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General for Elders

Wednesday, March 18, 2020

Preparing Older and Sick Loved Ones for Flu and Coronavirus


While we don’t believe that anyone should panic, we do want to encourage anyone with older or immuno-compromised loved ones to be prepared.

The CDC is encouraging everyone to have extra food and supplies on hand, in the event of sudden closures or quarantines. Please take the time to check on any seniors or people in your life who are ill/disabled to see if they need help getting things together. Key items to gather include:

  • Prescriptions and any over-the-counter medications

  • Those with breathing problems should ensure that any devices they use (nebulizer, oxygen) are working properly and they have enough medication on hand to power any devices.

  • A two-week supply of food

  • Drinks with electrolytes in the event the flu or another illness is contracted

  • Nutrition drinks such as Ensure for seniors

  • Lysol, disinfecting agents, and anti-bacterial soap

  • Extra toilet paper

  • Pet food for at least two weeks

  • Adult diapers, feminine products, and any other necessary supplies

Finally, it’s a wise idea to make copies of your loved one’s insurance cards and make sure that you can put your hands on any Powers of Attorney and Healthcare Directives that would allow you to legally communicate with doctors and make financial and medical decisions on your loved one’s behalf.
Read more . . .


Tuesday, March 17, 2020

THE CORONAVIRUS (COVID-19) AND RESIDENTS OF ASSISTED LIVING AND SKILLED NURSING FACILITIES


As I write this, there have been two cases of COVID-19 identified in the Atlanta, Georgia area.  One of the victims recently returned from a business trip to Milan, Italy, where the outbreak of COVID-19 has reached over 2500 cases.
 
The death toll in the U.S. as of the morning of March 4, 2020, is 9, and the number of identified cases is more than 100.
Read more . . .


Friday, February 7, 2020

Could Your Bad Estate Plan End Up as The Plot of a Book?


My favorite hobby is reading and I try to combine my love of reading with my profession of estate planning.  The plots of some of my favorite books are about dysfunctional family relationships complicated by really bad estate planning!

Here are three books I recommend where siblings were torn apart by their parents’ bad estate planning choices.

 

The Nest

by Cynthia D’Aprix Sweeney

The four siblings of the Plumb family - Leo, Melody, Beatrice, and Jack- are the beneficiaries of a trust fund they call “The Nest” left to them by their father. The terms of the trust provide that the trust assets will be distributed equally to the four siblings when the youngest, Melody, reaches age 40.

When the book begins, Melody is fast-approaching her 40th birthday, and each of the siblings is anxiously awaiting the distribution that could solve their self-inflicted life problems.
Read more . . .


Wednesday, December 4, 2019

How to Have A Family Conversation with Aging Parents at the Holiday


Happy Holidays! 

 Is It Time to Have a Conversation About Long-term Care with an Aging Parent?

Like many families, mine is scattered all over the United States.  Work and other commitments make it difficult to visit distant loved ones more than a few times a year.  When visiting, it is hard to gauge the health and safety of family members because they are often not going about their normal daily activities. 
A few years ago, while visiting my dad in Oregon, I noticed that there was something not quite right with him.  He was repeating himself and telling stories about his history that I was pretty sure were not true.
Read more . . .


Monday, November 11, 2019

Podcasts for Caregivers


There are not enough hours in the day – a familiar phrase I mutter to myself while trying to accomplish the items on my ever-expanding to-do list.  That phrase may really be true for those caring for a family member with disabilities. 

Although I haven’t found a way to add hours to my day, I have found ways to extend the time available for learning new things.  I’ve discovered that I can listen to podcasts and books while doing tasks that require my physical -but not necessarily my mental – presence. 

I listen to podcasts when I’m running, doing laundry or cooking, or while I’m wandering around Trader Joe’s picking up groceries.
Read more . . .


Friday, August 17, 2018

What it means to be a healthcare surrogate


In my practice, I spend a lot of time educating clients about the need to have an Advance Directive for Healthcare in place so that someone can make healthcare decisions for them if they are unable to make those decisions or to communicate them.  But what does the healthcare agent or surrogate do?

When nominated to become a surrogate healthcare decision maker for someone, you may be asked to make decisions about what healthcare procedures and care will be appropriate for someone other than yourself. You will only be asked to make healthcare decisions if the person is not able to make or communicate those decisions.  What that means is that you may have to decide what the person would want without ever having discussed the issue with them.

In general, as a healthcare surrogate you will have the right to:

  • Make choices about all medical care for the person, to include surgery, medical tests, medical tests or pain management.
    Read more . . .


Monday, June 26, 2017

The Four Most Important Legal Documents You Will Need to Manage Your Aging Parent's Affairs

To help your parents get their affairs in order, you should first make sure that you or someone trustworthy has the legal ability to manage your parent’s affairs.  This article is a guide to the four fundamental legal documents you and your parent may need in order to get financial affairs in order.



Read more . . .


Thursday, June 22, 2017

How Safe is My Mother from Financial Exploitation?


 

Jennifer’s 80-year-old mother seemed to be running low on funds every month.  By the end of the month, she had no money for groceries.  Jennifer had helped her mother with a budget, so she thought her mother had plenty of money to make it through each month.  When she asked her mother to allow her to look at her bank statements, though, Jennifer discovered a series of automatic debits to several companies she did not recognize.  It turns out, her mother had signed up for monthly book delivery clubs, as well as recurring magazine subscriptions for magazines Jennifer knew her mother did not read.
Read more . . .


Monday, January 23, 2017

Help, I’m Lost in the Medicare Alphabet Maze!


 

Recently, I had to help a relative reinstate her Medicare Part D insurance coverage after she forgot to pay the premiums for several months.  The insurance company sent many notices advising that they would terminate coverage if the past-due premiums were not paid, but she either ignored the notices or could not comprehend what they said and eventually lost coverage.

After spending hours on the phone first with the insurance company and then with Medicare, I realized that Medicare is somewhat of a mystery to me.  Medicare is not yet my health insurance provider, so other than knowing that most of my clients are covered by Medicare and pay a monthly premium for the health insurance, I really had little idea of how Medicare works.  This blog post is a general guide to Medicare, while the next four posts will explore the alphabet of Medicare in more depth.
Read more . . .


Thursday, December 3, 2015

Important Things You Need to Know About Medicare Part D

 

This year, a relative of mine had two issues that affected her prescription plan.  First, she was diagnosed with an illness and prescribed new drugs.  Second, she forgot to pay her Medicare Part D premiums and lost her prescription coverage.  How do you choose a Medicare Part D plan?  How do changes in medication affect the Part D insurance plan a participant might choose?  

Medicare Part D is the health insurance that covers prescription medication for outpatient drugs.  Part D is a fairly recent addition to the Medicare Alphabet, having been added in 2006.  This plan seems incredibly confusing, and it can require some research to determine the best plan for each individual.

Medicare Part D is a federally subsidized drug benefit.  The participants will pay a monthly premium to an insurance company that has contracted with the government.  In 2015, the average premium is around $33.15 per month.  After a participant has paid the deductible $320.00, the participant will pay 25% of the cost of the drugs until the total cost of the prescription drugs has reached $2960.  The federal government pays $2,220 of this amount and the participant will pay $760.  

But how to choose a Medicare Part D plan?  Medicare has a pretty powerful program online that can help you make the decision.  Go to www.medicare.gov/find-a-plan.  It will ask you to enter the zip code of the participant, and then will ask for all of the medications the participant is taking, the dosage of the medications, and the number of pills purchased each time.  It will also ask for the pharmacy where the participant usually purchases the drugs.  Once all of that information is entered into the find-a-plan site, the site will spit out a list of plans with comparative information including the cost of premiums, the annual drug deductible, the estimated annual drug costs, and the rating of the plan based on 3 out of 5 stars assigned by Medicare. Medicare sometimes assigns a 5-star rating for a Part D insurance plan that will be indicated by a yellow star with a 5 in the middle next to the Medicare Part D plan.   Once you have entered all of the information, you can compare the costs of the various plans.  Of course, the information is only valid if all of the drugs in the correct dosages are entered into the system.  Be sure to check to see whether the cost of the drugs will go up during the year.  Usually, the cost of the prescription drugs goes down once the deductible is met, and goes up again when the participant hits the donut hole at $2960.

The participant will have to go to a pharmacy in the plan’s network in order to get the lower price you expect to pay. 

Not everyone needs a Medicare Part D plan.  Some retirees may have coverage under their retirement plans, veterans who qualify for free or reduced price medications may not need the coverage. That is called “creditable coverage.”  If you do need it, though, and don’t sign up for it when eligible, you will be charged a penalty when you do finally sign up.  The penalty is at least 1% for every month you delay enrolling past the Initial Enrollment Period.

 

 

 

 


Thursday, November 19, 2015

What You Should Know About Medicare Part B

 

Medicare Part B pays for doctor’s services, whether in their offices, the hospital, your home or other settings, and lab tests, screenings, medical equipment and other supplies. 

You will pay a monthly premium, which may be deducted from your Social Security, Railroad Retirement or Civil Service check.  If the premiums are not deducted from your retirement or disability check, you will be required to pay premiums quarterly.  In 2015, the monthly premium for most recipients was $104.90, though the premiums are higher if your annual income on your individual tax return is over $85,001 or on your joint return it was over $170,001.  The highest premiums in 2015 are $335.70 per month.

Once you pay the premium, there is a deductible and a coinsurance amount that you will pay.  The yearly deductible is $147, and the coinsurance amount is 20% of the Medicare-approved amount that is charged by the providers. 

For example, if you visit a doctor and the doctor accepts assignment from Medicare, the doctor agrees to accept the amount that Medicare has approved for the service.  Medicare pays 80% of the cost and you will pay 20%.  If the doctor accepts Medicare patients, but not an assignment, the doctor can charge you up to 15% more than the Medicare approved amount and you will have to pay the extra amount unless you have a Medigap policy.  If the doctor does not accept Medicare, Medicare will not pay for the service and you will be responsible for the entire amount of the service provided.  Medigap insurance won’t pay for the cost of a doctor who has opted out of Medicare.

Do I have to have Medicare Part B?  You are not required to sign up for Medicare Part B, but you will be responsible for paying privately for the services covered by Part B (unless you have a Medicare Advantage Plan) if you have chosen not to sign up.  If you don’t enroll in Part B when you turn 65 and enroll in Part A, when you do sign up for Part B you may be have to pay a higher premium for Part B.  The premium can go up 10% for each 12-month period that you could have been enrolled in Part B.  If you have insurance through an employer or have a union group health insurance plan that is your own, a spouse’s or a family member’s (if you are disabled), you do not need to sign up for Part B if that insurance will be the primary insurer.  If the plan is not the primary insurer, and Medicare is the primary, you will need to sign up for Part B.

Note that Cobra coverage does not count as employer coverage.

 

 

 

 

 


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