Medicare Changes Planned by Congress

There is a great deal of nervousness and confusion surrounding changes to Medicare in the coming years.  In fact, many retirees and working adults near retirement age do not realize these changes were already set in motion in 2014 and, unless something happens to stop them, they could dramatically change the way people on Medicare receive their benefits.  As a result, I did more research on the current plans, the changes which are coming and, finally, I consulted AARP through their Facebook page to get clarification on exactly what is being proposed.

What are the Current Medicare Choices?

Currently, Medicare recipients have three choices for receiving their benefits.

1.  Basic Medicare only - Medicare pays about 80 percent of approved costs for hospitalization and doctor visits, including a short period of time in a skilled nursing or rehabilitation facility each year, when medically appropriate.  The medical procedures, lab tests and care which Medicare will cover are specified as defined benefits.  The beneficiary pays the cost of anything not covered by the government fixed benefits.

2.  Basic Medicare plus a supplemental insurance policy - This is currently the most popular choice for the majority of retirees, with beneficiaries using basic Medicare as their primary insurance carrier and buying a supplemental policy as a way to cover the 20 percent of their medical bills which are not covered by basic Medicare.  Beneficiaries pay a premium for their supplemental policy.  The premiums vary widely depending on the size of the co-pays and deductibles.

3.  Medicare Advantage plans - These plans are currently a type of voucher system with both a defined benefit and a defined contribution from the government.  Medicare pays a monthly premium (defined contribution) to the insurance company you choose, and the insurance company takes care of covering your medical care (defined benefit).  You may find a policy with either no additional premiums or which only have a small additional premium over the government's defined contribution.  You do not deal directly with Medicare; you only deal with your doctors and chosen insurance carrier.  Under a Medicare Advantage Plan, you have a defined benefit.  This means your policy has to cover AT LEAST all the benefits you would receive under basic Medicare.  It also has a defined contribution, which is the size of the voucher the government pays your insurance carrier.

What Would Be Different Under the Proposed Medicare Changes?

Essentially, under a 2015 House Budge Resolution which came out of a committee headed by Paul Ryan and was passed by the House of Representatives in 2014, Congress would like to drop the government's responsibility for guaranteeing a basic level of medical care for all senior citizens.  Medicare beneficiaries would no longer be assured they would have defined benefits.  Instead, ALL beneficiaries would be switched to a voucher system where they could purchase a Medicare plan which is either fee-for-service or from a private insurance carrier.

The government would no longer guarantee that seniors would be entitled to specific medical benefits.  You would pick an insurance company which could offer a range of choices, depending on how much you are willing to pay in additional premiums, above the government voucher.  As a result, the poorest Medicare beneficiaries are the people most likely to choose policies with no additional premiums. This means they could have high co-pays, high deductibles, fewer choices in physicians and fewer benefits.  AARP is concerned the poorest people could end up deeply in debt in order to cover medical expenses they incur late in life.

Analysis by the National Committee to Preserve Social Security and Medicare

One organization which is following this issue carefully is the National Committee to Preserve Social Security and Medicare.  Below is a excerpt from their website:

"The House Budget Resolution for Fiscal Year 2015, H. Con. Res. 96, introduced by Budget Committee Chairman Paul Ryan (R-WI), was passed by the House of Representatives on April 10, 2014.  It would end traditional Medicare, make it harder for seniors to choose their own doctors, and increase health care costs for both current and future retirees.  The House Republican budget ends traditional Medicare and achieves savings for the federal government by shifting costs to Medicare beneficiaries.

Privatizing Medicare with Vouchers/Premium Support Payments

Beginning in 2024, when people become eligible for Medicare they would not enroll in the current traditional Medicare program which provides guaranteed benefits.  Rather they would receive a voucher, also referred to as a premium support payment, to be used to purchase private health insurance or traditional Medicare through a Medicare Exchange.  The amount of the voucher would be determined each year when private health insurance plans and traditional Medicare participate in a competitive bidding process.  Seniors choosing a plan costing more than the average amount determined through competitive bidding would be required to pay the difference between the voucher and the plan's premium."

This means seniors who live in areas where medical insurance costs more, or those who have expensive medical needs could end up paying higher premiums to make up the difference. In addition, low-income retirees could be forced into networks with limited physician choices. 

In truth, no one is quite certain what effect this change from a defined benefit plan to a defined contribution plan, with limited government responsibility, will have on future and current retirees.  However, the reason the government is doing this is to shift the burden of paying for the medical care of retirees from the government to senior citizens.

Analysis by AARP

As mentioned above, I had a discussion with AARP on their Facebook page about the changes.  Below is a quote from that discussion:

"Hi Deborah, there's a lot of tricky language surrounding this issue, so I'm happy to help make sure it's clear: Under a voucher system, the federal government would replace Medicare beneficiaries’ guaranteed benefit package (the current system) with a fixed dollar amount or “defined contribution” that beneficiaries would apply toward a health plan they chose. You would apply your fixed-dollar-amount voucher on competing private health plans or traditional Medicare fee-for-service coverage. One major concern is that this voucher system ends the promise of a guaranteed set of Medicare benefits and could have higher risk of catastrophic out-of-pocket medical expenses for Medicare beneficiaries with lower incomes who would pick the lower-priced plans that could have high deductibles, limited benefits and restrictive provider networks. Here's the report from the AARP Public Policy Institute that breaks down exactly why this proposal could hurt seniors: http://www.aarp.org/ppi/info-2016/premium-support-and-the-impact-on-medicare-beneficiaries.html - Caroline D."

Highlights of The AARP Public Policy Institute Report 

According to the report mentioned in the paragraph above, the concerns of AARP about this Congressional plan are quoted below:

• Premium support could end the promise of a guaranteed set of Medicare benefits

• Beneficiaries in traditional Medicare could pay more

• Premium support could shift more costs to beneficiaries over time

• Most Medicare beneficiaries cannot afford to pay more for their health care

• Premium support could lead to reduced access and higher risk of catastrophic out-of-pocket medical expenses for Medicare beneficiaries with lower income
  

• Premium support assumes that beneficiaries are willing and able to make complex health care coverage decisions

How to Let Congress Know Your Opinion on These Changes

Since the above changes to Medicare have already been passed by the House of Representatives and are supported by the majority of Republican members of the Senate, they are likely to become law unless the American public lets their voices be heard.  If you want to keep the current defined benefit Medicare plans, rather than change to a voucher system and variable benefits, it is essential for every American to let the president and Congress know how you feel.

You can email the U.S. president at:  president@whitehouse.gov

Contact your Representative at:  http://www.house.gov/representatives/find/

Contact your Senators at:  https://www.senate.gov/senators/contact/

Join AARP and support their lobbying efforts at:  aarp.org 

This may not be the last attempt to undermine our Social Security and Medicare benefits.  You can stay current and contact your Congressional Representatives about ALL the bills which come before Congress on the non-Partisan site called Countable: https://www.countable.us/

If you are interested in staying up-to-date on retirement information, discover where to retire, learn about common medical issues, or more, use the tabs or pull down menu at the top of the page to find links to hundreds of additional useful articles.


You are reading from the blog:  http://www.baby-boomer-retirement.com


Photo credit:  morguefile.com

Products for Safer Aging in Your Home

By the time you are in your 70s or 80s, there is a very good chance you will either be living alone or with a partially disabled spouse. Since the vast majority of senior citizens choose to live independently in their own home or apartment, seniors may feel more secure if they take advantage of modern technology to help them age safely.

As you age, you may begin to feel lonely and isolated, especially if it becomes difficult to drive or walk long distances.  You may also become uncomfortable if familiar neighbors move away and strangers occupy the neighboring homes.  In some cases, you could become unsure who to rely on in an emergency. However, there are a few simple purchases you can make which will keep you connected to the outside world and help you feel safer.

There are a wide variety of safety options available.  Most of them are useful long before you need them because of aging.  The items mentioned below fall into three categories ... items which will keep you safe from intruders, tools to make it easier to get help in an emergency, and products to reduce accidents in your home. 

Products to Protect Yourself from Intruders

Security Systems - Security systems are available from a number of companies including ADT and Costco.  When activated, they will sound an alarm if someone enters a door or window.  If the system you choose is connected to a monitoring company, the agent can contact the police or fire department if there are signs of an intruder or fire.

Ring Video Doorbell - If you simply want to know who is ringing your doorbell, the Ring Video doorbell has a camera which connects to your smartphone and will show you who is standing at your door, whether you are home or not.  It also allows you to speak to the person without opening your door.  You can even tell the UPS deliveryman to leave a package at your door, so you do not have to open the door to a stranger, especially if you are not expecting a delivery.

Motion-detector lights - If the area around your home is dark, motion-detector lights which come on automatically when anyone approaches will make intruders more visible and likely to flee if they are trying to break into your home.  It will also make you more aware of the fact that a person or animal has approached your home. Home Depot, Lowe's and lighting supply companies can sell you the light fixtures and arrange installation, although some of the devices can be easily screwed into an existing fixture.

Products for Contacting Assistance in an Emergency

Personal Safety Devices - You have probably seen the television ads with an elderly person falling and calling out, "Help, I can't get up."  The older you are, the greater the possibility this could actually happen.  There are several companies, such as Great Call, Life Alert and Medical Alert, which have products that can solve this problem.  You wear a bracelet or pendant and, should you need an ambulance, the fire department, or the police, you only need to press a button in order to be connected to a response agent who will call a friend, neighbor or the appropriate emergency service for you. Some of the devices work only in your home when you are near the transmitter.  Others will work wherever you go.  Make sure you understand how the system works before you purchase it.

Jitterbug and other Smart Phones - If you do not want to wear a medical alert pendant or bracelet, you could purchase a product like the Jitterbug phone which is an easy-to-use cell phone, texting and email device; it also doubles as a personal safety device which comes with Great Call's safety app.  You simply press an icon on the face of the phone and will be connected directly to a response agent who can get you the help you need.  If you do not want to purchase a new device, you can set up your current smart phone with an emergency call app, so it is quick and easy for you to call emergency services.  If you decide you prefer using a mobile phone rather than a personal safety device, it is important you carry your phone on your person or keep it within reach at all times.

CapTel Captioned Telephone - Do you have trouble hearing, which makes it difficult for you to easily use your home telephone?  The CapTel amplified and captioned telephone has a screen which converts the spoken word to captions on the phone's screen.  At the same time, the sound of the words are amplified by the phone. The combination of having the words made louder and a screen which allows you to read what the person is saying, makes it much easier for you to communicate with the outside world.  This could be especially important in an emergency when you do not want to waste time asking the other party to repeat what they are saying. 


Products to Prevent Accidents in Your Home

Night lights - Accidents are more likely to happen in the dark.  Having night lights in the bathroom and dark hallways will reduce your risk of tripping over something in the dark. In addition, if there is a fire in your home and your access to the nearest exit is obscured by smoke, night lights could help you find your way. You can find inexpensive night lights at nearly any drug or grocery store.

Illuminated light switch covers - Another way to add light to your home at night is to have the light switch covers changed to ones which are illuminated.  They will emit a tiny amount of light, but make it much easier to find the switch in a dark room.

Stair lifts - If you live in a two-story home and have difficulty going up and down the stairs, you do not have to put yourself at risk of falling.  Companies such as Acorn, AmeriGlide and Bruno Stair Lifts provide a safe way to sit on a seat and be carried safely up and down the stairs.  A stair lift can also make it possible for you to stay in a home you love, rather than move because the stairs are giving you difficulty.

Walk-in Bathtubs - One major danger when you live alone is a fall in your shower or bathtub.  One solution is purchasing an inexpensive waterproof stool to use in the shower.  Another solution is a walk-in bathtub.  You open a door on the side of the tub, walk in, sit on the seat and close the door.  Then you fill the tub with water.  The tubs often have heated seats and massaging hydro-jets to make the experience even more relaxing.  Most of all, however, you no longer have to step over the edge of a slippery tub to take a bath.  After your bath, you remain safely seated while you drain the tub, open the door and then step out.  American Standard, Safe Step, Kohler, Jacuzzi and several other companies offer these tubs, so it is wise to shop around for the one which feels comfortable and is the most affordable option for your needs.

Lift Chairs - If you have difficulty getting out of a chair, especially after surgery or an injury, a lift chair may make it easier for you to get to a standing position.  Some of them also double as the perfect sleep chairs and may come with heat and massage.  They can be very helpful if you have difficulty sleeping on a flat mattress or getting out of bed in the morning.

If you are interested in more information about dealing with common medical problems as you age, where to retire, financial planning, Social Security, Medicare and more, use the tabs and pull down menu at the top of the page to find links to hundreds of additional articles.

You are reading from the blog:  http://www.baby-boomer-retirement.com

Photo credit:  morguefile.com

Strengthen the Memory of Your Spouse

Most of the focus on dementia, including Alzheimer's Disease, has been on what you can do to reduce your own risk of losing your memory.  But what if you are worried about your spouse's memory?  Is there anything you can do to help them?  According to the "Healthy You" column in the August/September 2016 issue of AARP Magazine, there are actually a number of steps we can take if we start to notice that our spouse is starting to have memory issues ... and you don't even have to tell them what you are doing!

How to Help Your Spouse's Memory (and Your Own)

The good news is that anything you do to help your spouse's memory will also help improve yours.  In this way, you both benefit.  Below are their recommendations:

Babysit your grandkids occasionally - According to Australian research, watching grandchildren once or twice a week stimulates our memories, but only if it doesn't become a daily grind.  Keep things fresh and new by doing it no more than twice a week.  Having fun with your grandchildren will also prevent a common problem as we age ... isolation and loneliness.

Both of you should lie down for a daily nap - A German study showed that getting enough rest improves our memories and a 45 to 90 minute nap has been shown to help us retain more information.

Explore your creativity - Mayo Clinic researchers discovered that having an artistic hobby during both middle age and old age reduces your likelihood of cognitive decline by a whopping 73 percent!  Encourage your spouse to pull out that old paint set, pick up the guitar, sign up for classes, or join a group.  While you're at it, explore your own creative side, too!

Do home repairs together - Doing home repairs is another way to draw on our creative juices.  Columbia University discovered that measuring, building, painting and making repairs requires us to activate our memories. 

Exercise together - Over and over again, different researchers have shown that any exercise that is good for the heart is also good for the brain ... since our brain is using about 20% of the blood in our body at any given time.  The effect of exercise on the the brain is so impressive that the Georgia Institute of Technology discovered that just one 20 minute exercise session can improve a person's long-term memory by around 10 percent!

Have a drink together - Up to one or two alcoholic beverages in a day have been shown to help your memory, in some studies.  However, if you don't drink, don't take it up in the hope that it will improve your health.  There are other techniques which are just as effective.  In addition, too much alcohol can do more harm than good and alcohol often has negative interactions with many of the medications senior citizens are prescribed.

Eat a healthy diet - A balanced diet is an important part of any memory prevention program.  Among the foods which were specifically mentioned in the AARP Magazine article were asparagus, shrimp, split peas and walnuts.  In other articles I have read, dark green vegetables and fatty fish are often recommended, as well.

How to Tell If You Need to See a Doctor (or Send Your Spouse to One) about Memory Loss

Let's face it.  All of us occasionally forget a name, miss an appointment or lose our keys.  When does that normal memory loss become something which should worry us?  The AARP Magazine article suggested you should discuss memory loss with your doctor if you answer "yes" to two or more of the questions listed below:

Do you look forward to lunch with friends, but forget to go?
Do you have trouble following a recipe you have made many times before?
Do you always have to rely on notes or your phone to remember things?
Do you have trouble remembering today's date or what season it is?
Are you paranoid and believe other people are "out to get you?"

If you are interested in more information about dementia, healthy aging, financial planning, where to retire, Social Security, Medicare and more, use the tabs or pull-down menu at the top of the page to find links to hundreds of additional articles.

You are reading from the blog:  http://www.baby-boomer-retirement.com

Photo credit:  morguefile.com