General for Elders

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.

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.

How do we decide how we want to be treated at the end of life?

What would a good day look like if you were suffering from a terminal illness?

This is one of the questions Dr. Atul Gawande asks in Being Mortal, Medicine and What Matters in the End, New York: Metropolitan Books, Henry Holt and Company, 2014, his book exploring medical treatment at the end of life.

Dr. Gawande looks at how this one question, along with a series of questions most physicians are not asking their patients, might shape the course of medical treatment and care of those who are terminally ill, as well as those frail elderly who are in need of long term care.

In the book, one patient says that he is willing to have medical treatment for his terminal illness so long as the treatment will allow him to eat ice cream and watch football on television.

July is SANDWICH GENERATION AWARENESS MONTH  

The Sandwich Generation refers to those caregivers, generally between the ages of 45 and 59, who are caring for aging parents while also caring for young children or dependent young adult children.  

One of the issues facing many of those caregivers is how to pay for the aging parent’s long-term care needs.  Long-term care refers to ongoing assistance to meet some of the basic activities of daily living, such as bathing, eating, dressing, using the toilet, transferring from bed or chair, caring for incontinence or eating.  The type and cost of long-term care depends on the services necessary for the health and safety of the person.

Keep in mind that Medicare does not pay for long-term custodial care.
Read more . . .

July is Sandwich Generation Awareness Month.  The Sandwich Generation refers to those people, mostly in their mid-40’s to late 50’s, who are caring for aging parents as well as caring for young children or dependent young adult children.  If you are the meat or peanut butter in that sandwich, you might be looking for help from your siblings or other family members.  One of the best ways to plan the care for an aging or disabled family member is by holding a family meeting.  The meeting is designed to do many things:  get information from the aging or disabled person about their needs, figure out what kind of care is needed and brainstorm about ways to find that care, gauge the financial resources available for care, and assign duties to various family members so that one caregiver does not get burned out.

Joe, an 89-year-old veteran served in WWII.  He and his wife, Mary, have been living in an assisted living facility for three years and Joe has been receiving VA Pension with Special Monthly Pension for Aid and Attendance.  Joe recently fell, and his physician has decided Joe cannot return to the assisted living facility.  Joe is now in a Nursing Home and needs to apply for Medicaid to cover the cost of his care.   

VA Pension Benefits can be a lifesaver for veterans or their surviving spouses who need home care or assisted living facility care.