How to Find Affordable Housing

Are there any resources to help individuals find and pay for affordable apartments? My aunt, who is 75 years old, needs to find a new place to live but has very little money. What can you tell me?

Finding affordable housing options can be difficult depending on where your aunt lives. Senior apartments are a good option for some retirees, and you will be happy to know that there are a number of government programs that can help financially. Here are some tips that can help you and your aunt find a low-income apartment that fits her budget and living preferences.

Housing Subsidy Programs


There are several different government programs available today that can help individuals who qualify to locate and pay for housing, including:
  • Housing Choice Voucher Program (Section 8): This program allows an individual to find their desired housing. The government provides the voucher amount to the landlord each month.
  • Privately-owned subsidized housing: HUD helps some apartment owners offer reduced rents to low-income tenants.
  • Public Housing: These communities are generally apartment buildings or complexes that are overseen by a city or county public housing agency and are available to low-income families, the elderly and those with disabilities.
  • Low-Income Housing Tax Credit: This program provides housing to low-income families and includes rents that do not exceed a fixed amount.
  • Section 202 Supportive Housing for the Elderly: This initiative helps older tenants and the disabled. It offers housing for individuals who are able to live mostly on their own but need assistance with certain daily tasks like cleaning and cooking.
For more information about these programs and to locate apartments in your aunt's area, visit the U.S. Department of Housing and Urban Development rental assistance page at HUD.gov/topics/rental_assistance.

You can also locate nearby affordable housing options by calling your local housing authority. Call 800-955-2232 to get your local number. If your aunt lives near multiple counties, check with the housing authority in each one to compare.

How to Choose


If you or your aunt find several apartment choices that fall within her budget, she should consider what is important to her. She may want housing that is close to family, religious organizations, community centers, or places she visits regularly, like grocery stores, parks or gyms. If she has a disabling condition, it may be especially critical for her to find a living space that has easy access to important services, such as senior transportation and health care centers.

In your housing search, you may also come across some red flags that indicate a retirement community would not be a good fit for your aunt. Keep an eye out for extra fees that may be applied to everyday items or perks you normally would not think about, including laundry service, parking or pets.

You should also make sure the apartment is in good condition and then scout out the neighborhood. Ask yourself if the community is clean and well maintained. If you notice anything out of the ordinary, follow up with questions before your aunt signs a rental contract.

Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of "The Savvy Living" book. Any links in this article are offered as a service and there is no endorsement of any product. These articles are offered as a helpful and informative service to our friends and may not always reflect this organization's official position on some topics. Jim invites you to send your senior questions to: Savvy Living, P.O. Box 5443, Norman, OK 73070.

 

Published January 29, 2021

Acupuncture: Does It Work and Is It Covered by Medicare?

Is acupuncture a viable treatment for pain and is it covered by Medicare? Since the pandemic hit, I have a lot of lower back and neck pain and am wondering if it is worth trying. What can you tell me?

Many studies, including studies funded by the National Institutes of Health, have found acupuncture to be very effective in easing pain and potentially helpful with a variety of other ailments too. Here is what you should know.

Acupuncture Treatment


First used in China more than 2,000 years ago, acupuncture has become increasingly popular in the United States over the past decade. While acupuncture is not a cure-all treatment, it is generally a safe, drug-free option for relieving many different types of pain. It may relieve low back pain, neck pain, osteoarthritis, migraine headaches, fibromyalgia, postoperative pain, tennis elbow, carpel tunnel syndrome, dental pain and more. Studies have also shown that acupuncture can be helpful in treating asthma, depression, digestive disorders, menopause symptoms (such as hot flashes) and nausea caused by chemotherapy or anesthesia.

Exactly how or why acupuncture works is not fully understood. Most practitioners believe that acupuncture works because it stimulates the nerves causing the release of endorphins, which are the body's natural painkiller hormones. Acupuncture may increase blood circulation, decrease inflammation and stimulate the immune system.

What to Expect


During acupuncture, practitioners stimulate specific points on the body by inserting thin needles through the skin. The needles are as thin as a cat's whisker and are solid, sterile, disposable and for single-use.

The number of needles used for each treatment can vary anywhere from a few, up to a dozen or more. Placement of the needles depends on the condition being treated. The needles are typically inserted about one-quarter of an inch to one-inch deep and left in place for about 20 minutes. After placement, the needles are sometimes twirled, manipulated or stimulated with electricity or heat.

You may feel a brief, sharp sensation when the needle is inserted, but generally it is not painful. Once the needle is in place, you may feel a tingling sensation, numbness, mild pressure or warmth.

The number of treatments you will need depends on the severity of your condition. It is very common to have sessions on a weekly or biweekly frequency with a total of 12 sessions completed. It is also important to know that acupuncture can be used by itself or in conjunction with other conventional medical treatments.

Cost and Coverage


The cost per treatment typically ranges from $40 to $150, depending on your location and what style of treatment you are receiving.

An increasing number of private insurance plans, including some Medicare Advantage plans and policies provided by employers offer some type of acupuncture coverage.

You will also be happy to know that in January 2020, the Centers for Medicare and Medicaid Services announced that original Medicare plans will now cover up to 12 acupuncture sessions in 90 days for patients with chronic lower back pain. Eight additional sessions can be added if patients show improvement.

In order to receive Medicare coverage, you must use a licensed acupuncturist who is supervised by a medical doctor, physician assistant or nurse practitioner trained in acupuncture. Licensed acupuncturists cannot bill Medicare directly, so the supervising professional will need to process the acupuncture claim.

To find an acupuncturist in your area, you can search online or ask your doctor for a referral. The National Certification Commission for Acupuncture and Oriental Medicine and the American Academy of Medical Acupuncturists are two organizations that offer a directory of certified acupuncturists.

Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of "The Savvy Living" book. Any links in this article are offered as a service and there is no endorsement of any product. These articles are offered as a helpful and informative service to our friends and may not always reflect this organization's official position on some topics. Jim invites you to send your senior questions to: Savvy Living, P.O. Box 5443, Norman, OK 73070.

 

Published January 22, 2021

Give It Twice Trust


A very popular option for a parent with children is called the "Give It Twice" trust. This is a trust funded when the surviving parent passes away. Part of the estate is transferred outright to children. The balance is placed in a special "Give It Twice" trust.

The trust pays income to children for a term of years—usually 20 years. The income can be divided equally among the children for that period of time. Following the selected term of years, the trust principal is then transferred to charity.

In effect, the property has been used twice—once to benefit children with income and the second time to help charity at the end of the trust.

Cindy is a surviving spouse. Her spouse, Michael, passed away four years ago. She is doing fine and combined both IRAs into one. Cindy's estate is now approximately $800,000. Her home, CDs and other property are valued at $400,000, and the combination of IRAs is also about $400,000.

She was reading online about the "Give It Twice" trust. Because Cindy is debt free and has Social Security plus pension income, she thinks that her estate, when she passes away, is likely to be fairly close to its current value. Cindy sat down with her attorney David, to discuss the possibility of creating a trust.

Cindy: "David, I was reading an article online about this special 'Give It Twice' trust. It sounds like you can give an asset once to children through the income stream and then transfer the trust property to charity."

Attorney: "Yes, Cindy, that can be done."

Cindy: "Before Michael passed away, we talked about this. We agreed to treat each of our four children equally and also provide a benefit to our favorite charity."

Attorney: "With your estate of $800,000, you have the ability to do something pretty significant for both your family and favorite charity."

Cindy: "Yes, but there is one big problem. Our three older children—Bill, Sue and Pete—do fine. They are quite financially responsible. But our youngest son Ted is very creative. He spends money like water. If we gave him one-fourth of the estate or $200,000, I am afraid he would spend that very quickly. We need to figure out a way to protect at least part of his inheritance."

Attorney: "That 'Give It Twice' plan could be very helpful. You can benefit all four children equally with an initial amount. For example, you could transfer the $400,000 to them when you pass away. That would be $100,000 per child. The other $400,000 could go to the trust. They would each receive one-fourth of that income for 20 years. That would give Ted a chance to learn to save and invest. In addition, if you transfer the IRA into that trust, you can save all that income tax because the special trust is tax exempt."

Cindy: "This sounds like a great plan. When I pass away, I could transfer my IRA into the "Give it Twice" trust and benefit my four children and my favorite charity. But how do I do that?"

Attorney: "I can write a trust that you sign. It is called an unfunded trust because there are no assets at present. Then we will contact your IRA custodian and select this charitable remainder trust as the designated beneficiary for your IRA. When you pass away, the IRA balance will be transferred to the trustee of your 'Give it Twice' trust."

Cindy: "This is very exciting. It is going to be great for my family and we will also be able to help our favorite charity after the term of years. I especially like the way that this will help Ted to learn to save and invest. Let's move forward as quickly as possible."

How to Make Bathrooms Safer and Easier to Use

What tips can you recommend for making a bathroom safer? My 78-year-old mother has mobility problems and fell getting out of the bathtub last month. I would like to modify her bathroom with some safety features that can help keep her safe.

More accidents and injuries happen in the bathroom than any other room in the house, this is a very important room to modify, especially for individuals with mobility or balance problems.

Depending on your mom's needs and budget, here are some simple tips and product recommendations that can help make her bathroom safer and easier to use.

Floor: To avoid slipping, a simple fix is to get non-skid bath rugs for the floors. If you want to put in a new floor, consider slip-resistant flooring or install wall-to-wall carpeting.

Lights: Good lighting is also very important. It is best to 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, she may want to consider a rubber suction-grip mat or put down adhesive nonskid tape on the tub/shower floor. It is also a good idea to have grab bars installed 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. If she loses her balance and grabs the shower curtain, the rod will not spring loose.

For easier access and safer bathing, consider getting your mom a shower or bathtub chair so she can bathe from a seated position. In addition, you should have a handheld, adjustable-height showerhead installed to make chair bathing easier.

If your mom has the budget for it, another good option is to install a curbless shower or a walk-in-bathtub. Curbless showers have no threshold to step over, and come with a built-in seat, grab bars, slip resistant floors and an adjustable handheld showerhead. While walk-in tubs have a door in front that provides a much lower threshold to step over than a standard tub. They also have a built-in seat, handrails and a slip resistant bottom. Some have therapeutic features like whirlpool water jets and/or bubble massage air jets.

Curb-less showers and walk-in-tubs run anywhere between $2,500 and $10,000 including installation.

Toilet: Most standard toilets are around 15 inches high and can be an issue as we age, especially for taller people with arthritis, back, hip or knee problems. If your mom has trouble getting on or off the toilet, a simple solution is to purchase a raised toilet seat that clamps to the toilet bowl, or purchase toilet safety rails that sit on each side of the seat for support. Alternatively, you can install a new ADA compliant "comfort height" toilet that is 16-to-19 inches high. It may also be worthwhile to have grab bars installed near the toilet for additional support.

Faucets: Consider replacing twist handles on the sink, bathtub or shower faucets with lever handle faucets or with a touch, motion or digital smart faucet. These are easier to operate, especially if your mom has hand arthritis or gripping problems. Also, note that it only takes 130-degree water to scald someone, so turn her hot water heater down to 120 degrees.

Doorway: If your mom needs a wider bathroom entrance to accommodate a walker or wheelchair, an inexpensive solution is to install swing clear offset hinges on the door. Offset hinges will expand the doorway an additional two inches.

Emergency assistance: As a safety precaution, you should also consider purchasing a voice-enabled medical alert system in her bathroom. This device would let her call for help by simple voice command, or by pushing a button or pulling a cord.

You can find all of these suggested products at medical supply stores, pharmacies, big-box stores, home improvement stores, hardware and plumbing supply stores, as well as online.

Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of "The Savvy Living" book. Any links in this article are offered as a service and there is no endorsement of any product. These articles are offered as a helpful and informative service to our friends and may not always reflect this organization's official position on some topics. Jim invites you to send your senior questions to: Savvy Living, P.O. Box 5443, Norman, OK 73070.

 

Published January 15, 2021

Is Social Security Income Taxable?

I understand that a portion of Social Security benefits may be taxable even when I retire. Can you tell me how to calculate this?

The requirement to pay federal income tax on your Social Security benefits will depend on your income and filing status. About 35% 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, add up all of your "provisional income." This includes wages, taxable and non-taxable interest, dividends, pensions and taxable retirement-plan distributions, self-employment and other taxable income, then add half of your annual Social Security benefits and subtract certain deductions used in calculating 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.

If you are single and your total income from all of the listed sources is:
  • Less than $25,000, your Social Security will not be subject to federal income tax.
  • Between $25,000 and $34,000, up to 50% of your Social Security benefits will be taxed.
  • More than $34,000, up to 85% of your benefits will be taxed.
If you are married and filing jointly and the total from all sources is:
  • Less than $32,000, your Social Security will not be taxed.
  • Between $32,000 and $44,000, up to 50% of your Social Security benefits will be taxed.
  • More than $44,000, up to 85% of your benefits will be taxed.
If you are married and file a separate return, you probably will pay taxes on your benefits.

To limit potential taxes on your benefits, you will need to be cautious when taking distributions from retirement accounts or other sources. In addition to triggering ordinary income tax, a distribution that significantly increases your gross income can bump the percentage of your Social Security benefits subject to taxation.

How to File


If you find that part of your Social Security benefits will be taxable, you will need to file using Form 1040 or Form 1040-SR. You also need to know that if you do owe taxes, you will need to make quarterly estimated tax payments to the IRS or you can choose to have it automatically withheld from your benefits.

To elect withholding, you will 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%, 10%, 12% or 22% of your total benefit payment withheld. If you subsequently decide you do not want the taxes withheld, you can file another W-4V to stop the withholding.

If you have additional questions on taxable Social Security benefits call the IRS help line at 800-829-1040.

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 links to state tax agencies see TaxAdmin.org/state-tax-agencies.

Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of "The Savvy Living" book. Any links in this article are offered as a service and there is no endorsement of any product. These articles are offered as a helpful and informative service to our friends and may not always reflect this organization's official position on some topics. Jim invites you to send your senior questions to: Savvy Living, P.O. Box 5443, Norman, OK 73070.

 

Published January 8, 2021

Trusts to Protect Children

 
Trusts are an excellent way to provide for the support and care of children while protecting them. Two important reasons to create a trust are to care for minor children or for a special needs child. In both circumstances, trusts can be an essential part of making plans to provide the best possible care.

How Trusts Work


There are several people and terms that you should know in order to understand how trusts work. Let's examine the different people or terms that will be useful in setting up and operating a trust for children.

Trustee: A trustee will be charged with managing the property under the terms of a trust document. The three choices for trustee are a bank or trust company, a private trustee or a charitable trustee for a trust that benefits charity.

A trustee has a particular name—a fiduciary. This means that the trustee is required under state law to provide appropriate management of the trust. Based on the trust document that you sign as the trust grantor, the trustee will do his or her best to follow your intent.

Property: The trust exists to hold and manage property. While in many states a trust is legally in existence after you sign the trust document, it doesn't actually have any purpose until it receives property. Your trustee refers to this as the "funding" of the trust. The trustee will manage the property according to the terms of your trust document.

Investments: Under state law, your trustee is required to follow the standards of a prudent investor. In most cases, the trustee will invest in a portfolio of stocks and bonds. Approximately 50% to 60% of the typical trust portfolio is invested in a diversified group of stocks, with the balance invested in bonds.

Under the prudent investor rules, the trustee is obligated to diversify. Through diversification the risk of loss will be reduced and the probability that the trust will function as you intend is greater.

Income: Income is defined under the law as either ordinary income or capital gain. The interest from bonds and mortgage notes is ordinary income. Historically, trusts have paid out their ordinary income. However, because many trustees now have more than half of the trust property invested in stocks, trusts now may pay out a portion of recognized capital gain as income.

Capital Gain: Capital gain is the other type of earnings of a trust. While a portion of the capital gain represents principal and will be retained in the trust to benefit the remainder recipient, part of the gain under modern investment strategies is typically allocated to income. The trustee will look at the trust document to determine who will receive the income. Normally, the trustee will pay out on a quarterly basis the ordinary income and part of the recognized capital gains.

Remainder: Under the trust document, the trust will pay income for a period of time, such as a life of a person or a term of years. After all of the income payments have been completed, the trust principal or remainder is usually transferred to the beneficiaries.

For example, a trust was funded with $300,000 and paid income to children Billy, Susie and Linda until they were age 30. At that time, the trust remainder value of $300,000 was divided between the three children. Because each received one-third of the remainder, the inheritance amount for each child was $100,000.

Trusts for Minor Children


Parents correctly understand that a minor child is not ready to receive a substantial inheritance. Therefore, it is very common for parents to create in their will or living trust a plan to set up a trust for minor children.

The trust for minor children frequently permits the trustee broad latitude to pay income and principal to the children or spend it for their healthcare or other needs. Because of this flexibility, the trustee of the trust for minor children is frequently a family member or professional advisor for the family. After all of the children reach a particular age, the trust is then usually distributed in equal shares to the then-living children.

Trust for Children Billy and Mary


Bill and Clara Jones are 36 and 34. They have two children—Billy (age four) and Mary (age one).

After visiting with their attorney, Bill and Clara signed their first will. If one of them should pass away, estate property and guardianship of the children will pass to the survivor. However, if they both pass away, then they have selected Clara's brother, Harold, and his wife as the guardians for the children. They also have selected Bill's sister, Susan, who is a CPA, as the trustee of their family trust for Billy and Mary.

CPA Susan has discretion under the trust instrument to make distributions of income or principal to Billy and Mary or to pay providers for their support or medical care. In order to provide maximum protection for Mary, the entire trust principal is retained until Mary is age 30. By that time, Bill and Clara believe that Mary will have completed her education and be well established in life. Even though Billy will be 33 and Mary will be 30, the trust principal will be divided equally between the two of them at that time.

With a family trust for minor children, the assets of the family are typically not large. Most trusts for minor children are funded primarily by term life insurance on the lives of Bill and Clara. Therefore, it is very common for the trust to continue in existence until the youngest child reaches the desired age. While this means that older children may have to wait longer for their inheritance, that is a secondary goal to making sure that the youngest children are all taken care of until they reach the selected age.

Special Needs Trust


A child with a disability or special need will require both a caregiver and financial resources.

During the lives of the parents, they are often able to provide the required care for a special needs child. However, after they pass away, there may need to be a more structured option that involves a special facility for that child.

To plan for the case when both parents pass away, arrangements for the care facility and financial requirements of a special needs child should be made in advance. A special needs child often has no major assets and therefore is qualified for the Social Security SSI Program or for Medicaid.

However, if the parents were to give the child an inheritance outright or a vested income stream, then those funds will all be expended before the child could receive federal benefits. As a result, the special needs trust was designed to allow parents to provide help for children, even though the child may be receiving federal or state benefits.

The key to the special needs trust is that the trustee has complete discretion over principal and income. He or she may add the income back to the trust corpus, or may make distributions to the child or for the benefit of the child.

Because the special needs trust depends on federal and state laws that regularly change, an attorney who specializes in these trusts is often used to draft the specific provisions. However, there generally are several items the trustee can provide the special needs child and still maintain his or her qualification for federal and state benefits. These include a vehicle, a home, home furnishings, property for self-support, medical care and educational expenses.

The special needs trust also should have an intention to preserve the trust for a remainder beneficiary. Even though the special needs child may receive income and principal that actually does exhaust the trust, the hope that another entity or person would benefit from the remainder is quite helpful.

What Caregivers Should Know About Medicare

I am the caregiver for my 81-year-old mother, who recently fell and broke her hip. I have a lot of questions about how original Medicare works and what it covers. Where can I get some help understanding this program?

Having a working knowledge of Medicare can help you take full advantage of the coverage and services it provides to ensure your mom receives the best care possible. Here is what you should know.

Medicare Assistance


A good starting point to get familiar with Medicare is the official "Medicare & You" handbook that overviews the program. It is mailed to all beneficiaries every fall and provides an up-to-date description of all services and benefits. You can also see it online at Medicare.gov/medicare-and-you.

If you have a particular question, you can call and visit with a Medicare customer service representative at 800-633-4227. Medicare also works closely with State Health Insurance Assistance Programs (SHIP) to provide free health insurance counseling. To find a SHIP counselor in your area visit ShiptaCenter.org or call 877-839-2675.

Caregivers may also find Medicare's secure website – MyMedicare.gov – especially useful. After setting up a personal account for your mom, you can view the details of her coverage, track recent health care claims and keep up to date on preventive services.

Compare Tools


Medicare can also help you locate the right health care providers for your mother. At Medicare.gov/care-compare. you can find and compare doctors, hospitals, home health agencies, dialysis facilities, inpatient rehab facilities, long-term care hospitals and nursing homes in your mom's area.

What Medicare Covers


Medicare can reduce many out-of-pocket medical expenses your mom incurs, but it does not cover everything. Understanding what Medicare covers can save you time and spare you frustration when navigating the caregiving maze. Here are some key points for caregivers:

Medicare covers basic hospital and physician services (which includes telehealth services), home health care and optional prescription drug benefits. To qualify, your mom must be homebound, under a physician's care and in need of part-time skilled nursing care or rehabilitative services, such as physical therapy.

Medicare also helps pay for oxygen, catheters and other medical supplies that doctors prescribe for home use. The same is true for medically necessary equipment, including oxygen machines, wheelchairs and walkers.

In addition, Medicare covers skilled care in a nursing home for limited periods – up to 100 days following hospital stays. It does not cover long-term stays. Patients who need custodial care (room and board) must pay out of pocket unless they are eligible for Medicaid or have private long-term care insurance.

Medicare also pays for hospice care for someone with a terminal illness with a life expectancy of six months or less. The hospice benefit also includes brief periods of respite care at a hospice facility, hospital or nursing home to give the patient's caregivers an occasional rest.

Besides long-term nursing home stays, original Medicare typically does not cover regular dental care or dentures, regular eye exams or eyeglasses and hearing exams or hearing aids. Likewise, it does not cover nonemergency ambulance trips unless a doctor certifies they are medically necessary.

To find out what Medicare covers, visit Medicare.gov/coverage and type in the test, item or service you have questions about, or download the Medicare "What's Covered" application on your mobile device.

Financial Assistance


If your mom lives on a limited income, you should check whether she qualifies for help with prescription drug costs or with other Medicare-related premiums, deductibles and copayments.

For help with prescription drug costs, visit SSA.gov/prescriptionhelp or contact Social Security at 800-772-1213 and ask about the "Extra Help Program." For help with other Medicare costs, go to Medicare.gov or call 800-633-4227 and ask about the "Medicare Savings Programs."

Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of "The Savvy Living" book. Any links in this article are offered as a service and there is no endorsement of any product. These articles are offered as a helpful and informative service to our friends and may not always reflect this organization's official position on some topics. Jim invites you to send your senior questions to: Savvy Living, P.O. Box 5443, Norman, OK 73070.

 

Published January 1, 2021

What You Will Pay for Medicare in 2021

I know there will be a small cost-of-living increase in Social Security benefits next year but what about Medicare? What will the Medicare Part B monthly premiums be in 2021, and when do the surcharges kick in for higher income beneficiaries?

The Centers for Medicare and Medicaid Services recently announced their cost adjustments for 2021 and the increases for premiums and out-of-pocket costs for most beneficiaries will be modest. But if you are a high earner, you will pay more. Here is what you can expect starting in January.

Medicare Part B


While Medicare Part A, which pays for hospital care, is premium-free for most beneficiaries, Part B, which covers doctor visits and outpatient services does have a monthly premium. Starting in 2021, the standard monthly Part B premium will be $148.50, up from $144.60 in 2020. That $3.90 bump represents a 2.7% increase, which is more than double the most recent Social Security cost-of-living adjustment of 1.3%.

But if you are a high earning beneficiary, which makes up about 7% of all Medicare recipients, you will have to pay more. Medicare surcharges for high earners are based on adjusted gross income from two years earlier, which means that 2021 Part B premiums are determined by 2019 annual income.

So, if your 2019 income was above $88,000 up to $111,000 ($176,000 up to $222,000 for married couples filing jointly), your 2021 Part B monthly premium will be $207.90, up from $202.40 in 2020.

Monthly premiums for singles with an income between $111,000 and $138,000 ($222,000 and $276,000 for joint filers) will rise from $289.20 to $297. Individuals earning above $138,000 up to $165,000 ($276,000 to $330,000 for joint filers) will see their monthly premium increase from $376 to $386.10.

Those with incomes above $165,000 up to $500,000 ($320,000 to $750,000 for joint filers), will pay $475.20 per month in 2021. Single filers with income of $500,000 or more ($750,000 or more for joint filers) will pay $504.90 per month next year.

Medicare Part D


For Medicare (Part D) prescription drug plans, the average premium in 2021 will be about $30 per month for most beneficiaries. But, again for a high earner with annual incomes above $88,000 ($176,000 for joint filers), there is a monthly surcharge between $12.30 and $77.10 on top of the regular Part D premiums.

How to Contest Income


Beneficiaries that fall into any of the high-income categories and have experienced certain life-changing events that have reduced their income since 2019, such as retirement, divorce or the death of a spouse, can contest the surcharge. For more information on how to do this, see "Medicare Premiums: Rules for Higher-Income Beneficiaries" at SSA.gov/benefits/medicare/medicare-premiums.html.

Other Medicare Increases


In addition to the Part B and Part D premium increases, there are other cost increases. For example, the annual deductible for Medicare Part B will see a bump from $198 to $203 in 2021. The deductible for Medicare Part A, which covers hospital services, will increase from $1,408 in 2020 to $1,484 in 2021. There are no surcharges on Medicare deductibles for high earners.

For more information on all the Medicare costs for 2021 visit Medicare.gov and click on "2021 Medicare Costs," or call 800-633-4227.

Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of "The Savvy Living" book. Any links in this article are offered as a service and there is no endorsement of any product. These articles are offered as a helpful and informative service to our friends and may not always reflect this organization's official position on some topics. Jim invites you to send your senior questions to: Savvy Living, P.O. Box 5443, Norman, OK 73070.

 

Published December 18, 2020

How to Make the Most of Your Doctor's Visit

I manage a large health clinic that treats thousands of patients each year. We have found that the patients who come in prepared are much more satisfied with the care they receive. Can you write a column educating patients on how to prepare for doctor's appointments?

Studies have shown that patients who provide important health information and prepare for doctor's appointments tend to receive better care than patients who do not. Here are some simple things we can all do to help maximize the benefits of our next visit to the doctor.

Before Appointments


Gathering your health information and getting organized before your appointment are key to ensuring a productive meeting with your doctor. This is especially important if you are seeing multiple doctors or meeting with a new physician. Here is what you need to do before your next appointment:

1. Get your test results: If you are seeing a new doctor, make sure he or she has copies of your latest X-ray, MRI or any other tests or recent lab results, including reports from other doctors. In most cases, you will need to do the leg work yourself. This may be as simple as a phone call to your previous doctor or you may need to pick it up yourself.

2. List your medications: Make a list of all the medications and dosages you are taking, including prescription medications, over-the-counter drugs and herbal supplements. Alternatively, put all your pill bottles in a bag and take them with you to your appointment.

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

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

During Appointments


When you meet with your doctor, it is important to speak up and get to the point. Right away, concisely explain why you are there. Do not wait to be asked. Be direct, honest and specific when recounting your symptoms or expressing your concerns. Many patients are reluctant or embarrassed to talk about their symptoms, which makes the doctor's job much more difficult. You may want to ask if you are able to bring along a family member or friend to your appointment, rules may vary with your doctor's office. They can help you ask questions, listen to what the doctor is telling you and give you support.

Consider taking notes or asking the doctor if you can record the session for later review. If you do not understand what the doctor is telling you, ask him or her to explain it in simple terms so you can understand. If you run out of time and do not get your questions answered, ask if you can follow up by phone or email, make another appointment or seek help from a nurse.

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

Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of "The Savvy Living" book. Any links in this article are offered as a service and there is no endorsement of any product. These articles are offered as a helpful and informative service to our friends and may not always reflect this organization's official position on some topics. Jim invites you to send your senior questions to: Savvy Living, P.O. Box 5443, Norman, OK 73070.

 

Published December 25, 2020

Noticing Memory Problems? What to Do Next

My mom is 76 and I have noticed her becoming more forgetful lately. I am worried she may be getting Alzheimer's disease. What resources can you recommend to help us?

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 mom's problem, here are some key warning signs to be vigilant of and some resources you can turn to for help.

Warning Signs


As we grow older, some memory difficulties – such as trouble remembering names of people or places or forgetting where you put your glasses or car keys – are associated with normal aging. The symptoms of Alzheimer's disease are much more than simple memory lapses.

Knowing the early warning signs is a good first step in recognizing the difference between typical age-related memory loss and a more serious problem. To help you evaluate your mom's condition, here is a checklist of some common early symptoms of Alzheimer's to watch for:
  • Asking the same questions repeatedly.
  • Getting lost in familiar areas.
  • Failing to recognize familiar people.
  • Having difficulty following directions.
  • Misplaces items in inappropriate places. For example, putting her keys in the microwave.
  • Having difficulty completing familiar tasks like cooking a meal or paying a bill.
  • Having trouble remembering common words when speaking or mixing up words.
A good tool to help you evaluate your mom is the Self-Administered Gerocognitive Exam (SAGE test) that was developed at The Ohio State University Wexner Medical Center. This free test helps identify mild cognitive impairment and early dementia. The SAGE test can be taken at home in about 10 to 15 minutes and can be found online.

Get Help


If you would rather have professional assistance, the Alzheimer's Foundation of America (see alzfdn.org) is another good resource. Every Monday, Wednesday and Friday they provide free, confidential virtual memory screenings done via video chat in real time. Your mother will need a phone, tablet or computer with a webcam and internet capability to complete the screening.

The screenings are given by healthcare professionals and take about 10 to 15 minutes to complete. Once the screening is complete, the screener will review the results with her and let her know if she should see a doctor for further evaluation. To set up a memory screening for your mom, call 866-232-8484 to make an appointment.

If your mom needs further evaluation, make an appointment with her primary care doctor for a cognitive checkup and medical examination. Depending on the results, she may be referred to a geriatrician or neurologist who specializes in diagnosing and treating memory loss or Alzheimer's disease.

Keep in mind that even if your mom is experiencing some memory problems, it does not necessarily mean she has early-stage Alzheimer's. Many memory problems are caused by other factors like stress, depression, thyroid disease, side effects of medications, sleep disorders, vitamin deficiencies and other medical conditions. By treating these conditions, she can reduce or eliminate the problem.

Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of "The Savvy Living" book. Any links in this article are offered as a service and there is no endorsement of any product. These articles are offered as a helpful and informative service to our friends and may not always reflect this organization's official position on some topics. Jim invites you to send your senior questions to: Savvy Living, P.O. Box 5443, Norman, OK 73070.

 

Published December 11, 2020

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