Wednesday, December 26, 2018

Top Retirement Posts in 2018

Every winter, our final post is a summary of the most popular posts of that year.  It has been interesting to see how the topics have changed slightly over the years.  This year, the top post was on End of Life Planning.  It was followed by posts on how to help your grandchildren earn scholarships, how Medicare handles certain health problems, and how to prevent dementia. In fact, concern about dementia has been the most recurring theme over the past few years.

There have been three developments with this blog in 2018.  The first was the addition of the services of a Medicare expert from Boomer Benefits, Danielle Roberts, who is licensed in 47 states.  Either she or one or her co-workers will be happy to answer your individual Medicare questions. You can find her photo, phone number and email address in the lower right-hand column of the blog.  Danielle also has written several guest posts about Medicare for this blog during the past year and you can find them by clicking on the Social Security and Medicare tab at the top of the page.

Secondly, as the author of this blog, I have decided to personally join an Alzheimer's research study at the University of California - Irvine MIND facility. I have been sharing what I have learned in some of my blog posts and plan to continue to do so in coming years.  I believe that my readers will find the information I am sharing will be valuable.  To see all the posts on dementia and Alzheimer's Disease which have been discussed in this blog, use the Medical Concerns tab at the top of the page to find links to all of them.

Thirdly, I narrowed down the variety of ads which are visible on the sidebar of my blog. All the ads in the right-hand column are either from Amazon or Google, both reputable advertisers.  This means you should be able to comfortably use the links in the sidebar to obtain information about advertised products without fear of malware or viruses.  I'm not sure you can say that for all the advertisers you encounter on other sites on the internet!

Now for the list of the most popular retirement posts in 2018.

End of Life Planning for Baby Boomers - The most popular post of the year was about the steps we all need to take in order to prepare for the end of our lives. For example, you should contact a lawyer, write a will, set up a trust, and complete an advanced healthcare directive. You should also talk to a mortuary, prepay your funeral, if possible, and leave instructions with your heirs.  Get details and learn more about the other steps you should be taking in this post.

College Scholarship Tips for Grandchildren - Despite the risk to their own financial future, according to AARP, approximately 53 percent of grandparents help their grandchildren with their educational expenses.  Learn how you can help your grandchildren earn scholarships and reduce their need to take out debt or turn to you for help.  This could benefit you both and was another very popular post over the past year!

Medicare Coverage for Heart Disease - If you have a heart attack, what will Medicare cover?  How many heart screenings, tests, etc., are covered each year?  Get the answers so you know what to expect before you find yourself in the hospital.

How Medicare-For-All Would Work - A number of recent politicians have expressed support for a Medicare-For-All program in our country.  However, how would it work? What are the benefits and concerns about a program like this?  Learn more about this proposal so you understand the concept and how it could gradually be implemented.

Hearing Loss Increases Dementia Risk Dramatically - An important way to prevent or postpone dementia is to engage with other people.  However, if you have hearing loss, your socialization could be reduced and your risk of dementia could increase.  Learn more about this important issue.

Lower Dementia Risk with Exercise - Anything which is good for the heart is good for the brain.  This is especially true when it comes to the importance of getting regular exercise.  Learn more about the best types of exercise to lower your dementia risk.  

International Travel Tips for Senior Citizens - Are you planning an international trip?  If you have not traveled overseas in a while, there are certain issues you need to consider in making your plans.  Even if you are a seasoned traveler, you may find these tips to be helpful, so be sure to check out this post before your next overseas trip.

Medicare, Substance Abuse, Addiction and Alcoholism - Many senior citizens suffer from problems with substance abuse, including addiction to legal and illegal drugs, as well as alcoholism.  If you need help recovering from these problems, how much of the cost will Medicare cover?

Socializing Reduces Dementia Risk - Did you know that following the MIND diet, getting adequate sleep, and engaging in a variety of types of exercise have all been shown to dramatically reduce your risk of dementia, including Alzheimer's Disease?  Socializing is another important way to improve your brain health and lower your dementia risk.  Learn more about how it can help you to spend time engaging with other people on a regular basis.

Prediabetes and Diabetes Prevention - Roughly one in four adults over the age of 65 have diabetes, and significantly more have prediabetes.  A large percentage of people with these conditions are NOT aware of it.  However, this is not a disease which you want to ignore.  Diabetes is the 7th leading cause of death in the U.S.  As a result, it is important we all understand how to avoid it and how to minimize the damage it can cause. This article is a good place to begin to expand your knowledge of this life-shortening disease.

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

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Wednesday, December 19, 2018

Does Music Help Dementia Patients?

Do you have a family member who suffers from dementia, including Alzheimer's Disease? Do you worry about developing dementia yourself? If so, you may be looking for ways to postpone the disease as long as possible and make life better for those who are already showing signs of dementia.  One of the questions which frequently comes up is whether or not music can make a difference.  The answer is that music does help dementia patients, though not in as many ways as you may hope.

Learning to Play an Instrument May Postpone Dementia

Researchers have discovered that learning something new is one way to exercise your brain and, in some cases, seems to postpone the development of dementia.  This can be true whether you are learning a new language, playing brain games on sites like Luminosity, or learning to play an instrument.  The greatest benefit to your brain comes when you are learning something completely new.  When you simply practice doing things you already know how to do, it may be pleasant and relaxing for you, but it is not helping your brain make new connections.

Everyone should find ways to keep their brain as active as possible. Finding a new hobby is one way to keep your brain active.  This includes learning to play a new instrument or challenging yourself to learn more difficult musical pieces on a familiar instrument.

Music is bi-hemispheric, which means it uses both sides of your brain.  For example, when former Arizona Congresswoman Gabby Giffords was shot in the head, she was shot in the left hemisphere of her brain.  It was very difficult for her to learn how to speak again because language is controlled by the left hemisphere.  However, speech therapists encouraged her to sing.  Singing is controlled by the right hemisphere and, by singing, her right hemisphere was able to eventually take over control of her speech, enabling her to talk again.

Does Music Help Patients Who Already Have Dementia?

Dementia patients may also be helped by exposure to music, but perhaps not in the way you think. According to Dr. Joshua Grill, a researcher in the MIND program at the University of California in Irvine, playing a dementia patient's favorite music may make them more alert and appear to be happier.   Music increases the dopamine, the reward hormone, in their brain.  This is especially true when they hear songs which have a pleasant association for them such as music from their youth or their favorite Christmas carols and other holiday music.

Because of the increase in dopamine, music may reduce the common Alzheimer's Disease symptoms of depression, apathy, agitation, aggression, excessive sleeping, and symptoms of psychosis.  As a result, many caregivers have found that playing the patient's favorite music makes it easier for the caregiver to take care of them.  Consequently, it can be said that music does help patients who already have dementia.

When dementia patients have listened to music from their youth, they often are able to sing along and learn the words to new songs, even when they are no longer able to remember the names of loved ones and have virtually stopped speaking in most situations.   The researchers at UCI MIND believe that music may remain a highly functioning part of the brain, even in a degenerating brain.  For some unknown reason, Alzheimer's disease, and perhaps other types of dementia, seems to spare the part of the brain involved in musical memory.

As a result, if you want your aging parent to enjoy time with the family during the Christmas holidays, for example, playing well-known and beloved holiday music in the background may help them stay more alert and cheerful.  This would also be true for other holidays and special occasions. That alone makes music a helpful addition to your holiday family traditions, especially when someone in the family is developing dementia.

Will Music Bring Back Memories in Dementia Patients?

Although learning how to play an instrument or learning how to play more complex music may help you postpone developing dementia, and listening to old music may brighten the day of a dementia patient and make it easier to manage them, there is no indication that music provides any type of generalized cognitive benefit for people who already have dementia.

In other words, music does not appear to bring back any memories for dementia patients, other than the memory of the music.  Listening to music, even if they sing along, will not make it easier for them to remember names, where they live, what they had for breakfast, when they should take their medication, significant events from their past or other important information.  The benefit which dementia patients derive from music seems to be very limited and temporary.  None-the-less, it is worthwhile to incorporate music into the lives of those with dementia because it seems to improve the quality of their lives and it can make it easier for the rest of the family to spend time with them.

If you are interested in learning more about common medical issues as you age, where to retire, financial planning, 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 helpful posts on this blog.

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Photo credit:  Sonata Retirement Communities Facebook Page / Senior Choir

Wednesday, December 12, 2018

Uber, Lyft, Taxi or Ambulance Hospital Rides? Which Should You Use?

Should you always take an ambulance to the emergency room when you are sick or injured and cannot drive?  Transportation choices have changed dramatically over the past few years.  Not only are people using ride-share services such as Uber and Lyft to go to work or run errands, those services are now becoming an option for non-life-threatening emergencies.  In fact, depending on where you live, the next time you call 911, a triage nurse may send a Lyft car rather than an ambulance to pick you up.

When is a Ride-Share Car a Good Alternative to an Ambulance?

Not every trip to urgent care or the emergency room is a true life or death emergency.  If you are seriously injured in an accident, experiencing chest pains or have symptoms of a stroke or anaphylactic shock, you definitely should call 911 and have paramedics and an ambulance rush to your location as quickly as possible.  They can begin life-saving care on the way to the hospital.

However, if you have the flu, a sprained ankle, a minor cut which may require stitches, or a similar emergency which is not life-threatening, it is possible you may be provided with transportation other than an ambulance.  For example, in Fort Worth, Texas when you call 911 a triage nurse will decide whether or not you actually need an ambulance. If not, they are now authorized to send a Lyft driver to pick you up and take you to the emergency room or urgent care, instead.  In Phoenix, the Fire and Rescue Department gives non-emergency patients a taxi voucher which is good for a ride to the hospital.  Other cities are beginning to offer similar programs.

Advantages of Ride Sharing and Taxis over Ambulances

The most obvious advantage of using a ride sharing or taxi service is that it can save a substantial amount of money for both you and your insurance company.  A ride in an ambulance can easily cost $1000 or more, and insurance often only partially covers the cost, with the patient expected to pay the remainder.  If you are unable to drive yourself because you are too ill or in pain, a taxi or ride share will be much less expensive.

Another advantage to using Uber or Lyft for non-emergency medical trips is that you can choose where you are taken.  They will drive you to the hospital emergency room or urgent care center of your choice.  This could be especially helpful if your personal physician is affiliated with only one of the local hospitals or if your HMO has specific hospitals which are in your network.

What Do Uber and Lyft Think About Being Used as Alternatives to Ambulances?

According to Kate Margolis, a spokeswoman for Lyft, "In any medical emergency people should be calling 911."  Uber agrees.

However, if you are unable to drive yourself, but you need medical attention, being transported by Lyft, Uber or taxi may be the perfect and more affordable alternative to calling an ambulance.

Ambulance services are seeing the difference. In areas where Uber and Lyft ride-sharing services are doing well, ambulance rides have decreased by an average of 7 percent.

Are you interested in more information about common medical problems as you age, Medicare, Social Security, financial planning, where to retire and more?  Use the tabs or pull-down menu at the top of the page to find links to hundreds of additional articles.

Reference:  AARP Bulletin April 2018

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Wednesday, December 5, 2018

How to Pick a Nursing Home

Are you looking for a nursing home facility for your parents, your spouse or yourself?  You may feel overwhelmed.  There are approximately 16,000 nursing homes in the United States and they vary widely in quality.  When possible, it is a good idea to do advance research on the ones in your area so you have two or three in mind before you or someone you love needs to move into one.  Nothing is worse than hurriedly trying to find a skilled nursing facility during an emergency.  It can be too tempting to choose one simply because it is close to your home or seems convenient, rather than because of the quality of the care. Below are some of the things you need to consider while doing your nursing home research.

What Questions to Ask When Looking for a Nursing Home

1.  What is their Medicare rating?

Before you do anything else, you will want to know which facilities in your community are rated the highest by Medicare.  You will also want to know the specifics about their rating.  How did they score on issues such as staff attentiveness, health inspections and nurse-to-patient ratio?  One source of this information is the Medicare website at:

2.  What is the Shower Schedule?

In some states, such as California, the staff is required to help their patients shower at least twice a week.  You will want to confirm the schedule and find out if it possible for a patient to receive showers more frequently, if requested.  If so, is there an additional charge and how much would that be?

3.  What is a Typical Daily Schedule?

People stay in skilled nursing facilities because they are no longer able to care for themselves due to old age or because they are recovering from surgery, illness or an injury.  In most cases, the daily resident schedule will include some type of rehabilitation therapy.  However, if that is the only time the residents are engaged in an activity, they are likely to become very bored and feel lonely.  It is important that residents also have social activities, entertainment, exercise classes for those who can participate, and hair salon services for those who have an extended stay.  The photo above shows a group singing and enjoying a voluntary spiritual circle. Having activities and companionship is very important for the well-being of all of us, including the elderly.

4.  What is on the Menu and What Options Are Available?

Today, large numbers of people have a variety of dietary restrictions because of the nature of their illness, their religion, ethnic background or food preferences.  Consequently, it is important for the residents' health and emotional well-being to have input regarding their food choices.  Ask if special holiday meals are available and what options are available on normal days.  If possible, ask if you can go to the dining room and enjoy a meal with the residents.  This will give you the opportunity to try the food yourself and will enable you to observe how attentive the staff is when assisting people who need extra help.

5.  Are You Being Shown a Typical Room?

Most skilled nursing facilities are happy to give you a tour.  Make sure you take the tour and do not consider a facility if they will not show you around.  However, during your tour it is important to ask a lot of questions and be a little skeptical. Are they showing you a typical room, or is their model a little larger and fancier than the rooms of most residents?  Are the rooms private or semi-private?  Can the residents bring along a few pieces of their own furniture, especially if the move is likely to be permanent? Do the residents have access to Wi-Fi and computers?  Are there in-room televisions, or is TV viewing only available in the central lounge area?  Are there telephones in the rooms?  Are the facilities clean and attractive?  Are there outdoor areas where the residents can relax?  Does the facility smell pleasant? Is it reasonably quiet and cheerful?

6.  What Additional Costs Can You Expect?

Nursing homes often quote a price per month for basic care which includes room and board, as well as essential care.  However, you may be surprised to discover there are usually extra charges for things such as patient medications, having someone dispense the prescriptions at the appropriate times, and assistance with bathing, dressing or eating.  Ask if there an extra charge to drive residents to doctor's appointments.  Do they charge for other special services such as changing bandages or providing adult incontinence supplies?   These expenses add up quickly and can turn an affordable nursing home into an unaffordable one.  You will also want to ask how often the rates increase and how much they have historically risen.

7.  Can this Nursing Home Meet Residents' Future Needs?

While you or your loved one may initially move into a skilled nursing facility because of the need for physical care as you age, what happens if residents develop more complex problems, such as dementia?  Is this facility capable of handling all future needs, or do residents have to move somewhere else when their needs become more severe?  Moving can be very upsetting and disruptive to an elderly person with dementia.

8.  What Safety Measures are in Place?

Are the floors non-skid?  Are there handrails along hallways and stairways, as well as grab bars in the bathrooms?  Are the walkways and emergency exits clear?   Does the facility have an emergency preparedness plan?  Is there a back-up generator in case the electricity goes off?  What happens if the facility needs to be evacuated in the event of a natural disaster?  What contingency plans are there, especially for the weakest patients?  Are there emergency supplies in case the facility decides it is safer to shelter in place?

9.  How are the Caregivers Recruited, Trained and Screened?

Are the caregivers given continuing education classes?  Are they subject to background checks before being hired?  What is the employee turnover rate?

10.  Can You Chat with a Few Residents and Visitors?

Ask residents if they are happy in the facility.  Most of them will be extremely honest, but recognize that some people will complain no matter how good the facility is.  Try to observe if the staff seems to have a good relationship with the residents. Do people generally seem happy or disgruntled?  Does the staff greet the residents by their name?  If possible, ask the residents if they like the food, activities and staff.  If you run into family members who are visiting, ask what they think of the facility.  Ask everyone if there is anything else you might want to know ... such as unusual rules or expenses you might not expect.

Once you have visited several facilities and answered all the above questions, you will have a good idea which skilled nursing facility is most likely to meet your unique needs.

If you are interested in learning more about where to retire, financial planning for retirement, Social Security, Medicare, common medical problems and more, use the tabs or pull down menu at the top of the page to find links to hundreds of additional helpful articles.

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Photo from public Facebook page of Serenades Assisted Living in Florida

Wednesday, November 28, 2018

Feel Younger at Any Age

How does your body feel at this very moment?  If you are like most Baby Boomers, you may be starting to feel your age and fear that things are only going to get worse as the years go by.  However, you do not have to just sit back in your recliner and assume that how you feel now is as good as it is going to get.  Instead, by applying the principles from the Younger Next Year books, you could slow down or even reverse the aging process and feel better than you have in years.

How to Feel Younger Within a Year

According to the authors of Younger Next Year, Chris Crowley and Henry Lodge, "how long you live is 80 percent genes and 20 percent you; but how well you live is 80 percent up to you and 20 percent genes."  They believe that people who follow their suggestions can avoid approximately 50 percent of all major diseases and accidents.  Of course, if this is true, it could make a tremendous difference in the quality of your life as you age.

AARP was so intrigued by the idea that the right lifestyle could help us all feel younger, they interviewed Henry Lodge, one of the authors of the Younger Next Year books (which I highly recommend) and summarized his findings in a special section of AARP Magazine in their October/November 2016 issue. So, what do you have to do in order to feel better and improve the quality of your life?

A Few Younger Next Year Recommendations

Exercise at least six days a week, as hard as you can, until the day you die!  Break it down into four days a week of aerobics and two days a week of strength training with weights.  Include some balance exercises.  Exercise regularly, even if you have arthritis.  It could actually reduce your pain.  Once you are in your 80s or older, continue with the exercise.  However, you can back off the high intensity workouts and rely more on longer, slower exercises.

Spend less money than you make.  This will help reduce the stress in your life.  You may even want to get a retirement job.  It will keep you active and involved in the world around you.  It will also make it easier to live within your means. 

Eat food which is alive, and stop eating dead, processed food.  Your diet should consist of 50 percent vegetables and fruit, 25 percent whole grains like brown rice, quinoa or whole wheat, and 25 percent meat, poultry and fish.  Replace butter and animal fat with olive oil. Limit alcohol to one or two glasses of wine a day, at most. Do not feel as if you have to eat everything on your plate.  The types of dead food we should minimize or eliminate from our diet include popular items such as bread, white rice, white pasta, sugar, chips, soft drinks, frozen meals, desserts, french fries, cheeseburgers, milk shakes, and anything which is fried. 

Care about others.  Connect with your friends and family, and commit to their well-being. Nurture yourself with friendships and, perhaps, a pet.

Enjoy your life. Explore your talents and follow your dreams.  Paint, write, or play an instrument.  Doing these things will make you happier, help you feel better, and you will enjoy your life more, too!

Of course, the entire book cannot be summarized in a short blog post.  As a result, I encourage anyone who wants to age well to read one of the Younger Next Year books.  You can use the Amazon link on the right side panel of this blog, near the top, to order the book.  The book makes a great gift, too! All ads on this blog are from quality, trustworthy sources such as Google, Amazon or Viglink.

If you are interested in learning more about dealing with common health problems as you age, 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.

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Tuesday, November 20, 2018

Alzheimers Research - How to Join a Study

Alzheimer's Disease, the most common form of dementia in the United States, is expected to sky-rocket over the next few decades as Baby Boomers grow older.  Currently, about 5.5 million Americans are living with Alzheimer's Disease.  Over the next 30 years, that number is expected to triple to 16 million people, with approximately one-third of all Medicare dollars spent to treat this one disease alone.  If this concerns you, it is now possible to sign up to participate in a long-term research program, even if you currently have no signs of dementia.

There are thirty Alzheimer's Research Centers in the United States which are funded by the National Institute on Aging, part of the National Institutes of Health..  The map at the top of this post shows the cities where they are located. 

On a personal level, I recently registered with the Alzheimer's Research Center in my area, at the University of California in Irvine.  In order to participate, I registered on their MIND website at  Readers who live in Orange County, California may also want to register with this Research Center.  Unfortunately, each Research Center has its own separate studies and websites. You can find more information about how to register with other centers at the National Institutes of Health website at

To initiate my registration with UCI MIND, I completed an online questionnaire which took about 30 minutes to complete.  It asked about my family background (my mother died of Alzheimer's, but my father is alive at 90 with no signs of the dementia.)  It also asked about my health, medications I take, and my lifestyle habits, including my diet, amount of sleep I get, alcohol consumption, etc.   In addition, they wanted to know what diagnostic and treatment medications I potentially would agree to, if offered.  I was a bit uncertain about how to answer these questions, since they included whether or not I was willing to take experimental medications, get brain scans, or donate my brain to the researchers upon my death.  I did not agree to all of these things, and apparently it was not necessary to agree to them all.

The speaker who suggested that interested parties should register for the UCI MIND Alzheimer's Research Project told us that people would qualify for the early clinical trial if they met the following criteria:
  • Are 60 to 85 years old
  • Have generally normal memory function
  • Are not being treated for memory problems
  • Have a close friend or relative who can partner with you
  • Are willing to take an investigational medication
I met the above criteria.  As a result, I was contacted about six months after I registered on the UCI MIND website.  I went to the offices at UCI and had an interview with one of the researchers.  During the interview, I was also given a basic cognitive test to determine whether or not I was currently showing signs of dementia.  I was not.  The researcher told me that I would be contacted periodically in the future.  I would be asked to update my online questionnaire annually so I could report changes to my health, medications or medical record. 

I may also be invited back to their office occasionally to be interviewed again and given another cognitive test.  The researchers may decide at some point that I might be a good subject for more intensive study, perhaps receiving a brain scan or an experimental medication to prevent the progression of dementia.  That decision could be made at any time, or years from now.  However, it is reassuring to know that I am now part of their database and will be followed for the rest of my life. 

There is also a special, separate research study at UCI MIND which is called the 90+ Study. It is for people over the age of 90 and it has been featured on the television show "60 Minutes."  Some of the subjects of this study have been participating for over 30 years. You can find a video of the "60 Minutes" segment on YouTube, as well as other videos featuring Dr. Claudia Kawas, who is the lead investigator.

Whether you ever develop dementia or not, your participation in a research study could help someone else avoid Alzheimer's Disease and other forms of dementia in the future. That makes your participation well worth the time and an excellent way to help others and, possibly, yourself.

For more information about dementia and other common health problems as we age, financial planning, Social Security, Medicare, where to retire and more, use the tabs or pull down menu at the top of the page to find links to hundreds of additional articles.

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Photo credit:  National Institutes of Health

Wednesday, November 14, 2018

Use the ACA for Pre-Retirement Medical Insurance - the Affordable Care Act

People between the ages of 50 and 65 often pay extremely high medical insurance premiums.  What they may not realize is that many of them may qualify for a discount on their medical insurance if they take advantage of the ACA or Affordable Care Act.  This is an income based discount and may only be available if you apply during the annual open enrollment period.  Currently, those who want to investigate whether or not they qualify for lower medical insurance premiums through the ACA need to apply between November 1 and December 15. 

Those who miss the deadline but have what is considered a special qualifying event, such as an adult child who recently lost coverage under their parents' plan, or someone who has lost their employer sponsored or COBRA insurance, can apply at any time of year.  However, they must apply within 60 days of the time the "qualifying event" occurred.    This program is available even if you only need the coverage for a few months until you get a new job or qualify for Medicare.

Apply Even if you did not Qualify in the Past

If you have not been eligible for a discount through the Affordable Care Act in the past, you may still want to try again this year.  Several states, including Idaho, Utah and Nebraska, have recently passed Medicaid expansions, which means hundreds of thousands of people who previously were not eligible to receive help from the Affordable Care Act are now eligible.  Other states have also expanded their programs.

How to Apply Online or in Person

The official national website for the Affordable Care Act is:  On the website you can either apply immediately for medical insurance or learn how to get personal help in the state where you live from a local agent or broker.  There is even a "Quick Start" guide on the website to make the application process easier.

If you live in California, the official site for receiving information about the Affordable Care Act is:  Covered California.  You can apply online or you can use the website to find the location of offices where you can get personal help with the application process.  You may also see small offices for Covered California in malls and shopping centers, manned by experts who can help you through the application process.

Pre-existing Conditions

According to the website, "Under current law, health insurance companies can’t refuse to cover you or charge you more just because you have a “pre-existing condition” — that is, a health problem you had before the date that new health coverage starts."

Preventive Care

The website also explains that the Affordable Care Act provides the following preventive care:

"You and your family may be eligible for some important preventive services at no additional cost to you.

If your plan is subject to the new requirements, you may not have to pay a copayment, co-insurance, or deductible to receive recommended preventive health services, such as screenings, vaccinations, and counseling.

For example, depending on your age, you may have access — at no cost — to preventive services such as:
  • Blood pressure, diabetes, and cholesterol tests
  • Many cancer screenings, including mammograms and colonoscopies
  • Counseling on such topics as quitting smoking, losing weight, eating healthfully, treating depression, and reducing alcohol use
  • Regular well-baby and well-child visits, from birth to age 21
  • Routine vaccinations against diseases such as measles, polio, or meningitis
  • Counseling, screening, and vaccines to ensure healthy pregnancies
  • Flu and pneumonia shots - Visit to learn more

Please Help Share this Information

It is important to pass this information to anyone you know who may benefit from the ACA, including your adult children who may no longer be eligible to be covered by your insurance.  Getting them insured under the Affordable Care Act could save you a great deal of money if they become injured or ill.

The advertising budget for the ACA has been drastically cut, so many people do not realize they are eligible and that we are currently in the open enrollment period.  There are virtually no television ads for the program. 

Feel free to email this information to friends you believe could benefit, or post a link to this article on Facebook, Twitter or other social media you use.  By sharing this information, you could make life much easier for someone who is not old enough to be eligible for Medicare, and may be feeling overwhelmed by the high cost of their medical insurance premiums.

If you are interested in learning more about Medicare, Social Security, common health problems as you age, where to retire in the US and abroad, financial planning and other retirement related issues, please use the tabs or pull down menu at the top of the page to find links to hundreds of additional helpful articles.

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Tuesday, November 6, 2018

Inflammation Link to Dementia and Alzheimer's Disease!

Many of the articles on this blog have dealt with how to reduce your risk of dementia and Alzheimer's Disease by focusing on eating the proper diet, exercising, getting enough sleep, treating symptoms of dementia and staying socially active.  Some of these behaviors, especially improving your diet, can also lower the level of systemic inflammation in your body.

Inflammation has now been connected to a number of health problems, including diabetes, heart disease, high blood pressure, cancer, Alzheimer's Disease and other forms of dementia.  According to Dr. Douglas DiSiena, the co-author of "Possibility Thinking: Adding Years to Your Life and Life to Your Years," one-third of the cases of Alzheimer's Disease and dementia could be prevented through dietary and lifestyle changes.  This is significant, because people over the age of 85 have a 47 percent chance of developing some cognitive decline.  If you do not want to suffer from this cognitive decline as you age, below are the actions you can take to protect your brain health.

Lab Tests to Determine Your Level of Inflammation

In a lecture by Dr. DiSiena, which I attended, he recommended that people first need to determine the current level of inflammation in their body.  In order to do this, they should ask their doctor for the following blood tests in order to determine their level of inflammation:

HS CPR or High Sensitive C-Reactive Protein - a level of 1 or lower is ideal.

A1C - This tests your blood sugar levels over the preceding three months - A score of 4.4 to 5.2 is ideal, although a score of 5.3 to 5.5 is OK.  This test will determine if you are pre-diabetic or diabetic. (Scores over 5.6 indicate pre-diabetes; high scores indicate diabetes.)

Test Your Current Level of Cognitive Function

Take a Standardized Mini-Mental State Examination (SMMSE) - You can find examples of the test online and ask a friend to give it to you.  You can also ask your doctor or therapist to give it to you. The websites explain how to score the test.  After making some of the healthy changes recommended in this article, take the test again and see if your scores have improved.

Causes of Inflammation

If you have inflammation anywhere in your body (such as gum disease or an injury), it will affect your brain and cause increased brain shrinkage.  There are a number of possible causes of any inflammation you may be experiencing:

A high carb diet which is heavy on grains and processed foods
Toxins, including drugs and heavy metals like aluminum in the blood
Trauma, such as a concussion or other injuries
Negative thoughts

Your Brain Can Recover at Any Age

The good news is that your brain has neuroplasticity.  If you currently have impaired cognitive function, it is almost never to late to reverse course and make diet and lifestyle changes which can reduce your inflammation and improve your test scores and brain function.

Try to eat a Mediterranean based diet, which relies heavily on vegetables, followed by nuts, fish like salmon or tuna, and olive oil.  This diet should increase the amount of Omega-3 fatty acids you consume and reduce the amount of Omega-6 fatty acids.  Taking an Omega-3 capsule can help you maintain the proper balance.

Neurofeedback training has also been shown to directly improve brain function.  In some studies, after 20 neurofeedback sessions the patients were able to improve their scores on the SMMSE (Standardized Mini-Mental State Examination) by six points.  That can make the difference between having a score which indicates cognitive decline and one which indicates healthy brain function.

Making the right dietary and lifestyle changes can be the difference between slowly losing your cognitive function and remaining mentally sharp for the rest of your life.  

If you want to learn more about preventing dementia and other common medical problems as we age, as well as retirement planning, where to retire, Social Security, Medicare and more, use the tabs or pull-down menu at the top of the page for links to hundreds of additional articles.

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Wednesday, October 31, 2018

Social Security Changes in 2019

Every year, the Social Security Administration makes a few changes to the program. The changes are intended to help retirees keep pace with inflation while, at the same time, maintaining the program's solvency.  It can be a difficult balancing act which does not always achieve its goals.

In 2019, beneficiaries can expect to get the largest cost-of-living increase in several years, which is wonderful news for the millions of people who depend on Social Security to cover all or most of their living expenses.  Even better, the cost-of-living increase should not get eaten up by an increase in Medicare premiums, which has happened in the past. However, this is not the only change we can expect to see in 2019.  Below is a list of some of the most significant changes to Social Security in 2019.

Largest Social Security Increase in Years

For many people, the most significant important change will be the 2.8 percent cost-of-living increase.  This means the average monthly payment will rise to $1,461 and the average married couple with receive $2,448 per month, if both of them receive benefits.  For those of you who have not begun to collect, this gives you an idea of what to expect.  For those who are already collecting, this will help you determine how your benefits compare with those of other recipients.

A Small Increase in Medicare Part B Premiums

In 2018, the Social Security COLA was so small that it was entirely eaten up by the increase in Medicare premiums for many beneficiaries.  Next year, the increase in Medicare Part B premiums is so small that things should be much better for most people.  The premiums are going to increase to $135.50 in 2019 from $134 in 2018.  This $1.50 increase in premiums is unlikely to have a negative impact on many Social Security beneficiaries.

However, there were some people whose Medicare premiums were less than $134 in 2018 because
they did not get a large enough raise last year to cover their increase in Medicare premium.  For those people, their Medicare premium this year could be greater than $1.50 and, therefore, might take all or most of their Social Security increase.

You could also have a large increase in your Medicare premiums for another reason, and that is if your income went up significantly last year.  Sudden increases in retirement income, because of an unusually large IRA withdrawal or windfall, can cause your Medicare premiums to increase dramatically and retirees should consult their tax attorney and take into consideration all of the financial consequences of a large IRA withdrawal or income increase. However, the Medicare premium increase should only apply to the year following the increase in income, unless it is permanent or continues for several years. This will only apply, however, to people who have a very large increase in their retirement income.

An Increase in the Maximum Social Security Benefit

If you have been fortunate enough to earn a high income during the 35 best years of your working career, the maximum amount of Social Security you could receive in benefits has increased.  For those people at the top of the income range who retire at age 62, they could receive up to $2,209 a month; at age 65 they could receive up to $2,757; and at age 70 they could receive up to $3,770.

Workers will Have Slightly More Income Subject to Taxation

If you are still working, you will see a small increase in the amount of your income which will be, subject to Social Security taxes.  The 2019 maximum taxable earnings will rise from $128,400 to $132,900.  Workers will be pleased to know that the tax rate itself will not change from its current rate of 12.4 percent, split evenly between employee and employer.

Normal Retirement Age will Increase by Two Months

Workers who want to collect their full Social Security benefits will need to work two months longer.  If you are turning 62 in 2019, your full retirement age will be age 66 years and six months.

You Can Earn More if You Work while Collecting Social Security

Many people find they need to continue to work and earn extra income, even after they begin to collect their Social Security benefits.  If you are under your full retirement age, collecting Social Security and working at the same time, the amount you can earn without having your benefits reduced will rise from $17,040 to $17,640.  You can earn more than that, but if you do, the Social Security Administration will withhold $1 for every $2 you earn above the $17,640 limit.

You should also know that if you reach your full retirement age in 2019 and earn over $46,920 in the months leading up to your retirement, Social Security will withhold $1 for every $3 you earn in excess of $46,920, but just for that one year.

Once you reach full retirement age, you can earn as much as you want without having your benefits reduced.  Today, we are seeing many people continue to work, either in their previous career or in a new career, for years after reaching full retirement age.

New Calculations for Your Social Security Benefits

Without going into complicated mathematical calculations, the government is making a few slight tweaks to how they calculate your past earnings, inflation adjusted.  These numbers are used to determine how much people will receive in benefits when they claim their Social Security, so the changes will benefit people who have not yet begun to collect.

Be Aware of More Changes Which Could be Coming

After the election, it is likely that Social Security and Medicare could be put on the cutting block by Congress.  Because of the 2018 income tax changes, government revenues have dropped dramatically and the deficit is increasing rapidly.  Some factions in Congress are proposing dramatic changes to these two programs which could result in cuts to both Social Security and Medicare.

Some of the changes could be very subtle.  For example, there is a faction which wants to change the way future cost-of-living increases are calculated, by using a different CPI or Consumer Price Index.  Currently, they use a CPI-W, which estimates the cost of living for a typical worker.  Some groups would like the government to use a CPI-E, which considers the cost of items typically used by the elderly, such as healthcare.  This would increase the size of future cost-of-living increases.

Unfortunately, a large group in Congress have stated they want to go with a Chained-CPI, which would be devastating for many senior citizens because they would only get extremely tiny increases, or none at all, because this CPI calculation assumes the elderly will just keep cutting down on what they pay for things by purchasing cheaper items.  Since many elderly already are living on very tight budgets, the possibility of the government using a Chained-CPI is very alarming for many senior citizens.

All older Americans, whether they are retired or not, should follow the debate over Social Security carefully, because it will affect nearly everyone in the nation.  Even if you have a private pension or you are wealthy, it is likely that some people in your family will be affected by changes to Social Security.  You can learn more about the changes being discussed at the website for The National Committee to Preserve Social Security and Medicare.

If you are interested in reading more about Medicare, Social Security, financial planning, where to retire, changing family relationships, common health problems, travel and more, use the tabs or pull down menu at the top of the page to find links to hundreds of additional articles.

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Wednesday, October 24, 2018

Medicare Open Enrollment - Expert Answers Your Questions

Are you thinking about changing to a different Medicare plan or making changes to your current one?  There are certain rules regarding when you can make these types of changes. This week we have another special post from our Medicare expert, Danielle Roberts.  She is highly qualified to answer your questions about Medicare, how it works and the timing of changes you may want to make.  If you still have questions after reading this post, her contact information is in the sidebar and there is a link to her site in the "About the Author section."


Getting Ready for Medicare Open Enrollment

Medicare has several periods each year when beneficiaries can make important plan changes and coverage elections. However, we often find that many beneficiaries are not certain what each of these election periods is for and what they should be doing each year to review their coverage.
In this post, we’ll explain the upcoming windows and how you can prepare for them.


Medicare Open Enrollment Period vs Annual Election Period


Medicare uses the term “open enrollment” for multiple different election periods, so it’s easy to get them confused. We find it easiest if beneficiaries refer to the fall enrollment period as the Annual Election Period (AEP). This helps to keep the election periods straight in your mind.

The Annual Election Period begins October 15th and goes until December 7th. There is also a new Medicare Open Enrollment Period for 2019 which will go from January 1st to March 31st.  Let’s go over what changes you can make in each period because they are different.


Medicare’s Annual Election Period: October 15 – December 7


When you enroll in a Medicare Advantage plan or a Part D drug plan, you are locked in for the rest of the calendar year. You must wait until the Annual Election Period to make changes to your plan(s).
During the AEP you can switch from one Medicare Advantage plan to another and you can switch from one Part D drug plan to another drug plan. You can also switch from a Medicare Advantage plan back to Original Medicare and vice versa. 

When you make any of these changes during the AEP, your new plan goes into effect January 1st of the following year. (If you don’t make any changes to your current plan, your current plan will auto-renew for the next year.)


Medicare’s New Open Enrollment Period: Jan 1 – March 31


Sometimes people who enroll in a Medicare Advantage plan during the AEP find that they do not like their new plan. It could be that they did not understand their coverage, or it might also be that they learned too late that one of their doctors is not in the network.

In recent years, these beneficiaries would be locked into that plan for the entire year. However, beginning in 2019, Medicare has a new Open Enrollment period from January 1st to March 31st that will allow beneficiaries who are enrolled in a Medicare Advantage plan to make a one-time change.
During this OEP, they can change to a different Medicare Advantage plan or they can disenroll from their Advantage plan to return to Original Medicare and elect a new standalone Part D drug plan to go alongside that coverage.

It’s important to note that if you drop your Advantage plan and decide not to enroll in a Part D plan, you can be penalized for the time you go without creditable drug coverage.

Here’s a recap:

The Medicare Annual Election period in the fall is for all Medicare beneficiaries. It is for enrolling in, disenrolling from or changing either your Medicare Advantage plan or your Part D drug plan. The last plan selection that you make prior to December 7th will become effective January 1st

The Medicare Open Enrollment Period which begins in January only applies to beneficiaries who are enrolled in a Medicare Advantage plan. These beneficiaries can either switch from one Medicare Advantage plan to another or they can switch from a Medicare Advantage plan back to Original Medicare.

You cannot switch from one Part D drug plan to another during the OEP. That’s the main difference between the AEP and the OEP.


Your Annual Notice of Change Letter


The first step to getting ready for the AEP is to review your Annual Notice of Change (ANOC). Your ANOC is a letter sent to you by your current Medicare Advantage plan or Part D drug plan.

This letter states all changes that your current insurance carrier is making for the following year. It lists changes in monthly premiums, copays, coverage, deductibles, and drug formularies. You will want to review this thoroughly to ensure you make the right decision during the AEP.


Medigap Open Enrollment


To add to the confusion around the term “open enrollment,” there is also a one-time Open Enrollment period for Medigap plans.

The Medigap Open Enrollment is a one-time window that begins with your Part B effective date. During the six months directly after your Part B effective date, all Medicare beneficiaries have a one-time chance to enroll in a Medigap plan without having to answer health questions. This is a “use it or lose it” enrollment period. Once it has passed, it does not recur again.

This does not mean that later you cannot attempt to change your Medigap plan. In fact, Medicare beneficiaries can apply for new Medigap plans anytime throughout the year. However, unless you live in a specific state with different rules or have a guaranteed issue window because you are leaving employer group health coverage, you will have to answer health questions whenever you apply for a Medigap plan outside of your one-time Medigap open enrollment period. Depending on your answers and your medical record, you could be denied coverage for a new Medigap plan.


Get Ready with A Medicare Broker


Working with a Medicare broker can take the stress out of the decision making. A broker can evaluate each of your plan options in your area and explain any applicable rules. This will help you have more confidence in your choice.

About Guest Post Author, Danielle Roberts:  This guest post was written by our Medicare expert, Danielle Roberts, one of the co-founders of Boomer Benefits and a frequent contributor to this blog.  As always, we greatly appreciate her willingness to share her expertise and her ability to calmly explain these difficult-to-understand issues in clear terms.

If you want to learn more about Medicare, Social Security, where to retire, financial planning, and more, use the tabs or pull down menu at the top of the page to find links to hundreds of additional articles.

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