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Aging Wisely September 2013 - Aging Wisely

What to Expect from Medicare in 2014: Medicare Advice/Analysis


Medicare Advice for 2014

There are big changes coming to healthcare in 2014 related to the Affordable Care Act (“Obamacare”) but less dramatic changes for Medicare recipients. The new state healthcare exchanges will have open enrollment from October 1, 2013 to March 31, 2014 but the Medicare open enrollment periods remain the same as last year (the health exchanges do not apply to Medicare recipients). Here we will outline some of the key information for Medicare in 2014–important dates and the changes you can expect if you are a Medicare recipient. Aging Wisely offers Florida Medicare advice/analysis, as well as help navigating other health insurance and benefits programs like Florida Medicaid and V.A. benefits. Contact us at 727-447-5845 for more information.

The standard open enrollment period for Medicare 2014 is from October 15, 2013 through December 7, 2013. This is the once yearly opportunity to review plans and make changes, such as switching Medicare D drug plans, enrolling in a Medicare Advantage plan or disenrolling from Medicare Advantage and enrolling in a stand-alone Part D plan along with returning to “regular” Medicare. Even if you are satisfied with your current plan, it makes sense to review your options to make sure there is not a more suitable plan for the coming year. Each year plans make changes and your medical situation may have changed as well. In 2012, a study indicated that some 90% of Floridians were in the wrong Florida Medicare plan, many of them paying more than necessary.

There is another annual period from January 1st to February 14th, which is specifically for disenrolling from Medicare Advantage and enrolling back in to regular Medicare and a new Part D plan. This is the only type of change that can be made during that period. There are also many special enrollment periods (SEPs), specific circumstances that may allow you to make changes. These include, for example, admission to or discharge from a nursing home. If you have problems with your Medicare plan or major changes, contact us for help navigating the options.

So what will change for Medicare recipients in 2014?

The “donut hole” (coverage gap in the Part D plans during which you must pay out-of-pocket for your drugs) continues to shrink as part of provisions made a few years back. In 2013 and 2014, you get a 52.5% discount on brand-name drugs in the donut hole; the subsidy for generic drugs in the donut hole rises from 21% to 28% in 2014.

Premiums for Part D plans are expected to remain similar in 2014, with a slight rise in the average cost from $30/month to $31. Other trends in the drug plans, such as increased copays, smaller pharmacy networks or changed drug tiers/coverage, may affect your out-of-pocket costs even if you stay in the same plan. Consider inputting your information in to Medicare’s Plan Compare Tool during the open enrollment period, or getting help from one of our Aging Wisely Patient Advocates in analyzing your best options.

Aging Wisely provides a concise “Medicare Fact Sheet” each year, which outlines the parts of Medicare and the corresponding costs for the year. You can download a copy of the 2013 Medicare Fact sheet here and keep an eye out for our 2014 information as soon as those numbers are released. Generally, there are small premium and deductible increases in each of the areas of Medicare yearly, but we do not expect anything dramatic for 2014.

Don’t forget Medicare now covers many preventative services (at 100%). For more information, check out Medicare’s Guide to Preventative Services.

Warning: Also, be aware that as Medicare plans start advertising, fraud issues are often on the rise as well. You may get false information or someone “phishing” for personal information. Do not give out personal or identifying information. Make sure you understand what you are doing before making changes and consider talking it through with a trusted family member or professional.

For new retirees trying to navigate all the Medicare and other health insurance options or current recipients trying to ensure the best coverage, we offer a Medicare Analysis Package as well as patient advocacy services to deal with specific issues. Contact Sue Talbott, Senior Care Consultant, at 727-447-5845 for questions or to schedule your appointment today!

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The Keys to Caring for Elderly Parents Long Distance


challenges of long distance caregiving

Many of the families we help at Aging Wisely are caring for elderly parents long distance. This adds a unique dimension to caregiving that can be particularly anxiety-provoking. Our website contains a number of articles about important caregiving issues and tips for long-distance caregivers. We offer many checklists and resources that can help caregivers in all types of situations, as well as one-on-one help from our care management team. Today we’ll focus on some of the most important keys for managing aging parents’ care from a distance.

As this U.S. News and World Report article reports, the approximately 14 million long-distance caregivers in the U.S. tend to feel greater anxiety, guilt and uncertainty. They often feel they don’t really know what is going on and may mistrust information given from local family or other sources. Long-distance caregivers face difficult choices in trying to decide when to visit, how to be involved and approach different concerns and how to deal with emergencies. Long-distance caregiving can often become quite costly, with last minute travel to help the caree and costs of support services.

How you will experience caring for elderly parents long distance depends a lot on your situation. Do you have other family members that are local? What type of support system do your aging parents have in the community? What resources do your aging parents have (or can access) to help? What is your lifestyle and career situation (i.e. how much time can you dedicate to caregiving tasks and how easy will it be for you to visit or get there in an emergency)?

Regardless of these specifics, though, there are certain keys to managing long distance caregiving which can help you be more prepared and reduce your anxiety. Take these key steps:

  1. Rally the troops/marshal your resources. Get to know your parents’ local support system and make some key contacts. Do a little homework on local resources and talk to some potential care providers, so you know where to turn as things change.
  2. Think safety first. Have a home safety assessment completed and get suggestions for making the environment more age-friendly. Falls are a major source of those emergency phone calls that long-distance caregivers receive. Preventative steps can reduce risk of falls and related injuries.*
  3. Open the lines of communication. This starts first between you and your aging parents, with opening the discussion about aging and eldercare issues and continuing to check in as things change. Do you have difficulty getting your aging parents to share information with you? Now’s the time to discuss it or bring in help from a geriatric care manager who can get the conversation started. If you have local loved ones, discuss how/when you are going to communicate. Think about tools that will make it easier, such as online care portals. As your parents allow, make contacts with key professionals such as doctors and advisors so they know you and can ascertain permission from your parents to share information with you.
  4. Create a “checking in” plan. Create a plan for calling and visiting regularly. Work together with other family members and local resources. Consider whether you need support like a home caregiver or geriatric care manager. A geriatric care manager can attend medical appointments and do periodic assessment visits, keeping you informed and keeping things on track. Then, you also have a resource to call upon to deal with crises. A home caregiver can not only be local “eyes and ears” for you but ensure better safety, good nutrition, and proper medication management, for example.

If you are caring for aging parents in Florida long distance, let us help you. Give us a call today to discuss options and ways to be more prepared. Our Senior Care Consultant will do a free needs analysis, in person or via phone, for you and your family. Give us a call at 727-447-5845! 

*September 22nd is National Fall Prevention Awareness Day. Aging Wisely is a proud founding member of the Pinellas County Falls Prevention Coalition (now the Fall Prevention Coalition of Pinellas Pasco). Our Senior Care Consultant, Sue Talbott, represents us on the coalition as we contribute to raising safety awareness for seniors in the local community. To learn more about Fall Prevention and the awareness day, you can visit NCOA’s site or like the Fall Prevention Coalition on Facebook.
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Florida Eldercare: The Costs of Long Term Care


the costs of florida eldercare long term care

Having an understanding of long term care costs is important for both the aging person who may need care now (or soon) and the Boomer adult who should be considering long-term care costs as part of retirement planning. Especially in light of the recent AARP study on the massive shortage of caregivers that will be available for the Boomer generation, we all need to be putting some consideration in to these issues.

Here are some quick statistics on nationwide average costs for long term care (from the 2012 MetLife market study of long term care):

  • The national average daily rate for a private room in a nursing home was $248, while a semi-private room was $222 up from $239 and $214 respectively in 2011.
  • The national average monthly base rate in an assisted living community rose from $3,477 in 2011 to $3,550 in 2012.
  • The national average daily rate for adult day services remained unchanged from 2011 at $70 in 2012.
  • The national average hourly rates for home health aides ($21) remained unchanged, while the homemaker hourly rate increased by 5.3% from $19 in 2011 to $20 in 2012. 
More specifically, the average costs of long term care in Florida are:
  • A private room in a nursing home in Florida averaged $259/day, while a semi-private room (far more common) averaged $230.
  • The assisted living base rate averaged $3234/month.
  • Adult day services averaged about $60/day throughout the state.
  • Home care costs in Florida: the rate for a home health aide averaged $18/hour and for a homemaker companion slightly less at $17 (a homemaker companion provides non-hands on help only, such as light housekeeping, meal preparation, transportation and companionship).
Florida is relatively affordable in the range of costs compared with nationwide averages, though by no means the cheapest state (and slightly above average in nursing home rates). As in most states, these costs also vary fairly significantly by area, with larger metropolitan areas like Miami tending to have higher costs. Additionally, there is wide variation from lowest to highest cost and all types of options for receiving care (from large rooms at “luxury” assisted living facilities to smaller “Mom and Pop” ALFs with options like shared rooms).
Here are some important considerations about long term care costs and Florida eldercare as you look beyond these averages:
  • Assisted living rates are given as base rates. ALF contracts and billing vary widely, with some using a “level of care” model in which they determine the additional cost based on an assessment that places you within a certain level based on your needs or a la carte pricing for specific care services. Some use a more all-inclusive pricing model or may even use a combination of approaches. 
  • Often care is closely tied in to other living expenses and comparing costs requires looking at a more comprehensive budget. For example, a person receiving care at home has normal housing and living expenses such as utilities, groceries, mortgage/rent and maintenance. In a nursing home, residents will generally not incur any of those costs unless they continue to maintain their original home. In an assisted living facility, a number of those items are rolled in to the rate, though there may be additional costs (such as paying for phone or cable or buying personal groceries or restaurant meals).
  • Related to the budgeting information above, long term care insurance will generally only pick up the costs of care. However, living expenses aren’t necessarily separated out in facility-based care (in other words, if you receive care at home, your LTC insurance will not cover utilities and home costs but a daily rate in a facility is more likely to include all of those costs).
  • What other expenses should you consider in overall costs? Do not forget, for example: medical costs/insurance, medications, travel expenses, quality of life items (newspaper subscriptions, snacks, getting your hair done, personal training services, extra companion/help), transportation costs.
  • Account for inflation. These are good estimates of today’s costs and you should expect prices to rise along with other living expenses.

A geriatric care manager can help you with understanding your potential long-term care costs, the options for eldercare and creating a projected budget. If you are a professional advisor, it may be worthwhile working in partnership with a care manager to help better prepare and advise your clients. A care manager can give you real insight about true costs so that you can really be as prepared as possible.

At the time of need, a care manager will help you access the care you need (and get the best care possible), assist with advocacy and claims, help you prepare a care plan for your budget and help you with eligibility for benefits programs. A care manager can also help you understand contracts and payment options, as well as negotiate and determine the appropriate level of care.
If you have questions or would like to set up an appointment with one of our professional geriatric care managers, give us a call any time at 727-447-5845!
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Patient Advocacy and Navigating the Changing Healthcare Maze


As the various components of Obamacare become available, healthcare options will be changing fairly dramatically, particularly for disabled and chronically ill patients. We recently shared some detailed information about Special Needs Trusts and coming changes related to the Affordable Care Act (Obamacare)Regardless of your personal feelings about the Affordable Care Act, the reality is that our healthcare landscape is changing and there will be different options for people. Clients who have had difficulties due to issues like pre-existing conditions or lifetime limits will now be offered some additional choices.

patient advocacy navigating ObamacareWe have seen the health and long-term care landscape change drastically over the years already. Consider today’s abundance of rehabilitation, assisted living and home care options. These choices did not exist when many of our grandmothers were caring for their own parents. Having the options is definitely positive, but navigating them proves a challenge for many families. We try to keep you updated with educational resources and specific information that we see affecting our clients. If you are dealing with these issues and trying to navigate how the provisions will affect you, it is worthwhile to contact a professional patient advocate such as one of our Aging Wisely care managers. 

The Affordable Care Act provides a number of mechanisms, such as mandates, subsidies and insurance exchanges designed with the goal of increasing affordability and access. Here is an overview of some of the major mechanisms of Obamacare:

  • Mandate: requires all individuals not covered by an employer plan, Medicaid, Medicare or other public insurance to purchase an approved private insurance policy or pay a penalty (waived if part of a religious group approved by IRS or for financial hardship cases)
  • Health Insurance Exchange: a set of government standardized healthcare plans from which individuals may purchase health insurance, eligible for government subsidies
  • Subsidies: tax breaks and other subsidies to assist with transition and access
  • As of January 2014, Floridians will be able to purchase private plans on the insurance exchange which must meet these minimum requirements
    • No pre-existing medical condition issues

    • No annual or lifetime limits

    • No difference in premium due to health conditions

    • The insurance is guaranteed renewable until the age of 65

    • Premium support available to purchase insurance (based on the modified adjusted gross income income)

    • The insurance must include these essential health benefits:

      1. Ambulatory patient services
      2. Emergency services
      3. Hospitalization
      4. Maternity and new born care
      5. Mental health and substance use disorder services, including behavioral health treatment
      6. Prescription drugs
      7. Rehabilitative and habilitative services and devices
      8. Laboratory services
      9. Preventative and wellness services
      10. Chronic disease management
      11. Pediatric services including oral and vision care

What will all of this mean for patients? It will certainly mean that those with chronic illness or serious disability have new alternatives. As mentioned in our previous article on Special Needs Trusts, this means the pros and cons of each choice must be carefully weighed. Professionals advising clients must make sure to have a comprehensive understanding of: the patient’s diagnosis, prognosis and medical/care needs; current and projected expenses; care and benefits options (what types of benefits is the person eligible for and how does that affect planning?); and the client’s and family’s priorities, concerns, etc.

Many of our clients are eligible for Medicare due to either age or disability. The Medicare program has already seen a number of changes related to the Affordable Care Act and its precursors. We assist our clients to stay ahead of these changes. Medicare open enrollment is coming up October 15th-December 7th and our care managers are available to help clients reexamine their plan choices. We also assist new retirees with navigating their healthcare choices and understanding the deadlines and decisions they need to make.

Our patient advocates are experts at bringing you through the healthcare maze with relative ease. We can save you costs and get you the best options, as well as assist in times of crisis or resolving problems or claims issues. Contact us at 727-447-5845 to discuss how we can help.

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Our goal is to enable every individual we work with to live the most fulfilling life possible, with utmost dignity, focusing on their physical, mental, spiritual, family and financial wellbeing.