Medicare

Understanding the Basics about Medicare

Published on: April 25, 2017 | By McCulloch & Miller, PLLC

Even if you are still working, once you turn 65, you have to navigate your way through an entirely new and complex health care system. While there’s no HR department, there are resources.

It starts the day you turn 65, and it’s a bit of a challenge. Seniors need to get up to speed fast on the many requirements of Medicare. A recent post of Kiplinger’s, “FAQs About Medicare,” warns that mistakes can be extremely costly and difficult to fix. You’ll want to study up on this in advance.

For starters, if you signed up for Social Security before age 65, you’ll automatically be enrolled in Medicare parts A and B and receive your card three months before your 65th birthday. Part A covers hospitalization and is generally premium-free. Part B covers outpatient care, such as doctors’ visits, x-rays and tests, and costs $134 a month for people who enroll in 2017 (or more for high earners).

Alzheimer’s or Dementia Screening Now Covered by Medicare

Published on: February 8, 2017 | By McCulloch & Miller, PLLC

You might think that any doctor seeing patients over a certain age would automatically screen for Alzheimer’s or other dementia-related diseases, but until now that has not been the case.

Starting in January, Medicare will now begin reimbursing doctors for screening and providing information about care planning for patients with Alzheimer’s and other cognitive impairment diseases. What seems like common sense public health policy, took many years of advocacy from patient groups.

Santa Cruz Sentinel’s recent article, “Diagnosing Alzheimer’s: Medicare now pays doctors to stop and assess memory loss,” reports that more than 5 million Americans are living with Alzheimer’s, and as many as 16 million will have the disease in 2050. The cost of caring for those with the disease and other types of dementia is also skyrocketing. In the U.S., it’s estimated to total $236 billion in 2016 and is anticipated to increase to $1.1 trillion by 2050.

How to Prepare for Long-Term Care Costs in Houston

Published on: August 15, 2016 | By McCulloch & Miller, PLLC

The cost of long-term care can take a huge bite out of retirement savings, exhaust family resources and create strain on relationships. Don’t count on Medicare, but do plan in advance.

At least seven out of ten Americans age 65 and over will need long-term care at some point. Most people simply underestimate the cost of long-term care, or they think that Medicaid will cover the costs. Your best defense against long-term care costs: advance planning with professional help.

The Memphis Daily News article, “Long-Term Care – Not for Everyone,” says that Medicare does little for these costs and only for a short time period. Medicaid doesn’t apply until the assets of an estate are spent down, so many people must pay for these costs out-of-pocket. The article says that there are only two ways to address these expenses: with your investment/retirement portfolio and with long-term care insurance. Most people review the cost of long-term care insurance and elect to roll the dice, but when that first round of expenses hits, they probably will wish they’d bought it long ago. Now it’s usually too late to buy it. If you can afford to self-insure, you can save your estate and yourself some serious money.

Hawaiian Advocates Focus on Dementia Task Force

Published on: December 8, 2015 | By McCulloch & Miller, PLLC

As with the rest of America, Hawaiians are coping with a growing population of citizens over age 65 diagnosed with Alzheimer's, approximately 25,000 in total. Advocates, including members of a dementia task force under the Executive Office on Aging and members of the local Alzheimer's Association, are focusing on preparing professionals and caregivers to address the often complex needs of individuals with dementia.

A recent article in KHON, titled "Task force aims to help seniors living with dementia" recently reported on this.

James Pietsch, the director of the University of Hawaii Elder Law Program, told KHON that there are multiple tasks under this task force, one of which is supportive research to determine whether professionals are qualified or capable of handling these type of cases. Professionals like doctors, social workers, nurses, and lawyers need to be better prepared to handle issues involving dementia.

Medicare 2016 Premium Concerns Loom

Published on: October 23, 2015 | By McCulloch & Miller, PLLC

As a direct result of complex relationships between Social Security and Medicare and a number of other unforeseen issues, 2016 will be an expensive year for some seniors, according to Forbes' recent article, "Untangling the Medicare Premium Mess — And What It Means For You." Medicare laws require it to increase premiums annually to cover increases in per capita costs. This would typically be about $16, which most seniors can manage.

Except that 2016 will not be a normal year. Most retirees have their Medicare premiums deducted from their Social Security benefits, but because inflation was so low this year, there won't be a cost-of-living increase in 2016 for Social Security. And the law says that if Social Security benefits don't rise—you guessed it—neither can the Medicare premiums.

That means about 70% of Medicare beneficiaries won't see the premium hike. However, that leaves the entire burden of this year's Medicare cost increases on the remaining 30%. Those guys are going to be hit with 50% premium hikes.

What Is Your Houston Family’s Long-Term Care Plan?

Published on: October 8, 2015 | By McCulloch & Miller, PLLC

Do you have a plan for long term care? It can be costly and prohibitive for many families, especially for dementia care. Several key points about long term care are clarified in a recent article from The Arizona Daily Star, “Costs pile up fast for dementia care.”

Don’t count on Medicare. The median annual cost for a private room in a skilled nursing facility in Tucson last year was more than $90,896. Assisted living costs about $45,000. In a 2015 annual Cost of Care survey, results showed that Americans paid approximately $16,060 more per year in 2015 for a nursing home than they paid in 2010.

Remember that Medicare doesn’t pay for long-term care, including home care, aside from 100 days of skilled services or rehabilitative care. After that, it’s up to the family to figure out how to pay. The options include long-term care insurance, public assistance through Medicaid programs for people over 65, Veterans Aid, or private pay. On average, an American turning 65 today will incur $138,000 in future long-term services. This cost could be financed by setting aside $70,000 today.

Can You Navigate the Medicare Maze?

Published on: June 24, 2015 | By McCulloch & Miller, PLLC

"If you get a claim denial, always contact your doctor or hospital to see if they can help you through the appeal," said Shirley Whitenack, president of the National Academy of Elder Law Attorneys and a partner with law firm Schenck, Price, Smith & King.

Larry Tocco retired last year from a job in the collections department of a credit union. After some medical treatment, he started receiving past-due notices from health care providers after his claims on a Medicare plan weren't paid. After several frustrating phone calls, Larry learned he was still on the active employee roll of the health insurance plan covering his former employer. As a result, his Medicare plan was considered secondary coverage.

A benefits manager from the credit union told him they sent the retirement paperwork, but the representatives with the Medicare provider said they didn't get it.

Retirement Planning Mishaps Can Impact Houston Seniors

Published on: April 27, 2015 | By McCulloch & Miller, PLLC

Here are a few of the most common mistakes we’ve seen seniors make in regard to their retirement planning.

Sometimes knowing what NOT to do is just as important as knowing what to do. So it is with retirement planning.

Physician’s Money Digest lists some of the most common mistakes that the authors have seen seniors make in a recent article titled “Top Mistakes Seniors Make”:

Partial Roth IRA Conversions May Reduce Tax Impact for Houston Investors

Published on: September 8, 2014 | By McCulloch & Miller, PLLC

Today, ordinary income plus various other taxes could boost the effective tax rate on those second-level RMDs well over 40%. Who knows what tax rates might be in effect when current clients eventually pass their IRAs to future generations?

Some individuals choose to have partial Roth IRA conversions so they remain in their current income tax bracket and decrease other taxes and charges, according to a recent article in Financial Planning titled "Estate Planning: Smart Roth Conversion Trick." Along with a Medicare surtax and deduction phase-outs, Medicare Part B premiums are also part of the mix.

Medicare enrollees typically pay about $105 monthly for Medicare Part B. This covers doctor bills and some other medical expenses. However, seniors who have a modified adjusted gross income (MAGI) above $85,000 (or $170,000 on joint returns) will pay anywhere from roughly $145 to $335 a month for that same coverage. This is because Roth IRA conversions increase an individual's MAGI. The original article advises those in this situation to take an annual series of partial conversions now to thereby limit future taxes, as well as “stealth” taxes like extra Part B premiums.

Tips for Planning The “Financial Talk” With Houston Parents

Published on: August 21, 2014 | By McCulloch & Miller, PLLC

The best time to discuss finances with your parents is when they are competent, self-sufficient adults. Planning ahead and seeking out the appropriate professional financial assistance on their behalf can help ensure your parents enter their golden years in the most comfortable, stress-free and secure way possible.

You may dread having the "financial talk" with your aging parents, but this is one conversation that needs to happen sooner rather than later.

A recent article on KARE11.com, titled "Helping aging parents with financial matters," wisely advises approaching this topic in a respectful manner. The article stresses that you be extremely mindful of the delicate nature of your parents' financial and emotional needs, and that you should not step in if it is not necessary.