Health Insurance Options After a Spouse Retires

My 63-year-old spouse, who does not work, is on a health insurance plan through my employer. I will retire next month and go on Medicare. What are the options for getting health insurance for my spouse before they turn 65? Is there any Medicare coverage for dependent spouses?

Unfortunately, Medicare does not provide family coverage to younger spouses or dependent children when the older spouse qualifies for Medicare. No one is eligible for Medicare benefits before age 65 unless they are eligible due to a specified disability. With that said, here are some options for obtaining health coverage for your spouse.

Affordable Care Act: One option is to purchase an individual health insurance policy for your spouse through the Affordable Care Act (ACA) Health Insurance Marketplace. The Marketplace offers comprehensive health coverage and will not deny coverage or charge extra for preexisting health conditions.

The American Rescue Plan and Inflation Reduction Act enhanced premium subsidies for Marketplace plans through 2025. If your income falls below 400% of the poverty level after you retire – below $73,240 for a couple or $54,360 for a single person in 2023 – your spouse will be eligible for a tax credit that will reduce the amount you pay for the policy. The Marketplace also ensures that households with incomes above 400% of the poverty level will not have to pay more than 8.5% of their income for a benchmark policy.

To calculate your estimated subsidy, search online for a "health insurance marketplace calculator" and enter your family's information. To shop for Marketplace plans in your state, visit HealthCare.gov or call 800-318-2596. If you want extra help, you can search the online directory at HealthCare.gov/find-assistance to locate an agent or broker in your area.

COBRA: Another option is the Consolidated Omnibus Budget Reconciliation Act (COBRA) which is a federal law that would allow your spouse to remain with your employer's insurance plan for at least 18 months after you make the transition to Medicare. If the older spouse becomes eligible for Medicare and leaves their employer within 18 months of eligibility, COBRA coverage can continue for up to a maximum of 36 months. Not every employer plan is COBRA eligible. Contact your employer's plan administrator to find out if COBRA applies to your plan.

You should be aware that COBRA can be expensive because it requires you to pay the full monthly premium yourselves. But, if you have already met or nearly met your employer's plan deductible or out-of-pocket maximum for the year and do not want your spouse to start over with a new plan, it may make financial sense to keep your spouse's current coverage under COBRA. Even if your spouse is eligible to elect COBRA coverage, you should compare premiums from the Marketplace and those through a private insurer to see what is most affordable.

Short-Term Health Insurance: If you cannot find an affordable Marketplace plan and COBRA is too expensive, the next option is short-term health insurance. These plans are more affordable no-frills plans that provide coverage for up to 12 months and may be renewed for up to three years in some states. Be aware that short-term plans are not available in every state and do not comply with the ACA protections. They can deny sick people coverage, refuse to cover preexisting conditions and can exclude coverage essentials like prescription drugs.

Healthcare Sharing Ministries: One other coverage option you should know about is healthcare sharing ministries (HCSMs). These are cost-sharing health plans in which members – who typically share ethical or religious beliefs – make monthly payments to cover the expenses of other members including themselves.

HCSMs are less expensive than paying full out-of-pocket costs for traditional health insurance but are not health insurance companies. They do not have to comply with the consumer protections of the ACA. They also may reject or limit coverage for pre-existing health issues and often limit how much you will be reimbursed for your medical costs.

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 June 16, 2023

Tips for Finding Over-the-Counter Hearing Aids

Can you recommend some good over-the-counter hearing aids for individuals on a budget? I am not sure what to get or where to buy them.

The new FDA approved over-the-counter (OTC) hearing aids have become a very attractive alternative to millions of older Americans with hearing impairments. This new category of hearing aids went into effect in October of 2022.

These new hearing aids can be purchased at pharmacies, consumer electronics stores or online without requiring a hearing exam, prescription or appointment with an audiologist. The savings are significant, with the average cost of an OTC hearing aid at around $1,600 per pair, which is approximately $3,000 less than the average price of a prescription hearing aid.

Sorting through all the different options and styles of hearing aids can be time consuming and confusing. Here are some tips that can help you choose the right aid for you.

Check Your Hearing


Your first step to getting a hearing aid is to have your hearing tested. Be aware that OTC hearing aids are designed only for people with mild to moderate hearing loss. Common signs include trouble hearing speech in noisy places, in group settings and during phone calls.

The best place to get your hearing tested is through a hearing care provider such as an audiologist. These in-person tests are usually covered by private medical insurance. Medicare will cover general hearing evaluations every 12 months without a doctor's referral. You can also assess your hearing at home with a free app-based hearing test.

If your test results indicate that you have severe hearing loss (signs include being unable to hear spoken words even in a quiet room or trouble hearing loud music or power tools), then OTC aids are not the right solution for you. You will likely need a prescription hearing aid obtained through an audiologist or hearing instrument specialist.

Choosing an OTC Aid


If you decide that an OTC hearing aid may work for you, here are some suggestions to help you choose the best one for you.

OTC hearing aids come in two types: self-fitting and preset. Self-fitting aids typically use a smartphone app to set up and adjust the device to suit your specific hearing needs, which makes them better suited for individuals who are technologically inclined. Preset hearing aids are much simpler devices that come with a number of set programs for different levels of hearing loss and controls that are set directly on the hearing aid.

Additionally, because OTC hearing aids have a learning curve, it is very important to know the level of customer support you will have access to. Before you buy an OTC hearing aid, find out how long the company provides support after your purchase and the credentials or expertise held by customer service individuals.

You should also inquire about the company's return policy. It can take weeks to get accustomed to wearing hearing aids and figure out whether they are really working for you. Make sure to choose a brand that offers a minimum 30-day free trial period or money back return policy.

Best OTC Hearing Aids


To help you navigate through all the different options, the National Council on Aging (NCOA), which is a national nonprofit organization that advocates for older Americans, recently assembled a review team who collectively spent more than 5,000 hours researching, testing and interviewing customers about OTC hearing aids. To learn more, see NCOA.org/adviser/hearing-aids/best-otc-hearing-aids. If you want to see all the options available on the market, check out online options to help you compare features.

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.

Social Security Benefits for Family Members

What are the Social Security benefits for family members? What are the qualifications for eligibility?

Depending on your specific circumstances, you may be eligible for Social Security benefits as a spouse, child or a divorced spouse. Here is what you should know.

Who is Eligible?


Eligibility requirements for social security benefits vary based on the beneficiary's classification. A spouse beneficiary may be eligible if they are 62 years of age and receive retirement or disability benefits. Children who have parents that receive Social Security retirement, disability benefits, or have passed away may be eligible for Social Security benefits if the children are unmarried, under 18 years of age, between the ages 18 to 19 and a full-time student or if they are 18 years and older and are disabled from a disability that occurred before age 22. Eligible children include biological, adopted and stepchildren. A divorced spouse can collect Social Security retirement benefits based on their ex-spouse's earnings record if they are at least 62 years of age, were married to the ex-spouse for at least 10 years, are not remarried, are not eligible for a higher benefit based on their own earnings record and qualify for Social Security retirement or disability benefits.

Benefit Amount


For a current spouse, the amount will be determined based on the starting age of receiving benefits. For individuals between the ages 62 through full retirement age, the amount of benefits will be permanently reduced by 25/36 of 1% for each month before the full retirement age, up to 36 months of reduction. At full retirement age, the benefit cannot exceed one-half of the full retirement amount of the spouse.

Benefits paid to eligible children do not decrease the retirement benefit. The amount may be up to half of the parent's full retirement or disability benefit amount. The benefits will end when the child reaches age 18 unless there is an eligible disability. If the child is a full-time student, benefits will continue until the child graduates or two months after the child reaches age 19, whichever occurs first.

A divorced spouse can receive up to 50% of their former spouse's full Social Security benefit. The amount is less if they take benefits before their full retirement age, which is age 66 for people born in 1943-1954 and age 67 for people born in 1960 or later. To determine your full retirement age and approximate reduction for early retirement, see the Social Security retirement chart located on SSA.gov/benefits/retirement/planner/agereduction.html.

Please note that if you qualify for benefits based on your own work history, you will receive the larger of the two benefits. You cannot receive benefits based on both you and your ex-spouse's earning records.

You can learn more about your Social Security benefits by creating an account on the Social Security website and requesting a Social Security Statement. Visit SSA.gov/myaccount to create an account.

To apply for benefits, additional information may be required to apply as a spouse or ex-spouse. Visit SSA.gov/forms/ssa-2.html for more information.

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 June 2, 2023

IRS Warns About ERC Scams

On May 25, 2023, the Internal Revenue Service (IRS) alerted businesses to be careful about new scams that focus on the Employee Retention Credit (ERC).

The IRS has been monitoring a "barrage of aggressive broadcast advertising" that seriously misrepresents and exaggerates the qualifications for the Employee Retention Credit. Due to the proliferation of ERC scams, the IRS is increasing its effort both in audits and criminal investigations.

IRS Commissioner Danny Werfel stated, "The aggressive marketing of the Employee Retention Credit continues preying on innocent businesses and others. Aggressive promoters present wildly misleading claims about this credit. They can pocket handsome fees while leaving those claiming the credit at risk of having the claims denied or facing scenarios where they need to repay the credit."

The IRS emphasized that the Employee Retention Credit is a legitimate taxpayer benefit. It was created to help businesses with employment challenges during the COVID-19 pandemic.

However, the ERC has been abused. Werfel continued, "This continual barrage of marketing by advertisers means many invalid claims are coming into the IRS, which also means it takes our hard-working employees longer to get to the legitimate Employee Retention Credits. The IRS understands the importance of these credits, and we appreciate the patience of businesses and tax professionals as we continue to work hard to get valid claims processed as quickly as possible while also protecting against fraud."

The IRS emphasizes the improper ERC credits may result in an obligation to pay back the IRS, potentially including penalties and interest. There are several signs to indicate that taxpayers should be wary of ERC promoters.

1. Unsolicited Calls — Promoters will send out millions of calls and advertisements claiming that the ERC is an "easy application process."

2. ERC Eligibility Within Minutes — The promoter claims he or she can determine eligibility in a few minutes.

3. Upfront Fees — Promoters require you to pay a large upfront fee before they are willing to submit your claim to the IRS.

4. Percentage of the Refund — If the promoter desires a percentage of the ERC amount, this is a red flag. You should not hire individuals who provide tax advice based on a percentage of a refund or credit received.

5. Aggressive Claims — Many promoters claim your business will qualify before a review of your tax situation. The truth is that the ERC is a complex credit that applies only to a limited group of businesses.

6. Nothing to Lose — The IRS considers the claim that there is nothing to lose as a "wildly aggressive suggestion" and discourages fraudulent claims for the ERC.

Taxpayers and businesses should be cautious because the promoters follow proven methods but omit requirements for eligibility. They engage in aggressive marketing, send out fake letters claiming to be from non-existent groups such as the "Department of Employee Retention Credit" and will leave out key details. One point to know is that the ERC cannot be claimed on wages that were reported as payroll costs for amounts forgiven under the Paycheck Protection Program.

The best protection is to work with a trusted tax professional. Your local CPA can determine qualification requirements and can file the appropriate tax forms with the IRS. The ERC is available for companies that suffered from a full or partial suspension of operations due to COVID-19 lockdowns during 2020 or the first three quarters of 2021. There is a requirement for a substantial decline in gross receipts. Any recovery startup businesses must have commenced operations during the 3rd or 4th quarter of 2021.

Editor's Note: The IRS advice to trust your local CPA is excellent. A local CPA will be familiar with your business and can determine whether you are qualified to file for the ERC. While Congress allocated billions in government funding in an effort to try to address record levels of unemployment, it is important to be certain you are properly qualified before filing for the ERC.

Does Medicare Cover Nail Care?

Can you recommend some solutions regarding nail trimming? My nails have gotten increasingly thicker over time and I struggle with using nail clippers.

Nail health can be an indicator of a person's overall health. If you have brittle, dull or discolored nails, you may want to speak with your primary care physician to rule out fungal infections or other systemic diseases.

Some Original Medicare Part B and Medicare Advantage Part C members have coverage for medically necessary nail trimming and certain foot care services. Routine foot care is covered by Medicare if you have an underlying condition or injury that requires a professional to tend to your feet. You should ask your primary care physician to review your situation and, if appropriate, certify that your nail care should be handled by a podiatrist or other healthcare professional.

It is important to have a regular maintenance routine to keep nails short and free from infections. Trimming nails is a task that can become very challenging. For many adults, nails can become thicker and harder to cut over time. Nail clippers can be difficult to use if you have arthritis or mobility issues. It may be hard to maneuver into the right position to cut toenails depending on your flexibility. Fortunately, there are solutions available that can help.

Nail Care Tips


One of the simplest tips for cutting nails is to soak your nails in warm water prior to cutting them. This can be done in a bath or shower. The water is a cost-effective solution to soften them for easier cutting.

There are also nail softening creams that temporarily soften the nails. Simply rub the softening cream into your nails both in the morning and at night to make them easier to cut and file. This not only makes trimming easier but reduces cracked and jagged edges and is safe for those with diabetes.

Most nails grow at a moderate rate, so it is recommended to cut them every six to eight weeks. If your nails grow quickly, you should adjust the schedule to keep your nails at a good length. When cutting nails, be cautious not to cut too far down. Overaggressive trimming and cutting nails too short can lead to ingrown nails and discomfort. Podiatrists typically recommend leaving a very small bit of nail (about 1/32 inch) past the nail bed when trimming.

You should also avoid a rounded cut. It is best to cut nails straight across, ensuring that the corners of the nail do not cut into the skin. After cutting, use a nail file to smooth the jagged edges and corners that can snag and potentially tear the nail as it grows.

Types of Clippers


There are several medical-grade and specialty clippers recommended by professionals for older adults. For thick nails, it is best to use a clipper with a sharp and curved blade to easily cut through. Additionally, it may be helpful to find a nail clipper with a cushion grip to allow for comfortable clipping.

For those with limited flexibility, there are nail clippers available with long plastic grips which are much larger than a standard set of nail clippers and a blade head that swivels 180 degrees. By providing more control and an extended range, these features enhance accessibility for anyone with arthritis or mobility issues.

Lastly, for those who have a hard time bending over, there are long handled toenail clippers that come in various lengths including 20, 24, 28 and 32 inches. There are also heavy-duty clippers available with a 1/8-inch-wide jaw opening designed to cut thicker nails.

All of these types of nail clippers are available through online retail websites at prices ranging between $10 and $50. Be sure to take necessary care when clipping your nails at home. You may want to clean the clippers with rubbing alcohol or other cleaning solutions between uses.

Nail Trimming Services


If you have diabetes, limited vision or other health issues, you should consider finding a podiatrist that can provide care. If your healthcare professional deems it medically necessary, this may be covered by your health plan.

If you are generally in good health, you may be comfortable finding a reputable nail salon that can meet your needs for nail grooming. To find a suitable nail salon, you may want to ask trusted friends or family members for recommendations, visit the salon in person and or read online reviews. A standard nail salon service will include soaking, nail and cuticle trimming, under nail cleaning and exfoliation. You should also ask about sanitation and sterilization procedures to ensure you feel comfortable with their processes. You may also be allowed to bring your own nail clippers and other items to the service appointment.

While tending your nails at home is the least expensive option, nail salons generally cost less than visiting a podiatrist. Whichever option you choose, regular trimming can help you avoid serious problems in the future.

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 May 26, 2023

WCCF Donors Honor High School Seniors with Scholarships

Thanks to the generous donors to the Washington County Community Foundation and originators of the foundation’s scholarship funds, Washington County students are getting some relief from the high cost of higher education.

The following scholarships, held at the Washington County Community Foundation, were awarded to our local students:

 

1020 Scholarship

Sidney Brown

Madi Irwin

Taylor Garvin

Jan Williams John

Katelynn Larrimore

Charles and Ada Williams

Allie Elrod

Darcy Stout

Meghan Harrington

Hailey Reed

 

Albert and Manda Huff

Cecile Tate

Audrey Mounts

Chase Coleman

Grayson Hunt

Madeline Galvin

Brileigh Denham

Kaylie Fourman

Addison Maudlin

Ivy Harris

Neary Maddix

Aynsley Nance

Triston Miller

McKenna Jeter

Mercedes Branaman

Brant Farris

Sydney Broy

Jasmine Dewitt

Meadoe Creech-Shelley

Edmund and Mary Drabek

Natalie Adamson

John E. Elliott

Natalie Adamson

Gracie Lewis

John C. Tackett Healthcare

Halle Shelton

John D. Fultz

Kristine Turner

AWC Class of 2002

Sidney Brown

Bailey Hamilton Salem Football Alumni

Parker Boulet

Maurice and Jean Berkey

Ivy Harris

Brileigh Denham

Grayson Hunt

Ellie Thompson

Kady Shocke

Sarah Call

Aynsley Nance

Madeline Lewellen

Abigail Jones

Anna Trueblood

Gracie Lewis

Kyia McKinley

Meadow Creech-Shelley

Howard and Juanita Hinkle

Kyia McKinley

Johnica Branaman

Bianca Garcia

Kays Chapel

Darcy Stout

Amzel and Knofel Fortner

Elizabeth Chastain

Billy Stonecipher

Eva Bundy

Prof. William Yarber

Taylor Garvin

William Clarence and Martha Branaman

Katelynn Larrimore

Wyatt Rainbolt

Delta Kappa Gamma

Macey Hamilton

Dr. Ranessa Cooper

Madi Irwin

Glen and Madge Day

Addison Maudlin

Greg McCurdy

Taylor Garvin

Bernice Anderson

Malachi Eddings

 

Helen Gill

Malachi Eddings

Montana Cortez

Alexander Howard

Frank and Jo Cole

Easton Jones

Holly Humphrey

Patience Gumaelius

Jack and Carol Mahuron IUS Scholarship

Wyatt Rainbolt

Jason Wade

Justin Stephenson

Joseph and Joanna Gili

Eva Bundy

Johnny Elrod

Raymond Bowers

Braxton Sprouse

Larry and Rita Turpen

Eva Bundy

Larry Stephenson

Sidney Brown

Little York Grade School

Jared Scott

Lucille McIntosh Rawlings

Lucas Bower

Sarah Call

Kaylie Fourman

Lily Campbell

Holden Collins

Macey Hamilton

Charlize Bramer

Rogan Howey

Malaina Hubbard

Wyatt Johnston

Maleah Blevins

Gracie Hurst

Audrey Moore

Montana Cortez

Alexander Howard

Easton Jones

Maggie Lee

Kaylee McKinley

Braydon Snelling

Motsinger Family

Gracie Hazelip

Mary Payne

Kaleb Tucker

Max and Phyllis Hinkle

Madeline Garvin

Holden Collins

Bryce Rhinehart

Morris and Marty Rosenbaum

Cassie Walls

Ralph and Faye Motsinger Mahuron

Aidan Hacker

Patience Gumaelius

Isabella Medlock

Allie Elrod

Maleah Blevins

Elizabeth Trueblood

Devin McDonald

Christopher Terry

Marjorie Ann Martin Souder History Prize

Devin McDonald

William O. Martin Math Prize

Natalie Adamson

Pekin Alumni

Elizabeth Trueblood

Kenneth W. Collins

Anna Trueblood

Ralph and Mae Decker

Kaleb Tucker

Randy Johnson

Sidney Brown

Grayson Hunt

Rogan Howey

Robert and Clarice Morris

Macey Hamilton

Aynsley Nance

Emma Dean

Salem Education Foundation

Grayson Hunt

Chase Coleman

Zach Humphrey

Matthew Strange

Ivy Harris

Cassie Walls

Wyatt Rainbolt

Kaleb Tucker

Hayden Baughman

Parker Boulet

Cecile Tate

Ellie Thompson

Raymond Bowers

Aaron Hankins

SHS Class of 1962

Sawyer Davis

SHS Class of 1963

Aaron Hankins

SHS Class of 1971

Lucas Bower

Sabra Smith

Steve Davisson Memorial

Sidney Brown

Patience Guamaelius

Lily Campbell

Cecile Tate

Steven Spaulding

Kellen Humphrey

Warren and Maxine Stewart

Remington Tarr

Washington County Scholarship

Madi Irwin

Exchange Club of Salem

Sidney Brown

James L. Brown

Allie Elrod

** For any errors or omissions we humbly apologize.

Washington County Community Foundation is a nonprofit public charity established in 1993 to serve donors, award grants, and provide leadership to improve Washington County forever.

End

 

Free Direct File Pilot To Launch in 2024

Free Direct File Pilot To Launch in 2024

Internal Revenue Service (IRS) Commissioner Danny Werfel stated this week that the IRS plans to launch a pilot program to allow taxpayers to direct e-file tax returns in 2024.

The Inflation Reduction Act (IRA) allocated $15 million to study the possibility of creating a Direct File tax return system. The IRS worked with New America think tank to conduct a review. The New America review stated it is possible to build an e-file system, but it "depends critically on their ability to maintain this initiative as a leadership priority, start with a limited scope and expand the system over time."

The Department of Treasury chief implementation officer for the IRA is Laurel Blatchford, stated on May 16 that, "filing taxes is expensive and time-consuming for American taxpayers. Dozens of other countries have provided free tax planning options to their citizens, and American taxpayers who want to file their taxes for free online should have an accessible option."

The IRS plans to use the U.S. Digital Service to build a system. Commissioner Werfel stated the IRS "will now be able to expand the amount of people that are interacting with such a prototype in order to further answer questions and provide more insight into whether a full-scale solution should be pursued."

The IRS Direct File system may be able to pre-populate returns with tax information. This may not be part of the pilot program but is a long-term goal.

There was both support and opposition for the Direct File solution. Senate Finance Committee Chair Ron Wyden (D-OR) indicated his approval. He noted the review "confirms that the overwhelming majority of Americans want the IRS to provide a free voluntary option to file their taxes directly online." Wyden explained the concept of a government Direct File program has been in existence for many years. However, Finance Committee Ranking Member Mike Crapo (R-ID) was not as positive. He noted that the IRS should "not act without explicit legal authority."

A major consideration is the cost for development of the direct file system. The initial IRS estimate was an annual operating cost of $64 million to $249 million. While the Department of Treasury stated a "future direct file program could potentially save taxpayers billions of dollars annually," members of Congress were concerned that the annual cost would be in excess of the initial projection.

Commissioner Werfel stated the IRA funds would be sufficient to start the Direct File program, but that he would be discussing funding with Congress for a "full-scale" system.

Many taxpayers in past years use commercial software from members of the Free File Alliance. Understandably, the commercial companies are concerned that the IRS program would compete with them. One large tax-preparation company spent $44 million lobbying Congress during the past two decades to oppose the Direct File option.

Groundwork Action representative Igor Volsky stated the Direct File system "is a strong step forward in the fight for free and simplified tax filing services and a clear rebuttal to big online tax preparers, their lobbyists, and their conservative allies who are committed to keeping tax-filing in America costly and difficult."

Editor's Note: Your editor does not take a position on the merits of developing a Direct File system. This information is offered as a service to our readers.

Does Medicare Cover Physical Therapy Services?

How much coverage does Medicare provide for physical therapy? My spouse was recently diagnosed with Parkinson's disease and will need ongoing physical therapy.

Medicare can cover the cost for physical therapy along with occupational and speech therapy too if it is medically necessary and prescribed by a healthcare professional. Fortunately, Medicare has no limits on how much it will pay for therapy services, however there is an annual coverage threshold to be aware of. Here is what you should know.

Outpatient Therapy


To get Medicare Part B (which covers outpatient care) to help cover your spouse's physical therapy, it must be considered medically necessary and will need to be ordered by the doctor. The same holds true for occupational and speech therapy.

Individuals can receive these services as an outpatient at a number of places. Services can be provided by a doctor or a therapist office, in a hospital outpatient department, at an outpatient rehabilitation facility, at skilled nursing facilities if he or she is being treated as an outpatient, or at home through a home health agency therapist if your spouse is ineligible for Medicare's home health benefit.

For outpatient therapy, Medicare will pay 80% of the Medicare-approved amount after you meet your Part B deductible ($226 in 2023). Patients will be responsible for the remaining 20% unless it is covered by supplemental insurance.

Please note that if your spouse's therapy costs reach $2,230 or more in the 2023 calendar year, Medicare will require your spouse's healthcare provider to confirm that the therapy is still medically necessary. Medicare previously restricted coverage on outpatient therapeutic services, but the cap was eliminated a few years ago.

Keep in mind that treatment recommended by a physical therapy provider but not ordered by a doctor is not covered. In this situation, the therapist is required to give the patient a written notice called an "Advance Beneficiary Notice of Noncoverage" (ABN), that Medicare may not pay for the service along with an estimate of the costs. If the patient chooses to proceed with the therapy, it is an acknowledgment the patient is agreeing to pay in full.

Inpatient Therapy


If your spouse happens to need physical therapy at an inpatient rehabilitation facility like at a skilled nursing facility or at your home after a hospitalization lasting at least three days, Medicare Part A (which provides hospital coverage) will cover the costs.

To be eligible, a doctor will need to certify that the patient has a medical condition that requires rehabilitation, continued medical supervision and coordinated care that comes from doctors and therapists working together.

Whether a patient will incur out-of-pocket costs such as deductibles and coinsurance, and how much they are, will depend on the setting for the treatment and how long it lasts. For more information on inpatient therapy out-of-pocket costs see Medicare.gov/coverage/inpatient-rehabilitation-care.

Medicare Advantage Coverage


If your spouse is enrolled in a Medicare Advantage plan (like an HMO or PPO), these plans must cover everything that is included in Original Medicare Part A and Part B coverage. However, some Medicare Advantage plans may require a person to use services from physical therapy practices within an agreed network. If your spouse has a Medicare Advantage plan, it is best to contact the specific plan before selecting a physical therapy provider to confirm the provider is in network.

More Questions?


If you have other questions about coverage and costs for therapeutic services, call Medicare at 800-633-4227. Your State Health Insurance Assistance Program (SHIP) also provides free Medicare counseling and is a great resource to help answer any questions. Visit ShipHelp.org or call 877-839-2675 to connect with a local SHIP counselor.

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 May 19, 2023

Protect Yourself From Natural Disasters

The Internal Revenue Service (IRS) published a letter this week that reminded taxpayers of National Hurricane Preparedness Week and National Wildfire Awareness Month. Individuals should be prepared for natural disasters such as wildfires, mudslides, landslides, severe thunderstorms or tornadoes. A natural disaster is a devastating event that can have a lasting impact on you and your family. It is always good to be prepared and plan to protect your personal financial and tax information.

1. Key Documents — Your initial priority should be protecting important documents. This may include recent tax returns, Social Security cards, birth certificates, deeds, insurance policies and medical records. These documents should be kept in a waterproof container in a secure location. You may want to make copies of the documents and store the digitized files on a portable external hard drive kept in a safe deposit box or entrusted to an individual in a different area.

2. Records of Your Valuables — Many individuals own art, collectibles or other types of valuable personal property. It is recommended that you compile a list of your valuables and have photos or videos to catalogue the items. These photos or videos will help you support your claims for insurance proceeds or an applicable tax deduction. The IRS offers disaster loss publications for both individuals and businesses that need guidance in making a list of valuables. An individual should refer to Publication 584, Casualty, Disaster, and Theft Loss Workbook (Personal-Use Property). If you own a business, you may want to review Publication 584-B, Business Casualty, Disaster, and Theft Loss Workbook.

3. Reconstructing Records — If you are a victim of a natural disaster, you may lose important financial or tax records. These could be required for federal assistance or insurance reimbursement. Many types of reimbursement require an accurate estimate of the amount of the loss. The "Reconstructing Records" webpage on IRS.gov is an excellent starting place if you need to rebuild your records.

4. Employer Fiduciary Bond — Employers who use a payroll service provider should verify there is a fiduciary bond in place. If the payroll service provider is in the natural disaster region, the organization may suffer a major business loss and default on its obligations. An employer may obtain a fiduciary bond that will protect it in the event of a disaster that causes the payroll service provider to default.

5. IRS Tax Relief — Following a declaration of a disaster zone by the Federal Emergency Management Agency, the IRS frequently postpones tax filing and payment deadlines, more information is available on the IRS Disaster Relief page on IRS.gov. If you are in a federal disaster zone, you may qualify for filing and payment relief. Individuals who are not in the covered disaster area but are impacted by a specific disaster may still qualify for relief. If you wish to speak to a trained IRS specialist, you may call 866-562-5227 for answers to disaster-related concerns.

Online Dating

Can you recommend online dating apps or websites? I am looking for someone to spend my time with and I am uncertain on the best way to find a companion.

Whether you are interested in dating or just looking for a friend to spend time with, online dating is an easy and convenient way to meet new people from the comfort of your own home. Today, most websites use matchmaking algorithms that factor in your interests and preferences to match you with individuals that are best suited for you. Here are some tips to help you get started.

Choose a website: With various matchmaking websites and smartphone apps available today, choosing the right one for you may be confusing. While many sites offer free versions, many websites offer premium services with paid versions. In general, paying for dating apps can get you increased visibility and the ability to learn who has liked your profile.

There are various types of matchmaking websites that cater to your specific preferences. If you are looking to connect with other older adults, educated professionals or are considering religious preferences, there are several specialized websites that can help your search.

Create a profile: If you choose to join a matchmaking website, you will need to create a profile that reflects who you are. Your profile may include recent photos, hobbies, interests, favorite activities and more. It is important to provide just enough information to highlight your personality and not reveal private information that could compromise your privacy or safety.

Practice caution: When you register with a website you no one gets access to your personal contact information until you decide to give it out. Be cautious to who you disclose personal contact information. You should talk on the phone or through video a few times prior to meeting in person. When you do meet in person, it is best to select a public place or bring a friend. If someone asks for money or your financial information, do not provide it. Online dating and sweetheart scams are rampant so be very cautious.

Be skeptical: Some people may exaggerate in their profiles. Some users may use misleading pictures or use another person's picture. As such, it is suggested to maintain a reasonable level of skepticism when you enter dating websites.

Make an effort: Users will often sit back and wait for others to reach out to them. Do not be afraid to make the first move. When you find someone you like, you might want to send them a short message that acknowledges your common interests and compliments their profile.

Do not get discouraged: If you do not get a response from someone, do not take it personally. There are many others that will be interested and it only takes one person to make online dating worthwhile.

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