Healthy Aging Today - Medicare Basics, Baby Boomers

Dennis Stretar (dennis@healthyagingtoday.com, 303.619.7562) in collaboraton with Karin Hall at the SeniorsResourceGuide.com produced videos explaining the basics of the Medicare program. The nine part series was specifically designed for the Baby Boomer Generation who began aging into Medicare this past January, 2011. There is a clear need for accurate information about Medicare options.  Click on www.MedicareBasics2012.com to see the nine part videos. In length, the nine parts total approximately 40 minutes. Given people's time constraints the videos are easily viewed in 3 to 5 minute segments.  The Medicare Basics video series was reviewed for accuracy and critiqued by Gloria Baca, Dennis Del Pizzo, and Brenda Hudson of Region VIII External affairs as well as Michael Fierberg, former Denver broadcast journalist and current Public Affairs Specialist for Region VIII, Centers for Medicare & Medicaid Services (CMS). 

Contact the Colorado SHIP office for specific questions on Medicare - 303.629.4920 where I am a current SHIP counselor. The service is free, and volunteers are standing by to assist you by phone.

Job Opportunity - The American Geriatrics Society say there is roughly one geriatrician physician for every 2,600 people 75 and older. By the year 2030 the rate is projected as one physician for every 3,800 people 75 years of age and older. The greatest societal population growth in the US is in this same age group. Medical advances including technology support the increased population growth in citizens age 75 and oldger.   The median U.S. salary for geriatric phyicians is $183,523. Only 56 percent of medical students had clinical rotations in geriatrics in 2008, the last significant survey year.

Quality Long Term Care_The National Consumer Voice

Check out this great new tool from The National Consumer Voice for navigating the long-term care system.

Last month The National Consumer Voice for Quality Long Term Care released a new guide book to help people with questions about long-term care services navigate the system and better advocate for themselves. The new tool, Piecing Together Quality Long-Term Care: A Consumer’s Guide to Choices and Advocacy, is designed to educate people with disabilities and older adults about their options for long-term services.



The guide book fully embraces the philosophy of person-centered or person-directed care, which means you are the one directing or guiding the services you receive, when you receive them and how you receive them. By educating consumers about their options and choices, the guide empowers individuals to make decisions for themselves rather than relying on professionals or family members. The concept of person-directed care is at the heart of “culture change,” a movement to provide older adults services in a way that values choice, dignity, respect, self-determination and purposeful living.



The Consumer Voice has developed a website (www.theconsumervoice.org/piecing-together-quality-long-term-care) for the guide, which features Piecing Together Quality Long-Term Care in different formats, including an HTML version, a PDF version and audio portions of the guide. The website will also include three state-specific guides funded by the Consumer Voice and written by citizen advocacy groups in Kansas, North Carolina and Virginia. These state guides are designed to assist older adults and persons with disabilities in making informed decisions when choosing long-term care services. A hardcopy of the 80-page, professional bound guide is available for $20 and can be purchased online.



“While older adults and individuals with disabilities may have different needs, they all deserve a choice of quality long-term care services,” said Consumer Voice Executive Director Sarah F. Wells. “Many consumers face the daunting and overwhelming task of trying to navigate a long-term care system that is fragmented and complicated. This project aims to build a bridge between the aging and the disability communities and create a strong, unified long-term care consumer voice.”

Senior Living - Financial issues - Two State Living

Marla Brill pointed out a number of financial issues for those involved in two state (two country) living between seasons. The link to her article in Yahoo finance is posted herein. Those of you who live a two state lifestyle ("snowbirds" is the classic example) face a number of issues worth reviewing.

Health insurance - examine your health care coverage (especially restrictions contained in Medicare Advantage programs, aka Part C Medicare) and determine if your HMO or PPO provides coverage in your second resident state. Medicare supplemental coverage may be less restrictive on coverage. Typically, out of area coverage is a part of medicare supplemental coverage, but not all medicare supplemental plans cover foreign travel.  Depending on the area within the United States it may be possible to obtain guest memberships in HMOs and PPOs for stays exceeding 90 days.

Taxes -  Determine residency for state tax reporting requires looking at vehicle registration, voter registration, professional licensure, mailing address, the number of days spent, and other facts.  The primary motivation is locating the lowest tax rate state. Tax planning should include estate tax. Consultation with a CPA and attorney is critical to avoid traps.

Insurance  (especially vehicle) - Talk with your insurance representative when seeking to reduce insurance costs while absent from one state. Also, review lender or other lien holder requirements prior to suspending coverage to ensure debt compliance. Suspending, or cancelling and reinstating coverage may be required if state requirements include mandatory insurance on any registered vehicle.

Legal documents/estate planning - the most desirable position is finding an attorney licensed in both resident states. A high likelihood exists for having two sets of estate planning documents, one for each state you inhabit.  Out of state documents like advance directives, powers of attorney, and trust documents may not be accepted in resident states unless drafted to conform to the state statute for such documents.  Holding real estate in non trust format may necessitate probate court filing to transfer title. Planning with a CPA and legal counsel is critical to minimize administrative cost and effort.

Taxes and the Health Care Reform

Overview

The 2010 Health Care Reform law puts into motion alterations in tax-related issues for businesses and individuals. Employers should prepare their systems well ahead of the dates of the proposed changes. Individuals also need to understand the changes that the health care reform bill brings to their personal taxes.

Timeline for Tax Implications

Year 2011

• Exclude the costs for over-the-counter drugs not prescribed by a physician from being reimbursed through a Health Reimbursement Account (HRA) or a Flexible Spending Account (FSA) and from being reimbursed on a tax-free basis through a Health Savings Account (HSA) or an Archer Medical Savings Account (MSA).
• Increase the penalty for non-health withdrawals from an HSA to 20% of the disbursed amount.

Year 2013

• Limit the amount of contributions to an FSA for medical expenses to $2,500 per year. This will be increased annually by the cost-of-living adjustment.
• Increase the threshold for the itemized deduction for unreimbursed medical expenses from 7.5% to 10% of adjusted gross income (AGI). This increase will be waived for individuals over 65 for tax years 2013-2016.
• Increase the Medicare payroll tax by 0.9% on earned income in excess of $200,000 for individual taxpayers and $250,000 for married couples filing jointly. Employers do not have to match this amount.
• Imposed a 3.8% investment tax on unearned income for taxpayers with an adjusted gross income in excess of $200,000 for individual taxpayers and $250,000 for married couples filing jointly.

Saging, not Aging by Rabbi Zalman Schachter-Shalomi

Rabbi Zalman Schachter-Shalomi,, professor emeritus of Temple University and founder of the Spiritual Eldering Institute is the author of  From Age-ing to Sage-ing' (Warner books, 1995). Rabbi Zalman says,

“Every life matters immensely; every well-lived and completed  life helps in healing the world.”

“Elders are the jewels of humanity that have been mined from the earth, cut in the rough, then buffed and polished by the stonecutter’s art into precious gems that we recognize for their enduring value and beauty. "

Rabbi  Zalman holds that we all have the potential for fulfilling elder years, but first we may need to free ourselves from resentments or angry feelings over past events by doing forgiveness work.  We also may need to deal with fear of the future and come to terms with our own mortality.  Only then will we be able to pursue our elder years with an open heart. 

More information is available from the Sage-ing Guild, a networking organization. The Eldering Institute, www.eldering.org, suggests life can continuously improve as we get older, provided that we continue to add value (be of service) and that we create and sustain authentic relationships with other of all ages.

A local 22 week information and education session on spiritual aging will start Oct 13th at Our Savior's Lutheran Church, 915 E 9th Ave in Denver. Email Sister Macrina Scott, O.S.F at macrina@mpbdenver.org. for additional details.