The Savvy Senior

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If you're looking for answers to your senior questions and don't know where to turn, The Savvy Senior is the solution. Why spend endless hours searching the Internet or talking to automated phone systems when trying to figure out your Social Security benefits? Don't spend a penny more than you need to on your prescription drugs. Make sure you're getting what you are owed from Medicare. Turn to the source that millions of readers have trusted - Jim Miller, the author of "The Savvy Senior" newspaper column, ...
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If you're looking for answers to your senior questions and don't know where to turn, The Savvy Senior is the solution. Why spend endless hours searching the Internet or talking to automated phone systems when trying to figure out your Social Security benefits? Don't spend a penny more than you need to on your prescription drugs. Make sure you're getting what you are owed from Medicare. Turn to the source that millions of readers have trusted - Jim Miller, the author of "The Savvy Senior" newspaper column, published in over 400 newspapers nationwide. This indispensable guide serves the growing needs of the senior population and their families by providing useful information and valuable resources.
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Editorial Reviews

Publishers Weekly
Those interested in making plans for their own retirement years or concerned about a parent's retirement will find many of their questions answered here. The author writes the syndicated column "The Savvy Senior," which is published in 400 newspapers, and he bases his book on the thousands of questions he receives on social security issues, Medicare, estate and retirement planning, health issues, caregiving, grandparenting and more. Miller's writing style is a mixture of "just the facts, please" and light humor, allowing him to establish himself as a credible and knowledgeable expert. Numerous checklists, resources and charts make it easy to learn about such mundane topics as Medicare and living trusts, while "savvy notes" interspersed between paragraphs enlighten with odd factoids. Baby boomers caring for elderly parents will want to pay special attention to the section on avoiding telemarketing scams to seniors, who are the number one target for this type of criminal activity. And seniors on a fixed income will find the section on "Cost-Cutting Tips on Prescription Drugs" helpful as they learn how to apply for free prescription drugs from the pharmaceutical companies. (June 9) Forecast: The book's title will attract those familiar with Miller's column (it claims to have 18 million readers), and an appearance on The Today Show will tip off new readers. According to Miller, America's senior population will double over the next 25 years. Copyright 2004 Reed Business Information.
From The Critics
"A good, important column that is full of information and resources." (Patricia St. Louis, The Fountain Valley News, Fountain, Colorado)
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Product Details

  • ISBN-13: 9780786269273
  • Publisher: Gale Group
  • Publication date: 11/2/2004
  • Edition description: Large Print
  • Pages: 474
  • Product dimensions: 6.22 (w) x 8.22 (h) x 1.02 (d)

Read an Excerpt

-The Basics of Medicare-

We all know what Medicare is, but do we actually understand it?

The Medicare program is a federal health-insurance program for people 65 years of age and older, and certain disabled people under age 65. To be eligible for Medicare you must be a U.S. citizen or permanent resident of the United States who is eligible to receive benefits from Social Security.

Medicare Part A
Medicare has two parts, Part A and Part B. Medicare Part A (hospital insurance) helps pay for inpatient hospital care, inpatient care in a skilled-nursing facility, home health care and hospice care.

Savvy Note: The Medicare Part A deductible for inpatient hospital care per benefit period is $876 in 2004, and increases every year. The term "benefit period" is a period of time that begins the day you enter the hospital or skilled-nursing facility and continues until you have been out for 60 consecutive days.

Medicare Part B
Medicare Part B (medical insurance) helps pay for doctor services, some preventive services, outpatient hospital and emergency room services, medical equipment and supplies, laboratory services, X-rays, physical therapy, ambulance services and a number of other medical services and supplies that are not covered by Medicare Part A.

Medicare Cost
Medicare Part A is free, but Medicare Part B is a voluntary program (which may be refused) and costs $66.60 a month in 2004. Medicare Part B pays 80 percent of services covered under Part B after a $100 deductible.

Savvy Note: In 2005 the Medicare Part B deductible will increase to $110 and rise yearly afterward.

Medicare and Nursing-Home Care
To qualify for Medicare nursing-home benefits you must have been an inpatientin a hospital for at least three days and discharged no more than 30 days before entering the nursing home. A physician must also "certify" that you require skilled-nursing care or rehabilitation that can only be provided in a skilled-nursing facility. If you qualify, Medicare pays 100 percent of the charges for the first 20 days. From day 21 to day 100, the patient must pay $109.50/day while Medicare picks up the difference. After day 100, Medicare pays nothing.

What Medicare Does Not Cover
Other medical services and products not covered by Medicare include outpatient prescription drugs, private hospital room, hospital telephone and TV, routine physicals, most dental care, dentures, routine foot care, hearing aids, routine eye care, acupuncture, health care outside the United States and cosmetic surgery.

Savvy Tip: For detailed information on what Medicare covers in your area, visit the Medicare Coverage Database at

Supplemental Health Care
It is savvy advice to purchase a Medicare supplemental or Medigap policy (see Medigap Insurance, page 155) at the time you apply for Medicare services. This type of policy (regulated by state insurance departments and sold by many companies) is designed to fill in the health-care expenses not covered by Medicare. Every new Medicare recipient who is age 65 or older has a guaranteed right to buy a Medicare supplement policy. A company cannot reject you for any policy it sells, nor can it charge you more than anyone else your age. You must, however, purchase the supplement policy within the six-month window after enrolling in Medicare Part B for the first time. If you apply for a policy after your six-month period, some companies may refuse coverage for health reasons.

Savvy Note: If you are age 65 and not eligible for the free Medicare Part A, you can still get it, but you'll have to pay a steep monthly premium. Medicare Part B is also available (for $66.60/month in 2004). You can enroll in Part B without getting Part A, but if you choose to enroll in Part A you are required to get Part B too. For more detailed information on Medicare, visit or call 1-800-633-4227 and order the Medicare & You handbook. This is a free publication that provides great information and is updated every year.

-The New Medicare Prescription Drug Benefit-
How will it affect you?

Containing the most extensive changes to the Medicare program since it began in 1965, the new $400 billion prescription drug benefit will offer some help to its beneficiaries, but how much?

Currently, Medicare covers 40 million elderly and disabled Americans. Of those, more than 10 million are without any form of prescription drug coverage and 14 million are low-income seniors. Here's a preview of what you can expect from the new prescription drug benefit, which will be known as Medicare Part D. This information was obtained in part from the Department of Health and Human Services and the Associated Press.

Interim Discount Card
From June 2004 through 2005 a discount card will be available for Medicare recipients to buy for $30. This card will reduce drug costs by 15 percent or more.

Medicare Drug Benefit
Beginning in 2006, Medicare beneficiaries can sign up for a drug plan or join a private health plan that offers drug coverage. Under the Medicare plan, you will be charged a $35-a-month premium per person, or $420 a year. After you pay a $250 deductible, insurance will cover 75 percent of your drug costs up to $2,250. You would thus pay up to $750 out of pocket. (The $250 deductible plus 25 percent of the cost from $251 to $2,250, or $500.) This does not count your $420-a-year premium.

Coverage Gap
After you have incurred $2,250 in total drug costs, Medicare will pay nothing more until you have paid $3,600 out of pocket, meaning you would have to pay $2,850 more out of pocket in addition to the $750 already paid. This does not count your $420 annual premium.

Catastrophic Coverage
When your out-of-pocket spending reaches $3,600, you will pay 5 percent of the cost of each prescription. Medicare pays the other 95 percent.

Savings Chart

The following chart shows how more than 25 million seniors, mostly middle income, will fare under the 2006 Medicare prescription drug benefit. Another 14.1 million lower-income seniors, including those eligible for Medicaid, will fare better.

Note: You Pay is your total out-of-pocket expense, which includes the $420 annual premium, the $250 deductible and the 25 percent additional costs based on a complex formula. Catastrophic coverage is also figured into the formula.

Savvy Tip: You will have to spend at least $810 a year on prescription drugs to benefit from the Medicare prescription drug benefit. That's because you'll spend more on your premium ($420), deductible ($950) and 25 percent out-of-pocket drug costs than you'll get back in Medicare coverage.

Limited-Income Subsidies
In 2004 and 2005, low-income recipients earning less than $12,124 a year, or $16,363 for married couples, will receive an annual subsidy of $600 credited to their drug discount card to help defray drug costs.

Beginning in 2006, people eligible for Medicaid and Medicare will pay no premium or deductible and have no gap in coverage. They will pay $1 per prescription for generics and $3 for brand names. Copays are waived for those in nursing homes.

Members with limited income below the federal poverty line -- around $13,000 for individuals and $17,600 for couples, with assets under $6,000 for individuals and $9,000 for couples -- will be entitled to different benefits: They will pay no premium or deductible, nor will they face a gap in coverage. For generic drugs there is a $2 copay and a $5 copay for all other drugs, up to the out-of-pocket limit.

Members with savings and incomes below the federal poverty level -- between $13,000 and $14,400 for individuals and $17,600 and $19,500 for couples, with assets under $10,000 for individuals and $20,000 for couples -- will be entitled to the following benefits: a monthly premium based on a sliding scale; a $50 deductible; no gap in coverage; coinsurance of 15 percent, up to the out-of-pocket limit; and copayments of either $2 or $5 after reaching the out-of-pocket expense limit.

Savvy Tip: For people already in Medicare, open enrollment for the prescription drug coverage will begin November 15, 2005, and run through May 15, 2006. The benefits are scheduled to begin January 1, 2006.

Retiree Coverage
Tax-free subsidies, worth more than $70 billion over 10 years, will be provided to employers who maintain drug coverage for retirees once the Medicare drug benefit begins in 2006. But some employers may still drop their drug coverage. You'll need to check!

Generic Drugs
The ability of pharmaceutical companies to block cheaper equivalents will be limited, which should help speed generic drugs to the market.

Drugs from Canada
The ban on importing prescription drugs from abroad will be maintained, but such drugs will be allowed from Canada if the Department of Health and Human Services certifies their safety, which the department has thus far refused to do. Also, a study of safety issues will be authorized.

Other Changes to Medicare

Doctors' Services and Other Out-of-Hospital
(Part B) Coverage

People with incomes greater than $80,000 a year will pay a larger Part B premium for doctors' services and outpatient care. The size of the premium will increase with income, roughly tripling for people with an income over $200,000.

The deductible will rise from $100 to $110 in 2005, and thereafter will be indexed to the growth in Part B spending.

New Benefits
Medicare will cover an initial physical examination for new beneficiaries and screening for diabetes and cardiovascular disease. It will provide benefits for coordinated care for people with chronic illnesses and will increase payments for doctors administering mammograms to encourage their use.

Health Savings Accounts
People under age 65 with high-deductible health-insurance policies -- $1,000 a year for individuals, $2,000 for couples -- will be allowed to shelter income from taxes by depositing a certain amount of money in health savings accounts. Investors will receive a tax deduction and pay no taxes on the investment and earnings upon withdrawal, provided the money is used for health expenses; otherwise, a 10 percent penalty will apply. Talk to your health-insurance provider for more information on health savings accounts.

Rural Health
Medicare payments to rural hospitals and doctors, among others, will be increased by $25 billion over 10 years.

Hospital Payments
Hospitals can avoid future cuts in payments by submitting data on the quality of care to the federal agency that runs the Medicare program. At the same time, payments through Medicaid to hospitals that serve a large number of disadvantaged patients will increase. An 18-month pause in the development of new specialty hospitals will be imposed, and there will be a limit on the expansion of existing ones.

Physician Payments
Doctors will receive increases of 1.5 percent per year in Medicare payments for 2004 and 2005.

Home Health Care
Payments to home health agencies will be cut, but copayments from patients will not be required.

The New Role of Private Companies
Private firms will administer the new drug benefit on a regional basis. It will provide $12 billion in subsidies to private insurers that choose to offer basic health insurance. Those insurers include preferred provider organizations (PPOs), which encourage use of certain doctors but allow patients to go elsewhere if they pay extra, and private fee-for-service plans, which allow patients to see any doctor.

Savvy Note: Medicare Advantage will replace Medicare + Choice, the current managed-care program, in 2006.

Medigap Change
Starting in 2006, Medicare beneficiaries who enroll in the new drug plan will not be allowed to buy Medigap policies to help defray drug costs. However, those people who choose to forgo the new Medicare drug benefit can renew their Medigap drug benefit policy.

2010 Competition
Starting in 2010, Medicare will test competition between private health plans and the government. The experiment will involve up to 2 million seniors in six metropolitan areas for six years. Affected seniors might have to pay 5 percent more a year to stay in Medicare if private insurers offer cheaper coverage.

Savvy Tip: To help you better understand the new Medicare reform changes and prescription drug benefit, call your local health-insurance counseling program (SHIP). Call 1-800-633-4227 to get your local number. Also see Health-Insurance Help on page 164.

-Medicare + Choice Plan-

Are you ready to experience the Medicare alphabet in a whole new way? There is Medicare Part A, Part B, and now C, also called the Medicare + Choice Plan.

Congress created the Medicare + Choice program to provide you with more choices and sometimes extra benefits by letting private companies offer you your Medicare benefits.

Original Medicare Plan
It's important to be clear on the Original Medicare Plan, also known as Medicare Part A and B, because this will affect your Medicare + Choices. Simply put, Part A is the hospital insurance, and Part B, referred to as medical insurance, helps pay for doctor visits or medical equipment that you may need. At age 65 (if eligible), you automatically get Part A when you sign up for Medicare, although Part B is optional. If you sign up for Part B, you pay a monthly premium, but if you don't, you won't be eligible for Medicare + C.

Think C, for Choice
Medicare + Choice is offered by private companies that contract with the Medicare program to offer services. It is still part of Medicare, and depending on your circumstances and where you live, it certainly may be worth a look.

Medicare + Choice plans include

--Medicare managed-care plans (like HMOs), and
--Medicare private fee-for-service plans.

The real advantage of Medicare + Choice is that it goes beyond traditional Medicare coverage. It may pay for a general annual physical, for example, or for prescription drugs, which are not covered under traditional Medicare (A and B). And while there is a monthly premium, there may be lower out-of-pocket costs with such things as deductibles and copays. But Medicare + Choice options are not offered everywhere, and while there are some limited fee-for-service packages available, most Medicare + Choice programs are managed-care plans like HMOs, PPOs, PSOs and PFFS, in which the patient/member agrees to receive care from specific doctors, hospitals and others -- called a network -- in exchange for reduced overall health-care costs. That's the part of the plan that many people don't like, especially if it means they can no longer continue to see their own doctor or use the hospital of their choice. But your doctor may already participate in a plan for your area. You'll have to check.

Copyright © 2004 Jim Miller

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Table of Contents

Acknowledgments 13
Introduction 15
Driver Safety Program 19
Senior Transportation 23
Utility Assistance 29
Volunteerism 34
Senior Employment 40
Telemarketing Fraud 44
Identity Theft 49
Visiting Grandchildren 53
Grandparenting from Afar 56
Financial Tips for Grandparents Raising Grandchildren 60
Money-Managing Grandparents 66
The 529 Plan 70
Traveling with Your Grandchildren 73
Genealogy 101 79
Become a Computer-Savvy Senior 86
Home Modification 95
Fall Prevention 99
Gadgets for Seniors 102
Downsizing 107
Senior Living Options 110
Assisted-Living Facilities 116
Continuing-Care Retirement Communities 120
Alternatives for Senior Care 124
Choosing a Nursing Home Wisely 128
Ombudsmen 137
Intergenerational Living 141
Long-Distance Caregiving 146
Geriatric-Care Manager 149
Alzheimer's Caregivers 153
Senior Eye Care 161
Stroke Signs 165
Subtle Heart-Attack Symptoms 170
CRP Test 174
Alzheimer's and Other Forms of Dementia 177
Arthritis and Exercise 183
Remember Your Flu Shot 186
Hearing Loss 191
Incontinence 194
Macular Degeneration 199
Osteoporosis 205
Teeth, Gums and Heart 210
Prostate Checkups 214
Senior Insomnia 219
Post-Retirement Blues 223
Men and Grief 227
Senior Nutrition 230
Second Opinions 235
Weight-Training Seniors 238
End-of-Life Decisions 241
Funeral Ready 246
Medicare and More
The Basics of Medicare 259
The New Medicare Prescription Drug Benefit 263
Medicare + Choice Plan 274
Medicare Enrollment 279
Appealing Medicare 284
Medigap Insurance 291
Medicare Preventive Services 296
Hospice Care and Medicare 298
Home Health Care 303
Health-Insurance Help 307
Medicaid and Nursing-Home Care 310
Medicare Fraud 316
Cost-Cutting Tips on Prescription Drugs 320
Social Security
Social Security Retirement Basics 343
Social Security Age Hike 350
Social Security Benefits: Now or Later? 354
Survivors Benefits 360
Divorced Benefits 364
Divorced Widows and Widowers Benefits 366
How Work Affects Social Security 369
Social Security Benefits and Taxes 374
Social Security Disability 377
Social Security Appeals 381
SSI 384
Notch Notes 387
Financial Tips for Retirement 393
Choosing a Financial Planner 397
401(k) Retirement Options 403
IRA Savvy 407
Health-Insurance Options Before Medicare 412
Senior Legal Services 416
Free Tax Preparation 420
Get a Will 423
Living Trusts 428
Reverse Mortgages 434
Long-Term-Care Insurance 447
Senior Debt 454
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