Seniors
Quit Smoking with the Help of Medicare and Other Tools | Print |  E-mail
Friday, 21 November 2014 15:56

112014sen1By Jim Miller • Special to the Times

Medicare actually covers up to eight face-to-face counseling sessions a year to help beneficiaries quit smoking. And, if you have a Medicare Part D prescription drug plan, certain smoking-cessation medications are covered too. Here are some other tips that can help you kick the habit.

Never Too Late

Of the 46 million Americans who smoke, about 5.5 million are Medicare beneficiaries. According to the Center of Disease Control and Prevention (CDC), about 50 percent of smokers, age 65 and older, indicate they would like to completely quit, but because of the nicotine, which is considered to be more addictive than heroin, it’s very difficult to do.

Tobacco use is the leading cause of preventable illness, responsible for an estimated one-fifth of deaths in the United States each year.

But research shows that quitting, even after age 65, greatly reduces your risk of heart disease, stroke, cancer, osteoporosis and many other diseases.

It also helps you breathe easier, smell and taste food better, not to mention saves you quite a bit of money. A $5 pack-a-day smoker, for example, saves about $150 after one month without cigarettes, and more than $1,800 after one year.

How to Quit

The first step you need to take is to set a “quit date,” but give yourself a few weeks to get ready. During that time you may want to start by reducing the number or the strength of cigarettes you smoke to begin weaning yourself.

Also check out over-the-counter nicotine replacement products — patches, gum and lozenges — to help curb your cravings. And, just prior to your quit day, get rid of all cigarettes and ashtrays in your home, car and place of work, and try to clean up and even spray air freshener. The smell of smoke can be a powerful trigger.

Get Help

Studies have shown that you have a much better chance of quitting if you have help. So tell your friends, family and coworkers of your plan to quit. Others knowing can be a helpful reminder and motivator.

Then get some counseling. Don’t go it alone. Start by contacting your doctor about smoking cessation counseling covered by Medicare, and find out about the prescription anti-smoking drugs that can help reduce your nicotine craving.

You can also get free one-on-one telephone counseling and referrals to local smoking cessation programs through your state quit line at 800-QUIT-NOW, or call the National Cancer Institute free smoking quit line at 877-44U-QUIT.

It’s also important to identify and write down the times and situations you’re most likely to smoke and make a list of things to do to replace it or distract yourself.

Some helpful suggestions when the smoking urge arises are to call a friend or one of the free quit lines, keep your mouth occupied with some sugar-free gum, sunflower seeds, carrots, fruit or hard candy, go for a walk, read a magazine, listen to music or take a hot bath.

The intense urge to smoke lasts about three to five minutes, so do what you can to wait it out. It’s also wise to avoid drinking alcohol and steer clear of other smokers while you’re trying to quit. Both can trigger powerful urges to smoke.

For more tips on how to quit, including managing your cravings, withdrawal symptoms and what to do if you relapse, visit smokefree.gov and nihseniorhealth.gov/quittingsmoking. If you’re a smartphone user, there are also a number of apps that can help like LIVESTRONG MyQuit Coach, Cessation Nation and Quit It Lite.

 

 
Engage Family Members Suffering from Dementia on Holidays | Print |  E-mail
Friday, 21 November 2014 15:55

112014sen2Whether it’s Mom, Dad, Grandma or Grandpa — or your spouse — holidays can present special challenges for families with a loved one suffering from dementia.

“We have an expectation that loved ones should never change from the person we’ve perceived them to be for years, but everyone changes significantly over an extended period, especially those diagnosed with dementia,” says Kerry Mills, a researcher in best-care practices for people with dementia, which includes Alzheimer’s.

“Dementia encompasses a wide range of brain diseases, which means it’s not the fault of a Grandma if she has trouble remembering things or gets flustered. Empathy for what she’s experiencing on the level of the brain will help your relationship with her. Do not expect her to meet you halfway to your world; you have to enter her world.”

Spouses have a particularly difficult time coping with their partner’s dementia, Mills says. A spousal relationship is a team and is central to the identities of both people. So, while you’re paying special attention to a parent’s or grandparent’s condition, extend it to his or her spouse, she says.

Families tend to have a hard time coping with a loved one’s dementia during holiday gatherings. Mills offers these suggestions for how to interact with a loved one — say, Grandma — whose brain is deteriorating.

• Do not get frustrated. “First, do no harm” — the excellent maxim taught to medical students, is also a great first principle for those interacting with Grandma, who may be experiencing a level of frustration and anxiety you cannot comprehend adequately.

She simply doesn’t have access to certain details, but she is still a conscious and feeling person who has plenty to offer. If you get frustrated, she’ll pick up on it.

• Dedicate someone to Grandma during the gathering. Of course, loving families will want to include Grandma in the group, but be careful not to overwhelm her with attention. Her brain, which has trouble processing some information, could use assistance — a liaison to help her process things. A son or daughter may be the best handler during a gathering.

• Give Grandma purpose; give her a task in the kitchen. Keep her engaged! Simple tasks, such as mashing potatoes or stirring gravy, may be best. Engage her in conversation about the food.

If it’s Grandpa whose suffering dementia, include him in a group. Engage him in a conversation about football, which may allow him on his own terms to recall details from the past.

• Use visual imagery and do not ask yes-or-no questions. Don’t expect someone with Alzheimer’s to remember a specific incident 23 years ago — it may be physically impossible. Direct the conversation; say things to stimulate recollection, but don’t push a memory that may not be there. Pictures are often an excellent tool.

• Safety is your biggest priority. Whether during a holiday gathering or in general, Grandma may commit herself to activities she shouldn’t be doing, such as driving. This major safety concern applies to any potentially dangerous aspect to life.

“Currently, there’s a stigma with the condition,” Mills says. “As with other medical conditions, Alzheimer’s should not be about waiting to die — patients often live 15 years or more after a diagnosis. It should be about living with it.”

 

 
Make Plans Now for Your Trustee Succession | Print |  E-mail
Friday, 21 November 2014 15:52

By Gene L. Osofsky, Esq. • Special to the Times

Q: I have a Living Trust. I am the original trustee and my children are the successor trustees. Do you have any thoughts about easing the transition of trustee duties from me to my children when the management of my finances has become too much for me?

A: Yes. It is important for that transition to be as seamless as possible, so that your assets can be managed and bills paid without delay. Here are some suggestions:

(1) Simplify Succession “Trigger”: Take a look at your trust to determine what triggers the change of trustees from you to your children.

Typically, it may be the written determination by one, or perhaps two, physicians, reciting your inability to handle your financial affairs.

If your trust requires a letter from two physicians, I suggest changing that requirement to only one. Reason: If you are then residing in a nursing home, where patient care is typically monitored by one physician, it may be difficult to arrange an evaluation for this purpose by a second physician.

Reducing the requirement to only one doctor may save your children much grief with medical logistics.

(2) HIPAA Release. Make sure that your trust, or related document, provides a HIPAA privacy release authorizing your doctor to disclose information about your ability to manage your affairs. Absent a privacy release, some physicians may be reluctant to write a letter regarding your capacity.

(3) Add Co-Trustee. At some point, consider adding one of your children as a co-trustee and recite in your trust, or in an amendment to your trust, that any single trustee has the power to write checks or take other action on behalf of the trust.

This would then authorize your child to gradually take over more responsibility for managing trust assets without a formal certification of your incapacity. Doing so sooner than later also allows you the opportunity to watch your child perform his or her duty, and afford you the opportunity to provide pointers to them based upon your years of accumulated wisdom.

(4) Consider Resignation. Alternatively, when you feel that managing your trust has become too much for you, you might consider the proactive approach of resigning. A formal resignation triggers the succession of trustee duties to your child without a formal finding of incapacity. It, too, can accomplish a smooth transition without the need for doctors’ letters.

(5) Minimize Successor Liability. To encourage a successor trustee to step into the shoes of the predecessor, recite in your trust that the successor is not responsible for any acts or omissions of his predecessor. You might also recite that whoever is serving as trustee is not liable for any action taken in good faith.

These two protective clauses would help induce your designated nominee to assume their duties when appropriate, whether that successor is one of your children or the trust department of your favorite bank.

(6) Inform Your Bank: Make sure that your financial custodians have your list of successors on file, so that when they step forward to assume their duties their identity is known to the bank. You might even introduce your nominees to your bank officers, and suggest that they take a sample signature and make note of the child’s address and driver’s license.

By taking some or all of the above steps, you will have taken proactive steps toward a seamless transition of trustees when the time comes.

Gene L. Osofsky is an elder law and estate planning attorney in Hayward.  Visit his website at www.LawyerForSeniors.com.



 
Finding Affordable Dental Care | Print |  E-mail
Thursday, 06 November 2014 15:23

110614sen1By Jim Miller • Special to the Times

Finding affordable dental care can be challenging for seniors living on a tight budget. Most retirees lose their dental insurance after leaving the workplace, and original Medicare does not cover cleanings, fillings or dentures.

While there’s no one solution to affordable dental care, there are a number of options that can help cut your costs. Here’s where to look.

Medicare Advantage

While original Medicare (Part A and B) and Medicare supplemental policies do not cover routine dental care, there are some Medicare Advantage (Part C) plans that do. Many of these plans, which are sold through private insurance companies, cover dental care along with eye care, hearing and prescription drugs, in addition to all of your hospital and medical insurance.

If you’re eligible for Medicare, see medicare.gov/find-a-plan to look for Advantage plans in your area that covers dental care.

Dental Discounts

Another way you can reduce your dental care expenses is to join a dental discount network. How this works is you pay an annual membership fee — around $80 to $200 a year — in exchange for a 10 to 60 percent discount on service and treatments from participating dentists.

To find a network, go to DentalPlans.com (or 888-632-5353), where you can search for plans and participating dentists by zip code, as well as get a breakdown of the discounts offered.

Dental Schools

Dental school clinics offer savings opportunities, too. All 65 accredited dental schools in the U.S. offer affordable care provided by dental students who are overseen by their professors. You can expect to pay about half of what a traditional dentist would charge and still receive excellent, well-supervised care.

Another option is to check with local colleges that offer dental hygiene programs. For training purposes, many programs provide teeth cleanings by their students for a fraction of what you’d pay at a dentist’s office.

To search for nearby dental schools or dental hygiene programs visit ada.org/dentalschools.

Veterans Benefits

If you’re a veteran enrolled in the VA health care program, or are a beneficiary of the Civilian Health and Medical Program (CHAMPVA), the VA is now offering a dental insurance program that gives you the option to buy dental insurance through Delta Dental and MetLife at a reduced cost.

The VA also provides free dental care to vets who have dental problems resulting from service. To learn more about these options, visit va.gov/dental or call 877-222-8387.

Low Income Options

If you’re low income, there are various programs and clinics that provide dental care at a reduced rate or for free. To look for options in your area, contact your state dental director at www.astdd.org/state-programs/California/ or phone 916-552-9896.

You may also be able to get discounted or free dental care at one of the federally funded HRSA health centers (findahealthcenter.hrsa.gov, 877-464-4772), or at a privately funded free clinic (nafcclinics.org).

Also, check with the Dental Lifeline Network (dentallifeline.org, 888-471-6334) which provides free dental care for low-income elderly and disabled; Remote Area Medical (ramusa.org) which offers free health, eye and dental care to people in select locations; and Indian Health Service (ihs.gov), which provides free dental care to American Indians and Alaska Natives who are members of a federally recognized Indian tribe.

Also, see toothwisdom.org, a website created by Oral Health America that will help you locate low-cost dental care.

 

 
Improve Your Balance as You Age | Print |  E-mail
Thursday, 06 November 2014 15:21

Most people don’t think much about practicing their balance, but you should, the same way that you walk to strengthen your heart, lungs and overall health, or you stretch to keep your body limber.

As we age, our balance declines — if it isn’t practiced — and can cause falls. Every year, more than one in three people age 65 years or older fall, and the risk increases with age. A simple fall can cause a serious fracture of the hip, pelvis, spine, arm, hand or ankle, which can lead to hospital stays, disability, loss of independence and even death.

How Balance Works: Balance is the ability to distribute your weight in a way that enables you to hold a steady position or move at will without falling.

It’s determined by a complex combination of muscle strength, visual inputs, the inner ear and the work of specialized receptors in the nerves of your joints, muscles, ligaments and tendons that orient you in relation to other objects.

It’s all sorted out in the sensory cortex of your brain, which takes in the information from those sources to give you balance. But aging dulls our balance senses, and causes most seniors to gradually become less stable on their feet over time.

Poor balance can also lead to a vicious cycle of inactivity. You feel a little unsteady, so you curtail certain activities. If you’re inactive, you’re not challenging your balance systems or using your muscles. As a result, both balance and strength suffer.

Simple acts like strolling through a grocery store or getting up from a chair become trickier. That shakes your confidence, so you become even less active.

Balance Exercises: If you have a balance problem that is not tied to illness, medication or some other specific cause, simple exercises can help preserve and improve your balance. Some basic exercises you can do anytime include:

• One-legged stands: Stand on one foot for 30 seconds, or longer, then switch to the other foot. You can do this while brushing your teeth or waiting around somewhere. In the beginning, you might want to have a wall or chair to hold on to.

•Heel rises: While standing, rise up on your toes as far as you can. Then drop back to the starting position and repeat the process 10 to 20 times. You can make this more difficult by holding light hand weights.

• Heel-toe walk: Take 20 steps while looking straight ahead. Think of a field sobriety test.

• Sit-to-stand: Without using your hands, get up from a straight-backed chair and sit back down 10 to 20 times. This improves balance and leg strength.

For additional balance exercises, visit go4life.nia.nih.gov, a resource created by the National Institute on Aging that offers free booklets and a DVD that provides illustrated examples of many appropriate exercises. You can order your free copies online or by calling 800-222-2225.

Some other exercises that can help improve your balance and flexibility is through tai chi and yoga. To locate a beginner’s class in your area that teaches either of these disciplines, call your local senior center, health club or wellness center, check your yellow pages or try online directory sites like americantaichi.net and yogafinder.com.

If nothing is available near you, there are DVDs and videos that offer tai chi and yoga instructions and routines for seniors that you can do at home. Some good resources for finding them are amazon.com, collagevideo.com and iefit.com, or check with your local public library.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org.


 
Do’s and Don’ts of Disinheriting a Family Member | Print |  E-mail
Thursday, 06 November 2014 15:19

By Gene L. Osofsky, Esq. • Special to the Times

Q: Regretfully, our son has been a ne’er-do-well for some time. He has been only sporadically employed and would likely squander any inheritance on drugs. My wife and I are thinking of taking him out of our will and leaving everything to our other two children. Any thoughts about how we should go about doing this?

A: I am sure that this decision must hurt both of you deeply. However, since you asked: Yes, I do have some advice, which I call the “Do’s and Don’ts” when disinheriting a child:

1) Do Consider a “Skip Bequest” to His Children: If your son has children, you might leave his share directly to his own children, perhaps in a trust or guardianship arrangement managed by one of your other children. That might be more palatable to both you and your wife, and might very well discourage a will contest by him.

2) Do Consider an Incentive Trust: You might leave your son’s share to an Incentive Trust. This is a trust designed to encourage behavioral changes as a condition to receiving trust benefits.

For example, if your goal is to encourage him to be drug-free, you might specify that he must test free of drugs for a period of 24 months before he receives any benefit from the trust. You could also require that he maintain steady employment and provide proof of same to the trustee.

3) Do Document Your Decision: If you feel there is any possibility that your son might challenge your will on the ground that you lacked capacity, take steps now to help your other children defend against a challenge later.

You might suggest to your attorney that, at the time of signing your will, he or she record an audio or videotape interview with you and your wife, wherein you discuss your reasons for disinheriting your son. Additionally, it might be wise to secure from each of your physicians a letter affirming your capacity to make estate planning decisions.

4) Don’t Overlook Naming Him In Your Will or Trust. If you stay with your decision to disinherit your son, it might be tempting to not even identify him in your estate plan. That would be a mistake.

Were you to omit his name entirely, the law would presume that you just had a memory lapse, and a judge would likely insert him back into your will to take his proportionate share as a pretermitted heir. To protect against this, you should specifically identify him in your plan documents, and only then recite that he is left nothing.

5) Don’t Rely Exclusively on the “No Contest Clause:” While designed to discourage will contests, the common No Contest Clause (“NCC”) often included in wills, standing alone, would likely not work.

The NCC merely says that anyone who unsuccessfully challenges a will receives nothing. It is designed to discourage a beneficiary from trying to get a larger share of one’s estate. However, in your case, you propose to leave nothing to your son at the outset. Thus, he would have nothing to lose — and potentially a lot to gain — by challenging your will.

For this reason, it would be better to leave him something, say, just enough to discourage a will contest. He would then have something at risk, and the NCC would have a greater chance of achieving its purpose.

Gene L. Osofsky is an elder law and estate planning attorney in Hayward.  Visit his website at www.LawyerForSeniors.com.


 
Medicare Covers Mental Health Services | Print |  E-mail
Thursday, 16 October 2014 14:52

101614senBy Jim Miller • Special to the Times

Medicare recently upgraded its coverage of outpatient mental health services to help beneficiaries with depression and other needs. Here’s how it works.

If you have original Medicare, your Part B coverage will pay 80 percent (after you’ve met your $147 Part B deductible) for a variety of counseling and therapy services that are provided outside a hospital, like individual and group therapy, family counseling and more. They also cover services for treatment of beneficiaries who struggle with inappropriate alcohol and drug use.

You or your supplemental insurance is responsible for the remaining 20 percent coinsurance.

Medicare also gives you the option of getting treatment through a variety of mental health professionals such as psychiatrists, psychologists, clinical social workers and clinical nurse specialists.

It’s also important to understand that if you decide to see a non-medical doctor (such as psychologists or a clinical social worker), you’ll need to make sure that he or she is Medicare-certified and takes assignment, which means they accept Medicare’s approved amount as full payment. If they don’t, Medicare will not pay for the services.

Medicare will, however, pay for the services of Medicare-certified medical doctors (such as psychiatrists) who do not take assignment, but these doctors can charge you up to 15 percent above Medicare’s approved amount in addition to the 20 percent coinsurance, which you will be responsible for.

To locate a mental health care professional in your area that accepts Medicare assignment, use Medicare’s online Physician Compare tool. Just go to medicare.gov/physiciancompare and type in your zip code, or city and state, then type in the type of profession you want to locate, like “psychiatry” or “clinical psychologist” in the “What are you searching for?” box. You can also get this information by calling Medicare at 800-633-4227.

Medicare Advantage

If you get your Medicare benefits through a private Medicare Advantage plan, they too must cover the same services as original Medicare, but they will likely require you to see an in-network provider. You’ll need to contact your plan directly for the details.

Additional Coverage

In addition to the outpatient mental health services, you should also know that Medicare covers yearly depression screenings that must be done in a primary care doctor’s office or primary care clinic that can assure appropriate diagnosis, treatment and follow-up. Annual depression screenings are covered 100 percent.

Medicare will also cover almost all medications used to treat mental health conditions under the Part D prescription drug benefit. If you’re prescribed an antidepressant or some other medication, and you have a Part D plan, you should call to confirm coverage or you can search the plans formulary (the list of medications they cover) on their website.

For more info, call Medicare at 800-633-4227 and request a copy of publication #10184 “Medicare & Your Mental Health Benefits,” or read it online at medicare.gov/publications/pubs/pdf/10184.pdf.

Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior.”


 
Does My Living Trust Contain a ‘Poison Pill?’ | Print |  E-mail
Thursday, 16 October 2014 14:50

By Gene L. Osofsky, Esq. • Special to the Times

Q: In past articles you have written about the option of seeking a Medi-Cal subsidy to help pay for the cost of nursing home care if that need arises. I have a Living Trust. Are there provisions that I should include, or some that I should avoid, in order to facilitate Medi-Cal qualification?

A: Great question. While I cannot provide an exhaustive list in the space of this article, I can comment on one that is critically important: a Living Trust-based estate plan should permit amendment or revocation by a trusted agent if the trustor, himself, later becomes incapacitated.

Background: When many people set up trusts, they provide that only they, themselves, are empowered to make amendments or withdrawals from the trust. For persons in robust good health, that restriction makes perfect sense: they understandably do not want others tampering with their trust.

However, when those same individuals age, become infirm and face the need for nursing care, this restriction can become a financial obstacle.

Reason: In order to invoke strategies to accelerate eligibility for a Medi-Cal nursing home subsidy, it is often necessary to first remove assets from the trust. The same is true when the goal is to protect the home or other assets from a Medi-Cal “payback,” or recovery claim, after death.

The problem arises where the infirm trustor does not then have sufficient mental capacity to sign documents to amend or remove assets from his trust.

In that case, his family may be unable to invoke planning strategies to deal with excess resources and qualify him for Medi-Cal. Without help from Medi-Cal, the cost of care could potentially drain the trust estate, to the financial detriment of the trustor and his family.

Check to see if your trust provides that the right of amendment or withdrawal is “personal” to you, as the trustor. If so, you may have a problem. Such a provision might read something like the following:

“The power to revoke or amend this trust is personal to the settlor and shall not be exercisable on the settlor’s behalf by a conservator, an agent under a power of attorney, or any other person or entity.”

If your trust contains a provision like the above, it could be the “poison pill” which later exposes your trust assets to rapid spend down in the event you need nursing care and/or to a substantial Medi-Cal recovery claim after death.

Perhaps a better plan would be to change your trust now to authorize your trusted agent under a Durable Power Of Attorney (“DPOA”) to amend or revoke your trust in certain circumstances, such as if the need for nursing care arises. If you are concerned that such power might be abused, you might build restrictions into its exercise, such as by requiring the written certification of a physician that you need nursing home care, the approval of an attorney who practices in the field of Medi-Cal planning and/or the approval of a judge.

If you do opt to so modify your trust, be sure to include coordinating provisions in your DPOA, a legal requirement that is often overlooked.

Lastly, for those who no longer have capacity to change their trust, know that application can sometimes still be made to the superior court for permission to amend or revoke the trust when need requires, a process which is expensive and the outcome uncertain.

Gene L. Osofsky is an elder law and estate planning attorney in Hayward. Visit his website at www.LawyerForSeniors.com.



 
Choose Your Flu Shot Option | Print |  E-mail
Thursday, 02 October 2014 18:16

100214senBy Jim Miller • Special to the Times

Depending on your health, age and personal preference, there’s a buffet of flu shots available to seniors this flu season, along with two vaccinations for pneumonia that you should consider getting too.

Flu Shots Options

Just as they do every year, the Centers for Disease Control and Prevention (CDC) recommends a seasonal flu shot to almost everyone, but it’s especially important for seniors who are at higher risk of developing serious flu-related complications.

The flu puts more than 200,000 people in the hospital each year and kills around 24,000 — 90 percent of whom are seniors. Here’s the rundown of the different options:

• Standard (trivalent) flu shot: This tried-and-true shot that’s been around for more than 30 years protects against three strains of influenza. This year’s version protects against the two common A strains (H1N1 and H3N2), and one influenza B virus.

• Quadrivalent flu shot: This vaccine, which was introduced last year, protects against four types of influenza — the same three strains as the standard flu shot, plus an additional B-strain virus.

• High-dose flu shot: Designed specifically for seniors, age 65 and older, this vaccine, called the Fluzone High-Dose, has four times the amount of antigen as a regular flu shot does, which creates a stronger immune response for better protection. But, be aware that the high-dose option may also be more likely to cause side effects, including headache, muscle aches and fever.

• Intradermal flu shot: If you don’t like needles, the intradermal shot is a nice option because it uses a tiny 1/16-inch long micro-needle to inject the vaccine just under the skin, rather than deeper in the muscle like standard flu shots. This trivalent vaccine is recommended only to those ages 18 to 64.

To locate a vaccination site that offers these flu shots, visit vaccines.gov and type in your ZIP code. If you’re a Medicare beneficiary, Part B will cover 100 percent of the costs of any flu shot, as long as your doctor, health clinic or pharmacy agrees not to charge you more than Medicare pays.

Private health insurers are also required to cover standard flu shots, however, you’ll need to check with your provider to see if they cover the other vaccination options.

Pneumonia Vaccines

The other important vaccinations the CDC recommends to seniors, especially this time of year, are the pneumococcal vaccines for pneumonia. An estimated 900,000 people in the U.S. get pneumococcal pneumonia each year, and it kills around 5,000.

This year, the CDC is recommending that all seniors 65 or older get two separate vaccines, which is a change of decades-old advice. The vaccines are Prevnar 13 and Pneumovax 23. Previously, only Pneumovax 23 was recommended for seniors.

Both vaccines, which are administered just once, work in different ways to provide maximum protection.

If you haven’t yet received any pneumococcal vaccine, you should get the Prevnar 13 first, followed by Pneumovax 23 six to 12 months later. But, if you’ve already been vaccinated with Pneumovax 23 you should get Prevnar 13 at least one year later.

Medicare currently covers only one pneumococcal vaccine per older adult. If you’re paying out of pocket, you can expect to pay around $50 to $85 for Pneumovax 23, and around $120 to $150 for the Prevnar 13.

 

 
How Does the Reading of a Will Work? | Print |  E-mail
Thursday, 02 October 2014 18:13

By Gene L. Osofsky, Esq. • Special to the Times

Q: My brother-in-law just died, and I expected the entire family to be invited to a formal reading of his will. So far, nothing has been set up. Does that sound right?

A: Actually, yes it does. You have probably seen a number of old movies where, after a person’s death, his next of kin gather in the attorney’s office for a formal “reading of the will.”

In the movies, the attorney somberly reads the will aloud while the family listens with anxious anticipation to learn how the decedent provided for them. Typically, the camera captures audience reaction as the decedent’s wishes are finally made known.

In real life, however, that scenario does not occur.

Instead, the heirs and beneficiaries typically receive a copy of the will in connection with the commencement of a formal probate proceeding:  Within 30 days of death, the original of the decedent’s Last Will must be lodged with the Superior Court clerk in the county of the decedent’s residence.

If there is to be a probate of the will, the decedent’s attorney will then prepare a formal Notice of Petition To Administer the Estate and mail it to all heirs and beneficiaries.

This formal Notice is usually accompanied by a true copy of the decedent’s will. If not, a copy of the will is available for viewing and copying at the clerk’s office as a public record.

However, even if there is no probate (for example, if the decedent held all assets in a trust), the original will is still kept in a secure file by the court clerk and there remains a semi-public record, available for viewing or copying upon showing the clerk the decedent’s death certificate or by obtaining a court order.

Essentially, each interested person receives, or can secure, a copy of the will to read for himself. That is typically how the ‘reading of the will’ actually occurs in today’s world.

Some have suggested that the former ceremony of reading the will has its roots in earlier times when literacy was not as common as it is today, and that the ceremonial reading aloud was therefore necessary to inform beneficiaries of the will’s contents.

However, it is my guess that there is another explanation which might have more to do with technology, i.e. the advent of copy machines. Certainly, in the days of Abraham Lincoln and even into the last century, copying a legal document for distribution to others would have been a labor-intensive process, usually performed by hand and therefore prone to error. In that context, reliance upon a single original made sense.

By contrast, today we can quickly and accurately reproduce the decedent’s Last Will and easily distribute a true copy to all those who have a legitimate interest.

Hence, in today’s world there is no need for a solemn gathering to hear the reading aloud of the original Last Will, and the law does not require that an attorney do so. That said, we can still enjoy old movies with the drama of the reading of the will in the presence of the assembled family members.

Gene L. Osofsky is an elder law and estate planning attorney in Hayward. Visit his website at www.LawyerForSeniors.com.


 
Generic Drugs Offer Big Savings | Print |  E-mail
Thursday, 18 September 2014 13:50

091814sen1By Jim Miller • Special to the Times

Are brand-name medications better than generic?

No. Brand-name medications are not better, safer or more effective than their generic alternative because they’re virtually the same.

To gain approval from the U.S. Food and Drug Administration (FDA), generic drugs are required to have the same active ingredients, strength and dosage form as their brand-name counterpart. The generic manufacturer must also demonstrate that people absorb the drug at the same rate.

The only difference between a brand-name drug and its generic is the name (generics are usually called by their chemical name), shape and color of the drug (U.S. trademark laws don’t allow generics to look exactly like the their brand-name counterparts) and price.

Generic drugs are often 10 to 30 percent cheaper when they first become available, but by the end of the first year the price can drop in half. And, by the second and third year, it can drop 70 to 90 percent.

Cost Difference

The reason generic drugs are so much cheaper is because their manufacturers don’t have the hefty start-up costs that the original creators of the drug do.

When a pharmaceutical company creates a new drug, it spends millions of dollars on the research, development and clinical testing phase. Then, if it gets FDA approval, it has to turn around and spend even more money to market the drug to the health care industry and the public.

The total cost can rise into the hundreds of millions by the time the drug is in the hands of consumers.

In an effort to recoup their investment, the brand-name drug makers charge a premium price, and are given a 20-year patent protection, which means that no other company can make or sell the drug during that period of time.

After those 20 years are up, however, other companies can apply to the FDA to sell generic versions. But because generic manufacturers don’t have the same research, development and marketing costs, they can sell their product much cheaper.

Also, once generic drugs are approved, there’s greater competition, which drives the price down. Today, nearly 8 in 10 prescriptions filled in the United States are for generics, which saves U.S. consumers around $3 billion every week.

New Generics

You should also know, in 2014 and 2015, patents on a wide variety of popular brand-name drugs will expire and become available in generic, including Celebrex, Copaxone, Actonel, Nexium, Exforge, Cymbalta, Lunesta, Avodart, Abilify, Evista, Maxalt, Maxalt MPT, Micardis, Micardis HCT, Reneagel, Twynata and Xeloda.

For more information, Community Catalyst, a national, nonprofit consumer advocacy organization, provides a list on their website of the top 50 brand-name drugs and the dates they should become available as generics. Go to communitycatalyst.org, and type “Drugs Going Generic 2014 – 2015” in their search bar to find it.

You can also find out if a brand-name drug has a generic alternative by simply asking your doctor or pharmacist. Or, visit GoodRX.com, an internet tool that provides prices on brand-name drugs and their generic alternatives (if available) at virtually every pharmacy in the U.S. so you can find the best deals in your area.

 

 
Does Medicare Offer Coverage for Mental Health Services? | Print |  E-mail
Thursday, 18 September 2014 13:48

By Gene L. Osofsky, Esq. • Special to the Times

Q: I hear that Medicare will now cover mental health services much like it covers care for medical and surgical conditions. Do you know anything about this?

A: Yes. Beginning Jan. 1, 2014, Medicare began reimbursing the cost of outpatient mental health treatment services on a par with its reimbursement for other Part B medical services.

Previously, Medicare beneficiaries who received mental health services faced a higher co-pay and were initially required to pay up to 50 percent of the approved amount, whereas they only paid 20 percent for most other outpatient medical services. Many Medicare recipients and advocacy organizations felt this practice to be discriminatory. Congress ultimately agreed.

In July, 2008, Congress enacted the “Medicare Improvements For Patients and Providers Act” (“Act”).  Under the Act, Congress initiated a phase-out of this disparity over a five-year period from 2010 to 2014. That phase-out is now complete.  

As a result, at the first of this year, Medicare began paying the same 80 percent of the Medicare-approved rate for all covered mental health services, just like it does for medical and surgical services.

Also, if you have a Medicare supplemental policy, it may cover the 20-percent co-payment just as it now does for more traditional medical services. If you do not have a supplemental policy and need help paying the 20-percent co-pay, there are Medicare programs that may help.

The following are some of the mental health services that Medicare will now cover at 80 percent of the Medicare-approved rate:

• Visits to a psychologist or other professional counselor;

• Family therapy, as long as the focus of therapy is on the Medicare recipient;

• Substance abuse treatment;

• Occupational therapy that is part of mental health treatment;

• Prescription medicine that cannot be self-administered;

• Art, dance and music therapy if deemed necessary to prevent hospitalization.

Medicare also covers inpatient care in a general or psychiatric hospital. However, unlike with non-mental health services, Medicare puts a cap on coverage for inpatient psychiatric care and will only pay for up to 190 days of inpatient psychiatric hospital services in a lifetime.

Be aware that Medicare will pay for services only if they are provided by a mental health professional who accepts Medicare assignment, so be sure to check with your health professional before you receive services.

Note: If you have a Medicare Advantage Plan, coverage rules may be different, so check with your plan before receiving services.

For more information on covered mental health services, visit www.Medicare.gov and download Medicare’s new guide entitled “Medicare And Your Mental Health Benefits,” or call 1-800-633-4227 and ask for a copy.

For help with paying the co-pays, visit www.Medicare.gov and select “Get Help Paying Costs” under “Your Medicare Costs,” or call the 800 number above.

Gene L. Osofsky is an elder law and estate planning attorney in Hayward.  Visit his website at www.LawyerForSeniors.com.


 

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