Democrats Trying to Sway Senior Voters

The Associated Press: Democrats, "running scared in an election year," are hopeful that a $250 check - to help seniors afford prescription drugs - will turn the tide of public opinion. "Democrats ... are trying to overcome older people's mistrust of the new health care law, which expands coverage for younger generations by cutting Medicare payments to hospitals and insurers. … Behind the hoopla, the reality is modest.

"The $250 check, for example, is just a fraction of what many people in the prescription coverage gap have to pay. The gap starts after Medicare beneficiaries and their insurance plan have spent $2,830 on medications. Once total spending reaches $6,440, Medicare's catastrophic coverage kicks in, and people pay only a small amount. That means the 'doughnut hole' is $3,610 this year. ... . A previous Congress, led by Republicans, came up with the idea to control costs. It's never been popular" (Alonso-Zaldivar, 8/16).

The Hill reports that administration is acting on other fronts: "Stephanie Cutter, assistant to the president for special projects, took to the White House blog Friday to lambaste Rep. Paul Ryan's proposal to turn Medicare into a voucher program. … 'Under the Ryan plan, the Medicare seniors know and trust would disappear,' Cutter writes. 'In its place, seniors would receive a voucher to buy insurance on the private market.' Ryan argues that the current system, even taking into account the healthcare reform law, is 'on course to collapse'" (Pecquet, 8/14).

In the meantime, outside groups are hoping to bolster Democrats' political fortunes.

Roll Call: "Americans United for Change is dispatching staff and resources to battleground states in what appears to be a shoestring effort to paint Republicans as seeking to destroy Social Security and Medicare. … To prove their claims that Republicans are targeting Social Security and Medicare, Democrats and activist groups like the AUFC cite Wisconsin GOP Rep. Paul Ryan's 'Roadmap for America's Future,' which proposes to overhaul the two programs to ensure they remain solvent without eating up more of the federal budget. ... Republicans contend that Democrats are trying to scare voters" (Drucker, 8/14).

The Seattle Times: In addition, advocacy groups are protesting the presence of lobbyists at the gathering this week of state insurance regulators. "Health-care-reform activists sported surgical gowns and masks as they chanted and handed out packets that offered to 'disinfect' the gathering from a 'lobbyist pandemic.' The packets included soap, a hand wipe, a clothespin and a face mask to protect against 'lobbyist lies ... lobbyist germs ... and lobbyist stench' — underscoring that emotions over health-care reform haven't entirely subsided since President Obama signed a historic reform law in March. … The protest was organized by Washington state Health Care for America Now" (


For more information contact Senior Solutions at (954) 456-8984 or toll free at 1-800-213-3524

It's Almost $20,000 a Year for Seniors to Live

September 15, 2010
By Ashley Gebb/Appeal-Democrat

Rising costs and fixed incomes are an incompatible combination — yet it is one senior citizens face every day.

Seniors, no matter their source of income, often struggle to make ends meet in Yuba and Sutter counties, according to standards released Wednesday by UCLA and the Insight Center for Community Development.

The standards calculate for each county the minimum income necessary to cover an older adult's basic expenses and estimate the number of senior citizens who have — or do not have — that income.

A local senior citizen would need a minimum income of $19,629 a year to meet their basic needs — housing, food, medical care and transportation, according to those standards.

Using that data, the Area 4 Agency on Aging estimates 4,432 seniors in Sutter County and 2,847 seniors in Yuba County fall in the eligibility gap, said Planner Will Tift. Those citizens are above the federal poverty level but still don't earn enough for their basic needs.

"That's a substantial percentage," he said. "Somewhere between a third and a half of seniors in both counties do not have enough money to make ends meet."

Some accumulate debt, others turn to family and friends to help them out and others go without.

"They may not be going to doctor's appointments or dental appointments or having their vision checked because they can't afford to do those things," Tift said. "Some may drive without insurance because they can't afford it."

The greatest challenge is not fixed incomes but rising costs, said Yuba City resident Norman Walker, 80.

"They are nickel-and-diming us to death," he said.

Every expense continues to rise, from groceries to utility bills, taxes to dog food, medical care and license plate fees, he said.

"You name something that hasn't gone up," he said. "It's stressful, when you sit back and watch your bills come in and think about what you make."

He retired in 1993 after working for more than 50 years. At the time he had several hundred thousand dollars saved in the bank, plus his pension. That's what has helped him hold on all these years.

"I don't know how people live on Social Security," Walker said.

He's also fortunate because he does not have a house payment to make, he said. He knows other seniors who have had to sell their homes or move in with their children.

But finances have not been easy for Walker, despite how well he planned. Every year he has to dip into his savings, and there is only about $90,000 left, he said.

"If I live to be 100, I'll be on welfare," he said.

Yuba City resident Joe Thordsen, 80, retired in 1992. This year was the first time in 18 years he did not receive an increase in his Social Security payment, and the house he bought six years ago has declined in value by $33,000, he said.

His pockets have felt the hit, and so he continues to pinch pennies anywhere he can. This means clipping coupons, searching out freebies and drinking water instead of coffee or other costly drinks when he goes out to eat.

"It gets a little tough, but we adjust as we go along," he said.

Thordsen knows how to live on a tight budget. As a child of the Great Depression, he remembers his parents standing in soup lines to get a hot meal.

That's the point many seniors are almost pushed into today, he said.

"They say it's a recession, but if you're not working, it's a depression," he said.

The battle between rising costs and fixed incomes has always existed but the current recession has exacerbated the problem, Tift said.

"We definitely need to be looking at all kinds of solutions," he said.

The standards released by UCLA and the Insight Center are a valuable tool that can be used in planning, advocacy and general education about the financial struggles seniors are facing.

"It's the first step in quantifying the issue," he said. "It puts it into real terms and numbers people can see and deal with."

Meanwhile, seniors get by however they can and combat the stress and depression caused by financial strain with inexpensive fun. For Walker and Thordsen, that means frequent billiards sessions with their buddies at the Yuba City Senior Center.

"We pay $33 a year, and we get to shoot pool all day long," Walker said

For more information contact Senior Solutions at (954) 456-8984 or toll free at 1-800-213-3524

Baby Boomers: Rethink Retriement Costs

by Philo Gabriel

The “Baby Boomer” generation is a colloquial term for those born during the time after World War II when the birth rate increased significantly due to the bulk of the marriage-age males returning from having been away at war, ready to settle down and start a family. Consensus places the starting year for the Baby Boomers at 1946 (nine months after the end of World War II). There is no similar consensus as to when the last Baby Boomers were born, with 1960 and 1964 being the two most common years used as the endpoint.

In any case, now retirement is very much on the Baby Boomer’s minds, and for a number of reasons it’s maybe not looking as rosy as it was a few years ago. Once aging Baby Boomers really sit down and analyze their financial situation in light of the projected costs of retirement, many of them will have reasons for concern.

First, the good news: Baby Boomers will likely live a lot longer. With life expectancy on the rise, after the typical Baby Boomer retires at 65 or 70 or whenever they choose, it’s not as if their life will be at an end or close to it. Most will enjoy many more years of life; many will enjoy multiple decades more of life.

Now, the bad news: Baby Boomers will likely live a lot longer. However many post-retirement years their parents and grandparents needed sufficient funds to cover, it’ll likely be substantially more for the Baby Boomers.

Let’s look at some of the reasons that might be a problem:

1. More years means more living costs

After you retire and no longer have work income, that doesn’t stop your bills. You still have to eat, you still have to keep a roof over your head. And a good portion of that for many seniors will be at assisted living facilities or nursing homes, which are far from cheap.

2. Medical costs go up with age

Medicare is undeniably a godsend for seniors, but it isn’t perfect. It’s not as if seniors never have to pay a penny again for medical treatment once they hit 65. Medical issues can still deal a major financial blow even to those on Medicare, and the older one gets, the more likely one is to suffer from medical problems that are very expensive to fix, or more often very expensive not so much to fix as to survive with a little longer.

3. Social Security won’t cover much

Social Security serves its purpose of keeping (most) seniors out of abject, homelessness-levelpoverty, but if your sole income is Social Security it’s not going to do much more than that.

It’s not that the doomsayers are right who’ve been saying since about five minutes after Social Security was enacted in the 1930s that it’ll be bankrupt right around the corner, that “Social Security won’t even be around by the time I retire anyway.” No, Social Security is so untouchable politically that it’ll be paying out for as long as the present form of government in the United States exists, regardless of what else has to be shuffled around to make that happen. It’ll end when an asteroid strike, or global warming, or a total economic meltdown far worse than the Great Depression wipes away the present economy and system of government, and not a moment before.

It’s not that the Baby Boomers won’t get their Social Security checks; it’s that those checks are pretty paltry, relative to their expenses.

4. Savings have taken a hit

The recent downturn in the economy and major bear market has left many seniors and near-seniors with less savings entering retirement than they anticipated. Exacerbating this is the fact that in this bear market and that of the dot-com bust of 2000-2002, many people worried about their impending retirement scrambled to get out of the market at or near what turned out to be its low point out of fear of it collapsing even further, and thus missed a good portion of the upturns.

5. Inheritance ain’t what it used to be

Once upon a time, Baby Boomers were projected to receive trillions of dollars. (A Columbia University study projected $10.4 trillion.) For the most part that hasn’t materialized.

The reasons are parallel to those facing the Baby Boomers themselves. While the parents and grandparents of the Baby Boomers are not living as long as the Baby Boomers are expected to, they’re living longer than previous generations, and therefore using up a lot more of their net worth on themselves. Furthermore, they too have taken a big hit from the downturn in the economy.

6. You can only work so long

Many people as they approach retirement age assume that as a fallback, they can simply work longer than planned. If they had hoped to retire by 63, maybe that could be set back to 66 or 67. If they had always assumed they’d be retired by 70 at the latest, maybe they’ll just haveto keep getting that paycheck to age 72 or 73 or even 75.

No doubt that will work for some Baby Boomers. They’ll be able to work a few extra years, and if they like what they do they might even be happier than if they had stopped.

But it won’t work for everyone. Aging beats people up, physically and mentally. You might be able to hold down a job in your 60s, maybe your 70s, maybe even beyond. But you might not. You certainly can’t guarantee that you’ll have the energy and the mental sharpness to have a paying job when you’re 78. The age will vary from person to person, but you’ll reach a point when retirement isn’t a matter of choice.

For more information contact Senior Solutions at (954) 456-8984 or toll free at 1-800-213-3524

New York State: Highest Insurance Cost in USA

State is tops in survey of health insurance plan costs

Now the Empire State can claim another dubious honor: the nation's highest health insurance rates, at least by one measure.
According to an industry trade group, America's Health Insurance Plans, a basic individual health policy premium for one person in New York averages $6,630 -- more than $1,000 more than second-place Massachusetts and $4,779 in third-place Rhode Island. For a family plan, New Yorkers pay $13,296.

The "individual market" cited in the survey is a small segment of the health insurance spectrum -- fewer than 70,000 individual New Yorkers now have such plans, with thousands dropping them as the prices have risen over the years. Most people get health insurance through their employers.

The Washington, D.C.-based group recently compiled the rankings of 29 states where data on such plans was readily available.

New York's top ranking for individual plan buyers came as no surprise to industry insiders as well as the corporations' critics, who say it's emblematic of the Empire State's cost of living.

What they don't agree on is why the prices are so high.

The industry puts the blame on taxes and regulations, while critics say health insurers have had a decade of unrestrained price hikes -- which they are now trying to halt.

"It's because of state actions taken almost 15 years ago that we are the highest nationally," said Leslie Moran, senior vice president for the state Health Plan Association, a trade group.

Ever-expanding mandates about what insurers must cover, as well as steadily growing taxes on the insurance companies, Moran said, have fueled many of the increases.

"We're highly taxed," added Deborah Fasser, spokeswoman for the state Conference of Blue Cross/Blue Shield Plans. She noted that health insurance taxes total about $4.7 billion a year, and much of that is passed along to consumers.

Aside from the individual market, group plans are costly as well: New York ranks 14th for employee-based insurance costs, according to the Kaiser Family Foundation. Health insurance for a single employee, for instance, averages $4,638 in New York.

Critics say such costs are the reason why New York, a decade after deregulation, should bring back the requirement that health insurers get permission from the state Insurance Department before raising their rates.

"New York is a profit center for insurance companies," said Elisabeth Benjamin, vice president of health initiatives for the Community Service Society, an anti-poverty group pushing for the return of "prior approval."

"The idea that you can raise rates without any sort of review is a terrible position to be in from a good government point of view," added Sen. Neil Breslin, D-Delmar.

Breslin, who chairs the Senate Insurance Committee, has joined Gov. David Paterson in calling for the return of prior approval, which would once again allow the state to regulate rates

Benjamin noted that since prior approval was fully phased out in 2000, annual health insurance costs in general rose from 5 percent to 14 percent. In the rest of the nation, costs are rising about 10 percent annually.
That's why people like Lisa Scerbo have gone without health insurance for the past 16months.

The co-owner of Hot Shots, a Latham photography and portrait studio, the 53-year-old dropped her insurance when rates rose to about $12,000 a year in 2009.

"The prices just got really, really high," said Scerbo, who said that her cost had tripled since 1995.

Now, Scerbo is looking at signing for up a state-subsidized plan. "The taxpayers will have to pay for my health insurance," she said.

Scerbo was among a group of advocates who came to the Capitol last month to call for the return of prior approval.

Re-regulating health insurance rates could emerge as a hot topic -- and a potential bargaining chip for any number of other initiatives -- as budget negotiations continue and lawmakers struggle to finish their legislative session.

Paterson included the measure in his budget plan, and the Assembly Democrats have also sought prior approval, but it was left out of the Senate Democrats' spending proposal.

Insurance firms, who have launched a push against its return, contend that New York's regulations already keep companies from offering more choices to consumers.

Moran noted that companies in other states -- including New Hampshire, Georgia, North Carolina and California -- face less onerous regulations and offer high-deductible plans that appeal to young, healthy people who may only want catastrophic coverage.

Others note that prior approval was phased out as part of a compromise in which insurers agreed not to discriminate based on age, gender or the health of customers.

But those who support prior approval say all that pales in comparison with the steep rate increases of the past decade. Currently, about 2.7 million New Yorkers are without health insurance, said Benjamin.

The push for prior approval "is still alive," Breslin said. "There are a lot of negotiations going on."

For more information contact Senior Solutions at (954) 456-8984 or toll free at 1-800-213-3524

At Last I'm Turning 65: Medicare

Senior Health Insurance
Written By : Karen Ruff, DA

One thing everyone who turns 65 has in common is an increase in "junk mail." You receive packets, cards, booklets, and invitations along with multiple phone calls, all offering information or assistance in choosing your Medicare options. Often the offers and solicitations-from multiple companies-do little more than increase your worry and confusion.

TIP 1:UNDERSTAND YOUR MEDICARE

Contrary to what many people expect, Medicare was never intended to provide totally free health care to seniors. During your working years, money was deducted from your pay for Medicare Part A. Part A pays the hospital, 100 days of skilled care in a nursing home, and certain other benefits. Deductibles and Co-payments apply; these costs increase every year. In 2008, the Part A deductible alone is $1025.

Medicare Part B could be thought of as the part that pays the doctor, but actually it pays everything Medicare covers that is not covered under Part A. This does not include prescription drugs. Medicare Part B also comes with a premium that increases yearly. Part B pays 80% of the eligible expenses after your annual deductible. Unless you have creditable coverage somewhere else (such as employer group retiree coverage), you must sign up for Part B. Otherwise you will be ineligible for any other coverage such as Medigap Insurance or Medicare Advantage plans. Also failure to take part B when you are eligible results in a 10% penalty per year which is applied when you try to get it later.

TIP 2: TIMELINESS AND FULL-DISCLOSURE, NOT EMOTION, SHOULD IMPACT YOUR DECISION

There is no annual out of pocket max on what you could owe under Medicare alone. While Medicare pays a great deal, your copays and deductibles will mount up quickly if you have a major illness. Don't try to tell yourself that you won't get sick. One of every four people over the age of 65 has 3 or more chronic conditions.

That is why most people choose either a Medigap Insurance or a Medicare Advantage Plan. There are important differences in these plans, but when you are turning 65, you are in open enrollment for any plan that fits your need and is available in your coverage area. Time is an important factor. When choosing a Medigap policy, you do have a 13 month window of opportunity--six months before and after your birth month-but it is to your advantage to make sure your coverage begins in the same month your Medicare does.

However, with a Medicare Advantage Plan, your window is open only three months before and after your birth month. Consequently, you may receive solicitations urging you to switch to an Advantage Plan after you have already decided on a Medigap Plan. It is a sales strategy to wait until you have already paid premium for a Medicare Supplement and then tantalize you with what you could spend that money on if you didn't have a premium.

The MA sales agents are trained in high pressure strategies and will often present only the best features of the MA unless you insist on reading the book first. Then they may ask you to "go ahead and sign, and just cancel if you don't like it." That, too, is a pressure technique as MA plans are difficult to get out of without waiting until open enrollment. By then, it may be too late to get the more dependable coverage offered by a supplement. If you have analyzed your financial and medical situation properly, there will be no reason to re-think your first decision. Listen to your head, not your emotions. There is no such thing as free health insurance, regardless of what some high pressure guru tells you.

TIP 3: DON'T BE CONFUSED BY THE LANGUAGE

A major cause of confusion when choosing Medicare related options is the language. Medicare itself uses the word "Part" to refer to Part A, Part B, and now the separate Part D for drug plans.

All Medigap plans-also called Medicare Supplement Insurance-use the word "Plan." Currently, there are 11 Medicare Supplement plans identified with the letters A through L. Not all plans are available in all states or with all companies, but any given plan will have identical coverage from one company to another. For example, a J plan with "Smith" Company and a J plan with "Jones" Company will provide exactly the same coverage. The only differences will be in the premium, which changes every year, and in the quality of service-which can be significant. When using a Medicare Supplement, you use your Medicare first. The supplement pays the copays and deductibles according to the terms of the specific plan.

Medicare Advantage (MA) plans are NOT Supplement or Medigap plans. They may be Private Fee for Service (PFFS), HMO, or PPO plans. If you choose an MA plan, you will not use your Medicare card although you will keep paying your part B premium. That's because Medicare will be paying a private company to handle your health insurance needs. Medicare Advantage Plans are sometimes called "Medicare Part C," but they are actually owned by private companies. Some of them include prescription drugs and are then referred to as MAPD plans.

TIP 4: MEDICARE ADVANTAGE PLANS VARY ANNUALLY AND FROM COMPANY TO COMPANY

Medicare Advantage plans help control your health care costs by giving you a low premium. Several of the MA plans (plans that do not include prescription drugs) have zero premium. You usually have a co-payment to the doctor and co-payments, co-insurance, or deductibles to the hospital. However, most plans have an annual out of pocket max. These ceilings from $1000 to $6,000 change annually and can be found in the back of your Medicare and Me Handbook.

MA and MAPD Plans do not change for your age, and are not medically underwritten-except for certain Special Needs Plans. The only exclusion for most MA plans is for kidney dialysis.

MA plans (including MAPD) often DO change the details of coverage and the premiums annually. Your coverage is guaranteed for the current year only. And if your doctor does not accept payment, you will have to pay the bill yourself, and you will not be re-imbursed.

TIP 5: MA PLANS COVER DIFFERENTLY FROM MEDICARE, AND MEDICARE DOES NOT PAY THE REMAINDER

In addition to controlling your costs, MA plans usually offer some benefits that Medicare does not cover. For example, many health screenings such as colonoscopies and pap smears are free under MA plans, but have a 20% co-pay under Medicare alone. Also, MA plans may provide limited benefits for dental, vision and hearing needs.

A important difference between MA and original Medicare, however, is the nursing home coverage. While MA plans may not require a hospital stay first, some only give three days free instead of the 20 under original Medicare. All MA plans cover up to 100 days, but the co-payments can vary significantly. When choosing a MA or MAPD plan, it is important to go over the coverage details before signing. Unless you are in open enrollment or a special enrollment period, you may have difficulty changing if the coverage is less than you expected.

TIP 6: MEDICARE SUPPLEMENT-A WAY TO LIFE-LONG, WORRY FREE COVERAGE.

Medicare Supplements are designed by Medicare and offered by private companies. Because of the way they are created, a supplement will not change terms of coverage once you purchase it. The premium will usually go up each year, but, depending on the plan you choose, you can limit your out of pocket costs to just your premium and any care not covered by Medicare. For example, Medicare does not generally cover routine dental work, or eye glasses. Thus, your Medigap policy will not cover those items either.

You can choose a Medigap coverage that leaves you with zero co-pays or deductibles for any Medicare covered expense. However, several other Medicare Supplements, such as the L plan or the High Deductible F, may fit your budget better and are equally dependable and predictable. Your best option is to work with a reputable agent who is able and willing to find the plan that will serve you the best for as long as you live.

TIP 7: CHRONIC ILLNESSES CAN LIMIT YOUR CHOICES

During your "aging in" open window, you can freely choose either Medicare Supplement or Medicare Advantage. However, it is important to recognize that if you have or develop certain chronic illnesses, such as congestive heart failure, kidney disease, insulin dependent diabetes, and others, you will only have this one opportunity to purchase a Medicare Supplement. Furthermore, if you drop a Medicare Supplement after developing a chronic illness, you will be unable to get it back. You will be able to get original Medicare, but you will never have another opportunity for true Medicare Supplement Insurance.

Most doctors who accept Medicare assignment also accept Medicare Supplement Insurance. If, however, you have one who does not, you can submit the claims yourself and be reimbursed for the Medicare approved copay amount. With plans F and J you can also be reimbursed if the doctor charges the "excess charges" allowance of 15% over the Medicare approved fee.

SUMMARY

So which Medicare option is best for you? The piles of brochures and rate books tell you what options are available. They don't tell you what fits your needs. It is also difficult to fit a plan to your situation in a 15 minute high-pressure appointment.

There is more to being a senior than just choosing an MA or Supplement plan. Other options to be considered are your own health, the medical history of your family, your own finances-both now and several years into retirement, your preparation for extended care needs later in life, and your own expectations and comfort level related to out of pocket expenses.

Your best option will be to work with a reputable agent or advisor who will put your needs first, both now and in the future when you need service. Give the worry to someone else; let a licensed career agent help you find peace of mind and security related to all of your senior health and finance needs.



For more information contact Senior Solutions at (954) 456-8984 or toll free at 1-800-213-3524