Social Distancing Tips for Retirees - How to Stay Safe

As the novel coronavirus Covid-19 continues to spread across our country and around the world, it is becoming more and more important for senior citizens and others to practice social distancing. Everyone is encouraged to stay at home and, when they must leave their house, to maintain a distance of six feet or more from anyone they encounter. This is especially important for senior citizens, since they may be more at risk of dying from the disease, especially if they have a pre-existing condition such as diabetes, heart disease, kidney disease or cancer.

To make the issue more complicated, seniors are normally encouraged to stay in touch with friends and family, both for their mental health and so someone always knows they are alive and well. This can be difficult to achieve when so many seniors live alone or with only a spouse, especially when they are intentionally trying to self-isolate or practice social distancing. How can you stay safe and isolated while, at the same time, trying to keep in touch with others?

What is Social Distancing?

Good social distancing means staying home as much as possible, and avoiding all contact with anyone outside your home.  It means you should not visit anyone and you should not allow visitors to your home.  You have to act as though every other person may have a highly contagious disease, whether it is Covid-19 or something else.

The U.S. Centers for Disease Control is recommending that people avoid being in groups of more than 10, and you should only be in a group of that size if everyone can maintain a separation of six feet or more.  In addition, everyone should wash their hands or use hand sanitizer upon arrival and frequently during the gathering, since people tend to touch various surfaces and then their faces several times a minute, which allows viruses easy access to their bodies.  These types of gatherings should be reserved for important public meetings, and only when necessary, not for socializing in a private home or playing a game of bridge.

Ideally, people should spend most of their time alone, or only with their spouse or other people they live with.  Everyone should stay home as much as possible and avoid going anywhere not absolutely necessary.

Work from home, if you can. If you or someone in your family must work outside the home, take extra precautions around them, especially if they work in the medical field or with the public.  In some cases, it may be smart for them to isolate themselves in a separate room or section of the house, away from everyone else, whenever they are home.

While you are social distancing, enjoy things such as online classes, whether it is to finish a degree or just to enrich your mind.

Postpone visits to doctors and dentists, if they are not immediately necessary.  Use the telephone, email or a video chat service to communicate with your doctor.

Do not go to restaurants, bars, country clubs, places of worship, sports arenas, theaters, museums,and other spots where people tend to congregate.

Postpone visits to hairdressers, barbers, massage parlors, and nail salons ... anywhere you will be in close physical contact with another person.

Avoid visits with friends and family.  You may miss the grandkids, but they do not want to carry a disease to you, and you do not want them to feel guilty if you get sick, even if they did not give it to you.

Do not visit friends or relatives in nursing homes, rehab centers, or assisted living. They may be lonely, but you do not want to give them a virus which could shorten their lives.

How to Get Food and Supplies

If you are spending time alone, or only with a spouse, it can become a serious concern to figure out how you can get the supplies you need.  Here are some suggestions:

Order your groceries and other necessities online from sites like Amazon Fresh and Walmart.  They are also a good place to get cleaning supplies such as Lysol or Clorox.  (Ad)

Your local grocer may also have a delivery service. Call them and ask if they use Instacart or a similar service.

Use a curbside pickup grocery service, which is available at some Walmarts and, possibly, other stores.  You place your order online and then pull up to a designated spot in the Walmart parking lot when the order is ready. Someone puts your groceries in the trunk of your car for you. Two of our daughters regularly use this service and love it.

Are you hungry for a meal from your favorite restaurant or fast food place? Use a meal delivery service such as GrubHub or Postmates.  Throw away the outer wrappings and containers as soon as the food arrives, and then wash your hands.  You may even heat the food up again for a few seconds in the microwave.

Patronize local restaurants by getting take-out or going through the drive-in window. 

Have prescriptions mailed to you.  Request a three month supply, if possible.

If you have to go into a store yourself, cover as much of your skin as possible and go during non-peak hours, when the store is not crowded and you can maintain space between yourself and other shoppers. Wipe down the cart handle and anything else you must touch with disinfecting wipes. Wear gloves and a face mask or bandana, or wrap a scarf around your lower face, so you do not touch items on the store shelves and then touch your face.  Your goal is to protect your face from being contaminated by your own hands!  Try to limit your trips to the grocery store or pharmacy to no more than once a week.

Once I leave a store, I lay my gloves palm side up on the dashboard of my car so the sun will hit them.  Direct sunlight is believed to kill the virus on fabric. After removing my scarf and gloves, I use hand sanitizer on my hands and around my nostrils. Finally, when I arrive home, I remove my shoes and jacket and leave them in direct sunlight on an enclosed patio with large windows.  Afterwards, I wash my face and hands.  You may also want to use a disinfecting wipe to clean the packages you brought home and your reusable grocery bags.

According to Professor Greg Polan at the Mayo Clinic, "You cannot get infected if your hands are clean before you touch your face, and if you don't breathe in air from somebody who's sick and coughing."  The steps above should protect you from those possibilities.

How to Stay in Touch with Others

Even though you are social distancing, it is very important for your safety and mental health that you regularly communicate with other people.

Call and chat with family and friends regularly, especially if you live alone.  It is important to have real conversations and use your voice.  Conversations are an essential part of postponing dementia. Just because you are social distancing yourself from other people, you do not want to let yourself mentally deteriorate.

Use FaceTime, Skype, Zoom or WhatsApp to have video chats with family members.  It is a great way to stay in touch with grandchildren and other members of the family.

If you have no one who can check on you regularly, you may want to try an automated daily phone call check-in service such as iamfine.  They will place a daily call to you to make sure you are OK.  It is an invaluable service for people who live alone.  During the months of March and April 2020, they have offered to waive their monthly fee temporarily, since so many people are feeling isolated.  To get the free temporary service, people should enter the Code APRIL2020 when they sign up. 

In addition, you may want to send out personal notes and emails to friends, as well as stay active on social media, such as Facebook, Instagram and Twitter.  My daughters text me nearly every day and they call me periodically.  I also chat weekly with my sister and father, and occasionally have phone conversations with friends.  Since I have a husband, I live with someone I talk with daily. I have also read reports of people who moved in with friends or relatives before the virus became widespread, just so they would have companionship.  They call them "quarantine friends" or their "quarantine squad."

How to Safely Get Fresh Air and Exercise

Social Distancing does not mean you cannot go outside.  If you have a yard, balcony or patio, enjoy some time outside whenever possible.  Open your windows in good weather and let in some fresh air. Enjoy a little sunshine.

Take a walk or a hike, keeping a six foot space between you and other people.

A friend of mine and I often walk around a small neighborhood golf course. We drive to our favorite meeting place in separate cars and we stay five or six feet apart as we walk.  We both have seriously ill husbands, so we are extra careful. We wear gloves and, sometimes, I wear a scarf wrapped over my lower face, to keep myself from touching my mouth or nose.  Just as I do when I go to the grocery store, after the walk I lay my gloves on the dashboard of my car, remove my scarf and use hand sanitizer on my hands and around the edges of my nostril and mouth.

Another way to get exercise is to use free weights or exercise videos, following along at home.

Be sure to wipe down any home exercise equipment you use, before and after you handle it, especially if anyone else may use it after you, even someone in your household.   (Ad)

How to Quarantine Someone in Your Family

The time may come when one person in your family is ill with the coronavirus or another contagious disease, but everyone else is healthy. How can you care for them, while keeping yourself and other family members safe?  Here are some suggestions:

The ill person should stay in a separate room, and not share a bed or anything else with other people.

If possible, have a designated bathroom that only they use.

Everyone should be especially careful about hand-washing and using hand sanitizer. Everything possible should be wiped down with sanitizing wipes several times a day, including doorknobs, counters, bathroom fixtures, etc.

Food should be left for the sick person by the door to their room, or placed on a table just inside the door, while the caregiver maintains a distance of six feet or more from the sick person.  They should have their own dishes, which are washed separately as soon as they are finished eating, or placed in the dishwasher to be sterilized.  The caregiver should wear rubber gloves while handling the dishes, and then the gloves should be washed off. Whenever the caregiver must approach the sick person, they should wear gloves and a mask.  However, they should maintain a safe distance unless it is absolutely necessary they get closer.

If the person is seriously ill, has a high fever, is becoming dehydrated or having trouble breathing, call your doctor and follow their directions to take the patient to a hospital, where they can get the care they need.  This will also protect the rest of the family. 

How to Get Medical Care While Maintaining Social Distancing

If you or someone in your family needs to go to a hospital or to see a physician, do NOT show up at your doctor's office or the local urgent care facility or hospital unless you CALL AHEAD.  Some facilities have special, separate locations or entrances for suspected cases of coronavirus and people with other highly contagious diseases.  This is to keep contagious patients separate from people who may be having a baby, a heart attack, stroke, broken bone, or other routine medical event. 

Even if you are seeing the doctor for a common health condition, you want to be sure you are using the correct location and entrance.  You do not want to walk into a lobby full of highly contagious people if you are not sick, and you do not want to contaminate a room full of healthy people, if you are sick.

Do Your Research

Stay up-to-date on information about the coronavirus or any other contagious disease which may be going around.  Watch for news stories on major news networks such as ABC, CBS, NBC, PBS and the BBC.  Cable stations may also carry stories about Covid-19 and other contagious diseases, but they are more likely to have a political bias, which can affect what they report and even cause a delay in getting life-saving information.  It is better to get an excessive amount of accurate information, than miss an important report because of the political bias of your news source.  In particular, you may want to watch your local news stations for any special instructions or information which could pertain specifically to your state or community.

You may also want to read my related article:

Coronavirus Quarantine: Seniors Should Prepare for Covid-19

To learn more about common medical problems as we 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 helpful articles.

Disclosure: This blog may contain affiliate links. If you decide to make a purchase from an Amazon ad, I'll make a small commission at no extra cost to you.

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

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Dying at Home - What is Best for You and Your Family?

More Americans are deciding to die at home, rather than in the hospital, for the first time in over 100 years.  Many people believe they would rather spend the last few weeks or months of their life in their own home, being cared for by their loved ones.  It is true that they are likely to feel less lonely and depressed when they are surrounded by their family in their final days. There are also financial incentives for hospitals when they encourage people to leave the hospital and go home to die.  However, is this really the best thing for either the dying person or for their family?

Dr. Nathan Gray wrote an op-ed which appeared as a full-page ad in the Los Angeles Times and other newspapers on February 16, 2020.  He is an Assistant Professor of Medicine and Palliative Care at Duke University School of Medicine, as well as an artist who draws informative comics on medical topics.  His editorial made some serious points which people need to consider before making the final decision about where they want to die.

Are We Truly Living Longer or Taking Longer to Die?

While experts often tout how they have extended the lives of senior citizens by a few months, they rarely describe what those additional months are like for people who are dying.  Often, the dying are nauseous, exhausted and in pain.  In many cases, I have observed that people in the final months of their lives are not truly enjoying themselves, feeling alert, and chatting with adoring loved ones.  They often spend those last months suffering through an extended, unpleasant death.  During this period of time, they are can be miserable and unhappy. They may be barely aware of what is going on.  

Who Will Care for You If You Die at Home?

If your spouse or an adult child is going to be your sole caregiver, other than a few short visits from a hospice team each week, are you expecting too much of your loved one when you ask to go home to die?  Are they going to be able to help you get up during the night to use the bathroom, manage your medications, bathe you, and feed you, while still meeting their own basic needs?  Studies show that 30 percent or more of caregivers end up dying before the patient under their care.  Are you willing to take the risk that someone you love could die while caring for you?  Is this the burden you want to place on your beloved spouse or other family member?

Can Your Family Afford for You to Die at Home?

Another point made by Dr. Gray is the high financial burden of having a loved one die in your home.  The caregiver may have to give up their current job, or they may have to hire a paid caregiver to assist them. In some cases, they may have to do both ... quit their job and hire extra help to do the things they cannot manage on their own. As a result, dying at home can create a financial burden for your spouse or adult child, making it more difficult for them to pay the bills.  You may be so "out of it" from pain medication and your loss of awareness, you may not even realize how hard life has become for your spouse or adult child, and how much stress they are under.

Will Home Hospice Help?

Fortunately, home hospice will provide some assistance to your family if you choose to die at home.  Hospice agencies are reimbursed about $200 a day to provide you with necessary medical equipment, pain medication, and a few visits from nurses each week. This compares to the approximately $2000 in reimbursements which hospitals receive to provide you with 24 hour-a-day care as long as you stay there.  Obviously, as much as they try to provide all the help they can, home hospice providers cannot do everything a hospital can do during the last few months of your life.

It is important for people to know that Medicare will pay for a few weeks in a skilled nursing facility, if you go directly there after having stayed in a hospital as an admitted patient (not just under observation) for at least three nights. If you have a low income and few assets other than a house and/or car, Medicaid will pay for an extended stay in a skilled nursing facility, but you or your family should apply for Medicaid as soon as the patient moves into the facility.  You may need to get an expert to help you with the application process. Ask the nursing home to help you or get a referral to a service which is able to help. 

Have You Planned Ahead?

If you have made arrangements in advance for long-term care insurance, or you have moved into a Continuing Care Retirement Community prior to developing a terminal illness, then you may be better prepared to die in your home or at the retirement community where you are living.  Your long-term care insurance or the CCRC where you live will help your spouse or other family members manage your care during the end of your life.  Caring for you during this emotional time will be much less of a burden on your family if you have planned ahead.

It could be helpful to read "Long-Term Care: How to Plan and Pay for it." (Ad) The information in this book will make your decision to die at home much easier for everyone.  

However, if you do not make arrangements in advance, you may wish to rethink your decision to die at home.  Spending those last few weeks in a hospital or skilled nursing facility may be the last, considerate action you can take to help your family be under less stress at the time of your death.  It's something to think about.

If you are interested in additional Social Security and Medicare information, retirement planning, where to retire, or wish find out about common medical 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.

Disclosure: This blog may contain affiliate links. If you decide to make a purchase from an Amazon ad, I'll make a small commission at no extra cost to you

Reference:  https://www.latimes.com/opinion/story/2020-02-16/doctor-patients-send-home-to-die 

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

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Coronavirus Quarantine: Seniors Should Prepare for Covid-19

The father of one of the students at our grandson's school has been hospitalized with a confirmed case of the novel coronavirus, Covid-19. As a result, our daughter and her family have been ordered into self-quarantine at their home in New York State.  Fortunately, our daughter informed us that they have plenty of food, her husband's employer agreed to let him work from home, and they will be fine until the quarantine period is over. In fact, they all have a positive attitude about this unexpected period of family time they will have together.

However, it occurred to me that everyone should know how to be prepared for a period of self-quarantine in case they are exposed to any contagious disease.  In particular, seniors should be ready to survive at home alone for at least two weeks, whether it is because of a virus in their community, or as a result of some other type of disruptive disaster.

Facts About the Coronavirus Covid-19

First, everyone should be aware of what we currently know about the novel coronavirus called Covid-19 as of early March, 2020.

The older and sicker you already are, the more likely you are to become seriously ill or die from Covid-19.  Children are rarely seriously affected, although they can be carriers of the virus.  Some babies have been diagnosed with the virus shortly after birth, which is a concern for expectant mothers.

The overall risk of dying from this disease is estimated by the Chinese Centers for Disease Control to be about 2.3 percent.  The World Health Organization actually believes the rate may be 3.4 percent. This makes it appear to be 23 to 34 times more lethal than regular influenza, which has a death rate of 0.1 percent. However, the death rate for Covid-19 should decrease as the number of people are tested and many are discovered to only have a mild case. The reason more people currently die from the flu is because it has been around much longer and millions of people get it every year.  Eventually, the Covid-19 may become more common, too.  Hopefully, before that happens, we will have a vaccine and more effective treatments than we have now, and these interventions will lower the death rate.

Until then, senior citizens should know that people in their 70s have an estimated 8% death rate, when they get the Covid-19; people in their 80s have a 15% death rate.  Older patients are much more vulnerable than younger adults.

The estimated death rates for people with certain underlying disease are:

Heart disease - 10.5%
Diabetes - 7.3%
Chronic Respiratory Disease - 6.3%
High blood pressure - 6%
Cancer - 5.6%

As mentioned above, these numbers should decrease once we are able to test people sooner and quickly get them treatment.

The good news is that the vast majority of people survive this illness, even if they are elderly and have an underlying condition. However, if you do have one of these conditions, it is wise to be extra careful by practicing good hand washing hygiene and practicing social distancing, which is explained in greater detail below.

Once you feel you have done everything you can, then relax and continue to enjoy your life.  Stress can lower your immunity, so do not let yourself become too anxious.

How to Minimize Your Exposure to Covid-19

The first thing you want to do is minimize your exposure to this coronavirus.  You have almost certainly seen the news reports about thoroughly washing your hands, which is always a good idea.  Some people, especially those with sensitive skin, have also found it helpful to wear gloves when they are in public.  You can either use disposable gloves, (Ad) or fabric gloves which can be removed and laundered when you return home.  You may want to purchase several pairs.  Perhaps we can make it stylish again to wear attractive gloves whenever we are out in public!  Recently, the Queen of England has been spotted wearing gloves when she is in public.  We may all want to follow her lead.

Experts also recommend that we practice a certain amount of reasonable social separation.  This means avoid shaking hands, hugging others, using common cups in religious services, or spending time near people with obvious symptoms of a cold or the flu, such as coughing or sneezing. We may also want to avoid crowded spaces in which you are in close proximity to large groups of people. Older adults may want to avoid friends for a couple of weeks after they have been on a cruise or when they have recently returned from an overseas trip. 

You do not need to completely isolate yourself from other people. Just practice reasonable self-defense.  Hopefully, people who are sick will be thoughtful and stay home when they are not well.

How to Prepare for Self-Quarantine

Despite your best efforts, the time may come when you discover you have been in the vicinity of someone who has been diagnosed with the coronavirus or another highly infectious disease.  If this happens to you, you need to be prepared to self-quarantine until you have been cleared by the experts.  What do you need to have in your home in order to be prepared for a successful self-quarantine?

Keep at least a two to three week supply of the following items on hand at all times:

Canned, frozen and dry food, such as pasta, soup and frozen meals
Pet food, if you have a pet
Prescription medications and nutritional supplements
Toilet paper, tissues and paper towels
Soap, shampoo and personal hygiene products
Cleaning supplies, such as Clorox wipes, Lysol, laundry soap, etc. (Ad)
Spare batteries for any medical devices or entertainment items you have.

You do not need to hoard these things.  Just have a two to three week supply of them on hand.

You may also want to keep a supply of a few other things:

Over-the-counter cough medicines, nasal sprays, and Advil (ibuprofen) (Ad) are good to have in your medicine cabinet, just in case you need them.  Mild cases of the coronavirus can be treated at home with cold medicines, rest, and plenty of fluids. These medications only treat the symptoms; they do not cure the disease. The good news is that 80% of all cases of Covid-19 appear to be mild and people recover in a few weeks.  However, if you have a dry cough and a temperature of over 104 F, or you start to have breathing problems, call your doctor and make arrangements to go to the emergency room.  This could mean you have developed a severe form of the disease. Hospitals want you to call in advance so you can be isolated when you arrive.

You may also want to keep an assortment of items around the house to keep you busy while you are under quarantine, such as books or supplies for your favorite hobbies.

Remember that being self-quarantined does not mean you cannot enjoy gardening in your yard and getting some fresh air.  Depending on what authorities have told you, you might even take a walk around the block, as long as you stay six feet or more away from other people. If you do go outside, this is when it would be thoughtful to wear a face mask, so you do not cough and expose someone else.

You can also stay in touch with friends and family through emails, phone calls, Facetime, and text.  In fact, it is advisable to let your loved ones know how you are feeling and whether or not you are starting to get sick.  It will reassure them if you are well, and allow them to seek help for you if you need it.  It will also help keep you sane during this period of forced isolation! Being alone for too long can be very stressful for many people, so you need to stay connected.  You may even arrange to contact someone once a day to confirm you are still OK.  If they do not hear from you, give them permission to ask the police to do a welfare check on you. 

What If You Run Low on Supplies?

Fortunately, we now live in an internet connected world.  If you run short on supplies, you can order virtually anything you need online.  You can order a pizza delivered to your home, or have groceries, medications, cleaning supplies, and almost anything else shipped to you by Amazon, Walmart, or a local store.  Most pharmacies will mail your medications to you.  Since you pay online, you can even have them leave everything outside your door, especially if you feel sick and want to avoid speaking with the delivery person.  You can tape a note with instructions to your front door or, if you have the Ring doorbell, (Ad) you can use it to chat with them.

What is important to know is that you do not have to panic if you are unexpectedly quarantined, even if you were not prepared or you find yourself short on supplies.  You can get virtually anything you need delivered to you within a day or two.

Avoid Being Scammed

Finally, you should not let yourself be scammed by people who want to cheat you by selling over-priced "Covid-19 Kits" and other products you do not need. There are reports that some on-line sellers are asking over $100 for a bottle of hand sanitizer or $20 for a face mask.  You do not need either of these things during a home quarantine, and you certainly should not pay an unreasonable price for them.  Even if you do need something, it is smart to look for the best possible price.  Do not panic.  Do not let yourself be cheated.  All you really need are basic supplies, and you should not have to pay extra in order to get them.  In most places, price gouging is against the law.

To learn more about common medical problems as we 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 helpful articles.

Disclosure: This blog may contain affiliate links. If you decide to make a purchase from an Amazon ad, I'll make a small commission at no extra cost to you.

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

Photo credit:  Pixabay.com

High Healthcare Costs Sink Retirement of Many

If you have paid into Medicare for most of your working years, you may be surprised to learn that after retirement a couple could still spend an estimated $285,000 or more on their out-of-pocket healthcare expenses.   If you are a single man, you should expect to spend approximately $135,000 for future healthcare costs; a single woman could need $150,000, since women tend to live longer.

The amounts mentioned above are what people commonly spend for their Medigap supplement premiums, plus their co-pays, deductibles, dental care, eyeglasses, hearing aides, prescription drugs, over-the-counter medications, and other out-of-pocket expenses from the time they begin Medicare at age 65, until their death. These estimates DO NOT include your basic Medicare premiums or the money you will spend on long-term care at the end of your life, which can become a devastating expense for many families. Most people are not prepared for the high cost of their medical care after they retire.  In fact, because people think their healthcare costs will go down after they are on Medicare, they are often shocked by how much their medical expenses actually are!

In addition to the costs mentioned above, many newly retired seniors are also surprised to discover that they will have to pay monthly premiums for their basic Medicare, and it is likely to be deducted from their Social Security benefits. They will not be getting nearly as much income as they planned. The high cost of healthcare has been known to virtually wipe out the life savings of many retirees.

Even if you believe you have saved plenty of money, paid off your debts, and prepared to cover your living expenses during retirement, you may not have adequately prepared to cover all your future healthcare costs.  In fact, people over the age of 75 spend an estimated 20 percent of their total income on out-of-pocket medical expenses and this amount often grows even faster than their income, according to a 2018 report by Rutledge and Sanzenbacher, which was published by the Center for Retirement Research.

Below are some of the expenses you need to be aware of:

Medicare Premiums

Even though you spent years paying into Medicare, the only part of the program which is free is Part A or hospitalization.  Even then, only 80 percent of hospital costs are covered. You will pay a premium for Part B, which covers your doctor and other health care providers' services, outpatient care, durable medical equipment, home health care, and some preventive services.

In 2020, the Part B premium started at about $144.60 a month. The premium is deducted from the Social Security benefits of most retirees each month.  If the retiree receives a public pension (such as retired teachers and government employees), they may pay an even higher premium directly to the Social Security Administration to cover their Medicare benefits.  High income retirees are also expected to pay a higher Medicare premium.

The Medicare premium rises most years and it is not unusual for the premium increase to entirely wipe out any increase in Social Security benefits.  Consequently, the increases in Medicare premiums often cause people to gradually fall behind inflation, making it even more difficult for them to keep up with other expenses, including their growing medical costs.

If Medicare confuses you, do not be embarrassed.  It confuses most people.  If you are planning to apply soon and want to understand the program better, it may help you to get one of these Medicare books (Ad) which can help clear up your confusion.  There are several good choices and any one of them would be well worth reading, especially if you are new to Medicare.  Most of the books are updated annually.

Medicare Supplements or Medigap Policies

As mentioned above, basic Medicare only covers approximately 80 percent of your medical bills.  Deductibles and co-pays are paid by the retiree.  Because of this, many people buy a Medicare Supplement or Medigap policy to "fill in the gaps."  There are a number of plans available and the cost can add several hundred dollars a month to your monthly bills.  This is in addition to the premium you are required to pay for basic Medicare.

Even if you have a supplement or Medigap plan, it will usually not provide dental benefits, eyeglasses, contact lenses, hearing aids and other common medical necessities.

Prescriptions

Prescription drug costs are covered under Medicare Part D, and like Part B, there is an additional premium which you must pay to have a drug plan.  You can get a Part D policy from the same company which provides your Medigap plan, or you can purchase a plan from a different company.  Your pharmacist may help you choose the best plan for you. Like the premium for your basic Medicare Part B, your Part D prescription plan can be deducted from your Social Security benefits and may range from about $12 to $77 a month.  You should also know that most Part D prescription drug plans also require patients to pay a co-pay, or a portion of the cost of their medications.  Without a prescription plan, however, your medications could cost you hundreds of dollars a month, so it is important to have a prescription drug plan.

Hearing and Vision Exams

Half of Americans over the age of 75 have a disabling hearing loss.  Millions of senior citizens have some type of vision loss.  Medicare Parts A, B and D do not cover exams for these health issues; nor do they cover eyeglasses and hearing aids.  Many retirees also have dental problems, and the out-of-pocket expense can run quite high, especially if they need crowns, caps, dentures or implants.   None of this is covered by Medicare.  You may want a separate dental plan to help with some of these expenses ... one more premium to pay.

A Medicare Advantage Part C Plan May Be the Most Affordable Choice

There is one way you may be able to substantially reduce your medical costs during retirement. If you are willing to join an HMO medical network and use doctors and medical facilities which are part of that network, you could save hundreds of dollars a month in Medigap and Part D premiums by signing up for a Medicare Advantage plan.  These plans are also referred to Medicare Part C.

Most Medicare Advantage Part C plans only charge their members the same premium as you would be paying anyway for basic Medicare, or they may charge a small additional fee in the range of $40 to $50, but this is not nearly as much as the cost of a Medigap plan, plus an additional Part D plan and other uncovered medical expenses.

If you decide to choose a Medicare Advantage Part C plan, such as SCAN, Kaiser Permanente, Humana, Aetna or one from another company, the insurance provider is required to provide all the services which basic Medicare covers.  In addition, they often include a prescription plan for no additional premium.  Frequently, the plan also includes a discount on dental work, vision care and/or hearing aids.  However, even if you choose a Medicare Advantage plan, you should still expect to pay some deductibles and co-pays.  In addition, while the policy may give you discounts on vision, dental and hearing care, they will not fully cover those items and you will still be expected to pay large portions of the cost yourself.  Despite these remaining expenses, you will almost always find that a Medicare Advantage plan is much less expensive than basic Medicare, plus a Medigap plan, a drug plan and a dental plan. You could save hundreds of dollars a month.

Personally, my husband and I use the Kaiser Permanente Medicare Advantage plan (called Senior Advantage) and it saves us thousands of dollars a year compared to what we spent early in retirement on basic Medicare, an Anthem Blue Cross Medigap plan, and a drug plan.  We have been very happy with Kaiser.  The downside is that we are limited to Kaiser's in-network doctors and facilities, except in an emergency.  However, when my husband became ill in another state where Kaiser did not have a presence, Kaiser reimbursed us for our expenses.  For us, the savings has been well worth it.

A Health Savings Account Might Also Help Cover Out-of-Pocket Expenses

Another way to deal with the high cost of healthcare after retirement is to prepare years in advance by saving money in a Health Savings Account.  Currently, an individual can contribute $3,000 a year into an HSA and a family can contribute $7000.  People over the age of 55 can save an extra $1,000 a year.  While people can make withdrawals prior to retirement, the money in these accounts can also be invested and allowed to grow until needed after retirement. However, the money can only be used in conjunction with a high-deductible HSA eligible health plan.  This takes some advance planning, but it can be a solution for people who do not want to use a Medicare Advantage plan.

It is recommended that you do your research and work carefully with a medical insurance agent to find the plan which is best suited to your needs.

Long-Term Care is the Big Unknown

Most of the expenses mentioned above, including premiums, deductibles and co-pays, can be estimated fairly well as part of your retirement planning.  However, if you or your spouse needs long-term care at home or in an assisted living or memory care facility as you age, the expense can be disastrous.  Your best bet is to purchase long-term care insurance or a hybrid life insurance policy that includes long-term care coverage.  The other option is to save an extra $300,000 or so in a separate account just for your future care, so you have the money available when you need it.

It is said that the very rich and the very poor do not need long-term care insurance.  This is because the rich can afford to pay for the help they need.  At the other end of the spectrum, those who have a low income and few assets will find that their long-term care might be covered by Medicaid.  Ironically, it is the Middle Class who are the most seriously affected by the cost of long-term care.  If you fall into this group, you need to prepare ahead.  By the time you need long-term care, it is too late to get the insurance.  You need to buy it years in advance.

What are the odds that you or your spouse will need long term care?  For the most part, it depends on how long you live and your medical condition.  It can also make a difference whether or not you live alone.  People who live alone may need care sooner than someone who has a spouse or family member who will care for them during the final years of their life.  People who have chronic health conditions, such as COPD or other lung problems, diabetes, chronic kidney disease, heart disease, a history of strokes, severe osteoporosis, or cancer are more likely to need long-term care.  So are those who live long enough to develop memory problems. At age 80, a person has a 10 percent risk of serious cognitive impairment.  By age 85, the risk jumps to 20 percent.  At age 90, your risk is 40 percent and continues to rise as you age.  Even without other chronic conditions, simply the possibility of getting old can increase your need for long-term care.

Basically, nearly everyone needs to plan for a period when they will need long term care because of age related debilitating health problems which will eventually make it impossible for them to care for their own needs.  Overall, a person who is currently age 65, has a 70 percent chance of eventually needing some type of long-term care services!  Are you prepared?

Are You Prepared for High Healthcare Costs?

The general consensus is that retirees need to be prepared for high medical expenses in the final two or three decades of life.  Depending on their needs, they can prepare by saving enough money in advance, signing up for an affordable Medicare Advantage plan, and/or including long-term care insurance in their plans.

Part of your retirement planning should also include a plan to stay as healthy as you can for as long as possible.  Over and over again, research has shown that the people least likely to need long-term care are those who have taken care of themselves. This means they have eaten a healthy and varied diet, exercised outside in nature regularly, learned to handle stress, managed to sleep seven to nine hours a night, avoided smoking or heavy drinking, and followed the recommendations of their personal physician.

You can get more tips about healthy aging by reading the Blue Zones books.  (Ad) The Blue Zones are places in the world where the residents regularly live long, healthy lives.  However, research has shown that you need to do virtually everything they recommend, not just a couple of their suggestions.  As it is, simply by living in a typical American community, with air pollution, stress, isolation, easy access to frozen meals, and few places to walk, it will be harder for you to get all the same health benefits as people who lived their entire life in a Blue Zone.

The Blue Zone life is one of exuberance. They are people who enjoy delicious food with plenty of herbs, spices and olive oil, eaten often with large groups of friends and family, often accompanied by a glass of red wine.  They are people who encorporate exercise into their normal daily routine, getting outside to enjoy nature in the early morning sunshine and fresh air.  They believe in a bountiful earth. It is a wonderful way to stay healthy and live long.  It is worth a try to follow their lifestyle.  It can also save you a lot of money on healthcare during retirement!

To learn more about Medicare, Social Security, common medical problems as we age, 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 helpful articles.

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