated with higher prescription co-payments and may end up being more expensive. Look at the “estimated annual drug costs” that shows how much you can expect to pay over a year in total out-of-pocket costs – including premiums, deductibles and co-pays.

Also, be sure the plan you’re considering covers all of the drugs you take with no restrictions. Most drug plans today place the drugs they cover into price tiers. A drug placed in a higher tier may require you to get prior authorization or try another medication first before you can use it.

Need Help?
If you need some help choosing a new plan, contact your State Health Insurance Assistance Program (SHIP), which provides free one-on-one Medicare counseling in person or over the phone. They also conduct seminars during the open enrollment period at various locations throughout each state. To find the contact information for your local SHIP visit shiptacenter.org, or call the eldercare locator at 800-677-1116.

Shrinking Donut Hole

You also need to know that Medicare’s “donut hole” – the coverage gap in which you must pay out-of-pocket for your drugs – continues to shrink. In 2016, you will get a 55 percent discount on brand-name drugs, and the federal subsidy for generic medications will rise to 42 percent.

The 2016 coverage gap begins when your total drug cost exceeds $3,310 (that includes your share and the insurer’s share of the costs) and ends when your total out-of-pocket costs reach $4,850. After that, your Part D plan usually covers around 95 percent of your remaining drug costs for the year.

Low-Income Assistance
Also, be aware that if you’re income is under $17,655 or $23,895 for married couples living together, and your assets are below $13,640 or $27,250 for married couples not counting your home, car or life insurance policy, you may be eligible for the federal Low Income Subsidy known as “Extra Help” that pays Part D premiums, deductibles and copayments. For more information or to apply, call Social Security at 800-772-1213 or visit socialsecurity.gov/extrahelp.

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 Plan an Affordable Funeral

Dear Savvy Senior,
When my brother died last year, my sister and I had a regular funeral for him and got stuck with a $12,000 bill. Can you recommend some funeral cost cutting tips or cheaper alternatives? I don’t want to stick my kids with a big funeral bill after I’m gone.
Looking Ahead

Dear Looking Ahead,
With the average cost of a full-service funeral running over $10,000 today, many people are seeking alternative options to make their final farewell more affordable. Depending on how you want to go, here are some money saving options to consider.

Traditional funeral: If you’re interested in a traditional funeral and burial, your first money saving step is to shop around and compare funeral providers, because prices can vary.

If you want some help, contact your funeral consumer alliance program. These are volunteer groups that offer information and prices on local funeral providers. See funerals.org/affiliates-directory or call 802-865-8300 for contact information.

There are also free websites you can turn to, like funeralhomeindex.com that lets you compare prices, and funeraldecisions.com that will provide estimates from local funeral homes based on what you want.

When comparing, make sure you take advantage of the “funeral rule.” This is a federal law that requires funeral home directors to provide you with an itemized price list of their products and services so you can choose exactly what you want. Be sure to ask for it.

Another way to lower your costs is to buy your own casket. You can save at least 50 percent by purchasing one from a store or online and having it delivered to the funeral home, and the funeral home providing the service must accept it. Two good casket-shopping resources that may surprise you are Walmart.com and Costco.com, which offer a variety of caskets and urns at discounted prices.

Direct burial: Another way to cut your funeral home bill is to get a direct burial. With this option your body would be buried shortly after death, skipping the embalming, viewing and use of the funeral facilities. If your family wants a memorial service they can have it at the graveside or at your place of worship without the body. These services usually cost between $1,000 and $2,000, not counting cemetery charges. All funeral homes offer direct burial.

Cremation: An increasingly popular and affordable way to go, cremation can run anywhere from around $600 (for a direct cremation) up to $4,000 or higher depending on the provider and services you choose. To locate funeral homes that offer cremation or cremation providers in your area, look in your local yellow pages under “cremation” or “funeral” or visit cremation.com.

Green burial: An eco-friendly green burial is another affordable option that costs anywhere from $1,000 to several thousand depending on the provider. With a green cemetery burial, the body is buried in a biodegradable coffin or just wrapped in a shroud, without embalming chemicals or a burial vault. The Green Burial Council (greenburialcouncil.org, 888-966-3330) has a state listing of cemetery operators who accommodate green burials, as well as funeral professionals who provide the services.

Veteran’s burial:
If you are a veteran, you’re entitled to a free burial at a national cemetery and a free grave marker. This benefit also extends to spouses and dependent children. Some veterans may even be eligible for funeral expense allowances too. To learn more, visit www.cem.va.gov or call the VA at 800-827-1000.

Body donation: Donating your body to a medical facility for research is another popular way to go, and it’s completely free. After using your body, your remains will be cremated and your ashes will be buried or scattered in a local cemetery or returned to your family. To locate body donation programs in your state, see anatbd.acb.med.ufl.edu/usprograms.

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

Dear Savvy Senior,
Can you give us a rundown of how reverse mortgages work? I’ve see actors Fred Thompson and Henry Winkler pitching them on TV, and they sound like a good deal. What can you tell me?
Need the Money

Dear Need the Money,
When it comes to celebrity spokespeople pitching reverse mortgages on TV, don’t believe everything you hear. Many of these ads are misleading and don’t always give you the whole story. In fact, the Consumer Financial Protection Bureau recently issued a warning to seniors to watch out for these deceptive advertisements. With that said, here’s the lowdown on reverse mortgages.

The Basics

A reverse mortgage is a unique type of loan that allows older homeowners to borrow money against the equity in their house that doesn’t have to be repaid until the homeowner dies, sells the house or moves out for at least 12 months. At that point, you or your heirs will have to pay back the loan plus accrued interest and fees, but you will never owe more than the value of the house.

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

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

You will also need to undergo a financial assessment to determine whether you can afford to continue paying your property taxes and insurance. Depending on your financial situation, you may be required to put part of your loan into an escrow account to pay future bills. If the financial assessment finds that you cannot pay your insurance and taxes and have enough cash left to live on, you’ll be denied.

Loan Details
Around 95 percent of all reverse mortgages offered today are Home Equity Conversion Mortgages (HECM), which are FHA insured and offered through private mortgage lenders and banks. HECM’s also have home value limits that vary by county, but cannot exceed $625,500.

How much you can actually get through a reverse mortgage depends on your age, your home’s value and the prevailing interest rates. Generally, the older you are, the more your house is worth, and the lower the interest rates are, the more you can borrow. A 70-year-old, for example, with a home worth $250,000 could borrow around $136,000 with a fixed-rate HECM. To estimate how much you can borrow, use the reverse mortgage calculator at reversemortgage.org.

You also need to know that reverse mortgages are expensive with a number of fees, including: a 2 percent lender origination fee for the first $200,000 of the home’s value and 1 percent of the remaining value, with a cap of $6,000; a 0.5 percent upfront mortgage insurance premium (MIP) fee, plus an annual MIP fee that’s equal to 1.25 percent of the outstanding loan balance; along with an appraisal fee, closing costs and other miscellaneous expenses. Most fees can be deducted for the loan amount to reduce your out-of-pocket cost at closing.

To receive your money, you can opt for a lump sum, a line of credit, regular monthly checks or a combination of these. But in most cases, you cannot withdraw more than 60 percent of the loan during the first year. If you do, your upfront MIP fee will be bumped up to 2.5 percent.

Get Educated

To learn more, read the National Council on Aging’s online booklet “Use Your Home to Stay at Home,” which you can download at homeequityadvisor.org.

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

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

Dear Savvy Senior,
I’ve been told that my children, who are 13 and 16 years old, may be eligible for Social Security when I file for my retirement benefits. What can you tell me about this?
Older Dad

Dear Older Dad,
It’s true. If you’re retired and are still raising young children, there’s a little-known Social Security benefit that can put some extra money in your family coffers.

Here’s how it works. When you file for Social Security retirement benefits, each of your minor children can get money on your work record equaling half of what you would receive at full retirement age, which is currently 66. Even if you were to take a smaller benefit by claiming earlier, your kids will still get half of your full-retirement age amount.

To qualify, your kids – whether they’re biological, adopted or step children – must be unmarried and under age 18. Kids that are over 18 but still in high school, can collect too until they graduate or turn 19, whichever comes first. (Other rules apply to kids that are disabled.)

But that’s not all.

Because you have one child that’s only 13, your wife (if you’re married) can collect Social Security benefits on your work record too. And it doesn’t matter if she’s just 40 years old. The minimum age requirements to collect retirement benefits (62) or survivor benefits (60) do not apply when it comes to collecting benefits as the caregiver of a young child. The spouse’s benefit, which is also worth up to half of your benefit, will stop when your child turns 16.

But be aware that there are limits to the amount of money that can be paid to a family. The Social Security “family maximum payment” is determined by a complex formula (see ssa.gov/oact/cola/familymax.html) and can range from 150 to 180 percent of your full retirement benefit amount. If the total exceeds that, each person’s benefit, except yours, is cut proportionately until it equals the maximum.

Here’s an example of how that’s figured. Let’s say, for example, that your full retirement age benefit is $2,000. After doing the Social Security math computations that would make your family maximum benefit $3,500.

Subtract your $2,000 benefit from the $3,500 family maximum benefit, which leaves $1,500. That’s the monthly amount that can be split between your two children – $750 each. If your wife wants in on it too, the individual checks are smaller, at $500 a piece, but the family amount is the same.

File and Suspend
One other benefit boosting strategy you should know about that’s relevant here is “file and suspend.” If you’re still working and would like to wait, say to age 67 or even 70 to start claiming your own benefits, you can file and suspend starting at full retirement age 66.

This option gives you the ability to start monthly payments for your minor children and wife, but suspend your own benefit so you can collect a larger amount later. Your benefit will increase by 8 percent per year for every year you delay collecting your retirement benefit up until age 70. That means your retirement benefit at age 70 will be 132 percent of what it would have been if he had collected at age 66.

You should also know that minor children can collect Social Security benefits based on the earnings of a parent who is disabled or dead too.

To learn more, see the SSA publication (No. 05-10085) “Benefits For Children” at ssa.gov/pubs/EN-05-10085.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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September Columns
1. How Seniors Can Stop Robocalls
2. Adjusted Flu Vaccine Options Available to Seniors This Year
3. Roadside Assistance Services for Older Drivers
4. How to Save on Hearing Aids

How Seniors Can Stop Robocalls

Dear Savvy Senior,
What can I do to stop the perpetual prerecorded robocalls I keep getting? I’m signed up with the National Do Not Call Registry, but it seems like I still get three or four robo telemarketing calls a day offering lower credit card interest rates, medical alert devices and more.
Fed Up Senior

Dear Fed Up,
Millions of Americans on the National Do Not Call Registry (donotcall.gov) complain they still receive unwanted calls from robocallers. Why? Because most robocalls are scams run by con artists who are only trying to trick you out of your money, and they simply ignore the law.

But there’s good news on the horizon. A few months ago, the Federal Communications Commission (FCC) passed a rule giving telecommunication companies more leeway to block robocalls. Before this ruling, the FCC has always required phone companies to complete all calls, much in the same way the postal service is required to deliver all your mail, even the junk. So, look for your phone service provider to start offering call-blocking tools in the future. But in the meantime, here are some things you can do to reduce those unwanted calls.

Set up “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.

Sign up for Nomorobo: This is a free service and works only if you have an Internet-based VoIP phone service. It does not work on traditional analog landlines or wireless phones. 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.

Buy a robocall-blocking device: If you don’t mind spending a little money, purchase a call-blocking device like the Sentry 2 ($59) or Digitone Call Blocker Plus ($100), sold at Amazon.com. These small devices, which plug into your phone line allow you to blacklist numbers you no longer wish to receive, and set up a whitelist, or manually program the phone to recognize and accept a certain number of safe numbers. Both devices are very effective.

Don’t pick up: If you have a caller ID, another tip is to simply not answer the phone unless you recognize the number. But if you do answer and it’s a robocall, you should just hang up the phone. Don’t press 1 to speak to a live operator and don’t press any other number to complain about the call or get your number off the list. If you respond by pressing any number, you’re signaling that the autodialer has reached a live number and will probably lead to more robocalls.

Get a cell phone app: To help with robo telemarketing calls and robo spam texts to your cell phone, get a call-screening app like Truecaller (truecaller.com) or PrivacyStar (privacystar.com) that screens and blocks them.

It’s also important that you report illegal robocalls to the Federal Trade Commission at consumercomplaints.fcc.gov or call 888-225-5322, and sign the Consumer Union petition at EndRobocalls.org to pressure phone companies to start offering free call-blocking technology.

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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Adjusted Flu Vaccine Options Available to Seniors This Year

Dear Savvy Senior,
What can you tell me about this year’s flu shot? Last year’s vaccine was ineffective at preventing the flu, especially among seniors. What options are available to me this year?
Seeking Protection

Dear Seeking Protection,
You’re right. Last season’s flu shot was not very effective at preventing the flu. In fact, according to the Centers for Disease Control and Prevention (CDC), people who got the shot were just 19 percent less likely to visit the doctor for flu than people who did not get the shot. In good years, flu shot effectiveness is in the 50 to 60 percent range.

The reason for the shot’s ineffectiveness last year was because the vaccine was mismatched to the circulating flu viruses, which can genetically shift from year-to-year.

This year, U.S. health officials have tweaked the flu vaccines to include last year’s missing strain, which will hopefully provide better protection. But a flu shot is still your best defense against the flu. So, depending on your health, age and personal preference, here are the flu vaccine options (you only need one of these) available to older adults this year.

Standard (trivalent) flu shot: This traditional flu shot has been around for more than 30 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.

Quadrivalent flu shot: This vaccine, which was introduced two years ago, protects against four types of influenza – the same three strains as the standard flu shot, plus an additional new B-strain virus.

High-dose flu shot: Designed specifically for seniors, age 65 and older, this trivalent vaccine, called the Fluzone High-Dose, has four times the amount of antigen as a regular flu shot does, which creates a stronger immune response for better protection. However, note that the high-dose option may also be more likely to cause side effects, including headache, muscle aches and fever.

FluBlok vaccine: Created for adults 18 and older who have egg allergies, this is a trivalent flu vaccine that does not use chicken eggs in its manufacturing process.

Intradermal flu shot: For those who don’t like needles, the 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 shots. This trivalent vaccine, however, is recommended only to adults, ages 18 to 64.

To locate a vaccination site that offers these flu shots, visit vaccines.gov and type in your ZIP code. You’ll also be happy to know that if you’re a Medicare beneficiary, Part B will cover 100 percent of the costs of any flu shot, as long as your doctor, health clinic or pharmacy agrees not to charge you more than Medicare pays. Private health insurers are also required to cover standard flu shots, however, you’ll need to check with your provider to see if they cover the other vaccination options.

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 is now recommending 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. But if you’ve already been vaccinated with Pneumovax 23, wait at least one year before getting the Prevnar 13.

Medicare Part B covers both shots, if they are taken at least 11 months apart.

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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Roadside Assistance Services for Older Drivers

Dear Savvy Senior,
I would like to get my wife and I set up with some type of roadside assistance service in case we get a flat tire or our battery conks out. Can you recommend some good and affordable services for retirees on a budget?
Too Old to Fix a Flat

Dear Too Old,
Getting set up with a roadside assistance service you can call on day or night if your vehicle breaks down is a smart idea, and can provide you and your wife some real peace of mind. Here are some different options to look into that help you find a plan.

Already Covered?
For years, auto clubs like AAA were the only option drivers had when it came to roadside assistance, but today you have lots of choices. Most roadside assistance plans provide services like towing, flat-tire changes, jump-starting a battery, lost-key or lockout services, fuel delivery and help with stuck vehicles.

Before you start shopping for a roadside assistance plan, you first need to find out if you already have coverage, or have access to inexpensive coverage that you’re not aware of.

For example, if you drive a vehicle that is still under warranty, there’s a good chance you’re already covered. Most auto manufacturers now include comprehensive roadside assistance coverage for free when you buy a new or certified used car. This typically lasts as long as the basic warranty, but not always. Be sure you check.

Also check your auto insurance provider, your credit card issuers and cell phone service providers. Many of these services provide different variations of roadside assistance as add-on plans that cost only a few dollars per year, or they’re free.

But be aware that many of these services are limited in what they cover. When investigating these options, find out the benefit details including: Who’s covered (individuals and vehicles); how many roadside-assistance calls are allowed each year (three or four is typical); the average response time per service call; and the towing rules on where they will tow (to the nearest repair shop, or one that you choose) and how far (about 5 miles for basic plan is common, although some plans might cap the amount they pay for a tow at $100 or less).

Auto Clubs
If you find that you aren’t covered, or you want a better roadside plan than what’s currently available to you, you’ll want to check out auto/motor clubs. Most of these clubs offer two or more levels of membership depending on how much roadside assistance you want and are willing to pay for, and they often provide a variety of discounts on things like hotels, rental cars and other services.

One of the best known and longest running clubs, AAA (aaa.com) offers comprehensive services and has an extensive network of more than 40,000 roadside assistance providers, which usually means fast response times. Costs vary widely from $48 to $162 per year depending on where you live and the plan you choose, plus an additional fee for adding a family member.

Some other clubs to consider that may be a little less expensive include Allstate Motor Club (allstatemotorclub.com); AARP Roadside Assistance (aarproadside.com) for AARP members only; Better World Club (betterworldclub.com); BP Motor Club (www.bpmotorclub.com); Good Sam (goodsamroadside.com); and GM Motor Club (gmmotorclub.com).

On-Demand Assistance
Another new money saving option to consider is pay-on-demand roadside assistance services like Urgently (urgent.ly) and Honk (honkforhelp.com). If you use a smartphone and live in their service area, these non-membership app-based services will let you call for help via smartphone, and will only charge you for the assistance you need at a low price.

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 Save on Hearing Aids

Dear Savvy Senior,
Where can we find affordable hearing aids? My husband needs a set but we can’t really afford to pay the exorbitant prices. Can you help us?
Loud-Talking Wife

Dear Loud,
It’s unfortunate, but millions of Americans with hearing loss don’t get hearing aids because they simply can’t afford them. Hearing aids – typically sold through audiologists’ offices – are expensive, usually costing between $1,000 to $3,500 per ear. What’s more, traditional Medicare doesn’t cover them and private insurance typically hasn’t either.

But there are numerous ways to save on hearing aids if you know where to look. Here are a few tips.

Check Your Insurance
While most private health insurance companies do not cover hearing aids, there are a few that do. United Healthcare, for example, offers high-tech custom hearing aids to their beneficiaries through HealthInnovations for $599 to $899 each.  And a small number of other plans will pitch in $500 to $1,000 towards the cost of hearing aids, or give you a discount if you purchase hearing aids from a contracted provider.

And due to state law mandates, three states – Arkansas, New Hampshire and Rhode Island – currently require private insurance companies to provide hearing aid coverage for adults and 20 require it for children. So check with your insurance provider to see if it offers a hearing aid benefit.

If your husband is a Medicare beneficiary you should know that while original Medicare (Part A and B) and Medigap supplemental policies do not cover hearing aids, there are some Medicare Advantage (Part C) plans that do. To look for a plan in your area that covers hearing aids visit Medicare.gov/find-a-plan.

If he is a current or retired federal employee enrolled in the Federal Employees Health Benefits Program, some plans provide hearing aid coverage, including the Blue Cross Blue Shield plan that covers hearing aids every three years up to $2,500.

And, if you are on Medicaid, most state programs cover hearing aids, but requirements vary. To find out if he qualifies, contact your state’s Medicaid program or visit Medicaid.gov.

Veterans Benefit
If your husband is a veteran, the VA provides a hearing aid benefit if his hearing loss was connected to military service or linked to a medical condition treated at a VA hospital. He can also get hearing aids through the VA if his hearing loss is severe enough to interfere with his activities of daily life. To learn more, call 877-222-8387 or visit VA.gov.

Assistance Programs
If your income is low, there are various programs and foundations that provide financial assistance for hearing aids to people in need. Start by calling your state vocational rehabilitation department (see parac.org/svrp.html) to find out if there are any city, county or state programs, or local civic organizations that could help.

Also contact Sertoma (Sertoma.org, 816-333-8300), a civic service organization that offers a comprehensive list of state and national hearing aid assistance programs on their website. Or call the National Institute on Deafness and Other Communication Disorders at 800-241-1044, and ask them to mail you their list of financial resources for hearing aids.

Cheaper Buying Options

If you are unable to get a third party to help pay for your husbands hearing aids, you can still save significantly by purchasing his hearing aids at Costco or online.

Most Costco stores sell top brands of hearing aids for 30 to 50 percent less than other warehouse chains, hearing aid dealers or audiologists’ offices. This includes an in-store hearing aid test, fitting by a hearing aid specialist and follow-up care.

And websites like EmbraceHearing.com and Audicus.com, sell quality hearing aids directly from the manufacturer for as little as $400 or $500. But, he will need to get a hearing evaluation from a local audiologist first, which can cost between $50 and $200.

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

Dear Savvy Senior,
What are the best Medicare coverage options for retirees who travel a lot?
Almost 65

Dear Almost 65,
The best Medicare options for retirees who travel extensively depends on your destination.

Let’s start with a quick review of the different coverage choices Medicare offers beneficiaries today.

One option is Original Medicare, which has been around since 1966, and covers (Part A) hospital services and (Part B) doctor’s visits and other medical services.

If you choose Original Medicare, you may also want to get a Medicare (Part D) prescription drug plan (if you don’t already have coverage) to cover your medication costs, and a Medicare supplemental (Medigap) policy to help pay for things that aren’t covered by Medicare like co-payments, coinsurance and deductibles.

Or, you could get Medicare Advantage (Part C) plan, which is sold through private insurance companies, that covers everything Original Medicare covers, plus many plans also offer prescription drug coverage and extra services like vision, hearing and dental care all in one plan.

To help you evaluate your options, the National Council on Aging offers an online tool at MyMedicareMatters.org, and your State Heath Insurance Assistance Program (SHIP) provides free Medicare counseling – call 800-677-1116 for contact information.

You can also shop and compare Medicare health and drug plans and Medigap policies at Medicare.gov/find-a-plan, or call 800-633-4227.

Also note that whatever Medicare plans you choose to enroll in, if you find that they are not meeting your needs or your needs change, you can always switch to a different plan during the open enrollment period, which is between Oct. 15 and Dec. 7.

U.S. Travel
If you and your husband are planning to travel domestically, Original Medicare provides coverage everywhere in the U.S. and its territories (this includes all 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands and American Samoa) as long as the doctor or hospital accepts Medicare.

But, if you have a Medicare Advantage plan, your coverage may be restricted. This is because most Medicare Advantage plans (which are usually HMOs or PPOs) require you to use doctors, hospitals and pharmacies that are in the plan’s network within a service area or geographic region. So if you’re traveling outside that area, you may need to pay a higher fee, or your services may not be covered at all.

Before enrolling in a Medicare Advantage plan, check the benefit details carefully to see what costs and rules apply when traveling outside your service area.

Traveling Abroad
If you’re planning to travel abroad, Original Medicare does not provide coverage outside the U.S. including cruising, except in rare cases, and Medicare drug plans will not cover prescription drugs purchased outside the U.S. either.

But, there are some Medigap policies that do provide limited coverage abroad. Medigap C, D, F, G, M, and N plans will pay for 80 percent of medically necessary emergency care outside the U.S., but only for the first 60 days of the trip, and you have to meet an annual $250 deductible first. There’s also a lifetime maximum benefit of $50,000, so you’d need to cover any costs above that amount.

If you 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.

If you want additional emergency medical coverage when traveling abroad, some good shopping sites are squaremouth.com and insuremytrip.com, which compare policies from major travel-insurance companies. Prices vary considerably, ranging from under $100 to several hundred dollars depending on your age, what they cover and how long you’ll be away.

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

Dear Savvy Senior,
Do you know of any medical alert SOS buttons for seniors that work away from the home? I would like to get one for my 80-year-old mother, but would like to find one that’s not limited to the house.
Shopping Son

Dear Shopping Son,
There are actually a number of medical alert products on the market today that give seniors the flexibility to call for help both inside and outside the home.

For years, medical alert devices (also known as “personal emergency response systems” or PERS) have been popular home safety products for elderly seniors that live alone. These systems come with a wearable SOS pendent button – usually a necklace or wristband – and a base station that connects to the home phone line.

At the press of a button, your loved one could call and talk to a trained operator through the system’s base station receiver, which works like a powerful speakerphone. The operator will find out what’s wrong, and will notify family members, a neighbor, friend or emergency services as needed.

But these devices are limited because they only work in and around the house. If you’re away from home and need help, you’re out of luck. But today, there are numerous mobile products that work anywhere. Here are some top options.

High-End Devices
If you’re interested in getting your mom a comprehensive, high-end medical alert device that works everywhere, consider the Philips Lifeline GoSafe system. It provides a necklace pendent button, which works like a two-way communication device, allowing your mom to speak and listen directly through the pedant.

If your mom were to fall or need help at home, she could press the button and the home-base communicator system would be activated to make the call to the response center, who would then dispatch help as needed. But if she fell or needed help away from home, the system’s AT&T wireless network would kick in and place the call.

This system also has six sophisticated locating technologies so the response center would know your mom’s exact location, even where GPS signals are weak. And it has fall detection sensors built into the pendent that can automatically summon help if a fall is detected and your mom is unable to push the button.

The GoSafe is available at lifelinesys.com (or 855-276-7761) for $149, with monthly services fees that start at $55.

The Most Affordable Alert
If the GoSafe is more than your mom needs, another option that’s easier on the budget is the GreatCall Splash, which costs only $50, with a $35 activation fee and monthly service fees that starts at $20.

This pendent-style waterproof device, which fits in the palm of your hand, works like a cell phone with GPS tracking capabilities, and can be worn on a belt, around the neck or attached to a key chain.

To call for help, your mom would push one button, and an operator from the device’s emergency monitoring service would be on the line to assist her, and because of the GPS technology, her general location would be known. Or, for even more peace of mind, there’s the Splash with fall detection capabilities (this option costs $35 per month, and the pendent must be worn around the neck for it to work) that will automatically call for help when a fall is detected.

The Splash can be purchased at GreatCall.com (or 800-918-8543), or at Walmart, Sears, Best Buy and Rite Aid Pharmacy stores.

Other Options
If you want some additional options to shop and compare, there are other good companies that offer moderately priced mobile alerts, including Consumer Cellular (consumercellular.com/ally); Bay Alarm Medical (bayalarmmedical.com); MobileHelp (mobilehelp.com); Medical Alert (medicalalert.com); Life Alert (lifealert.com) and SafeGuardian (safeguardian.com).

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

Dear Savvy Senior,
Can you recommend any tips to help me save on my medication costs? I currently take five different prescription medications that are very expensive even with insurance.
Searching Susan

Dear Susan,
There are actually a variety ways you can reduce your out-of-pocket medication expenses without sacrificing quality. Here are a few strategies that can help, whether you are covered by employer-based health insurance, a health plan on the individual marketplace, or a private Medicare Part D drug policy.

Know your insurance formulary rules: Most drug plans today have formularies (lists 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.

Switch to generics:
Ask your doctor or pharmacist if the medications you’re taking are available in a generic form or a less expensive brand-name drug. About 75 percent of all premium drugs on the market today have a lower-cost alternative. Switching could save you between 20 and 90 percent.

Pay for generics yourself: Most generic medications cost less if you don’t use your insurance. For example, chains like Target and Walmart offer discount-drug programs (these programs will not work in conjunction with your insurance) that sell generics for as little as $4 for a 30-day supply and $10 for a 90-day supply, while some insurance companies charge a $10 copayment for a 30-day supply.

Ask your pharmacy if they offer a discount-drug 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.

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.

Try over-the-counter drugs: Ask your doctor if a nonprescription medication could work as effectively as a more expensive prescription drug. Many over-the-counter drugs for common conditions such as pain-relievers, allergy medications, anti-fungals and cold-and-cough medicines were once prescription only. But be aware that if you have a flexible spending account or a health savings account, you’ll need to get a doctor’s prescription for the over-the-counter drugs (except insulin) to get reimbursed.

Shop around: Drug prices can vary widely from drugstore to drugstore, so it’s definitely worth your time to compare prices at different pharmacies. To do this use GoodRX.com, a Web tool that lets you can find prices on all brand name and generic drugs at virtually every U.S. pharmacy.

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 BenefitsCheckUp.org, a comprehensive website that lets you locate the programs you’re 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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Understanding the Responsibilities of an Executor

Dear Savvy Senior,
An old family friend recently asked me to be the executor of his will when he dies. I feel flattered that he asked, but I’m not sure what exactly the job entails. What can you tell me?
Concerned Friend

Dear Concerned Friend,
Serving as the executor of your friend’s estate may seem like an honor, but it can also be a huge chore. Here’s what you should know to help you prepare.

Rules and Responsibilities
As the executor of your friend’s will, you’re essentially responsible for winding up his affairs after he dies. While this may sound simple enough, you need to be aware that the job can be tedious, time consuming and difficult depending on the complexity of his financial and family situation. Some of the duties required include:
* Filing court papers to start the probate process (this is generally required by law to determine the will’s validity).
* Taking an inventory of everything in his estate.
* Using his estate’s funds to pay bills, including taxes, funeral costs, etc.
* Handling details like terminating his credit cards, and notifying banks and government agencies like Social Security and the post office of his death.
* Preparing and filing his final income tax returns.
* Distributing assets to the beneficiaries named in his will.

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

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

If he has a complex estate, you may want to hire an attorney or tax account to guide you through the process, with the estate picking up the cost. If you need help locating a pro, the National Association of Estate Planners and Councils (naepc.org) and the National Academy of Elder Law Attorneys (naela.org) are great resources that provide directories on their websites to help you find someone.

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

Executor Fees

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

For more information on the duties of an executor, get a copy of the book “The Executor’s Guide: Settling A Loved One’s Estate or Trust” for $32 at nolo.com or call 800-728-3555.

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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Simplified Cell Phones for Seniors with Hearing Problems

Dear Savvy Senior,
Can you recommend some basic simplified cell phones for seniors with hearing loss? My 82-year-old father needs to get a new cell phone for occasional calls or emergencies, but he needs something that’s easy to use and one that he can hear on.
Looking Around

Dear Looking Around,
There are several simplified cell phones on the market today that are specifically designed for seniors – including those with hearing loss. These are basic cell phones that come with big buttons, easy to navigate menus, SOS emergency buttons, enhanced sound and are hearing aid compatible too. Here are some top options.

Senior-Friendly Phones
If your dad isn’t locked into a cell phone contract, there are three senior-friendly options to consider, all from no-contract cell phone companies.

One of best is GreatCall’s Jitterbug5 (greatcall.com, 800-918-8543). This custom designed Samsung flip-phone offers a backlit keypad with big buttons, large text on a brightly colored screen, and “YES” and “NO” buttons to access the phone’s menu of options versus confusing icons.

It also offers voice dialing, a powerful speakerphone, a built-in camera, and a variety of optional health and safety features like the “5Star” medical alert button that would let your dad call for help and speak to a certified agent 24/7 that could identify his location and dispatch help as needed. “Urgent Care,” which provides access to registered nurses and doctors for advice and diagnoses. And “GreatCall Link,” which keeps family members informed through your dad’s phone activities.

The Jitterbug5 sells for $99 with a one-time $35 activation fee, no-contract, and calling plans that start at $15 per month.

If you’re looking for something a little less expensive, the Doro PhoneEasy 626 sold through Consumer Cellular (consumercellular.com, 888-345-5509) is an excellent option.

This flip phone offers a backlit, separated keypad that can speak the numbers as you push them, which is a nice feature for seniors with vision problems. It also has a big easy to read color display screen that offers large text with different color themes.

Other handy features include two speed dial buttons, shortcut buttons to texting and the camera, a powerful two-way speakerphone, and a ICE (in case of emergency) button on the back of the phone that will automatically dial one pre-programed number.

The Doro 626 sells for $50 with service plans starting at $10 per month, and no long-term contract. They even offer discounts to AARP members.

Another budget-friendly cell phone you should look into is the Snapfon ezTWO for seniors (snapfon.com, 800-937-1532), which costs under $20, with a $35 activation fee, no-contract, and monthly service plans that start at $10. If you don’t want the Snapfon service plan (you can go through AT&T or T-Mobile), the phone is $80.

This is a bar-style phone that provides big buttons, a color screen, enhanced volume with a speaker phone, a speaking keypad, and an SOS emergency alert button on the back of the phone that can sound an alert when pushed and held down for five seconds. It then sends a text message to as many as five emergency contacts and calls those contacts in order until the call is answered. Or, for an additional $15 per month you can subscribe to their SOS monitoring service that will dispatch help as needed.

Shared Plan Options
If you want to get your dad a simple cell phone through your cell phone provider, most carriers – like AT&T, Verizon, Sprint and T-Mobile – still offer a few basic cell phones that are inexpensive and hearing aid compatible.

If you’re an AT&T customer the option is the “LG A380.” For Verizon users, there’s the “Samsung Gusto 3” and “LG Revere 3.” If you’re a Sprint customer there’s the “Kyocera Kona” and “Alcatel OneTouch Retro.” And for T-Mobile users there’s the “LG 450.”

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 and How Social Security Checks are Delivered

Dear Savvy Senior,
I plan to apply for my Social Security benefits in September. When can I expect my first check? And, is direct deposit my only option for receiving my monthly payment?
Almost Eligible

Dear Almost Eligible,
Generally, Social Security retirement benefits (as well as disability and survivor benefits) are paid in the month after the month they are due. So, if you apply for your Social Security benefits in September, you will receive your September benefits in October.

The day of the month you receive your benefit payment, however, will depend on either your birthdate, or the birthdate of the person whose work record you’re receiving benefits on.

If you’re applying for benefits as a retired worker, your benefit payment day will be determined by your own birthdate. But if you’re applying for spousal or survivors benefits based on your spouse’s or (if you were married at least 10 years) ex-spouse’s work record, your benefit payment date will be determined by his or her birthdate. Here’s the schedule of when you can expect to receive your monthly check:
* Birthdate is 1st through 10th of month: Payment day is second Wednesday of each month.
* Birthdate is 11th through 20th of month: Payment day is third Wednesday of each month.
* Birthdate is after the 20th of the month: Payment day is fourth Wednesday of each month.

There are, however, a few exceptions to this schedule. For example, if the day your Social Security check is supposed to be deposited happens to be a holiday, your check will be deposited the previous day. And, if you are receiving both Social Security benefits and SSI payments, your Social Security check will be deposited on the third day of the month.

You should also know that Social Security beneficiaries who started receiving benefits before 1997, their Social Security checks are paid on the third day of the month.

To get a complete schedule of 2015 payment dates, visit ssa.gov/pubs/EN-05-10031-2015.pdf.

Direct Deposit Delivery
There are two ways you can receive your Social Security benefits today. Most beneficiaries choose direct deposit into their bank or credit union account because it’s simple, safe and secure. But, if you don’t like this option or if you don’t have a bank account that your payments can be deposited into, you can get a Direct Express Debit MasterCard and have your benefits deposited into your card’s account.

This card can then be used to get cash from ATMs, banks or credit union tellers, pay bills online and over the phone, make purchases at stores or locations that accept Debit MasterCard and get cash back when you make those purchases, and purchase money orders at the U.S. Post Office. The money you spend or withdraw is automatically deducted from your account. And you can check your balance any time by phone, online or at ATMs.

There’s also no cost to sign up for the card, no monthly fees and no overdraft charges. There are, however, a few small fees for optional services you need to be aware of, like multiple ATM withdrawals. Currently, cardholders get one free ATM withdrawal per month, but additional monthly withdrawals cost 85 cents each not including a surcharge if you use a non-network ATM. To learn more about the Direct Express Debit MasterCard, visit usdirectexpress.com or call 800-333-1795.

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

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How to Choose the Best Place to Retire

Dear Savvy Senior,
My wife and I will both be retiring in a year or two and are interested in moving to a smaller house in a better climate but could use some help. What resources can you recommend for locating and researching good places to retire in the U.S.?
Looking To Relocate

Dear Looking,
If you’re interested in relocating when you retire, like millions of other baby boomers, there are a wide variety of free Web-based resources that can help you find and research a new location that meet your wants, needs and budget. Here are several to help you get started.

Where to Retire?
If you aren’t sure where you want to retire, a good place to begin is by taking a retirement test at sites like Sperling’s Best Places (bestplaces.net/fybp) or Find Your Spot (findyourspot.com). These are free quizzes that ask dozens of questions on your preferences such as climate, recreation, community size and more, and suggest possible destinations that best match your answers.

There are also various media sources and websites, like U.S. News and World Report, Kiplinger’s, Forbes, Money magazine, Reuters, Bankrate.com, TopRetirements.com, the Milken Institute and AARP that publish top retirement location lists you may find helpful too. To find them, go to any search engine and type in “best places to retire” along with the name of the media source.

You should also consider getting a subscription to “Where to Retire” magazine (wheretoretire.com, 713-974-6903), which is designed to help you find ideal retirement settings. A yearly subscription runs $18 for six issues.

Once you find a few areas that interest you, your next step is research them. Here are some important areas you need to investigate.

Cost of living: Can you afford to live comfortably in the location you want to retire to? BestPlaces.net and Numbeo.com offer tools to compare the cost of living from your current location to where you would like to move. They compare housing costs, food, utilities, transportation and more.

Taxes: Some states are more tax friendly to retirees than others. If you’re planning to move to another state, Kiplinger’s has a tax guide for retirees at Kiplinger.com/links/retireetaxmap that lets you find and compare taxes state-by-state. It covers income taxes, sales tax, taxes on retirement income, Social Security benefits taxes, property taxes, and inheritance and estate taxes.

Crime rate: To evaluate how safe a community or area is, NeighborhoodScout.com is a top tool that provides property and violent crime rates, and crimes per square mile.

Healthcare:
Does the area you want to relocate to have easy access to good healthcare? To locate and research hospitals in a new area, use HospitalCompare.hhs.gov and QualityCheck.org. To search for new doctors that accept your insurance, contact your plan, or, if you’re 65 or older use Medicare.gov/physiciancompare. It’s also important to know that healthcare costs can vary by region, so you should contact your insurer to check out possible cost variables.

Transportation: If you plan to travel much, or expect frequent visits from your kids or grandkids, convenient access to an airport or train station is a nice advantage. You should also investigate alternative transportation options, since most retirees give up driving in there eighties. To do this contact Rides in Sight (ridesinsight.org, 855-607-4337), a free transportation referral service, and the Area Aging Agency – call the Eldercare Locator at 800-677-1116 to get the local number.

Other Resources
To learn more about specific communities across the U.S., AARP’s new livability index (livabilityindex.aarp.org) along with Epodunk.com and GangsAway.com are three excellent resources, as well as the city’s chamber of commerce office. To locate it, go to any search engine and type in the name of the city and state followed by “chamber of commerce.”

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

Dear Savvy Senior,
Is macular degeneration hereditary? My mother lost her vision from it before she died a few years ago, and now at age 65, I’m worried I may get it. What can you tell me?
Nearsighted Susan

Dear Susan,
Having a parent or sibling with macular degeneration does indeed increase your risk three to four times. But the good news is there are things you can do to protect your eyesight, and a number of treatments that are available if you do happen to get it. Here’s what you should know.

What is AMD?
Macular degeneration, also known as age-related macular degeneration (or AMD) is the most common cause of vision loss in people over age 50, affecting about 10 million Americans.

AMD is a progressive eye disease that damages the macula, the part of the eye that allows us to see objects clearly, causing vision loss in the center of your vision. This affects the ability to read, drive, watch television and do routine daily tasks, but it does not cause total blindness.

There are two types of AMD – wet and dry. Dry AMD, which affects about 90 percent of all people that have it, progresses slowly and painlessly over a period of years. While wet AMD is much more aggressive and can cause severe vision loss in a matter of weeks or months.

Factors that can increase your risk of getting AMD include age (60 and older); smoking; excessive exposure to sunlight especially if you have light-colored eyes; certain genetic components; a family history of AMD; high blood pressure; obesity; and being Caucasian.

For anyone over the age of 60, it’s a smart idea to get your eyes examined by an ophthalmologist every year. They can spot early signs of AMD before vision loss occurs. Early signs, however, may include shadowy areas in your central vision or unusually fuzzy or distorted vision. The Amsler grid at amslergrid.org, is a good tool to check your eyes for AMD.

Preventing AMD

While there’s currently no cure for AMD there are some things you can do if you’re high risk. One option is to talk to your doctor about taking a daily dose of antioxidant vitamins and minerals known as AREDS – vitamins C and E, plus copper, lutein, zeaxanthin, and zinc. Studies by the National Eye Institute have shown that AREDS can reduce the risk by about 25 percent that dry AMD will progress.

Most drug stores sell these eye supplements in tablet or soft gel form over-the-counter for around $20 to $30, but be aware that not all eye supplements contain the proper formulation. Choose either the PreserVision Eye Vitamin AREDS Formula, PreserVision Eye Vitamin Lutein Formula, PreserVision AREDS2 Formula, or ICAPS AREDS. These four options contain the right formula mix.

Other lifestyle adjustments that may help prevent or delay AMD include eating antioxidant-rich foods such as dark green, leafy vegetables, and cold-water fish for their omega-3 fatty acids; protecting your eyes from the sun by wearing UV protective sunglasses; controlling high blood pressure; exercising regularly; and if you smoke, quit.

Wet AMD Treatments
For wet AMD, there are several effective medications (Lucentis, Avastin and Eylea) available that can stop vision loss and may even restore it. These medications are given by injection into the eye, and repeated every month or two, perhaps indefinitely.

Note that each of these three drugs works equally in treating wet AMD, but there’s a big cost difference. Avastin costs just $50 per month, compared with $2,000 for the other two. So experts recommend Avastin as the first choice for most people with wet AMD, especially if you don’t have supplemental Medicare coverage.

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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Financial Aid for Older Adults Going Back to School

Dear Savvy Senior,
Are there any financial aid resources you can recommend to baby boomers who are interested in going back to school? I’ve been thinking about taking some classes at a nearby college, and wanted to check into financial aid opportunities first.
Looking For Aid

Dear Looking for Aid,
If you know where to look, there’s quite a bit of financial assistance out there that can help working baby boomers and retirees go back to school. Here are some steps to take that can help you find it.

Fill out the FAFSA form: A good place to start is by filling out the Free Application for Federal Financial Aid (FAFSA). This will help you learn about grants, federal student loans (which are a better option than private student loans), and even work-study jobs. But, be aware that for most types of federal financial aid you will need to be enrolled at least half time in a degree or academic program to be eligible. To learn more or to fill out an application online, visit fafsa.gov. Or call 800-433-3243 and request a paper FAFSA.

Search for scholarships: While most scholarships are aimed at traditional undergraduates, there are a number of national and local scholarships offered specifically to older, non-traditional students. To find them try fastweb.com and scholarships.com. Both sites will prompt you to enter your birth date to find ones that are age appropriate.

Contact financial aid office: Call the financial aid office at the college or university that you plan to attend to see if they offer any other financial aid options you may be eligible for. Also, find out if they offer any special tuition wavers or discounts for students over age 50. Many community colleges and some four-year colleges offer discounted tuition rates, and many allow older students to audit courses for free.

Seek a tax break: Uncle Sam may also be able to help you with a tax credit, like the annual $2,500 American Opportunity Tax Credit, or the Lifetime Learning Tax Credit, which is worth up to $2,000 per year. Or, if you’re not eligible for the tax credits, the government also provides tuition and fees deductions for students that can cover up to $4,000 in expenses.

To learn more, visit the IRS’s Tax Benefits for Education Information Center at irs.gov – type in “tax benefits for education” in the search bar to find it. Or call 800-829-3676 and request a copy of IRS Publication 970: Tax Benefits for Education (irs.gov/pub/irs-pdf/p970.pdf).

Open a 529 account: If you don’t plan to go back to school right away, you should consider opening up a 529 college-savings plan for yourself (see savingforcollege.com). Available in every state, 529’s allow you to save money for college tax-free. And in many states you can even deduct part or all of your contribution on your state tax return.

Sign up for a free or low cost MOOC:
That’s the acronym for the popular “Massively Open Online Courses,” which offers thousands of certificate and no-certificate courses by the best universities around the world. MOOCs offer a free or cheap way to learn from their instructors anytime, anywhere. See mooc-list.com to search for courses.

Consider lifelong learning: If you’re interested in taking classes just for fun, consider Lifelong Learning Institutes (LLIs). These are noncredit educational programs designed for retirees that involve no tests or grades, just learning for the pure joy of it.

Usually affiliated with colleges and universities, LLIs offer a wide array of courses in such areas as literature, history, religion, philosophy, science, art and architecture, finance, computers and more.

To find an LLI, call your closest college or search the websites of the two organizations that support and facilitate them – Osher (osher.net) and Road Scholar (roadscholar.org/ein/intro.asp). Together they support around 500 LLI programs nationwide.

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 Compare and Locate Senior Housing Options


Dear Savvy Senior,
Can you go over the different types of housing options available to seniors, and recommend some good resources for locating and choosing one? I need to find a place for my elderly mother, and could use some help.
Searching Daughter

Dear Searching,
There’s a wide array of housing options available to seniors, but what’s appropriate for your mom will depend on her needs and financial situation. Here’s a rundown of the different levels of senior housing and some resources to help you search.

Independent living: If your mom is in relatively good health and is self-sufficient, “independent living communities” are a good place to start. Typically available to people over age 55, this type of senior housing is usually apartments or town homes that are fully functional. In addition, many of these communities also offer amenities such as meals served in a common dining area, housekeeping, transportation and a variety of social activities.

To locate this type of housing, contact your Area Agency on Aging (call 800-677-1116 to get your local number), or use online services like newlifestyles.com and caring.com. Most of these communities are private-pay only, and run anywhere from $1,000 to over $4,000 per month.

If that’s too expensive, another option is “senior apartments,” which are often subsidized by HUD for lower income seniors. You can locate these through your local housing authority or online at hud.gov – click on “Find Rental Assistance.”

Assisted living:
If your mom needs some help with daily living activities, an “assisted living facility” is another option. These facilities provide personal care (like bathing, dressing, eating, going to the bathroom) as needed, as well as meals, housekeeping, transportation, social activities and medication management. Many facilities also offer special care units for residents with dementia. Costs typically run between $2,000 to $5,000 or more per month. Most resident’s pay for assisted living from personal funds, and some have long-term care insurance policies. But, some states now have voucher plans that let you use Medicaid money.

Another similar, but less expensive option to look into is “board and care homes.” These offer many of the same services as assisted living facilities but in a much smaller home setting.

Your Area Aging Agency is again a good resource for finding these facilities, as are the previously listed senior housing locater websites. And for help choosing a facility, the Assisted Living Federation of America offers an excellent guide at alfa.org/checklist.

Nursing homes: If your mom needs ongoing medical and personal care, a “nursing home,” which provides 24-hour skilled nursing care, is the next option. To find a good one, use Medicare’s nursing home compare tool at medicare.gov/nursinghomecompare. But be aware that nursing home care is very expensive, costing anywhere between $4,500 and $11,000 per month depending on location. Most residents pay from either personal funds, a long-term care insurance policy, or through Medicaid after their savings are depleted.

Continuing-care retirement communities (CCRC’s): If your mom has the financial resources, a “CCRC” is another excellent option that provides all levels of housing (independent living, assisted living and skilled nursing home care) in one convenient location. But, these communities typically require a hefty entrance fee that can range from $20,000 to $500,000 or more, plus ongoing monthly service fees that vary from around $1,000 to over $5,000. For more information see carf.org/aging.

Need Help?
Consider hiring an aging life care expert (aginglifecare.org) who can evaluate your mom’s situation, and find appropriate housing for a fee – usually between $300 and $800. Or, you can use a senior-care advising service like A Place for Mom (aplaceformom.com, 866-344-8005) for free. (They get paid from the senior living facilities in their network.)

Some other helpful resources include the National Clearinghouse for Long-Term Care Information (longtermcare.gov), and your State Health Insurance Assistance Program (shiptalk.org), which provides free counseling.

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

Dear Savvy Senior,
Can you offer me any tips on choosing a home blood pressure monitor? I just found out I have high blood pressure, and my doctor told me I need a monitor for the house so I can keep an eye on it.
Shopping Around

Dear Shopping,
Almost everyone with high blood pressure or prehypertension should have a home blood pressure monitor. Home monitoring can help you keep tabs on your blood pressure in a comfortable setting. Plus, if you’re taking medication it will make certain it’s working, and alert you to a health problem if it arises. Here are some tips to help you choose a good monitor.

Types of Monitors
The two most popular types of home blood pressure monitors on the market today are (electric and/or battery powered) automatic arm monitors, and automatic wrist monitors.

With an automatic arm monitor, you simply wrap the cuff around your bicep and with the push of one button the cuff inflates and deflates automatically giving you your blood pressure reading on the display window in a matter of seconds.

Wrist monitors work similarly, except they attach to the wrist. Wrist monitors are also smaller in size and a bit more comfortable to use than the arm monitors, but they tend to be a little less accurate.

To help you choose the best monitor for you, here are several things you need to check into:
* Fit: Using a cuff that’s the wrong size can result in a bad reading. Most arm models have two sizes or an adjustable cuff that fits most people. Make sure your choice fits the circumference of your upper arm.
* Accuracy: Check the packaging to make sure the monitor has been independently tested and validated for accuracy and reliability. You can see a list of validated monitors at dableducational.org.
* Ease of use: Be sure the display on the monitor is easy to read and understand, and that the buttons are big enough. The directions for applying the cuff and operating the monitor should be clear.
* Extra features: Many monitors come with additional features such as irregular heartbeat detection that checks for arrhythmias and other abnormalities; a risk category indicator that tells you whether your blood pressure is in the high range; a data-averaging function that allows you to take multiple readings and get an overall average; multiple user memory that allows two or more users to save previous readings; and computer connections so you can download the data to your computer.
* Portability: If you plan to take your monitor with you while traveling, look for one with a carrying case.

Where to Shop
You can find blood pressure monitors at pharmacies, medical supply stores or online, and you don’t need a prescription to buy one.

The price will typically range anywhere from $30 to $120 or more. Unfortunately, original Medicare does not pay for home blood pressure monitors unless you’re receiving dialysis at home. But if you have a Medicare Advantage plan or a private health insurance policy it’s worth checking into, because some plans may provide coverage.

Some of the best arm monitors as recently recommended by Consumer Reports include the Rite Aid Deluxe Automatic BP3AR1-4DRITE; iHealth Dock BP3 (requires an Apple iOS device); Omron 10 Series BP786; A&D Medical UA767F; and the ReliOn BP200. And the top recommended wrist monitor is the Omron 7 Series BP652.

After you buy a monitor, it’s a good idea to take it to your doctor’s office so they can check its accuracy and teach you the proper techniques of how and when to use it.

For more information on how to measure your blood pressure accurately at home, see the American Heart Association Blood Pressure Monitoring tutorial page at homeBPmonitoring.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 Learn New Technology

Dear Savvy Senior,
What teaching resources can you recommend to help seniors learn how to use computers, tablets and smartphone devices? At age 72, I am interested in joining the technology revolution so I can keep up with my kids and grandkids a little better, but I need help.
Technology Novice

Dear Novice,
There are lots of different technology teaching tools available to boomers and seniors today, but what’s available to you will depend on where you live. Here are some different places and to look for help.

Local Classes and Workshops
There are many communities that offer beginning computer and personal technology classes for older adults that are new to technology. To find out what’s available in your area, contact your local public library, senior center, college or university, or local stores that sell computers. Your Area Agency on Aging may also be able to help you – call the Eldercare Locator at 800-677-1116 to get your local number. If you can’t find any local programs that meet your needs, here are some national resources that offer technology training in select locations.

SeniorNet: This organization offers a variety of basic online computer courses as well as instructor-led workshops at 36 learning centers throughout the United States. A first year membership fee of $43 is required. See SeniorNet.org or call 239-275-2202 for more information.

Oasis Connections: Provides primarily free computer, Internet and mobile technology classes in 30 U.S. cities. They partner with local libraries, job help centers, senior centers and faith-based organizations where these classes are offered. OasisNet.org/connections or 314-862-2933 ext. 272.

Lifelong Learning Institutes (LLIs): Usually affiliated with colleges and universities, LLIs offer a wide array of noncredit courses to retirees, and some may offer technology courses. To find an LLI that offers computer/technology classes, contact your closest colleges or search the websites of the two organizations that support and facilitate them – Osher (osher.net) and Elderhostel (roadscholar.org/ein/intro.asp). Together they support around 500 LLI programs nationwide.

AARP TEK Workshops: Available to everyone, TEK workshops are free technology learning events on tablets or smartphones and are offered in various cities throughout the U.S. AARPTEK.org or 202-434-3021.

Older Adults Technology Services (OATS): If you live in New York City, OATS provides free tech training to seniors in 70 locations throughout the city. OATS.org or 718-360-1707.

How-To Books
There are also a wide variety of books you can purchase that can help you learn how to use different types of technologies. Visual Steps (visualsteps.com), for example, offers a number of practical and accessible computer handbooks, software user guides and other instructional materials that are tailored specifically for seniors, as does the “For Dummies” books (dummies.com), which you can buy in book stores nationwide or online at sites like Amazon.com and BarnesAndNoble.com.

Online Instructional Services
If you already have a computer and some computer and/or Internet skills, but would like to expand your knowledge, there are a number of online services you can turn to that offer a wide variety of self-paced technology lessons and instructional videos.

Some good ones to checkout include GCFLearnFree.org, which is supported by the Goodwill Community Foundation and is completely free to use. And MyPCSchool.com, which is privately owned and offers nearly 700 lessons for $39 for three months or $79 for one year.

Also check out TechBoomers.com, a free educational website that teaches seniors with basic computer skills about frequently used websites, and Geekatoo.com, which offers tech support house calls in all 50 states, and offers two-hour tutorial instruction for $79.

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 Tame Pet Care Costs

Dear Savvy Senior,
What tips can you recommend to help senior pet owners with their veterinary bills? I have two cats and a dog that are family to me, but their vet bills have become unaffordable.
Fixed Income Frankie

Dear Frankie,
The high cost of veterinary care has become a problem for millions of pet owners today, but it can be especially difficult for seniors living on a fixed income. Routine medical care can cost hundreds of dollars, while urgent/specialized treatments and procedures can run into the thousands. But, it is possible to reduce your pet care costs without sacrificing their health. Here are some tips that can help you save.

Shop around: If you’re not attached to a particular veterinarian, call some different vet clinics in your area and compare costs. When you call, get price quotes on basic services like annual exams and vaccinations, as well as bigger-ticket items, like to repair a broken leg, so you can compare. Also, check to see if you live near a veterinary medical school (see aavmc.org for a listing). Many schools provide low-cost care provided by students who are overseen by their professors.

Ask your vet for help: To help make your vet bills more manageable, see if your vet’s office accepts monthly payments so you don’t have to pay the entire cost up front. Also, find out if your vet offers discounts to senior citizens or reduces fees for annual checkups if you bring in multiple pets.

Search for low-cost care: Many municipal and nonprofit animal shelters offer free or low-cost spaying and neutering programs and vaccinations, and some work with local vets who are willing to provide care at reduced prices for low-income and senior pet owners. Call your local shelter or humane society to find out what’s available in your area.

Look for financial assistance:
There are a number of state and national organizations that provide financial assistance to pet owners in need. To locate these programs, the U.S. Humane Society provides a listing on their website that you can access at humanesociety.org/petfinancialaid.

Buy cheaper medicine: Medicine purchased at the vet’s office is usually much more expensive than you can get from a regular pharmacy or online. Instead, get a prescription from your vet (ask for generic is possible) so you can shop for the best price.

Most pharmacies such as Walgreens, CVS, Walmart, Kmart, Rite Aid and Target fill prescriptions for pets inexpensively, so long as that same drug is also prescribed to humans. And, many pharmacies offer pet discount savings programs too.

You can also save by shopping online at one of the Veterinary-Verified Internet Pharmacy Practice Sites accredited by the National Association of Boards of Pharmacy, like 1-800-PetMeds (1800petmeds.com), Drs. Foster & Smith (drsfostersmith.com), KV Supply (kvsupply.com), and PetCareRx (petcarerx.com).

Consider pet insurance: If you can afford it, pet insurance is another option worth looking into. You can get a basic policy for under $10 per month, and some insurers provide discounts for insuring multiple pets. Seepetinsurancereview.com to compare policies. Membership discount plans like Pet Assure (petassure.com) are another way to save, but you’ll need to use a vet in their network.

Look for other ways to save: In addition to cutting your veterinary bills, you can also save on pet food and other supplies depending on where you shop. Target, Walmart, Costco and the dollar stores typically offer much lower prices than supermarkets and specialty retailers like Petco and PetSmart. You can also save on treats and toys at sites like coupaw.com and doggyloot.com.

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

Dear Savvy Senior,
What tips can you offer for tracking down a lost pension from a previous employer?
About to Retire

Dear About to Retire,
It’s not unusual for a worker to lose track of a pension benefit. Perhaps you left an employer long ago and forgot that you left behind a pension. Or maybe you worked for a company that changed owners or went belly up many years ago, and you figured the pension went with it.

Today, millions of dollars in benefits are sitting in pension plans across the U.S. or with the Pension Benefit Guaranty Corporation (PBGC), a federal government agency, waiting to be claimed by their rightful owners. The average unclaimed benefit with PBGC is about $6,500.

To help you look for a pension, here are some steps to take and some free resources that can help you search if your previous employer has gone out of business, relocated, changed owners or merged with another firm.

Contact Employer
If you think you have a pension and the company you worked for still is in business, your first step is to call the human resources department and ask how to contact the pension plan administrator. Ask the administrator whether you have a pension, how much it is worth and how to claim it. Depending on how complete the administrator’s records are you may need to show proof that you once worked for the company and that you are pension eligible.

Your old income tax returns and W-2 forms from the years you worked at the company will help you here. If you haven’t saved your old tax returns from these years, you can get a copy of your earnings record from the Social Security Administration, which will show how much you were paid each calendar year by each employer.

Call 800-772-1213, and ask for Form SSA-7050, “Request for Social Security Earnings Information,” or you can download it at ssa.gov/online/ssa-7050.pdf. The SSA charges a $136 for this information.

Some other old forms that can help you prove pension eligibility are summary plan descriptions that you should have received from your employer when you worked there, and any individual benefit statements that you received during your employment.

Search PBGC
If your former employer went out of business or if the company still is in business but terminated its pension plan, check with the PBGC, which guarantees pension payouts to private-sector workers if their pension plans fail, up to annual limits. Most people receive the full benefit they earned before the plan was terminated. The PBGC offers an online pension-search directory tool at search.pbgc.gov/mp/mp.aspx.

Get Help
If you need help tracking down your former company because it may have moved, changed owners or merged with another firm, contact the Pension Rights Center, a nonprofit consumer organization that offers seven free Pension Counseling and Information Projects around the U.S. that serve 30 states. For more information, visit pensionrights.org or call 888-420-6550.

If you, your company or your pension plan happens to be outside the 30-state area served by the projects, or if you’re trying to locate a federal or military pension, use Pension Help America at pensionhelp.org. This resource can connect you with government agencies and private organizations that provide free information and assistance to help your search.

For more pension searching tips, see the PBGC’s free online publication called “Finding a Lost Pension” at pbgc.gov/documents/finding-a-lost-pension.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 Recognize Stroke Symptoms and What to Do

Dear Savvy Senior,
What are the symptoms of a stroke? My 66-year-old aunt had a stroke a few months ago and neither she nor my uncle had a clue it was happening.
Concerned Relative

Dear Concerned,
Unfortunately, most Americans don’t know the signs of a stroke, but they need to. Stroke is the fifth leading cause of death in the United States and the No. 1 cause of disability. Being able to recognize a stroke and getting to the hospital quickly can make a huge difference in reducing its potentially devastating effects. Here are some tips that help you recognize a stroke, and what you should do if it happens to you or your loved one.

Types of Stroke

According to the Centers for Disease Control and Prevention, every year more than 795,000 people in the United States have a stroke – three-quarters of which are over the age of 65. A stroke occurs when a blood vessel that carries blood to the brain is suddenly blocked by a clot (ischemic stroke), or burst (hemorrhagic stroke), causing parts of the brain to become damaged or die. About 87 percent of all strokes are ischemic.

Depending on the severity of the brain damage, strokes can cause mild to severe disabilities including paralysis, loss of speech, vision and memory, along with other health and emotional issues, and death.

Stroke Signs
Because stroke injures the brain, the person having a stroke may not realize it. Stroke victims have the best chance if someone around them recognizes the symptoms and acts quickly. The five most common symptoms include:
* Sudden numbness or weakness of the face, arm, or leg, especially on one side of the body.
* Sudden confusion, trouble speaking or understanding.
* Sudden trouble seeing in one or both eyes.
* Sudden trouble walking, dizziness, loss of balance or coordination.
* Sudden, severe headache with no known cause.

The easiest way to identify a stroke is to use the F.A.S.T. test to identify the symptoms.

F (Face): Ask the person to smile. Does one side of the face droop?
A (Arm): Ask the person to raise both arms. Does one arm drift downward?
S (Speech): Ask the person to say a simple sentence. Is their speech slurred?
T (Time): If you observe any of these signs of stroke, call 911.

To help you remember the signs, the American Stroke Association has a free “Spot a Stroke FAST” app (see strokeassociation.org) that you can download on your smartphone or mobile device. Or, visit the National Stroke Association at stroke.org and print their “Act FAST” wallet card to keep as a reminder.

Act Quickly
Remember that stroke is a medical emergency and every minute counts. Even if you’re not sure a stroke is happening, call 911 anyway. The longer blood flow is cut off to the brain, the greater the damage. Immediate treatment can save a person’s life and improve their chances for a successful recovery.

Ischemic strokes are treated with a drug called t-PA that dissolves the blood clots that block the blood flow to the brain. The window of opportunity to start treating a stroke is three hours. But to be evaluated and receive treatment, patients need to get to the hospital within 60 minutes.

If you have a choice, wait for the paramedics rather than driving the patient yourself. Patients who are transported by EMS are evaluated and treated much quicker than people who are driven in. And, of course, don’t drive if you are the one having a stroke.

It’s also very important that you call 911 even if symptoms go away. When symptoms of stroke disappear on their own after a few minutes, a “mini-stroke” or transient ischemic attack (TIA) may have occurred which is a warning that a major stroke may be coming. That’s why mini-strokes need to be treated like emergencies too.

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

Dear Savvy Senior,
Do you know of any financial assistance programs or other resources that can help seniors with home improvement projects? I would like to help my 86-year-old father make a few modifications to his house so he can live there as long as possible, but money is very tight.
Inquiring Daughter

Dear Inquiring,
There are actually a number of programs available that can help seniors with home repairs and improvement projects for aging-in-place, but what’s available to your dad will depend on his financial situation and where he lives. Here are some different options to explore.

Medicaid waivers: If your dad is low-income and eligible for Medicaid, most states have Medicaid Home and Community Based Services waivers that provide financial assistance to help seniors avoid nursing homes and remain living at home. Many of the waivers pay for home modifications to increase a person’s ability to live independently. Each state has different waivers with different eligibility requirements and benefits. Contact your Medicaid office (see medicaid.gov) for more information.

State and local programs: Some states and local governments have financial assistance programs, often called “nursing home diversion programs” or “deferred payment loans” that are not funded by Medicaid. These programs, which may include grants or loans or a combination, helps pay for modifications that enable low to moderate income elderly and disabled to remain living at home. Modifications covered typically include accessibility improvements like wheelchair ramps, handrails and grab bars. And some may be used for home improvements like roofing, heating and cooling, insulation, weather-stripping and storm windows.

To find out if there’s a program in your dad’s area, contact the city or county housing authority, the local Area Aging Agency (call 800-677-1116 for contact information) or the state housing finance agency – see ncsha.org/housing-help.

Federal programs: The Department of Housing and Urban Development offers HUD Home Improvement Loans, which are HUD insured loans made by private lenders for home improvement and building projects. Contact a HUD approved counseling agency in your area (call 800-569-4287) to learn more.

And the U.S. Department of Agriculture has a Rural Development program that provides grants and loans to low-income, elderly or disabled, rural homeowners for home repairs and improvements. Your local USDA service center (see offices.sc.egov.usda.gov) can give you more for information.

Veteran benefits: If your dad is a veteran with a disability, the VA provides grants like the SAH, SHA and HISA grants that will pay for home modifications. See benefits.va.gov/benefits/factsheets/homeloans/sahfactsheet.pdf for details and eligibility requirements.

Another possibility that’s available to veterans enrolled in the Medical Benefits Package is Veterans-Directed Home and Community Based Services. This program provides veterans who need help with daily living activities with financial assistance to help them remain living in their homes, and provides them with a certain amount of discretion to use those funds. To learn more see va.gov/geriatrics, or call 800-827-1000.

Non-profit organizations: Depending on where your dad lives, he may also be able to get home repair and modification services through the national, non-profit organization Rebuilding Together (rebuildingtogether.org, 800-473-4229). They provide services to low-income seniors, veterans and military families, families with children, people living with disabilities and victims of disaster.

You should also check with the Area Aging Agency to see if any other local organizations that offer volunteer home modification help to low-income seniors.

Reverse mortgages: Available to seniors 62 and older who own their own home, or owe only a small balance, and are currently living there, a reverse mortgage (see reversemortgage.org) will let your dad convert part of the equity in his home into cash – which can be used for home improvements – that doesn’t have to be paid back as long as he lives there. But, reverse mortgages are expensive loans, so this should be a last resort.

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

Dear Savvy Senior,
What resources can you recommend to help me find and research some doctors in my area? I’m looking for a good primary care doctor or internist for my elderly parents, and need to locate a good orthopedic doctor for me.
Shopping for Doctors

Dear Shopping,
Thanks to the Internet, finding and researching doctors is a lot easier than it use to be. Today, there’s a wide variety of websites you can turn to that provide databases of U.S. doctors, their professional medical histories, and ratings and reviews from past patients on a number of criteria. Here are some of the best sites available, along with a few additional tips that can help you find the right doctors.

Locating Tips

To help you locate some doctors in your area, a good first step, and one that doesn’t require a computer, is to ask for a referral. Contact some other doctors, nurses, or health care professionals that you know, for some names of doctors or practices that they like and trust.

You should also call your insurance provider, or visit their website directory to get a list of potential candidates. If you or your parents are Medicare beneficiaries, you can use the Physician Compare tool at medicare.gov/physiciancompare. This will let you find doctors by name, medical specialty or by geographic location that accept original Medicare. You can also get this information by calling Medicare at 800-633-4227.

Once you find a few doctors, you need to call their office to verify that they still accept your insurance, and if they are accepting new patients.

Research Tools
After you find a few doctors you’re interested in, there are lots of online resources you can turn to, to help you check up on them.

For example, you can find out if a doctor is board certified at the American Board of Medical Specialties at certificationmatters.org or call 866-275-2267. And to learn about malpractice claims and disciplinary actions taken against doctors, you can use your state medical board – see fsmb.org/state-medical-boards/contacts to search your state.

Here are some other good websites that can help you find and/or research doctors in your area for free.

Healthgrades.com: This comprehensive easy-to-use site provides doctor’s information on education and training, hospital affiliations, board certification, awards and recognitions, professional misconduct, disciplinary action and malpractice records, office locations and insurance plans. It also offers a 5-star ratings scale from past patients on a number of issues like communication and listening skills, wait time, time spent with the patient, office friendliness and more.

Vitals.com: Provides background information on doctor’s awards, expertise, hospital affiliations, and insurance as well as patient ratings on measures such as bedside manner, follow-up, promptness, accuracy of diagnosis, and average wait time. There’s also a patient comment section.

RateMDs.com: Provides information on training as well as patient ratings on staff, punctuality, helpfulness and knowledge. Patients can also post questions and answers about doctors, and get doctor’s ratings based on patient reviews.

Look Up Tool: If you want to find out how many times a doctor did a particular service and what they charge for it, go to data.cms.gov and click on “Medicare Physician and Other Supplier Look-up Tool” at the top of the page.

AngiesList.com: If you don’t mind spending a little money ($20/per year), Angie’s List is a membership service that provides doctor reviews using an A through F scale.

When reaching a doctor, it’s wise to check out several of these sites so you can get a bigger sampling and a better feel of how previous patients are rating a particular doctor.

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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Easier Screening Tests for Colon Cancer


Dear Savvy Senior,
Are there any easier alternatives to a colonoscopy to check for colon cancer? I’m in my sixties and would like to be tested, but hate the idea of drinking all that laxative solution, and being sedated for the procedure.
Squeamish Jim

Dear Jim,
It’s a great question. While a colonoscopy is considered the gold standard screening test for detecting colon cancer and is widely recommended once adults reach age 50, only about half of Americans who’ve passed that milestone ever get tested.

Why? Because most people, like yourself, dread the all-day laxative prep and sedation, not to mention the procedure itself. Fortunately, there are some easier alternatives, but be aware that if these tests uncover any suspicious results, you’ll still need to undergo a colonoscopy.

Take-Home Tests
There are two different types of tests on the market today that you can take in the privacy of your own home that requires no laxative-taking/bowel-cleansing preparation.

The best option is the new FDA approved Cologuard test (see cologuardtest.com), which has a 92 sensitivity rate for detecting colon cancers. With this test you simply take a sample of a bowel movement, and mail it in to the lab for analysis. The lab looks for both blood and cancer-related DNA cells in your stool.

The Cologuard test, which is recommended every three years, requires a prescription from your doctor, and costs $599 but is covered by Medicare and many private insurers.

If, however, you find that the Cologuard test is not covered by your insurer, and you can’t afford or don’t want to pay the $599 fee, the other option is the fecal occult blood test (FOBT) or the fecal immunochemical test (FIT), which detects 74 percent colon cancers.

These tests, which are also provided by your doctor, check for traces of blood in the stool that could indicate cancer or large polyps that can develop into cancer, but they don’t look at the DNA. You simply send a stool sample to the lab.

Recommended annually, both of these fecal tests cost only around $25 and are covered by Medicare and most insurers.

Less Invasive Tests
Two other tests to consider that are less invasive then a colonoscopy but more entailed than the take-home tests are the virtual colonoscopy and the sigmoidoscopy (both tests are recommended every five years).

A virtual colonoscopy uses a CT scan to view your colon instead of a scope in the rectum, so it’s a less invasive procedure than a traditional colonoscopy and doesn’t require sedation. But, it still requires the same bowel-cleansing prep. It’s also more expensive, typically costing between $400 and $800 and is not covered by Medicare or most insurers.

A sigmoidoscopy exam, which is covered by Medicare and most insurers, uses a short, flexible scope inserted in the rectum like a colonoscopy to look at the lower colon only. This is a much faster and less involved procedure than a colonoscopy and one that doesn’t require sedation. You follow a clear liquid diet the day before the exam and take a laxative or enema the morning of.

Colon Cancer Numbers
Colon cancer, which develops slowly over several years without causing symptoms especially in the early stages of the disease, is the second largest cancer killer in the U.S., killing around 50,000 Americans a year.

The U.S. Preventive Services Task Force – an independent panel of medical experts that advises the government on health policies – recommends colon cancer screening to all adults, ages 50 to 75. Earlier screenings are recommended to people who have an increased risk due to family history or other factors.

Experts believe that as many as 20,000 lives could be saved each year, if the screening rate went up to 90 or 95 percent.

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

Dear Savvy Senior,
I’ve heard that Social Security offers a lump-sum payment to retirees who need some extra cash. I have not yet started drawing my benefits and would like to investigate this option. What can you tell me?
Almost Retired

Dear Almost,
There are actually two different kinds of Social Security claiming strategies that can provide retirees a big lump-sum benefit, but you need to be past full retirement age to be eligible, and there are financial drawbacks you need to be aware of too.

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

At full retirement age, you are entitled to 100 percent of your benefits. If you claim earlier you’ll receive less, while if you delay you’ll get more – roughly 8 percent more for each year until age 70.

Lump Sum Options

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

Here’s how it works. Let’s say you were planning to delay taking your Social Security benefits past age 66, but you changed your mind at 66 and six months. You could then claim a lump-sum payment equal to those six months of benefits. So, for instance, if your full retirement age benefit were $2,000, you would be entitled to a $12,000 lump sum payment.

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

Another option that provides even more cash is the “file and suspend” strategy. Again, this option is only available to people on (or after) full retirement age.

Here’s how this strategy works. Let’s say you’re 66, and you decide to delay your benefits. You could file for your benefit and then immediately suspend it. This gives you the ability to collect a lump sum going back to the date you filed. So if you need money at age 69 for example, and your full retirement age benefit was $2,000, you could get a three-year lump sum of $72,000.

Drawbacks
The big downside to these strategies is that once you accept a lump-sum payment, you’ll lose all the delayed retirement credits you’ve accrued, and your future monthly retirement benefit will be reduced to reflect the amount you already received.

Here’s an example of how this works. Let’s say that you are entitled to a $2,480 monthly benefit at age 69. By taking a three-year lump sum payment, your future benefits will shrink back to $2,000 per month, which is what you would have received at your full retirement age. This also affects your future survivor benefit to your spouse or other eligible family members after you die.

You also need to consider Uncle Sam. Depending on your income, Social Security benefits may be taxable, and a lump-sum payment could boost the amount of benefits that are taxed. To help you calculate this, see IRS Publication 915 “Social Security and Equivalent Railroad Retirement Benefits” at irs.gov/pub/irs-pdf/p915.pdf, or call 800-829-3676 and ask them to mail you a copy.

One other caveat: If you’re married and you “file and suspend” your Social Security benefit, you cannot file a “restricted application” too, which gives you the ability to collect spousal benefits while delaying your own retirement benefit past full retirement age.

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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Driving Safely with Dementia and Knowing When to Quit

Dear Savvy Senior,
Is it safe for seniors with dementia to drive, and if so, when should they stop? My dad has early Alzheimer’s disease but still drives himself around town just fine.
Looking Ahead

Dear Looking,
While most doctors agree that people with moderate to severe dementia should not take the wheel, in the early stages, the medical consensus is that driving performance should be the determining factor of when to stop driving, not the disease itself.

With that said, it’s also important to realize that as your dad’s driving skills deteriorate over time from the disease, he might not recognize it. So it’s very important that you work closely with him and his doctor to monitor his driving. Here are some tips that can help.

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

If you need some assessment help, hire a driver rehabilitation specialist who’s trained to evaluate older drivers. To locate a specialist see driver-ed.org or aota.org/older-driver.

Transition Tips

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

In addition, you should also consider getting a GPS vehicle tracking system for his car (like motosafety.com or mobicopilot.com) to help you keep an eye on him. These devices will let you track exactly where he’s driving, and allow you to set up zones and speed limits that will notify you via email or text message when he exits an area or arrives at a designated location, and if he’s driving too fast.

Time to Quit

When your dad’s driving gets to the point that he can no longer drive safely, you’ll need to talk to him. It’s actually best to start having these conversations in the early stages of the disease, before he needs to quit driving, so he can prepare himself.

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

For tips on how to talk to your dad, the Hartford Financial Services Group and MIT AgeLab offers a variety of resources at safedrivingforalifetime.com – click on “Dementia and Driving.”

Refuses To Quit
If your dad refuses to quit you have several options. First, suggest a visit to his doctor who can give them a medical evaluation, and “prescribe” that he stops driving. Older people will often listen to their doctor before they will listen to their own family.

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

If all these fail, consider hiding his keys or just take them away. You could also disable his vehicle, park it in another location so he can’t see it or have access to it, or sell it.

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

Dear Savvy Senior,
What products or solutions can you recommend to help seniors keep up with their medications? My mom is supposed to take several different medications at different times of the day but frequently forgets.
Reminding Son

Dear Reminding,
Anybody who juggles multiple medications can relate to the problem of forgetting to take a medication, or not remembering whether they already took it. This is especially true for people who take medications at varying times of the day. Here are some different product and service solutions that may help.

Medication Helpers
Getting organized and being reminded are the two keys to staying on top of a medication schedule. To help your mom achieve this, there are a wide variety of affordable pillboxes, medication organizers, vibrating watches, beeping pill bottles and even dispensers that will talk to her that can make all the difference. To find these types of products go to Epill.com (800-549-0095), where you’ll find dozens to choose from.

Also check out Reminder Rosie (reminder-rosie.com, $130), a voice activated talking clock that tells you when to take your medicine, and can be used for other reminders, too.

And for a super comprehensive medication management device, there’s the MedMinder automatic pill dispenser. This is a computerized pillbox that will beep and flash when it’s time for your mom to take her medication, and will call her if she forgets. It will even alert her if she takes the wrong pills. This device can also be set up to call, email or text family members and caregivers letting you know if she misses a dose, takes the wrong medication or misses a refill. Available at MedMinder.com, or 888-633-6463, the MedMinder rents for $40 to $65 per month.

Medication Packaging
Another possible way to help simplify your mom’s medication use is to get her prescriptions filled in single-dose packets that put all her medications (vitamins and over-the-counter drugs can be included too) together in neatly labeled packets organized by date and the time of day they should be taken. This does away with all the pill bottles and pill sorting. Some compounding pharmacies or independent drug stores offer single-dose packaging along with a number of online pharmacies like PillPack.com.

Reminding Services
Another simple solution that can help your mom stick to her medication schedule is to use a medication reminding service. These are services that will actually call, email or text your mother reminders of when it’s time to take her medicine and when it’s time to refill her prescriptions. Some even offer extra reminders like doctor and dentist appointments, wake-up calls and more.

Companies that offer such services are MyMedSchedule.com, which provides free medication reminders via text message or email. Their website can also help you make easy-to-read medication schedules that you can print out for your mom to follow. Or, if your mom uses a smartphone or tablet, there are free medication reminding apps that can help, like MediSafe (medisafeproject.com) or MedCoach (greatcall.com).

If, however, your mom doesn’t receive texts or use a smartphone, tablet or computer, OnTimeRx.com or Snoozester.com may be the answer. With starting prices ranging between $4 and $10 per month, these services will call your mom on her phone (they can send text messages and emails too) for all types of reminders including daily medications, monthly refills, doctor appointments, wake-up calls and other events.

Or, if you’re looking for extra help, Care Call Reassurance (call-reassurance.com, 602-265-5968 ext. 7) may be a better fit. In addition to the call reminders to your mom’s phone, this service can be set up to contact a family member or designated caregiver if she fails to answer or acknowledge the call. This service runs between $15 and $20 per month.

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

Dear Savvy Senior,
Can you give me a rundown on Medicare’s enrollment choices and rules along with when and how to apply? I turn 65 next year and want to make sure I know what to do.
Almost Retired

Dear Almost,
The strict rules and timetables for Medicare enrollment can be confusing to many new retirees, so you’re wise to plan ahead. Here’s a simplified rundown of what to know.

First a quick review. Remember that original Medicare has two parts: Part A, which provides hospital coverage and is free for most people, and Part B which covers doctor’s visits and other medical services, and costs $104.90 per month for most enrollees in 2015.

When to Enroll
Everyone is eligible for Medicare at age 65, even if your full Social Security retirement age is 66 or later.

You can enroll any time during the “initial enrollment period,” which is a seven-month period that includes the three months before, the month of, and the three months after your 65th birthday. It’s best to enroll three months before your birth month to ensure your coverage starts when you turn 65.

If you happen to miss the seven-month sign-up window for Medicare Part B, you’ll have to wait until the next “general enrollment period” which runs from Jan. 1 to March 31 with benefits beginning the following July 1. You’ll also incur a 10 percent penalty for each year you wait beyond your initial enrollment period, which will be tacked on to your monthly Part B premium. You can sign up for premium-free Part A, at any time with no penalty.

Working Exceptions
Special rules apply if you’re eligible for Medicare and still on the job. If you have health insurance coverage through your employer or your spouse’s employer, and the company has 20 or more employees, you have a “special enrollment period” in which you can sign up. This means that you can delay enrolling in Medicare Part B, and are not subject to the 10 percent late-enrollment penalty as long as you sign up for within eight months of losing that coverage.

Drug Coverage
Be aware that original Medicare does not cover prescription medications, so if you don’t have credible drug coverage from an employer or union, you’ll need to buy a Part D drug plan from a private insurance company (see medicare.gov/find-a-plan) during your initial enrollment if you want coverage. If you don’t, you’ll incur a premium penalty – 1 percent of the average national premium ($33.13 in 2015) for every month you don’t have coverage – if you enroll later.

Supplemental Coverage
If you choose original Medicare, it’s also a good idea to get a Medigap (Medicare supplemental) policy within six months after enrolling in Part B to help pay for things that aren’t covered by Medicare like co-payments, coinsurance and deductibles. See Medicare.gov and click on “Supplements & Other Insurance” to shop and compare policies.

All-In-One Plans
Instead of getting original Medicare, plus a stand-alone Part D drug plan and a Medigap policy, you could sign up for a Medicare Advantage plan (see medicare.gov/find-a-plan) that covers everything in one plan. These plans, which are also sold by insurance companies, are generally available through HMOs and PPOs and often have cheaper premiums, but their deductibles and co-pays are usually higher which makes them better suited for healthier retirees.

How to Enroll

If you’re already receiving your Social Security benefits before 65, you will automatically be enrolled in Part A and Part B, and you’ll receive your Medicare card about three months before your 65th birthday. It will include instructions to return it if you have work coverage that qualifies you for late enrollment. If you’re not receiving Social Security, you’ll need to enroll either online at socialsecurity.gov/medicare, over the phone at 800-772-1213 or through your local Social Security office.

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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Simplified Smartphone Options for Tech-Shy Seniors

Dear Savvy Senior,
I’m interested in getting my 72-year-old mother a smartphone, but want to get one that’s very easy for her to use. What can you recommend?
Shopping Around

Dear Shopping,
There are several different ways you can go about getting your mom a simplified smartphone that’s easy for her to use. Depending on how much you’re willing to spend, here are some different options to consider.

Simplify a Used Phone
The cheapest way to set your mom up with an easy-to-use, uncomplicated smartphone is to get her a second-hand android phone, and install a senior-friendly “launcher app” on it, which is a user interface software application.

This type of launcher will turn the appearance and performance of most android smartphone into a simplified phone with big understandable icons for commonly used features (phone, text messaging, camera, contacts, etc.) and no excess clutter. Most launchers can also be customized to fit your mom’s needs and preferences.

There are a variety of launcher apps available today that provide this type of technology and are completely free to use. Some popular options include, Necta Launcher (launcher.necta.us), Wiser (wiser-me.com), Seniors Phone (seniorsphone.mobi), Fontrillo (fontrillo.com) and Big Launcher (biglauncher.com), which also offers an upgraded version for $9.

Or, if you have an old Apple iPhone that you’d like to convert, check out Silverline Mobile (silverline.mobi) that converts both Apple and androids for free.

Purchase a New Phone
If you’re interested in purchasing your mom a new smartphone, you have options here too. For starters, you could purchase her a smartphone that’s specifically designed for seniors, like GreatCall’s Touch3 that costs $150 (with no contract) at greatcall.com or 800-918-8543. This is an android phone, made by Samsung, that has a 4-inch touchscreen and provides a simple menu list to often-used features like the phone, text messages, camera, pictures, email and Internet, along with your contacts and apps.

It also offers a variety of health and safety features like the “5Star app” that would let your mom speak to a certified agent 24/7 that could identify her location and get her the help she needs. “Urgent Care,” which provides access to registered nurses and doctors for advice and diagnoses. And “MedCoach,” which sends medication reminders.

Another way you could go is to purchase her a standard/mainstream smartphone that provides a built-in “Easy Mode” or “Simple” feature in the phone’s settings. This will let you convert the phone into a much simpler mode of operation, that provides larger, well labeled icons, to only commonly-used functions like the phone, camera, messaging, Internet, pictures, contacts and her favorite apps.

Smartphones that offer the “Easy Mode” or “Simple” feature include the Samsung Galaxy phones, which are available through most cell phone carriers at prices typically ranging between $400 and $850 without a contract. Or, for a more budget-friendly option, the Huawei Vision 2 and Huawei Ascend Mate 2, which you can buy as an unlocked phone or through Consumer Cellular (consumercellular.com, 888-345-5509) for $80 or $225 without a contract. Consumer Cellular is a top-rated no-contract service provider that also offers discounts to AARP members.

A nice advantage of getting your mom a mainstream phone is that if she masters the Easy/Simple mode (or gets bored with it), and is ready to expand her skills, you can always switch the phone back to the standard operation mode exposing her to more options. You can also add any number of health and safety features to her phone, like what the Touch3 offers, by downloading their apps at greatcall.com/medical-apps.

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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Essential Legal Documents All Seniors Should Have

Dear Savvy Senior,
What kinds of legal documents are suggested for end-of-life plans? I would like to get my affairs in order before it’s too late.
Getting Old

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

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

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

Durable Power of Attorney: This allows you to designate someone you trust to make financial, tax and legal decisions on your behalf if you lose your decision-making capacity.

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

Do-It-Yourself
If you have a simple estate and an uncomplicated family situation, there are several good do-it-yourself guides that can help you create all these documents for very little money.

For creating a will, a top resource is the Quicken WillMaker Plus 2015 software (available at nolo.com) that costs $50, works with Windows personal computers and is valid in every state except Louisiana. If you use a Mac, nolo.com offers an online will maker for $35.

Or, if you only need to create an advance directive you can do it for free at caringinfo.org (or call 800-658-8898), where you can get state-specific forms with instructions. Or for only $5, an even better tool is the Five Wishes document (agingwithdignity.org, 888-594-7437), which is valid in 42 states and will help you create a customized advance directive.

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

Costs will vary depending on where you reside, but you can expect to pay somewhere between $200 and $1,000 for a will, or $1,200 to $5,000 for a living trust.

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

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

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

Dear Savvy Senior,
How does Medicare cover home health care? Because of my illness, my doctor suggested I get home health care, but I want to find out how it’s covered before I proceed.
Need Some Help

Dear Need Some Help,
Medicare covers a wide variety of intermittent in-home health care services (usually up to 28 hours per week) to beneficiaries, if you meet their specific requirements. Here’s how it works.

In order for you to secure coverage for home health care, Medicare first requires that you be homebound. This means that it must be extremely difficult for you to leave your home, and you need help from a device (like a wheelchair or walker) or a person in doing so.

You will then need your doctor to approve a “plan of care” confirming that you need skilled-nursing care or skilled-therapy services from a physical or speech therapist on a part-time basis. Your doctor can also request the services of an occupational therapist and a home health aide to assist with activities of daily living such as bathing, dressing and using the bathroom. Your doctor must renew the “plan of care” once every 60 days.

You will also need to use a home health agency that is certified by Medicare.

If you meet all of the requirements, Medicare should pay for your in-home care.

But, be aware that Medicare will not pay for home health aide services (such as bathing, dressing or using the bathroom) alone, if you do not need skilled-nursing or skilled-therapy services too. Homemaker services, such as shopping, meal preparation and cleaning are not covered either.

You also need to know that Medicare has recently changed their home health care policy regarding degenerative diseases. They will now pay for in-home physical therapy, nursing care and other services to beneficiaries with chronic conditions like multiple sclerosis, Parkinson’s or Alzheimer’s disease in order to maintain their condition and prevent deterioration. In the past, Medicare would only cover home health services if the patient were expected to make a full recovery.

If you have original Medicare, you can locate a Medicare-certified home health agency by calling 800-633-4227 or by visiting medicare.gov/homehealthcompare. If you have a Medicare Advantage plan, you should contact your plan directly and ask which home health agencies work with the plan and are within the plan’s network of providers.

For more detailed information on how Medicare covers in-home health, see the “Medicare and Home Health Care” online booklet at medicare.gov/pubs/pdf/10969.pdf.

Other Options
If you don’t qualify for Medicare coverage, there are other coverage options depending on your situation, including:

Insurance: If you happen to have long-term care insurance, check to see if it covers in-home care. Or if you have a life insurance policy, see if it can be utilized to pay for care.

Medicaid: If your income is low enough, all states offer Medicaid programs that will pay for some forms of in-home care. To investigate this, contact your local Medicaid office.

Veterans Assistance: If you’re a veteran, some communities have a Veteran-Directed Home and Community Based Service program, which give veterans a flexible budget to pay for in-home care.

Also available to wartime veterans and their spouses is a benefit called “Aid and Attendance” that helps pay for in-home care, as well as assisted living and nursing home care.

To be eligible, you must need assistance with daily living activities like bathing, dressing or going to the bathroom. And, your annual income must be under $21,466 – minus medical and long-term care expenses. If you’re a surviving spouse of a veteran, your income must be below $13,794 to be eligible. Your assets must also be less than $80,000 excluding your home and car.

To learn more, see va.gov/geriatrics or call 800-827-1000.

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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Handy Aids For Achy Hands

Dear Savvy Senior,
What products can you recommend for seniors with hand arthritis? I really struggle with anything that requires gripping and turning, which makes most activities difficult.
Gripless Joan

Dear Joan,
There are literally hundreds of different arthritis aids and other products on the market today that can help people with arthritic hands and carpal tunnel syndrome.

To find out which devices can best benefit you, a good place to start is to ask your doctor for a referral to an occupational therapist, who can test the strength and functionality of your hands and recommend appropriate aids. With that said, here’s a rundown of some helpful products for different needs.

Kitchen aids: Activities like gripping cooking utensils, cutting and chopping, opening jars and cans, and moving around heavy pots and pans can make preparing a meal much more difficult when you have hand arthritis.

Some products that can help are Oxo Good Grips, which makes dozens of soft, large-handle cooking, baking and cleaning utensils that are easier to grip. And for cutting and chopping the Dexter DuoGlide and Ergo Chef knives are excellent ergonomically designed options.

For opening jars, the wall-mounted or under-counter mounted Zim Jar Opener is a top manual opener. It has a V-shaped grip that holds the lid as you twist the jar with both hands. Some other good options are the Hamilton Beach Open Ease Automatic Jar Opener, and a nifty tool called the JarPop that pops the seal on jars so lids can be removed easier.

For opening cans, an electric can opener is the best option. West Bend and Hamilton Beach make some of the best.

And if you’re interested in arthritis-friendly pots and pans, look for lightweight cookware that has two handles. These are much easier to lift and move around.

Household helpers: Turning doorknobs, key locks, twist-handles on kitchen or bathroom faucets, and twist-on lamp switches can also be difficult. To help, there are doorknob lever adapters, key turners, lamp switch enlargers, and lever handles for faucets that provide leverage for easier turning.

Personal care: Squeezing a shampoo bottle or a tube of toothpaste, or gripping a bar of soap, a toothbrush handle or even a piece of dental floss can make grooming a challenge. Solutions include a wall-mounted soap, shampoo and toothpaste dispenser, which provides easy access to suds. And for brushing and flossing, there are wide-handled, electric toothbrushes and flossers that vibrate or spin to do the cleaning for you.

Easier dressing: Fastening buttons, pulling zippers and tying shoelaces can also present problems. To help with these chores there are button hooks and zipper pulls, and elastic shoelaces, which transform lace-ups into slip-ons.

Reading, writing and computing: Holding and turning the pages of a book, hand writing and using a computer mouse can also stress arthritic hands.

For readers, an eReader like a Kindle or Nook is recommended because they’re lightweight and easier to hold than regular books. For writing, there’s the soft rubber Pencil Grip that fits on pencils and pens, and ergonomic-shaped pens like the Pen Again that reduce hand fatigue. And for easier computing, the 3M Ergonomic Mouse and Contour Roller Mouse can eliminate hand and wrist stress.

Hobby helpers: There are dozens of arthritis aids for hobbies too. For example, there are automatic card shufflers and cardholders for card players. If you like to paint, knit or crochet, there are ergonomic paintbrushes, and oversized knitting needles and crochet hooks that are easier to hold. And for sewing, quilting or crafting, there are tools like Fiskars self-opening Easy Action Scissors that spring open for easier cutting.

For a rundown of additional products and where you can purchase them, visit my online article at AchyHandAids.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 Make Your Bathroom Safer


Dear Savvy Senior,
What tips do you recommend for making a bathroom safer and more functional for seniors. My 79-year-old mother slipped and fell getting out of the shower last month, and I’d like to modify her bathroom a bit with some safety features that can help protect her.
Searching Daughter

Dear Searching,
Because more accidents and injuries happen in the bathroom than any other room in the house, this is a very important room to modify for aging in place. Depending on your mom’s needs, here are some tips for each part of the bathroom that can make it safer and easier to use.
Flooring:
To avoid slipping, a simple fix is to get non-skid bath rugs for the floors. Or if you want to put in a new floor get slip-resistant tiles, rubber or vinyl flooring, or install wall-to-wall carpeting.
    Lighting: Good lighting is also very important, so install the highest wattage bulbs allowed for your mom’s bathroom fixtures, and get a plug-in nightlight that automatically turns on when the room gets dark.
    Bathtub/shower: To make bathing safer, purchase a rubber suction-grip mat, or put down adhesive nonskid tape on the tub/shower floor. And have a carpenter install grab bars in and around the tub/shower for support.
If your mom uses a shower curtain, install a screw or bolt-mounted curtain rod, versus a tension-mounted rod, so that if she loses her balance and grabs the shower curtain the rod won’t spring loose.
If your mom has mobility issues or balance problems, get her a shower or bathtub seat so she can bathe from a seated position. In addition, you may also want to get a handheld, adjustable-height showerhead installed that will make washing while sitting down easier.
Another, pricier option is to install a walk-in-bathtub or a prefabricated curbless shower. Walk-in tubs have a door in front that provides a much lower threshold to step over than a standard tub. They also typically have a built-in seat, handrails and a slip resistant bottom, and some have therapeutic spa features with whirlpool water jets and/or bubble massage air jets.
Curbless showers have no threshold to step over, and typically come with a built-in seat, grab bars, slip resistant floors and an adjustable handheld showerhead. Prefabricated curbless showers and walk-in-tubs typically cost anywhere between $2,500 and $10,000 installed.
Toilet:
Most toilets are about 14 to 16 inches high which can be an issue for many people with arthritis, back, hip or knee problems. To raise the toilet height, which can make sitting down and getting back up a little easier, you can purchase a raised toilet seat that clamps to the toilet bowl, and/or purchase toilet safety rails that sit on each side of the seat for support. Or, you can install an ADA compliant toilet that ranges between 17 and 19 inches high.
Faucets:
If your mom has twist handles on the sink, bathtub or shower faucets, replace them with lever handle faucets. They’re easier to operate, especially for seniors with arthritis or limited hand strength. Also note that it only takes 130-degree water to scald someone, so turn her hot water heater down to 120 degrees.
Entrance:
If your mom needs a wider bathroom entrance to accommodate a walker or wheelchair, install some “swing clear” offset hinges on the door which will widen the doorway an additional two inches.
Emergency assistance:
As a safety precaution, purchase a waterproof phone for the bathroom or get a medical alert device (SOS emergency call button) that your mom could wear in case she falls and needs to call for help.
You can find all of the products suggested in this column at either medical supply stores, pharmacies, big-box stores, home improvement stores, hardware and plumbing supply stores as well as online.
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Who Should Buy Long-Term Care Insurance?

Dear Savvy Senior,
Is there a good rule of thumb on who should buy a long-term care insurance policy? My wife and I have a few assets we’d like to protect but we hate the idea of paying expensive monthly premiums for a policy we may never use.
Planning Ahead

Dear Planning,
There are two key factors – your financial situation and health history – you need to mull over that can help you decide if buying a long-term care (LTC) insurance policy is a wise decision for you and/or your wife. Currently, only around 8 million Americans own a policy. Here’s what you should know.

LTC Insurance?
As the cost of LTC (which includes nursing home, assisted living and in-home care) continues to skyrocket, it’s important to know that most people pay for LTC either from personal savings or Medicaid when their savings is depleted, or through a LTC insurance policy. National median average costs for nursing home care today is over $87,000 per year, while assisted living averages $42,000/year.
While national statistics show that about 70 percent of Americans 65 and older will need some kind of LTC, most people do not need to purchase a LTC insurance policy.
In fact, according to a recent study at the Boston College Center for Retirement Research only 19 percent of men and 31 percent of women should actually get one.
The reasons stem from a range of factors, including the fact that relatively few people have enough wealth to protect to make purchasing a policy worthwhile. Seniors with limited financial resources who need LTC turn to Medicaid to pick up the tab after they run out of money.
Another important factor is that most seniors who need LTC only need it for a short period of time – for example, when they’re recovering from surgery. For those people, Medicare covers in-home health care and nursing home stays of 100 days or less following a hospital stay of more than 3 consecutive days.
So who should consider buying a policy?
LTC insurance policies make the most sense for people who can afford the monthly premiums, and who have assets of at least $150,000 or more that they want to protect – not counting their home and vehicles.
Another factor to weigh is your personal health and family health history. The two most common reasons seniors need extended long-term care is because of dementia and/or disability. And, almost half of all people who live in nursing homes are 85 years or older. So, what’s your family history for Alzheimer’s, stroke or some other disabling health condition, and do you have a family history of longevity? The U.S. Surgeon General offers a free tool at familyhistory.hhs.gov to help you collect, organize and evaluate your genetic risks.
You also need to factor in gender too. Because women live and average of 5 years longer than men, they are at greater risk of needing extended LTC.
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Do You Need To File A Tax Return in 2015?    

    Dear Savvy Senior,
What are the IRS income tax filing requirements for retirees this tax season? I didn’t have to file last year, but I picked up a little income from a part-time job in 2014, and I’m wondering I need to file this year.
Part-Time Retiree

Dear Retiree,
Whether or not you are required to file a federal income tax return this year will depend on how much you earned (gross income) – and the source of that income – as well as your filing status and your age. Your gross income includes all the income you receive that is not exempt from tax, not counting your Social Security benefits, unless you are married and filing separately.
Here’s a rundown of the IRS filing requirements for this tax season. If your 2014 gross income was below the threshold for your age and filing status, you probably won’t have to file. But if it’s over, you will.
•    Single: $10,150 ($11,700 if you’re 65 or older by Jan. 1, 2015).
•    Married filing jointly: $20,300 ($21,500 if you or your spouse is 65 or older; or $22,700 if you’re both over 65).
•    Married filing separately: $3,950 at any age.
•    Head of household: $13,050 ($14,600 if age 65 or older).
•    Qualifying widow(er) with dependent child: $16,350 ($17,550 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.

Special Requirements
There are, however, some other financial situations that will require you to file a tax return, even if your gross income falls below the IRS filing requirement. For example, if you had earnings from self-employment in 2014 of $400 or more, or if you owe any special taxes to the IRS such as alternative minimum tax or IRA tax penalties, you’ll probably need to file.
To figure this out, the IRS offers a 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.
You can access this page at irs.gov/filing – click on “Do you need to file a return?” Or, you can get assistance over the phone by calling the IRS helpline at 800-829-1040. You can also get face-to-face help at a Taxpayer Assistance Center. See irs.gov/localcontacts or call 800-829-1040 to locate a center near you.

Check Your State
Even if you’re not required to file a federal tax return this year, don’t assume that you’re also excused from filing state income taxes. The rules for your state might be very different. Check with your state tax agency before concluding that you’re entirely in the clear. For links to state and local tax agencies see taxadmin.org – click on “State Agencies/Links” on the menu bar.

Tax Prep Assistance

If you find that you do need to file a tax return this year, you can get help through the Tax Counseling for the Elderly (or TCE) program. Sponsored by the IRS, TEC provides free tax preparation and counseling to middle and low-income taxpayers, age 60 and older. Call 800-906-9887 or visit irs.treasury.gov/freetaxprep to locate a service near you.
Also check with AARP, a participant in the TCE program that provides free tax preparation at more than 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.
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How to Protect Yourself from Osteoporosis Bone Fractures

    Dear Savvy Senior,
Can a person in their early 50’s have osteoporosis? When I fell and broke my wrist last winter the doctor that treated me told me I might have osteoporosis. What can you tell me?
Worried Ronda

Dear Ronda,
While osteoporosis is much more common in older seniors, it can strike at any age. In fact, the National Osteoporosis Foundation estimates that half of women and up to 25 percent of men in the U.S. over the age of 50 will break a bone due to osteoporosis. Here’s what you should know.

Who’s at Risk?
Osteoporosis is a disease that causes the bones to become brittle and weak and more susceptible to fractures. Around 10 million Americans already have osteoporosis (80 percent are women) while another 43 million have “pre-osteoporosis,” or osteopenia. But the good news is this disease is both preventable and treatable.
Most people, by the time they reach their late 30’s, gradually start losing some of their bone mass, but for women, menopause is the time when this process really accelerates. Bone loss for men occurs much more slowly. However, by age 75, osteoporosis is as common in men as it is in women.
Some of the key risk factors of developing osteoporosis include: being over age 50; being female; menopause; having a family history of the disease; being small and thin; having an eating disorder; not getting enough calcium and vitamin D; getting too much protein, sodium and caffeine; having an inactive lifestyle; smoking; drinking too much alcohol; taking certain medications (see nof.org/articles/6 for a list); and having certain medical conditions (see nof.org/articles/5).
To help you determine your risk of osteoporosis, the National Institutes of Health has a quick, online quiz you can take at bonecheckup.org.

Prevention and Treatment
A good first step in preventing and treating osteoporosis is to get screened. For women, that should start around menopause, especially if you’re not taking estrogen, or anyone who has broken a bone after age 50 or who has other risk factors.
All women over 65 and men over 70 should be tested every two years – Medicare covers it. Screening for osteoporosis is a simple, painless, bone density test, which takes about five minutes.
Here’s what else you can do to protect your bones.
Boost your calcium: The best way to get bone-building calcium is through your diet.  Dairy products (low-fat milk, cheeses and yogurt), dark green leafy vegetables (broccoli, kale, collards), sardines and salmon, cooked dried beans, soy foods, almonds and fortified cereals and juices are all good sources of calcium. Vitamin D is also important to help you body absorb calcium.
The National Osteoporosis Foundation recommends 1,000 mg of calcium daily for women under age 50 and for men under 70, and 1,200 mg for women 51 and older and for men over 71. Note: Recent studies have found that excess calcium could increase the risk of heart disease.
They also recommend all adults under age 50 get 400 to 800 IU of vitamin D, or 800 to 1,000 IU if you’re over 50. If you’re not getting enough vitamin D through sunlight or food, consider taking a supplement. Most daily multivitamins contain at least 400 IU.
Exercise: Weight-bearing exercises like walking, and strength training with weights or resistant bands three or four times a week can also significantly improve your bone health.
Control these vices: Avoid smoking, limit alcohol to no more than two or three drinks per day, and limit caffeine (coffee, tea or caffeinated soda) to three cups a day.
Consider medications: The most widely prescribed for osteoporosis are bisphosphonates, a class of drugs designed to slow or stop bone loss. Talk to your doctor about these and other medication options, as well as potential side effects.

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