Tuesday, August 30, 2016

Confusing Parts of Medicare

Are you confused about all the different parts of Medicare ... the so-called Medicare "alphabet?"  If so, you are not alone. Whether people are getting prepared to sign up for Medicare for the first time or are already using it, the different parts can seem like a foreign language.  Below is a brief summary of the different parts, as well as a little basic information that everyone needs to know. 

Medicare Parts A, B and D

Medicare is broken up into four different parts and each one has a different purpose and, in some cases, different requirements that determine whether or not you are eligible.

Medicare Part A:  This section will help pay for your stay in a hospital or skilled nursing facility. It might also pay for home health services and hospice care, if the patient meets certain criteria.  If you or your spouse paid into Medicare long enough during your working years, you do not pay monthly premiums for Part A.  If neither you nor your spouse paid into it while you worked, you can still buy Part A services by paying monthly premiums.  Everyone is entitled to Medicare Part A, either free or for a monthly fee.

Medicare Part B:  This section will help pay for doctors' services (whether in or out of the hospital) and outpatient care, including lab work, tests and health screenings.  It can also cover the cost of some types of medical equipment and supplies, under some circumstances, as well as most vaccines or drugs that the doctor gives you in his office.  You do pay monthly payments for Part B.  However, low-income people may quality for state assistance.  There is a seven month window to sign up for Part B ... three months before your 65th birthday month, during your birthday month, and three months after your birthday month.  If you wait too long to sign up, you can still obtain it, but you will pay extra premiums for the rest of your life.  Medicare Part B only covers about 80 percent of their approved costs and the patient pays the other 20 percent.  At the bottom of this article is more information on the two options you have for covering your portion of the bills.

Medicare Part D:  This section covers the cost of prescription drugs that you take at home.  There is an additional premium involved in getting a Part D drug plan, unless you purchase it as part of a Medicare Advantage Plan.

Medicare Supplements and Medicare Part C

Medicare parts A, B and D are frequently called "basic Medicare."  People often believe they are all you need.  However, sometimes they do not realize they need to sign up for Part D to cover their drugs.  In other cases, people do not realize that when they settle for basic Medicare alone, they are still obligated to pay 20 percent of their medical bills ... which can be substantial.

What do people do to solve these problems?  They have two choices.  First, they can get the three parts of basic Medicare (A, B and D) PLUS purchase a supplemental health insurance policy.  Second, they can simply get a Medicare Advantage plan, also known as Medicare Part C, PLUS a Part D plan if the Medicare Advantage plan they choose does not include drug coverage.  Confusing enough?  Below is a little more information.

Supplemental Insurance:  Many insurance carriers offer supplemental policies, sometimes called Medigap policies, including Anthem, Humana and United Healthcare.  There are different rates, depending on the size of the deductibles and co-pays you prefer. The government even has a website to help you compare Medigap policies.  If you decide to get a Medigap supplemental policy, do it as soon as you sign up for Medicare Part B.  If you buy one within six months of enrolling in Part B, the insurers cannot deny you coverage or charge higher premiums because of preexisting medical conditions.  With supplemental insurance, your doctor or hospital will send medical bills to Medicare first.  Once Medicare reimburses the doctor or hospital, next they bill the supplemental insurance carrier.  After that, they will bill you for any remaining costs.  This system sometimes confuses people, because they keep getting statements from the hospital, doctor and the insurance companies for the same procedure.  Sometimes they think they are being double-billed.

Medicare Advantage or Part C:  This is a completely alternative way to receive your Medicare services.  Everything is administered by one private managed care plan.  There are both HMO and PPO options.  These plans are required to cover everything that is offered in basic Medicare, but they may charge lower co-pays and/or offer additional benefits.  Some of the companies that offer these plans are Kaiser Permanente and Scan. The government also has a website to help you learn more about Advantage plans. The plan you buy may also include Part D drug coverage, or the company could offer you a choice of drug plans at a separate price.  Often they offer extra benefits such as dental, vision and hearing care.  In some cases, there are NO premiums, other than what you would pay for basic Medicare.  With other plans, you may have an additional premium.  They may restrict your choice of doctors to only ones who are in their network, or they may charge a higher copay if you go out of network.  Only one company is billed, the Medicare Advantage company, which is less confusing for some people, since they only receive one set of statements and bills for each procedure.

The Medicare Advantage choice is often the least expensive, since there is frequently no premium or only a small premium above the cost of basic Medicare.  However, it is always beneficial to shop around to make sure that you are getting the most for your money, from a reputable insurance company.  Make sure you are aware of all the major choices available in your state.

Summing Up Medicare

To bring it all together, it is important that everyone contact their local Social Security office as soon as possible when they get close to age 65.  In addition, most people will want to attend informational meetings and get more details about the insurance options for both Medicare Supplemental Plans and Medicare Advantage Plans in their state.  Don't make a decision until you have met with two or three different companies and learned about all your choices.

If you start with a company and realize that you wish you had chosen a different company or type of plan, you are not stuck with your first choice.  There is an open enrollment period every year between October 15 and December 7.  During that time, you are free to move to a different plan.

You May Also Want to Find Out About Common Medicare Mistakes

In addition to knowing the various parts of Medicare, you may also want to read the blog post linked below.  It explains the most common Medicare mistakes made by people approaching retirement:


Looking for more information about Medicare, retirement planning, where to retire, common health problems as we age or 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

Tuesday, August 23, 2016

Healthcare Advocates for the Seriously Ill

Life can get complicated at times and illnesses late in life can be especially difficult to handle.  Sometimes, a healthcare advocate can help patients get things sorted out and improve the quality of their lives.

An elderly couple we know have suddenly and unexpectedly gone through dual health problems at nearly the same time.  The wife injured her arm, making it difficult for her to lift or carry things.  Her husband developed multiple myeloma, causing cancerous tumors along his spine.  He cannot walk without a cane or other assistance.  She cannot help him.  They both are in physical therapy.  His chemotherapy includes numerous pills a day.  Their children do not live close enough to help with all the details of life ... handling doctor's visits, insurance forms, bills, etc.  Overwhelmed, their children hired a healthcare advocate to make certain the parents are getting the help they need.

The healthcare advocate will not carry the laundry for the wife; nor will the advocate help the man walk.  Her job is to help them hire a caregiver, go to doctor's appointments with them, get answers to their questions about treatment, make sure they are getting the attention and care they need and, at the same time, help them with insurance forms and other paperwork.

What Does a Healthcare Advocate Do?

Below is a list of the duties of a healthcare advocate. Most people will not need all of these services. However, it can be beneficial to have someone capable of handling these issues for you when you or a close family member is seriously ill:

•  Are you confused about choosing a new doctor or specialist? The healthcare advocate can provide you with a physician referral service.
•  Frustrated with your insurance company?  They will handle insurance disputes for you (fight for your payment, and handle insurance appeals & grievances).
•  Are your doctor and hospital bills too complicated to understand?  They will perform medical bill audits and dispute any questionable fees.
•  Are you paying a reasonable fee for your procedures?  Many of them will have a cost navigator that is designed to help you find lower cost procedures, when appropriate.
•  Are you getting the best deal for your prescriptions?  They will help you compare prices.
•  Are there alternative treatments or drug trials that may help you?  A healthcare advocate will assist you in finding treatments that could benefit you.
•  Do you have the best health insurance plan for your medical issues?  Your healthcare advocate will review your current insurance plan and help you decide if you would be better off with a different one.  Then, they will assist you in making the change, during the appropriate enrollment period.
•  Are you using the best prescription, dental and vision plans?  They will help you compare your choices and pick the appropriate one.
•  What if you need to go into a nursing home or assisted living facility, either for a short time while being treated, or permanently?  They will help you find one that will meet your needs both medically and financially.  They can help you apply for programs such as long-term care using Medicaid or VA benefits, if you qualify.
•  What if you are able to live at home during your treatment and recuperation, but only with the services of a home care aide?  Your healthcare advocate can help you hire one.  They can also coordinate visits with physical therapists, occupational therapists and other healthcare providers who may come to your home.
•  Do you feel as if you have a million forms to complete, and you feel too ill to deal with them?  The healthcare advocate can consolidate some of them and complete many parts of them for you ... especially the parts that are repetitive.
•  What if your physician tells you there is nothing more they can do to help you?  In this sad situation, you will be grateful for the assistance of the healthcare advocate in connecting you with caring hospice services to help you in your final days.

How Can I Find a Healthcare Advocate?

You can contact the National Association of Healthcare Advocacy Consultants
They have a member directory at:

You can also learn more about the services provided by healthcare advocates at:

(215) 735-7711
info @ healthcareadvocates.com 

What are the Advantages of Hiring a Healthcare Advocate?

Dealing with a serious illness can be overwhelming ... whether you are the one who is ill or it is your spouse, parents or another family member.  Whenever you are under stress or don't feel well, it can seem almost impossible to deal with insurance, hospital bills, medical specialists and all the other problems.

In addition, it can be extremely difficult to search for a skilled nursing facility or to hire a home care aid for yourself, should they be needed.

Using a healthcare advocate can be expensive, but they sometimes pay for themselves by saving you money in other ways.  They can also lower your stress ... important to help you heal both mentally and physically.

Interested in learning more about retirement planning, common medical problems, Medicare, where to retire, family relationships 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

Tuesday, August 16, 2016

Common Medicare Mistakes

Many people assume that when they sign up for Social Security they will sign up for Medicare at the same time.  They also expect the procedure to be fairly simple and uncomplicated.  While sometimes this is true, it isn't always.  Decisions about when to sign up for Medicare, which parts you should enroll in, and what supplemental policies to purchase can be very complex.

Many people make mistakes when they initially sign up for Medicare.  When they do, it can make a significant difference in what they will pay in premiums for the rest of their lives.  Below are the most common mistakes retirees make.  It is important to educate yourself BEFORE you sign up.  While you can make some changes later, for example in which supplement you want to use, other mistakes are irrevocable.

Common Medicare Mistakes

Do not assume that you do not qualify for Medicare if you have not worked long enough to qualify for Social Security (a total of about 10 years).  If you are age 65 or older, you qualify for Medicare Parts B and D as long as you are a U.S. citizen or a legal resident who has lived in the U.S. at least five years.  You might not qualify for Part A if you have not worked long enough, but you could qualify on a spouse's work record or you can pay premiums for Part A.  Go to your local Social Security office during the three months before you turn 65, or before another 3 months have passed afterwards, so you know your options ... even if you do not plan to start collecting your Social Security benefits for a few more years!

Do not postpone signing up for Medicare Part B, unless you have health coverage beyond age 65 through an employer or spouse's employer, and the employer has 20 or more employees.  Other than that exception, the seven month window for signing up is the month you turn 65, three months before and three months after.  If you fail to sign up on time, you will pay a penalty, in the form of a surcharge, for the remainder of your life.

Retirees covered by a COBRA or a retiree plan from an employer often still need Medicare Part B.  Many of these plans are set up to be a supplement to Medicare Part B.  If you fail to sign up on time, you'll have no coverage for doctors' services, outpatient care and medical equipment until you enroll.  You need to sign up either during your regular seven month window, or no later than eight months after you stop working (if you work past the age of 65).

Do NOT wait until your "full retirement age" or until you collect Social Security before you sign up for Medicare.  As mentioned above, the window for signing up for Medicare is NOT the same as your full retirement age.  They are not linked.  If your full retirement age is 66 or 67, you still need to sign up for Medicare around your 65th birthday, with the few exceptions mentioned above.

Do NOT postpone signing up for Part D drug coverage, just because you currently do not take any drugs.  You will end up paying extra penalties and have a delay in coverage when you need it.  One way to save money is to sign up for the Medicare approved Part D plan in your area with the lowest premiums. If you do use prescription drugs, you can research which plan is best for you by using the plan finder program on Medicare.gov or by calling Medicare at (800) 633-4227.

Do not get confused about the meaning of open enrollment.  The widely advertised open enrollment period of Oct. 15 to Dec. 7 each year only applies to people who are already on Medicare and wish to change their coverage.  If you are new to Medicare, you can sign up for a supplement or Medicare Advantage plan any time of year.

Do NOT wait too long to choose a Medicare Supplement or Medicare Advantage plan.  Since basic Medicare only covers about 80 percent of most medical bills, the majority of people will want to use either a Medicare Supplement or a Medicare Advantage plan.  You need to enroll in one within six months of enrolling in Part B.  If you do that, you cannot be denied coverage or charged higher premiums because of a preexisting medical condition ... no matter how sick you are.  This is a one-time opportunity.  If you are not happy with the plan you initially selected, in most cases you can change it each year during the open enrollment period. (Your choices may be limited if you have end-stage renal failure). If you sign up for Part B when you turn 65, but you do not get a supplemental policy within six months because you are still working and have employer provided insurance, you lose the federal protection against being charged higher premiums because of a preexisting medical condition.

Make sure you understand the difference between a Medicare Supplement and a Medicare Advantage Plan.  Both are available across the United States.  A Medicare Supplement is a policy you buy in addition to paying for your Medicare benefits.  You normally have a wider choice of doctors and hospitals; however, they are typically more expensive than a Medicare Advantage Plan and you are basically paying for and dealing with two insurance companies ... the basic government Medicare agency and the insurance carrier handling your Medicare Supplement.  A Medicare Advantage Plan limits you to their group of doctors and hospitals.  However, they are typically less expensive and sometimes cost no more than basic Medicare, yet offer better coverage.  In addition, you only need to file claims and deal with the Medicare Advantage insurance company.  They handle government claims for you.

Do not ignore the Annual Notice of Change.  It will be mailed to you every September if you are enrolled in a Medicare Advantage plan (either HMO or PPO) or a Part D prescription plan.  It will explain what changes in coverage and premiums will be made for the coming year.  After reading it, you can decide if you want to select a different plan during the fall open enrollment period.  This could help you avoid a nasty shock from rising premium prices or changes in coverage.

Do not forget that many retirees qualify for financial assistance.  This is not charity.  You are entitled to this assistance and extra benefits.  If money is tight, find out if you qualify for these programs:

Medicare Savings Program - Your state will pay the Part B premiums and possibly other expenses.

Federal Extra Help - You could qualify for low-cost Part D prescription drug coverage.

To find out if you qualify, contact your State Health Insurance Assistance Program (SHIP).  You can find the toll-free number at:   shiptacenter.org

Want to find more information about Medicare, Social Security, common health issues, financial planning or the best places to retire?  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

Wednesday, August 10, 2016

Protect Yourself from Investment Fraud

If you are like most people approaching retirement, you have worked hard all your life and put aside a nest-egg to help supplement your Social Security or pension.  Whether your nest-egg is small or large, the last thing you want is to lose it all to investment fraud.

The Securities and Exchange Commission has published a booklet titled "A Guide for Seniors - Protect Yourself Against Investment Fraud" (SEC Pub 144). The information is actually invaluable to investors of all ages, not only seniors.  While everyone may want to obtain a copy of this brochure, below are a few of the more important points made in this publication.

How to Avoid Investment Fraud

* Seniors tend to be especially vulnerable to scam artists who come across as being particularly "nice" or helpful.  Some seniors are too polite to turn down a friendly salesperson or they may feel they are indebted to someone who has provided them with investment advice.  Do not fall for the opposite tactic, either ... salespeople who prey on our financial fears and assure you that they have the best or, perhaps, the only solution.

* All investors need to ask questions and take the time to confirm the answers.  Do not rely on the references they give you ... do your own independent research on the company and the investment. One place to start is at the SEC's EDGAR database at www.sec.gov/edgar.shtml.  You can also contact your state's securities board.

*  Check out the salesperson and make sure they are licensed to sell securities in your state.  Find out if they have been disciplined by using the online databases of the SEC and the Financial Industry Regulatory Authority (FINRA).  Do not rely on someone simply because they say they are a "senior specialist" or "retirement advisor."  Check out the meaning of Investment Professional Designations at the FINRA website at www.finra.org/investors.

* Take your time before making an investment and be wary of those deals that are unsolicited or "too good to be true."

*  Do not trust a financial advisor who says, "leave everything to me."

Red Flags that Could Signal Possible Investment Fraud

*  Any promised returns that are significantly higher than normal are almost certainly risky ... if not completely fraudulent.  High returns typically means high risk; low returns should correspond to a lower risk ... although even that may not be true.

*  Be skeptical of guaranteed returns.

*  Ignore pressure to send money immediately.

*  Ignore and/or thoroughly investigate "once-in-a-lifetime" offers.

Common Types of Fraud

Every investor should be aware of the different types of fraud.  By educating yourself, you are less likely to be a victim of one.

Ponzi and Pyramid Schemes:  In these investments, the money manager basically robs one person to pay another.  The first people who get into the deal will initially get a high rate of return, and they happily promote the investment to others.  Unfortunately, eventually the money runs out and everyone loses both the high income and their principal ... since it was given to other people!

Oil and Gas Scams:  While there are legitimate deals, a large number of them are fraudulent deals promoted by telemarketers. If this is not your business, it is probably best to avoid these deals.

Promissory Notes:  These are widely promoted loans the investor supposedly makes to a company in return for a high interest return ... and they are commonly nothing more than a scam.

Prime Bank Fraud:  The salespeople convince you they are purchasing prime bank financial instruments overseas through secret deals only they can arrange.  The best that can be said about these deals is ... RUN!!

High Return or "Risk Free" Investment:  These are often actually unsuitable investment products, such as speculative or risky deals which are sold to the elderly, who are told that they are low-risk.  Confirm, confirm, confirm before taking on a new investment, especially if you have been promised a high rate of return.  Make sure you completely understand what you are buying.  If you can't understand it, don't buy it.

Internet Fraud:  The internet is just one more way these fraudulent salespeople try to contact potential investors.  Be as skeptical of something you receive over the internet as you would be of a phone call or letter from a stranger.

Where to Get More Information or File a Complaint

Sometimes, no matter how careful you are, you will need the information below to either file a complaint or check out an investment advisor.  I highly recommend that all investors use this information before dealing with any new investment advisor or purchasing a new investment product.  Print it out and keep it in your file with your brokerage statements.

Securities and Exchange Commission
Office of Investor Education and Advocacy
100 F Street, N.E.
Washington, D.C.  20549-0213

Telephone (800) 732-0330
Fax:  (202) 772-9295
Website for senior citizens:  www.sec.gov/investor/seniors.shtml

Complaints:  www.sec.gov/complaint.shtml
Email complaints:  help@sec.gov

FINRA Investor Complaint Center
1735 K Street N.W.
Washington, D.C. 20006

Fax: (866) 397-3290

File complaints online at: www.finra.org

Verify registration and disciplinary information about brokers and brokerage firms:

FINRA BrokerCheck at www.finra.org/brokercheck
Telephone:  (800) 289-9999

If you are interested in more helpful retirement information, including where to retire in the U.S. or overseas, helpful financial information, common medical problem, family issues 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


Wednesday, August 3, 2016

Self Help Tips for Heart Attacks

Like thousands of other people every year, my brother-in-law had a heart attack while he was alone in his car.  He drove himself eight miles to a hospital, where he collapsed as he entered the emergency room.  Although he survived, no one recommends that you try to drive yourself to the hospital if you suspect you are having a heart attack.  The chances are good that you will not reach the hospital and, to make things worse, you might kill someone else.

The truth is that nearly everyone spends at least some time alone.  As we get older, many people live alone and, in a health emergency, this can be dangerous.  Some people wear an emergency pendant which puts them in contact with emergency personnel, neighbors or relatives with the push of a button.  Other people keep their cell phone in their pocket at all times.  Those are both excellent ideas.

Every 60 seconds, someone in the U.S. dies of a heart attack.  What should you do if you are alone and suspect that you are having a heart attack? How can you tell?  These are important questions to ask, because 40 percent of heart attack victims never make it to the hospital. 

Symptoms of a Heart Attack

Heart attack symptoms can be wide-ranging and vague. Below you will find common and uncommon symptoms.  If you are in extreme discomfort or you are suffering from several of these symptoms, you should suspect a heart attack:

Chest pain (although 1/3 of patients do NOT have chest pain)
Pain or discomfort in one or both arms, the back, the shoulders, the neck, or the stomach (above the belly button)
Shortness of breath
Nausea and vomiting

The older you are, the more likely you are not to have chest pain, but have atypical symptoms, instead.  Some of the atypical symptoms are:

Labored breathing
Vague chest pressure

You may feel unwell for days or even weeks before experiencing the heart attack. 

Self Help Tips for Heart Attack Victims

If you experience the above symptoms and you are alone, here are a list of the steps you should take to save yourself.

* Call 911 - It is important to get to the hospital within an hour.
* While you are waiting for an ambulance, chew and swallow a regular, uncoated 325 mg. aspirin.
*  Unlock your doors so emergency personnel can get inside, in case you cannot open the door later.
*  Sit down, but do not lie down; try to rest and relax while you wait.
*  Call a neighbor, friend or relative and stay on the phone with them until help arrives. If they are close, ask them to come over and wait with you.
*  Do NOT drive yourself to the hospital or have someone else drive you; ambulances have defibrillators and clot-busting medications.  They will also be able to get help for you more quickly, once you reach the hospital.
*  When the EMTs arrive, be ready to tell them what medications you are using and explain exactly what you are feeling.
*  Be assertive.  If you seem shy or reticent, studies show that you may wait longer to receive treatment.  Speak up.  Even if it turns out that you were not having a heart attack, but some other health problem instead, it is important to get checked out as soon as possible.

Want to learn more about common health issues as you age?  Use the tabs or pull-down menu at the top of the page to find links to hundreds of additional helpful articles.

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

Photo of heart model courtesy of morguefile.com