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New Medicare Cards to be Issued

From the PA Department of Aging -The U.S. Congress directed the Centers for Medicare & Medicaid Services (CMS) to come up with a new Medicare card design, requiring that Social Security numbers no longer be used as the beneficiary’s claim number. Accordingly, the Social Security number will be removed from all new Medicare cards.

The new cards will have a randomly chosen Medicare Beneficiary Identifier of 11 characters that can include both numbers and capital letters. Simply put, each Medicare enrollee will receive a new Medicare Beneficiary Identifier that is unique to them, and it will only be used for the individual’s Medicare coverage.

Brandi-redd-122054-unsplashThis will help keep the Medicare beneficiary’s information secure and help protect against identity theft. There are a few additional points that need to be highlighted:

  • Persons enrolling in Medicare for the first time will be among the first to get a new Medicare card, no matter where they live.
  • For current Pennsylvania Medicare beneficiaries receiving a new card, it’s important to remind them that mailing everyone a new card will take some time. One person’s card might arrive at a different time than a family member, a friend, or a neighbor.
  • Receiving the new card will happen automatically. A card is mailed to each Medicare beneficiary, at no cost, to the address the beneficiary has on file with the Social Security Administration.
  • When the Medicare card is received, they should not simply throw their old card out. Rather, they should shred it or cut it up with a pair of scissors.

If you have questions about your estate planning, elder law, or your new Medicare Card, please feel free to contact us.  Just click here to give us a little information and we'll be in touch!

 

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Who’s Living Longer?

People standing on globeThe average woman in Japan is now living to 87. But Trust Advisor’s article, “The Rich Are Living Longer And Taking More From Taxpayers, notes that many Americans are dying younger.

The Society of Actuaries has decreased its life expectancy estimates for 65-year-olds in the U.S. by six months, and the health of middle-aged non-Hispanic white Americans is deteriorating fastest.

These trends show a widening gap between wealthier and poorer Americans. The richest people in the U.S. are getting several years of extra life and are also reaping a financial reward for their longevity. These trends will be important with any changes to Social Security, Medicare and other programs. A mere tweak to one of these programs—like retirement age or benefit formulas—may impact the rich and poor quite differently. The researchers wanted to see how long Americans can expect to live based on their income, focusing on earnings in midcareer, from 41 to 51 and using Social Security data.

In 1980, a 50-year-old man in the wealthiest 20% of the income distribution could expect to live five years longer than a 50-year-old man in the lowest-income group. In 2010, the gap between them increased to 12.7 years. The poorest 20% of 50-year-old American men can now expect to live just past 76, six months more than the previous generation. The richest 50-year-olds should make it almost to 89—seven years longer than their parents’ generation.

An important result of this 13-year life expectancy gap is the fact that Social Security and Medicare are becoming a much better deal for well-off Americans. Thirty years ago, the richest and poorest retirees could anticipate roughly the same amount of benefits out of government programs. The richest received larger Social Security payouts by qualifying for higher checks and by living longer. The poorest got more out of government programs. Medicare benefits were about the same for each group.

Now as wealthier people live longer, they can expect to collect a lot more from Social Security over their lifetimes than the poor. In 1980, a wealthier 50-year-old could anticipate collecting $103,000 more than a poor American. Fast forward 30 years and the gap was $173,000. This shows that Social Security is becoming significantly less progressive over time, due to the widening gap in life expectancy.

Some theories about this notion cite rising levels of substance abuse, obesity, and suicide. Others look at how economic inequality drives health inequality. The cost of good health care has skyrocketed—even for those technically covered by insurance.

Your expected life span is a critical factor in your retirement planning and saving for retirement. The longer you live, the more valuable Social Security is to supplement your savings. Life expectancy trends also affect the long-term finances of entitlement programs like Social Security.

Reference: Trust Advisor (April 24, 2017) “The Rich Are Living Longer And Taking More From Taxpayers

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Answers to Your Medicare Questions

Bigstock-Senior-couple-standing-togethe-12052331Did you know about 10,000 people turn 65 every day?

Along with that incredible number, comes the challenge of understanding Medicare. Kiplinger’s recent post, “FAQs About Medicare” says that if you signed up for Social Security before age 65, you’ll automatically be enrolled in Medicare parts A and B and receive your card three months before your 65th birthday. Part A covers hospitalization and is generally premium-free. Part B covers outpatient care, such as doctors’ visits, x-rays and tests, and costs $134 a month for people who enroll in 2017 (or more for high earners).

Sign-up for others. Everyone who is not part of the group above, must take action to enroll or face a lifetime late-enrollment penalty (unless you’re still working and have employer coverage). Go to www.socialsecurity.gov to sign up anytime from three months before until three months after you turn 65, your “initial enrollment period”. This is true, even if you’re waiting to file for Social Security benefits.

If you (or your spouse if you’re covered by your spouse’s insurance) are still working for a company with 20 or more employees, the employer’s insurance is your primary coverage. Medicare is secondary and can fill any gaps in coverage. You don’t have to sign up for Medicare at 65, and you won’t have a late-enrollment penalty, provided that you sign up within eight months of leaving your job and losing work-based coverage (or losing coverage under your spouse’s insurance).

If you work for a large employer and like the coverage, you can delay signing up for Part B. However, the rules are different if you work for a company with fewer than 20 employees: Medicare generally becomes your primary coverage at age 65, and you must sign up for Part A and Part B while you’re still working. You can’t delay signing up for Part A if you’re already receiving Social Security benefits and were automatically enrolled in Medicare, despite the fact you’re still working.

Health savings account. You can still contribute to a health savings account after you turn 65, provided you haven’t enrolled in Medicare. If you’re able to delay signing up for Medicare Parts A and B, you can continue contributing to an HSA. Before you do, see about the HSA’s tax breaks, any employer contributions and other benefits that would be more valuable than the premium-free Part A coverage.

Retiree health insurance. At age 65, unless you (or your spouse) are still working and have current employer coverage, you should sign up for both Medicare Part A and Part B. Retiree coverage can fill gaps in Medicare (which would otherwise require Medigap and Part D policies or a Medicare Advantage plan), but it’s secondary to Medicare after age 65. It may also not kick in at all, if you don’t sign up for Medicare. Federal retiree coverage is an exception. It remains your primary coverage if you don’t sign up for Medicare, but you’ll pay a penalty if you decide to sign up for Part B down the road.

The late-enrollment penalty is 10% of the Part B premium for every year you should have had coverage. The penalty applies as long as you receive Medicare benefits.

Medigap. You may need Medigap insurance to pay deductibles and co-payments. Most people buy a Medicare supplement (Medigap) policy to pay those costs, plus Part D prescription-drug coverage since Medicare generally doesn’t cover drugs. Another option is to sign up for a private Medicare Advantage plan, which provides both medical and drug coverage. These policies are sold by private insurers and come in ten standardized versions. You get to go to any doctor or facility that is covered by Medicare. Private insurers sell part D prescription-drug plans. Medicare Advantage plans combine medical and drug coverage and may also provide coverage that isn’t available through Medicare, like dental and vision care.

Medicare high-income surcharge. If your adjusted gross income plus tax-exempt interest income is more than $85,000 for singles or $170,000 if you’re married and filing jointly, you’ll be subject to the Medicare high-income surcharge and pay extra for Part B. You’ll also have to pay extra monthly for Part D drug coverage.

Reference: Kiplinger (May 2017) “FAQs About Medicare”

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Find Out More about Home Healthcare Services

Doctor with patient“It should ease your mind to learn that there are many more sources of funding for in-home healthcare than you may think.”

There can be stress, confusion and sadness when a person learns that a loved one needs in-home healthcare services. There are many things to evaluate when it comes to the different types of care and how to pay for home healthcare.

Miami's Community Newspapers’ recent article, “How to Pay for Home Healthcare without Going Broke,” says that many funding resources for in-home services may cost very little or nothing. There are some funding resources for seniors who don’t qualify for government programs. However, bear in mind that some carry financial risks. An experienced Elder Law attorney can help you find the best options for your circumstances.

There are also several different types of caregivers for senior caregiving. You should learn about various roles, since their funding is from different sources.

Personal Care. There are many names for personal care assistants like home care aides, custodial care aides, personal care assistants and companionship aides. They help seniors with hygiene and grooming activities. These caregivers are self-employed and aren’t required to have any certification, licensing, or insurance. They typically charge 20-30% less than workers from home health care agencies and you can usually get one on short notice. Medicare doesn’t cover funding for personal caregiving alone. As a result, most families use personal savings for this service.

Home Healthcare. Home healthcare aides (HHA) or certified nurse aides (CNA), personal care aides (PCA) and geriatric workers are considered skilled care. They perform duties like taking a pulse or monitoring blood pressure and personal care. They help with medication management and medical equipment, and provide a higher level of care. HHAs usually work with home health care agencies that have state certification to bill under Medicare and are bonded, licensed and insured.

Seniors who need these types of care, should look for funding for home healthcare in several areas:

Medicare and Veteran’s Administration. Two primary sources of funding for skilled senior care are Medicare and the Veteran’s Administration, and home health agencies take care of the billing.

Medicaid. Some in-home healthcare services may not be covered under Medicare or Veteran’s Administration coverage, so seniors with Medicaid may need to bill for some medical services separately.

State Programs. The Older Americans Act offers funding to states for Meals on Wheels and meals served in senior centers. It also funds programs for health promotion and family caregiving support.

Personal Funding. Maximize federal and state funding before you use your personal finances. There are several ways to finance uncovered costs like your personal savings, annuities, long term care insurance, a reverse mortgage, life insurance policy conversion, home care loans and a home equity line of credit.

Go with a Pro. Using your personal funds, life insurance and loans will affect the senior’s estate and financial worth, so talk with an Elder Law and estate planning attorney.

Reference: Miami's Community Newspapers (March 21, 2017) “How to Pay for Home Healthcare without Going Broke”

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The Bumpy Ride of Care for Your Parents

Holding elder persons hand“Thanks to Father Time and copious amounts of prescription drugs, people are living longer. But with longer lives comes the potential for increased healthcare needs.”

It can happen out of the blue. One second your folks are in pretty good shape. The next second, your dad is in the hospital with pneumonia and your mom is showing signs of early onset dementia.

How the devil did this happen? This is the basic question asked by Chicago Now in its recent article, “Getting Old Sucks: Why To Start Estate Planning With Your Parents.” As the article puts it: “you are officially on the rollercoaster ride to elder hell.”

Fortunately, there are things you can do on this bumpy ride to make it easier on you and your parents. While it’s uncomfortable at first discussing the topic of death with your parents, it’s necessary and important.

Talk to them about estate planning and make sure that they have wills, durable healthcare and medical powers of attorney (POA) and health care directives. If your parents don’t have these documents, you should make an appointment with a qualified estate-planning attorney and get this completed today as soon as possible.

For example, what if your father has a debilitating stroke, doesn’t regain consciousness and needs 24/7 medical support indefinitely? Without a health care directive, the hospital will keep him alive, even in a vegetative state, until he passes naturally.

You’ll be unable to have him removed from life support, unless you can show the physician and hospital administrators his legally valid health care directive and his medical POA that details his wishes. Without these estate planning documents, you and your mother will have limited control on how he should be treated.

From a financial standpoint, it is important to remember that the hospitals will continue to bill you even when your father is on life support and technically brain dead. After 100 days of Medicare coverage, your mom will be fully responsible for these care and treatment expenses, if there’s no supplemental insurance.

Start the dialog with your parents and let them determine how they want to live and die. This will save you and your loved ones considerable stress, frustration and heartache in the future.

Once this is under control, work on your own estate planning. You should contact a knowledgeable and experienced estate-planning attorney with your questions.

Reference: Chicago Now (March 7, 2017) “Getting Old Sucks: Why To Start Estate Planning With Your Parents”

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