Archive for the ‘Medicare’ Category

How to Age Well: Planning Your Path, Part 2: Home, Health, and “After I’m Gone…”

Thursday, May 2nd, 2019

By Mason Crane-Bolton

Have you planned for future health and home changes? | Photo via pexels.com

 

There is no way to get aging “right”…

 

…But it does help to plan.

Something is happening each and every day across New Jersey. Across the United States. Across the entirety of the planet.

We are all getting older.

Like it or not, each and every one of us is on a journey of aging. From the moment we are born until the moment we die, we are aging.

We tend to think of aging as being something saved for an arbitrary age, like 50, 60, 65,…etc. We could list off the ages at which society (for one reason or another) has decided we’ve hit a certain benchmark in aging. Whether it’s Social Security benefits, Medicare enrollment, retirement, “senior citizen” discounts, or a screening your doctor now wants you to undergo, we tend to have these changes attached to specific ages or with “being of a certain age.” We think of them as being times in our life when a monumental change has occurred, a mark of “aging.”

But the truth is, regardless of what arbitrary number might be assigned to program enrollments or coupons, we don’t age in random, sudden leaps. We age constantly and gradually. While this might make it tempting to wait to plan for your later years, you should plan now. No one wants to be caught unawares by changes as you age or a sudden health crisis, so it makes sense to plan for your later years as early as possible. Think of planning now as training for becoming an older adult.

What if you already consider yourself an older adult? That’s not to say this blog doesn’t apply to you too! It absolutely does—no matter where you are or where you consider yourself to be in your path of aging, it makes sense to plan now for the road ahead, whether that road is two days or twenty years from now!

Having plans in place will mitigate much stress and bad decision-making in emergency situations. Much heartache and avoidable stressed is caused by being forced to make difficult decisions in the heat of the moment; time spent worrying about what the best decision is and then wondering if the right decision is the one you made.

What are some priorities to focus on? We’re so glad you asked. In this three-part series we’ll cover different aspects of how-to age well as we lead up to our 21st Annual Conference. If you’d like to register for the conference but haven’t yet, go to www.njfoundationforaging.org for more information.

This week we’ll cover: home, health, and “after I’m gone.”

 

Home

Wherever you live, there are changes you can make today for a better home tomorrow. A home that’s better suited to your future self.

Area rugs may be soft on your feet, but they can be a major trip hazard. Remove area rugs to prevent falls and cut down on your number of tripping hazards. If you still want something soft for your feet, consider installing carpets—these aren’t as trip-free as hard floors, but better than area rugs. Also, stay in the habit of wearing secure shoes instead of open-toed sandals or loose slippers around your home.

Although we covered many changes that may be needed due to mobility changes in the first part of this blog series (How to Age Well: Planning Your Path, Part 1), it’s also worth considering what changes you may want to make for your own comfort or peace of mind.

If your home is too large for you to comfortably handle, you may want to consider downsizing. Constant upkeep and cleaning of rooms that aren’t being used can take a toll on your energy and your money. If you’re concerned about having rooms available for visiting friends and family, let them stay at nearby hotels, motels, or Airbnb listings while they’re visiting. Not having to pay for extra heat, air conditioning and electricity, or regularly clean an infrequently used room, will make the visits more fun for everyone.

And if you missed it in the first part in our series, we have a link to help you find an aging-in-place specialist in your area: Living in Place.

 

Health

Whether or not you consider yourself to be in good health now, chances are that sooner or later you’ll have to face potential health issues. And even if you’re blessed with good health for the rest of your life, it’s a good idea to plan for a potential emergency. Whether it’s the diagnosis of a long-term illness or a broken ankle after a tumble on a running trail, illnesses and accidents happen—it’s best to be prepared.

First, learn your family medical history as best as you can and share this information with your medical providers. Is there a family history of cancer? Heart disease? Glaucoma or cataracts? Dementia or Alzheimer’s? Have you been previously diagnosed with any conditions or illnesses? Your medical provider should be alerted to any family or personal health history you have—this isn’t a guarantee you’ll have the same conditions, but a way for your physician to know what they should pay special attention to and screenings or treatments that could best benefit you. And remember that routine screenings and hygiene appointments, such as dental exams and cleanings, should be done regardless of age.

Interview your medical providers. If they don’t have a good understanding of aging in medicine or make you uncomfortable, look for a provider better suited to your needs. Many in the community of aging professionals now recognize the benefit of annual screenings for changes in cognitive abilities for early detection of possible dementia and Alzheimer’s—ask your provider if they do such screenings and any other screenings you have concerns about. Stay on top of changes in your health and don’t delay bringing them up with your provider; bring any questions you may have to your provider and make sure you get answers for each question. Bring your list with you and something to write on and with (don’t trust you remember everything when you get home) or ask your provider to send you home with additional information materials or resources. If your provider is unwilling to answer your questions, they are probably not the right provider for you.

Plan too for future caregiving needs and needed adaptations to changes. If you need caregiving, who will provide it and how? Will it be a nurse or a friend or family member? Will you need to pay this person? How often will you need help? You can ask your provider what insight they might have into your future needs, but also plan to have these discussions with spouses/partners, family, and yourself.

In addition to these concerns, you may think about bringing someone with you to your medical appointments—especially if you find yourself getting overwhelmed during exams or need some assistance in understanding procedures or doctor recommendations. If you have a caregiver or think it would be beneficial to have someone in the exam room with you, bring this up with your provider. Ask them if you could have a trusted person or caregiver with you.

As long as you’re planning, you should also plan what you would like in your medical care and end-of-life care. Seriously consider creating an Advance Directive and POLST form (Practitioner Orders for Life-Sustaining Treatment). You can learn more about these and fill the forms here NJ Advance Directive and POLST. Having an Advance Directive or POLST form often makes people uncomfortable because they believe the form is only for declining further medical care. This is not true. These forms allow individuals to express, in writing, when they are mentally and physically capable of making decisions, what they would like their medical care to be. Individuals can choose to have as many OR as few life-saving measures they would like to be taken in the event they are not conscious to tell doctors or loved ones their wishes. The POLST form also travels from doctor to doctor, allowing individuals to make their wishes known without having to fill out the form over and over again.

 

“After I’m Gone”

A former co-worker of mine, a planned giving attorney, used to use the phrase “If I get hit by an asteroid crossing the street tomorrow…” when talking about all the things we’d need to know if he died suddenly (he liked it as opposed to, “If I get hit by a bus,” because it seemed so much less likely!). In his line of work he was constantly discussing wills and estates with the organization’s supporters. This wasn’t as morbid as it may sound—the conservations were much less about death than a way for these supporters to tell my co-worker how they wanted to be remembered.

We don’t need to necessarily dwell on death with morbidity, but it’s healthy to recognize it will, inevitably, happen to us all. Whether or not we’re planning to give away money or large assets when we die, it’s not only wise, but necessary to plan what will happen with ourselves, our loved ones, and our things before and after we’re gone.

If you’re an adult, you should have a will. Regardless of how many assets you have or don’t have, whether you own a car or a house, a pet, or you have only the clothes on your back, it makes sense to dictate who will get what in a will. You can make this will as secret or as public as you’d like, give it all away to a favorite school or organization, or pass it along to family and friends, but you should make a will. Make sure you also have your will and wishes reviewed by an attorney to ensure your wishes can be carried out.

Even though most of us may be reluctant to discuss our own deaths, it’s worth remembering that our loved ones will have to process taking on additional household and/or financial responsibilities in addition to processing the emotional toll of our deaths. To make things easier for loved ones, it’s wise to write a list of passwords for bank accounts, utility accounts, etc., and to create other lists, such as where household objects are stored, how to maintain appliances or accounts, and other useful information your spouse/partner or loved ones might want to have access to.

Also consider having conversations with your loved ones about how you would like to have your death recognized. Let your loved ones know if you have religious/spiritual or personal practices that you would like incorporated into any kind of memorial service, song or story requests you may have, and any other details about your preferred type of service. If you face reluctance from loved ones in discussing matters of death, try to gently and compassionately remind them that these conversations are going to make things easier and are, ultimately, about love.

 

As we said in the first in our series, there is no one solution to deciding how you will cope with your home, health, or end-of-life decisions. Just as your life changes, so may the appropriate solution—having a plan, or even considering your current or future needs, is the first step to aging well.

 

Stay tuned for our next blog post, the third and last part in our “Planning to Age Well,” series: money and retirement.


Mason Crane-Bolton is Communications Manager for the New Jersey Foundation for Aging. His writing has appeared in EpiphanyUU WorldTo Wake/To Rise, and others. 

Important Updates to Medicare: The New Medicare Advantage Open Enrollment Period

Thursday, February 7th, 2019

By Guest Blogger Charles Clarkson, Project Director, Senior Medicare Patrol of New Jersey

Medicare Advantage Disenrollment Period Ending.

Beneficiaries in a Medicare Advantage plan previously had a Disenrollment Period from January 1 – February 14 every year. This disenrollment period ended on December 31, 2018. It has been replaced with a new Medicare Advantage Open Enrollment Period. This new period was effective starting January 1, 2019.

The old Medicare Advantage Disenrollment Period had permitted beneficiaries to drop their Medicare Advantage plan and return to Original Medicare (Part A and Part B). It also allowed a beneficiary to sign up for a stand-alone Medicare Part D Prescription Drug Plan.

The New Medicare Advantage Open Enrollment Period

Starting January 1, 2019, a new Medicare Advantage Open Enrollment Period will run from January 1 – March 31 every year. If you are already enrolled in a Medicare Advantage plan, you will have a one-time opportunity to:

  • Switch to a different Medicare Advantage plan.
  • Drop your Medicare Advantage plan and return to Original Medicare, Part A and Part B.
  • Sign up for a stand-alone Medicare Part D Prescription Drug Plan (if you return to Original Medicare). Most Medicare Advantage plans include prescription drug coverage already. Usually you cannot enroll in a stand-alone Medicare Prescription Drug plan if you already have a Medicare Advantage plan.

Medicare Advantage Open Enrollment: why would I want to switch to a different Medicare Advantage plan?

  • Medicare Advantage plans can change every year. Premiums, co-pays and deductibles may change and a beneficiary may find and switch to a plan more suited to his/her needs.
  • If a beneficiary is not happy with the Medicare Advantage plan’s network (doctors and hospitals who participate in the plan) or a beneficiary discovers that their doctor has dropped out of the plan’s network and no longer accepts the plan, he/she may want to switch to a plan that their doctor participates in.
  • Medicare Advantage plans are required to provide beneficiaries with similar coverage as Original Medicare. Many of them also include coverage beyond Original Medicare (Part A and Part B). For example, most plans include prescription drug coverage, and some include routine vision services, some dental and hearing services or other benefits such as Silver Sneakers program. With new changes in Medicare, Medicare Advantage plans may soon offer other services such as adult day care services, home and bathroom safety devices, transportation and home meals. Of course a beneficiary should review the plan documents carefully to understand these services and their limitations.
  • These extra benefits (beyond Part A and Part B) can change year to year. For example, suppose you take certain medications and you have a Medicare Advantage Prescription Drug plan. Your plan might cover your prescriptions. But sometimes a plan changes its formulary (list of covered medications). If your drugs are no longer being covered, you should seriously consider changing Medicare Advantage plans.
  • Medicare Advantage plans may change premiums, deductible and co-pays every year. You might even be able to find a Medicare Advantage plan with a zero premium that was not available in 2018.
  • Some Medicare Advantage plans can provide better service than others and can be rated higher or lower than other plans. Medicare has a star rating system that rates Medicare Advantage plans from 1 to 5 stars. Many beneficiaries may feel uncomfortable staying in a lower rated plan.

 

Every fall, your plan will send you an Annual Notice of Change. Pay attention to this, because it lists any changes to your benefits or plan rules. A plan formulary may change at any time. You will receive notice from your plan when necessary.


Charles Clarkson, Esq. is the Project Director for Senior Medicare Patrol of New Jersey.

 

 

The Senior Medicare Patrol of New Jersey (SMP) is a federally funded program of the Administration for Community Living. The grant for this program has been awarded to the Jewish Family Services of Middlesex County, 32 Ford Avenue, Milltown, New Jersey 08850, telephone number 732-777-1940. Its mission is to assist Medicare beneficiaries in fighting health care fraud, waste and abuse. SMP also seeks to educate Medicare beneficiaries about Medicare so they will not become victims of fraud, waste and abuse.

It’s That Time of the Year‚ÄîMedicare Open Enrollment

Thursday, October 4th, 2018

This week’s guest blog is provided by Charles Clarkson, Esq. This article, originally posted in issue #21 of the New Jersey Senior Medicare Patrol (SMP) newsletter¬†Advocate, will cover Medicare Open Enrollment, your options, and information about Medicare scams.


By Charles Clarkson, Esq.

Jewish Family Services of Middlesex County

Project Director, Senior Medicare Patrol of New Jersey

 

 

Every year between October 15 and December 7, a period known as “Open Enrollment,” Medicare beneficiaries can make changes in their Medicare coverage. The Senior Medicare Patrol of New Jersey (SMP), a Federally funded program of the U.S. Administration for Community Living, believes that if you know your options you can avoid being scammed and make the right choices, giving you the best coverage at the least cost.

 

Why make a change?  Whether you have Original Medicare (Part A and/or B), Part D (prescription drug plan), or a Part C (Medicare Advantage Plan,) your plan can change. Premiums, deductibles  and coverages can all change.  Even if they remain the same, your health or finances may have changed. SMP encourages all beneficiaries to re-visit their coverage and decide whether or not to change during Open Enrollment.

Beneficiaries have these choices:

  1. If you are enrolled in Original Medicare, you can change to a Medicare Advantage plan with or without drug coverage. These plans are private companies approved by Medicare and give you the services of Original Medicare. If you join a Medicare Advantage plan, you do not need (and are not permitted) to have a Medicare supplement insurance plan (also known as a Medigap policy) and if your Medicare Advantage plan has drug coverage, you will not need a Part D plan.
  2. If you are in a Medicare Advantage Plan, you can switch to another Medicare Advantage plan or drop your Medicare Advantage Plan. If you decide to drop a plan and not switch to another plan, you will be enrolled in Original Medicare. You should then consider enrolling in a Medicare supplement insurance plan to cover the costs that Original Medicare does not pay for and enroll in a Part D plan for drug coverage.
  1. If you are in Original Medicare with a Part D plan, you can stay in Original Medicare and switch your Part D plan. Medicare has a Plan Finder on Medicare.gov which allows beneficiaries to compare plans for next year. The new Part D plans should be announced in late September or early October.
  1. If you are in Original Medicare and do not have a Part D plan, you can enroll in a Part D plan. If you join a Part D plan because you did not do so when you were first eligible for Part D and you did not have other coverage that was, on average, at least as good as standard Medicare drug coverage (known as creditable coverage), your premium cost will be penalized 1% for every month that you did not enroll in Part D. You will have to pay this penalty for as long as you have a drug plan. The penalty is based on the national average of monthly premiums multiplied by the number of months you are without coverage and this amount can increase every year. If you qualify for extra help (low income subsidy), you won’t be charged a penalty.

 

Why change Part D plans?

Beneficiaries may want to change Part D prescription drug plans (PDPs) for a number of reasons: (i) the PDP has notified the beneficiary that it plans to drop one or more of their drugs from their formulary (list of available medications); (ii) the beneficiary is reaching the coverage gap (donut hole) sooner than anticipated and may want to purchase a PDP with coverage through the coverage gap, if one is available; (iii) the PDP has notified the beneficiary that it will no longer participate in the Medicare Part D program; (iv) the PDP will increase its premium or co-pays higher than the beneficiary wants to pay and a less expensive plan may be available and (v) a beneficiary is not happy with the PDP’s quality of service or the plan has received low rankings for a number of years. For 2019 beneficiaries in New Jersey can expect to choose from a number of PDPs.

 

Compare plans each year.

Beneficiaries should remember that PDPs change every year and it is recommended that beneficiaries compare plans to insure that they are in the plan that best suits their needs. When comparing plans, keep in mind to look at the “estimated annual drug costs,” i.e. what it will cost you out of pocket for the entire year, from January 1 through December 31 of each year. Plans can be compared at the Medicare web site:  www.medicare.gov. If you do not have access to a computer, call Medicare at 1-800-Medicare to assist in researching and enrolling in a new plan. Medicare can enroll a beneficiary over the telephone.  When you call, make sure you have a list of all your medications, including dosages. Another resource for Medicare beneficiaries is the State Health Insurance Assistance Program (known as SHIP), telephone 1-800-792-8820. SHIP is federally funded and can provide beneficiaries with unbiased advice.  Call SHIP to make an appointment with a counselor. You do not need to use a broker or agent who may not be looking out for your best interest. Brokers and agents are usually being paid to enroll you in certain plans. Beneficiaries can also call the Senior Medicare Patrol of New Jersey at 732-777-1940.

 

Medicare Open Enrollment can also be a time of fraudulent schemes that can cost you money. The SMP wants you to be on the alert for scams. A word of advice:

When you realize that a scammer is calling. Just hang up. Do not be polite and just hang up. Also, let your answering machine do all the work. Never answer any call unless you recognize the number. If no message is left, you know the call is probably a scam or an unwanted solicitation. For any questions about Medicare and to report any Medicare scams, call the Senior Medicare Patrol of New Jersey at 732-777-1940.