Critter Corner: I Am My Mother’s Financial Caregiver. Now What?

Dear Bebe,

When my mother did her estate planning several years ago, I was told I would be the trustee for her trust and the agent under her Financial Power of Attorney, should there come a time when she can no longer handle her own finances. Well, that time has come and it’s my time to step in. My sister is my mom’s live-in caregiver, but I am in charge of all the financial matters. What does being a financial caregiver entail and do you have any tips for me in my new role?

Thanks!
Finn Anshul

Dear Finn,

According to a new Merrill Lynch study, 92% of caregivers are paying bills from their care recipient’s accounts; monitoring bank accounts; handling insurance claims; filing taxes, and managing invested assets.
Study authors offer advice to current and future financial caregivers, as follows:

· Find out where documents are located: Taking responsibility for a parent’s financial affairs will be easier if you’re able to have this conversation while your loved one still has the cognitive ability to understand the situation.
· Keep detailed records of all financial transactions made on behalf of your mother: Meticulous record-keeping is typically required with financial powers of attorney. So, make sure you stay organized from the start, noting every financial transaction – including income and expenditures – for your mother.
· Don’t commingle her property with your own: You may need to set up specially designated accounts for your mom in order to keep all funds distinct and separate. Commingling funds can lead to breaches of fiduciary duties, putting agents at risk of getting sued.
· Get help, if needed: If your mom’s financial affairs become complicated and overwhelming, get help from a professional in carrying out your duties. The best place to find a professional is on the website of the American Association of Daily Money Managers.

Take care of your own financial matters, as well

Respondents to Merrill Lynch’s survey report cutting back on expenses, having trouble paying their bills, dipping into personal savings, reducing their work hours, and leaving the workforce. As a financial caregiver, you need to remember to take care of yourself — health wise and financially!

Hope this is helpful. Good luck in your new role!

Bebe

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Can a Marriage Survive Caregiving for an In-Law?


Q. When my husband, Paul, first met my parents, they didn’t hit it off. He can be stubborn sometimes, and mom is difficult, and she never thought that he was good enough for me. After Thanksgiving dinner, when we announced we were engaged, my mother threw him out of her home, and my mother and I didn’t talk for nearly a year. She and my dad refused to pay for my wedding, so we eloped.

Ten years later, my father passed away. Paul and I have children of our own, and my mother has softened a bit. She isn’t exactly warm to Paul, but for the sake of seeing her grandchildren, they are cordial to one another.

Six months ago, my mother had a stroke and she needed my help. I am her only child, and all other family lives far away. To Paul’s dismay, I told her she could come live with us. Now, Paul claims that she is driving him crazy, and it’s either her or him. Do you have any guidance for people in this type of situation? Thanks for any help!

A. Even the strongest relationships are put to the test when one or both partners are caregivers for an in-law in the home. In most situations, issues such as financial pressures, resentment, distance, exhaustion, and lack of privacy can overwhelm a relationship. In your situation, the fact that your mother and your husband don’t get along obviously makes things dramatically more difficult.

Some spouses are completely supportive of an in-law being cared for in their home by their husband or wife, while other spouses may feel neglected. If the spouse never liked the elder, and now the elder needs a lot of care, the spouse becomes even more resentful. The stress in the marriage can be intolerable for both sides. A Caring.com survey found that for 80% of respondents, caregiving put a strain on their marriage or other partner relationship. So, as you can see, the sad reality is that many marriages can and do break under these extremely stressful circumstances.

What You Can Do to Improve Your Relationship?

Recognizing your needs as a couple and making your romantic relationship a priority is critical to your health and happiness. To protect and strengthen your relationship while caregiving, aim to:

Talk Openly: Opening up to one another can help you better understand each others’ feelings and behavior, prevent misunderstandings and resentment, and hopefully bring you closer. Your spouse may also be more willing to help manage responsibilities and offer emotional support when he understands where you’re coming from.

It may not be easy for you and your spouse to talk about how caregiving for your mother and how your husband’s difficult relationship with her is affecting your marriage. These are touchy subjects. One way to help get the conversation started might be to see a marriage therapist who is also familiar with family unrest and caregiver concerns. You can also consider joining a caregiver support group together. A caregiving support group can help you get new perspectives and talk to other people experiencing similar challenges. It can also be enormously helpful to have other people to lean on for support. Look for a group that meets in your area, or connect with one online.

It is also a good idea to talk openly with your mother. Tell her how much it would mean to you if she and your husband tried to be nicer to one another and get along, and how your marriage is being affected.

Spend time together: Don’t let the difficulties of caregiving and the issues with your husband and your mother take the joy out of your marriage. Make time to reconnect and have fun. If date nights and weekends away aren’t possible, find connection in the small, everyday moments. Even running errands as a team can offer time together in an otherwise packed schedule. Make little romantic gestures like a walk around the block while the sun is setting, a candlelit (takeout) dinner, or hidden love notes. Little actions can go a long way!

If you are able to get away, technology such as the Lively Urgent Response device can keep your relative connected to help in case of an emergency, so you can have peace of mind that they can get assistance even if you’re not there.

Space is good too: Offer your partner some space. He’ll likely want to get away for some alone time since he is experiencing such stressful times with your mother in the house. Don’t take it personally and encourage each other to get out of the house, do things you love, or take up new hobbies.

Get support: Don’t be afraid to ask for backup. Look to family, friends, community resources, and respite care to help you take time for your relationship. Check into the possibility of hiring an in-home caregiver for a few hours so you and your spouse can go to a dinner and a movie.

By prioritizing your relationship through teamwork, understanding and patience, you can hopefully not only cope with the challenges of caregiving but create a bond that may be better than ever.

Make family roles clear: Both your mother and your spouse have equally important places in your life, although generally one’s spouse has the stronger allegiance. However, there are times and circumstances when one of them has to take center stage—particularly in cases of a mother’s illness. It is up to you to evaluate who should get top billing, and communicate to the other why he or she has to take the backseat at the moment.

Other Alternatives

Most people would prefer to age in their home or in the home of a loved one, but they often can’t do so for the long-term. Or, the living situation might no longer work for your family or your loved one. This may be the case in your situation, if you are unable to get your marriage back on track. If your elderly parent is showing signs that he or she needs more assistance, or if aging in place is no longer the best option for one reason or another, it is time to consider other alternatives.

Whether the outcome is assisted living or nursing home care, it is essential to plan ahead, since assisted living costs $6,000 to $9,000 per month and nursing homes cost $10,000 to $14,000 a month in the Northern Virginia / Metro DC area. If you are going through this situation, please contact us to make an appointment for a no-cost initial consultation to discuss long-term care planning. If you know someone else who is going through this situation, please forward this information to them.

Fairfax Elder Law Attorney: 703-691-1888
Fredericksburg Elder Law Attorney: 540-479-1435
Rockville Elder Law Attorney: 301-519-8041
DC Elder Law Attorney: 202-587-2797

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Seven Marathons in Seven Days with Parkinson’s?

Bret Parker has had Parkinson’s for 11 years, since he was 38 years old. Recently, he made an amazing goal for himself of running 7 marathons on 7 continents in 7 days, and nothing was going to stop him from achieving it. That was his attitude, anyway, but was it enough to help him achieve his extremely ambitious goal?

Since Bret was diagnosed with Parkinson’s, he has been on the hunt for personal challenges, which have included the New York City Marathon, a triathlon along the Long Island Sound, and even a jump out of an airplane. Then, there was this- the World Marathon Challenge. Let’s see how he fared:

Bret’s first marathon was in Antarctica, but during a warmer season (temperatures were around 20 degrees Fahrenheit). Similar to the 50 or so others on the adventure with him, he wore ski goggles and trail shoes and lots of layers of clothing. Unlike them, however, he carried a tiny plastic bag of pills that he was regularly popping to help ward off the stiffness, cramping and tremors of his Parkinson’s. Bret crossed the finish line in just under 6 hours, 23 minutes, with a few Parkinson’s-related symptoms—uncontrollable head-to-toe shivering and aches and pains — along the way. At the end, his hands had curled up, his calves were cramping and he struggled to speak. However, with a positive “1 down, and 6 to go” attitude, he was ready to do it again in Cape Town, South Africa eight hours later. He had an easier run in Cape Town, and crossed the finish line there at a similar pace.

Bret’s third marathon was in Perth, Australia. Prior to the race, the top of his right foot and his left shin hurt badly. He also had developed blisters, including a huge one on the ball of his left foot. He sent out a Facebook post a half-hour before the start that said, “It’s possible I won’t make it through this one.” With lots of encouragement from family and friends and his own personal drive for success, he crossed the finish line with eight minutes to spare.

Bret mostly walked at a slower pace during the next three marathons — in Dubai, Lisbon and Cartagena, Colombia. When he arrived in Miami for his 7th and final marathon of the challenge, he could barely walk off the plane. With encouragement from friends, family, and strangers who heard about him through the Michael J. Fox Foundation, Bret felt euphoric that the end was in sight and embarked on the race. A chorus of loud cheers erupted as Bret crossed the finish line. He flashed seven fingers as he broke through the tape. He did it!

A Crazy Challenge

Running seven marathons in seven days can be damaging to a perfectly healthy adult. But having Parkinson’s doesn’t necessarily make it more so, said Melissa J. Nirenberg, a neurologist and researcher who treated Bret for the first 10 years after his diagnosis.

Nirenberg had the same reaction as many of Bret’s friends when he told her of his plans. She remembers saying, “What in the world are you thinking?” She did note, however, that exercise is known to slow the progression of the disease’s symptoms.

Bret’s Amazing Attitude

The way Bret challenges himself and his uplifting attitude and accomplishments have brought attention and awareness to himself and to Parkinson’s disease. Bret has become an advocate for the disease on social media, where he has built a support network that spans continents and includes people he’s never met. His feats have attracted donations totaling in excess of $215,000 for the Michael J. Fox Foundation.

According to Bret, “Parkinson’s has given me the freedom, the liberty to take on these things, even though they seem ridiculous,” Bret said in an interview. “It helps me get over a fear of water, it helps me raise money, it gives me a goal. It’s a lot better story when I’m trying to tell people to donate to be able to say I’m doing my part. “Also,” he added, “I don’t want it to be in charge of me.”

Bret is a husband, a father, a graduate of University of Pennsylvania (from where I and another Farr Law Firm attorney, Sara Entis, also graduated), and he is also the executive director of the New York City Bar Association. See the video of his story and marathon experience here.

Similar to Bret, the Washington Post published another story about a man with Parkinson’s who took up boxing to keep his body from freezing up. Read about him here.

Mental and Physical Toughness for Those with Parkinson’s

Many people with Parkinson’s and other chronic diseases without a cure find lots of ways to stay positive – from small, everyday things like keeping a diary of positive moments, to longer-term relaxation activities, such as taking up yoga or meditation classes. Many also do what they can to stay mentally and physically tough, to stave off the effects of the disease for as long as possible.

Here are some ways to stay mentally and physically strong if you have Parkinson’s:

1. Get the emotions out. Go ahead and get mad, throw a fit, cry for a while, then get over it and get on with your life.
2. Laugh a lot. Laughter stimulates all parts of the brain, including the parts of the brain that produce dopamine. Laughter enables dopamine to be released into the system and this is helpful for alleviating some of the physical and emotional symptoms of Parkinson’s. Laughter releases happy hormones, including dopamine, endorphins, and serotonin. The biochemical changes that occur during laughter create a more positive state of mind and a more optimistic outlook.
3. Exercise or at least get up off the couch and move. Maybe you found the story about Bret Parker motivational, or at least were inspired by his can-do attitude. Remember, you don’t have to run seven marathons, or even one! Take a walk, stretch. . . do what you can! Just keep moving. If you don’t use it, you might lose it!

Anyone can be diagnosed with Parkinson’s or any other debilitating disease. Remember, even though you may have certain obstacles and setbacks, life can be pretty amazing if you choose to adapt to it. Hopefully, Bret and others will inspire you to stay positive, have a can-do attitude, and do what you can to make your life the best it can be!

Do you or a Loved One Suffer from Parkinson’s or Another Debilitating Disease?

If you or a loved one is nearing the need for long-term care or already receiving long-term care or if you have not done Long-Term Care Planning, Estate Planning or Incapacity Planning (or had your Planning documents reviewed in the past several years), please call at one of the numbers below to make an appointment for an initial no-cost consultation, or sign up for one of our upcoming seminars:

Fairfax Elder Law: 703-691-1888
Fredericksburg Elder Law: 540-479-1435
Rockville Elder Law: 301-519-8041
DC Elder Law: 202-587-2797

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The Farr Law Firm Congratulates Sunrise Senior Living

Congratulations Sunrise Senior Living. According to the J.D. Power 2018 Senior Living Satisfaction Study, Sunrise Senior Living ranks highest among senior living communities with an overall satisfaction score of 802, driven primarily by high scores in caregiver and staff; services and activities; rooms, building and grounds; food and beverage; and service setup and new resident orientation. Holiday Retirement (792) ranks second and Capital Senior Living Corporation (780) ranks third.

The study is based on responses from 2,539 residents (or their decision-maker) living in an independent or assisted-living community within the previous five years, and was fielded in October-December 2017. Sunrise started right here in Fairfax.

For more information about the Senior Living Satisfaction Study, visit http://www.jdpower.com/resource/senior-living-study

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Why is Congress baiting Virginia for internet loan sharks?

baiting sharks

Thanks to the House of Delegate voting down HB 1248, Virginia will not be baiting for loansharks. Unfortunately, there is another big threat out there and this time it’s Bills in the U.S. Congress, including one sponsored by own Senator Warner.

H.R. 3299 and S. 1642 are Bills in both Houses of Congress that make it easier for internet loansharks to use sham connections to banks to ignore our state law. The sole purpose of these bills is to enable non bank lenders to use bank partnerships to override state interest rate limits.   The Bills would bless arrangements such as the partnership between the payday lender Elevate and Republic Bank through which Elevate is using to justify their 100% APR loans in Virginia (their loans are so confusing that the 100% APR is an estimate).

In Virginia, we have made a lot of progress.  The Virginia Poverty Law Center is doing our part to drive out illegal internet loansharks.  We have sued several internet lenders and forced them to stop lending in Virginia.   The Attorney General of Virginia has also done his part to stop these internet loansharks by filing lawsuits that force them to return illegal interest and stop lending in Virginia. Further, the Virginia General Assembly has done its part by defeating HB 1248.

Tell your congressmen and Senators to do their part too.  Don’t offer Virginia as bait to internet loansharks–vote NO on H.R. 3299 and S. 1642.

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Working to Improve Laws for Domestic and Sexual Violence Victims

DV photo

Every year at the Virginia General Assembly, VPLC supports, opposes and/or works to amend legislative initiatives that affect domestic and sexual violence victims. This year is no exception. As we approach Crossover (the point at which each chamber—the House of Delegates and the Senate—must finish hearing its own bills), we’ve highlighted some of the bills that have failed or that we expect to become law:

HB 262 (Delegate Jason Miyares) is a bill to prevent abusers with protective orders against them from cutting off victims’ cell phones. This safety measure  passed the House unanimously and reported out of Senate Courts of Justice on a 12-3 vote.

HB 807  is designed to allow judges to consider a parent’s “other violent abuse” in making a custody or visitation determination. But VPLC and other victim advocates fear its overly broad nature will lead to the unintended consequence of giving abusers yet another tool to use against victims. HB 807 failed to report from the House Courts of Justice Subcommittee.

HB 744  would have had a chilling effect on victims seeking Preliminary Protective Orders (PPOs) by requiring judges to make findings and a summary of allegations when an affidavit is not attached to the other documents served on abusers. In courts in populous areas that are very busy, if this bill were to become law, some judges might refuse to issue PPOs if they were forced to make findings and a summary of allegations. While VPLC supports abusers’ due process rights, HB 744 is burdensome for the court, requiring District Courts that are not courts of record, to MAKE records in what are supposed to be emergency, limited time orders designed to prevent further acts of violence, force or threat.  HB 744 failed to report out of the full House Courts of Justice Committee on a bipartisan 11-7 vote.  The Senate version of this bill, SB 85  passed the Senate, and will now be heard by the House.

A good bill, SB 952 (Senator Richard Stuart) passed the Senate Courts of Justice Committee only to be carried over to Senate Finance Committee in 2019 (failed to report for 2018). The bill would have given discretion to judges to issue longer protective orders than the current two-year term under circumstances where the abuser has also been convicted of a violent felony such as malicious wounding or strangulation. VPLC supported this bill (and its House companion, HB 1335 patroned by Delegate Bourne) as a common sense way to prevent victims from having to relive their trauma every two years.

For more information on these or other 2018 bills that affect domestic or sexual violence victims, contact Susheela Varky,Director, Center for Family Advocacy, at susheela@vplc.org or 804-351-5274.”

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Immigration Advocate/Paralegal Job Opening

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Vote NO on HB 1248–Don’t Feed the Internet Loansharks

Sharks-Circling-e1357316767658

The Online Lending Alliance–a group of internet loansharks is circling Virginia and telling your Delegate to vote for HB 1248.  Tell you Delegate to vote NO to keep the internet loansharks out.

HB 1248 will allow internet lenders with no locations in Virginia to get a license under the Virginia Consumer Finance Act.   This will allow these lenders, who could be located anywhere in the world, the opportunity to get a license to make loans to Virginians.

Although this Bill makes several changes to the Consumer Finance Act in order to accommodate internet lenders, it does not make any changes to the law that allows unregulated loans over $2,500.  Loans over $2,500 have no interest rate cap and no restrictions of any kind.

If this Bill passes, internet lenders will be permitted to get a license to make loans at very high interest rates.  Here are some examples of internet lenders that have already been making abusive loans in Virginia :

• Money Key was making loans at 399% interest until they were stopped by the Attorney General’s Office in 2016

• CashCall was making loans at over 200% interest to 10,000 Virginia borrowers until they settled a lawsuit with the Attorney General’s Office last year

Virginia has had responsible consumer finance companies operating all over the state for 100 years. Licensing lenders with no stores in Virginia with no interest rate caps and no restrictions will likely put many of these responsible lenders out of business resulting in loss of jobs and fewer affordable loan options for Virginians.

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Two Popular Medigap Plans are Being Shuttered — What It Means for You!

Q. A couple of years ago, my aunt Linda applied for a Plan F Medigap plan and the insurance company approved her. The following year, she saw a specialist about some hip problems she was experiencing, went for an MRI, and ended up needing hip replacement surgery. Medicare paid 80% of the cost of her visit to the specialist, the MRI, and the surgery. Plan F covered the other 20% owed under Part B, so Linda owed nothing!

Following the surgery, Linda spent a couple of days in the hospital, and then she had a home health care nurse come out to her home several times.

The total cost for Linda’s surgery, hospital stay and follow-up care was $70,000. Medicare paid its share of the bills and sent the remainder of about $14,000 to Linda’s supplemental insurance carrier. The carrier paid the entire bill, and Linda owed absolutely nothing for any of these Part A and Part B services. Her only out of pocket expenses were for some medications. This was all because of her Medicare Plan F!

My question is: I am eligible for Medicare this year. I thought I knew what I needed to know based on my aunt’s experience, and was going to follow in her footsteps and opt for Plan F as a supplemental plan. But, I read that Plan F and another popular plan are being taken away. What is the timeline for this, why is it happening, and what actions can I take at this time?

Thanks so much for your help!

A. Just when you think you finally understand Medicare and what coverage is best for you, they change it!
For decades, people on Medicare have had the option to supplement their Medicare benefits with Medigap coverage, also known as Medicare supplement coverage. And, as you can imagine, the most popular supplement plan for many years has been Plan F, the plan your aunt was on when she had her hip surgery.

The reason Plan F is so popular is precisely because of situations similar to what happened to your aunt. It takes care of all the gaps in Medicare, while leaving you with $0 out of pocket. This kind of certainty helps make planning for your healthcare spending easy to predict.

Plan F Is Being Eliminated

Sadly, all good things must come to an end. As part of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), Congress is eliminating Medigap plans that cover the Part B deductible, including Plan F and Plan C, effective in 2020. Another change is that Medicare premiums for higher income individuals will also be increasing. On a positive note, if this affects you, you have time to plan ahead to minimize the financial impact.

Why is Congress eliminating Plan F?

Medigap Plan F is the most popular of all supplement plans. Plan C is similar but doesn’t cover Medicare excess charges, so it is less popular. So, why is Congress eliminating these plans?

Some legislators fear that Plan F and Plan C policyholders visit their healthcare providers more often than someone who pays their own deductible. In other words, they worry that anyone with Part B deductible coverage will run to the doctor for every sneeze or paper cut. Conversely, if you were responsible for paying your own Part B deductible, then you might think twice about visiting your doctor for minor things, such as a cold.

But, will it cost more in the long run? Critics say that eliminating Plan F might cause some people to forego care, resulting in more expensive care later on. There could be health conditions that don’t get diagnosed early enough and end up costing Medicare big bucks down the road. While that may be true, it didn’t stop Congress from eliminating these plans in the next couple of years.

Good news: This change will only affect NEW Plan F Enrollees

Fortunately, these changes only affect new enrollees after January 1, 2020, so people currently on Plan F will be able to keep that plan in 2020 and beyond!

· Grandfathering will occur for current plan holders: While Medigap plans with deductibles are going away, enrollees with this coverage will be grandfathered in.
· Premiums will rise: Over time, you can probably expect Plan F premiums to slowly rise, since the total number of people enrolled will be shrinking each year.
· Enroll now: If you want this coverage, enroll in Plan F or C prior to 2020 so that you can then keep your policy.
· Consider alternatives: If you can handle a small Part B deductible, options such as Plan G and Plan N offer significantly lower premiums today and will also still be around after 2020. It’s still great coverage and you won’t find yourself stuck in an obsolete Medigap plan that might have rising costs over time.

Remember, selecting the right coverage now can help you attain rate stability down the road.

Higher Medicare premiums are coming for higher incomes.

The elimination of Medigap plans covering the Part B deductible is just one way that MACRA might affect you. The legislation also adjusts the income thresholds for Medicare Part B premiums beginning this year.

· Higher-income beneficiaries: This will largely affect higher-income beneficiaries, who will pay more for their Part B and D than they do now. Many in this group already pay higher premiums, and the MACRA legislation will increase those premiums further for individuals earning over $133,500 ($267,000 for married couples).
· A big increase for some: While this change affects only a small percentage of the Medicare population, the Kaiser Family Foundation reports that premiums for this group will be as much as 80% higher than the Part B base premium.
· If you’re affected, plan now: If you fall into this category, your health insurance costs in retirement may be higher than expected. Working out your estimated costs now will help you better plan for when you can retire.
If you are retired or about to retire, and are part of the estimated 2.9 million individuals who will pay income-related premium adjustments, it’s a wise idea to sit down with an experienced financial planner, such as myself, to discuss how you will handle these changes.

Medicare Doesn’t Pay One Penny for Long-Term Care

Regardless of the changes described, the fact remains that Medicare does not pay one penny, ever, for long-term care (often called custodial care) —which involves help with activities of daily living such as bathing, dressing, and using the bathroom; nor does Medicare pay for supervision needed by those suffering from dementia. And this is not changing. You can read more about this in our Critter Corner article, “Does Medicare Not Care about Long-Term Care?”

This means that, regardless of what is happening with Medigap policies in the future, it is wise to plan ahead for the catastrophic cost of long-term care ($10,000 – $14,000 a month in the DC Metro area)!

If you have not done Long-Term Care Planning, Incapacity Planning, or Estate Planning, or if you have a loved one who is nearing the need for long-term care or already receiving long- term care, please contact us to make an appointment for a no-cost introductory consultation.

Fairfax Elder Law: 703-691-1888
Fredericksburg Elder Law: 540-479-1435
Rockville Elder Law: 301-519-8041
DC Elder Law: 202-587-2797

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Critter Corner: Is Original Medicare Sufficient?

Dear Angel,

My mom is eligible for Medicare this year and is exploring her options. She is not sure whether to get a supplemental plan, or if original Medicare is enough. What are your thoughts on this?

Thanks,
Iz Ittanuff

Dear Iz,

Most people on Medicare feel that original Medicare is not sufficient, and have some source of coverage that supplements Medicare.

Original Medicare has been around for over 50 years and is run by the federal government. Part A and Part B make up the core of original Medicare, and cover the following:

•Part A Deductibles and Copays: In 2018, if you are admitted as an inpatient to the hospital, you will pay a deductible of $1,340 per benefit period. This deductible covers your inpatient hospitalization for the first 60 days. For days 61-90 you would be responsible for a $335 per day. If you need to stay in the hospital for longer than 90 days you can tap into your “Lifetime Reserve Days.” These days can only be used once in your lifetime, and once they are gone, you cannot use them again. While you are using your Lifetime Reserve Days you would be responsible for a co-pay of $670 per day. If hospitalized longer than 150 days, you are responsible for all costs.

Medicare Part A covers short-term skilled nursing care and rehabilitation. This is when you need round the clock medical attention to recover from an illness or injury. Skilled nursing facility stays are covered 100 percent by Medicare for the first 20 days, provided that you have been admitted to the hospital, as an inpatient, for a minimum of 3 days (actually 3 midnights). Once you’ve stayed in a skilled nursing facility for more than 20 days, you are responsible for a copay of $167.50 for days 21-100. You pay all costs if you are in a skilled nursing facility over 100 days. Medicare does not cover long-term care or any type of nursing home costs beyond the 100-day period.

•Part B Deductibles and Copays: In 2018, the Part B annual deductible is $183 and most beneficiaries pay a monthly Part B premium of $134. You may have to pay more if your income is above a certain threshold. Once you meet your deductible, you will pay a co-pay of approximately 20 percent for most of your medical expenses. There are some preventive services that are free and not subject to the Part B deductible.

Part A and Part B are not enough

Part A and Part B cost-sharing can really add up, especially when you consider what Medicare doesn’t cover (including eye exams, hearing evaluations, dental care, routine foot care, and more). And, original Medicare has no cap on out-of-pocket spending. So, it’s definitely not enough for most seniors!

Make sure you do your homework and explore all your options when selecting the Medicare supplemental plan that is right for you. See Medicare.gov for details and helpful tips. And see today’s other article for important information about supplemental plans that are going away in the next couple of years.

Hope this is helpful,

Angel

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