Take a Look at Social Security Today PDF  | Print |  E-mail
Thursday, 04 February 2016 14:33

By Nathaniel Sillin • Special to the Times

It’s easy to ignore what Social Security is doing, however, some significant announcements late last year make now a very good time to pay attention.

What follows is a summary of notable changes to Social Security at the start of 2016 and ways to ensure you’re making the right retirement planning and claiming ( decisions based on what’s ahead:

1. Social Security payments won’t increase in 2016. In late October, Social Security ( announced that there wasn’t enough inflation in 2015 to create a cost-of-living adjustment (COLA) to monthly benefits this year.

Understandably, this announcement shook up recipients who look to Social Security for a significant part of their monthly income. It’s only the third time payments were frozen in the past 40 years since automatic COLA adjustments began, but here’s the rub — all three occasions occurred after 2010. In short, most seniors will have to live with an average monthly payment of $1,341 with married beneficiaries receiving a total of $2,212.

2. Married and divorced individuals may have to rethink the way they claim benefits. Also last October, Washington settled a federal budget battle in part by closing some notable loopholes in Social Security law that allowed certain married couples to substantially increase their benefits over time and certain divorced individuals to claim benefits from former spouses under certain circumstances.

These new restrictions on so-called file-and-suspend and restricted-claim strategies go into effect this coming May. In short, if you’re close to age 62 (the earliest age you can start claiming Social Security benefits) getting qualified advice has never been more important.

3. When there’s no cost-of-living adjustment, there’s no change in the maximum amount of earnings subject to the Social Security tax, which will stay at $118,500.

This means earnings above that level aren’t subject to the Social Security portion of the payroll tax or used to calculate retirement payouts. At the same time, the Social Security earnings limit for people who work and claim Social Security payments will stay at $15,720 in 2016 for people ages 65 and younger. Social Security beneficiaries who earn more than this amount will have $1 in benefits temporarily withheld for every $2 in earnings above the limit.

4. Some benefits are going down… a little. The highest possible Social Security payment for a 66-year-old worker who signs up for Social Security this year will be $2,639 per month, down $24 from $2,663 in 2015.

The reason? Social Security noted that despite no cost-of-living adjustment there was an increase in the national average wage index, one of the statistical guideposts the agency uses to calculate benefits.

5. If you haven’t created a My Social Security account, do so for two reasons: First, there have been reports of ID theft related to thieves attempting fraudulent signups for such accounts. Second, the agency is making more detailed account data available online such as estimates of monthly payments at various claiming ages.

Also, Social Security expanded office hours in some of its field locations in 2015, so if you need face-to-face assistance, check hours of operation at your closest local office (

Nathaniel Sillin directs Visa’s financial education programs.

Choose the Right Hospice Program PDF  | Print |  E-mail
Thursday, 04 February 2016 14:31

By Jim Miller • Special to the Times

Hospice can be a wonderful option in the last months of life because it offers a variety of services, not only to those who are dying, but also to those left behind. Here’s what you should know.

What Hospice Offers

Hospice care is a unique service that provides medical care, pain management, and emotional and spiritual support to people who are in the last stages of a terminal illness — it does not speed up or slow down the process of dying.

Hospice’s goal is to simply keep the patient as comfortable and pain-free as possible, with loved ones nearby until death.

The various services provided by a hospice program comes from a team of professionals that works together to accommodate all the patients’ end-of-life needs.

The team typically includes hospice doctors that will work with the primary physician and family members to draft up a care plan; nurses who dispense medication for pain control; home care aids that attend to personal needs; social workers who help prepare for end of life; clergy members who provide spiritual counseling, if desired; and volunteers that fill a variety of niches, from sitting with the patient to helping clean and maintain their property.

To receive hospice, a person must get a referral from their physician stating that their life expectancy is six months or less.

It’s also important to know that home-based hospice care does not mean that a hospice nurse or volunteer is in the home 24 hours a day. Services are based on need and/or what you request.

Hospice care can also be stopped at anytime if a person’s health improves or if they decide to re-enter cure-oriented treatments.

How to Choose

The best time to prepare for hospice and consider your options is before it’s necessary, so you’re not making decisions during a stressful time. There are more than 5,500 hospice programs in the U.S.; so, depending on where you live, you may have several options from which to choose.

To locate a good hospice in your area, ask your doctor or the discharge planner at your local hospital for a referral, call your state hospice organization (see for contact information), or search online at sites like the National Hospice and Palliative Care Organization at

Look for an established hospice that has been operating for a few years and one that is certified by Medicare. To help you select one, the American Hospice Foundation provides a list of questions to ask at:

Who Pays

Medicare covers all aspects of hospice care and services for its beneficiaries. There is no deductible for hospice services although there may be a very small co-payment — such as $5 for each prescription drug for pain and symptom control, or a 5-percent share for inpatient respite care. Medicaid also covers hospice in most states, as do most private health insurance plans.

For more information, see the “Medicare Hospice Benefits” online booklet at


Financial Paperwork: What to Keep, What to Toss PDF  | Print |  E-mail
Thursday, 21 January 2016 14:00

012116senBy Jim Miller • Special to the Times

Q: How long should a person hang on to old receipts, stock records, tax returns and other financial documents? I have accumulated boxes full of such papers over the years and would like to get rid of some of it now that I’m retired.

A: This is a great time of the year to get rid of unnecessary or outdated paperwork and to organize your records in preparation for filing your tax return in the spring. Here’s a checklist of what to keep and what to toss out, along with some tips to help you reduce your future paper accumulation.

Toss Out

• ATM receipts and bank-deposit slips as soon as you match them up with your monthly statement.

• Credit card receipts after you get your statement, unless you might return the item or need proof of purchase for a warranty.

• Credit card statements that do not have a tax-related expense on them.

• Utility bills when the following month’s bill arrives showing that your prior payment was received. If you wish to track utility usage over time, you may want to keep them for a year, or if you deduct a home office on your taxes keep them for seven years.

To avoid identity theft, be sure you shred anything you throw away that contains your personal information. It’s best to use a crosscut shredder rather than a strip one, which leaves long paper bands that could be reassembled.

Keep One Year

• Paycheck stubs until you get your W-2 in January to check its accuracy.

• Bank statements (savings and checking account) to confirm your 1099s.

• Brokerage, 401(k), IRA and other investment statements until you get your annual summary (keep longer for tax purposes if they show a gain or loss).

• Receipts for health care bills in case you qualify for a medical deduction.

Keep Seven Years

Supporting documents for your taxes, including W-2s, 1099s, and receipts or canceled checks that substantiate deductions. The IRS usually has up to three years after you file to audit you but may look back up to six years if it suspects you substantially underreported income or committed fraud.

Keep Indefinitely

• Tax returns with proof of filing and payment. You should keep these for at least seven years, but many experts recommend you keep them forever because they provide a record of your financial history.

• IRS forms that you filed when making nondeductible contributions to a traditional IRA or a Roth conversion.

• Receipts for capital improvements that you’ve made to your home until seven years after you sell the house.

• Retirement and brokerage account annual statements as long as you hold those investments.

• Defined-benefit pension plan documents.

• Savings bonds until redeemed.

• Loan documents until the loan is paid off.

• Vehicle titles and registration information as long as you own the car, boat, truck, or other vehicle.

• Insurance policies as long as you have them.

• Warranties or receipts for big-ticket purchases for as long as you own the item, to support warranty and insurance claims.

Keep Forever

Personal and family records like birth certificates, marriage license, divorce papers, Social Security cards, military discharge papers and estate-planning documents (power of attorney, will, trust and advanced directive). Keep these in a fireproof safe or safe-deposit box.

Reduce Your Paper

To reduce your paper clutter, consider digitizing your documents by scanning them and converting them into PDF files so you can store them on your computer and back them up onto a USB flash drive or external hard drive like or

Your can also reduce your future paper load by switching to electronic statements and records whenever possible.

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

CAPTION: To avoid identity theft, be sure you shred anything you throw away that contains your personal information.

Is Our Ohio Will Still Valid in California? PDF  | Print |  E-mail
Thursday, 21 January 2016 13:51

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

Q: Before relocating to California, my wife and I lived in Ohio where we signed wills. Are they now valid in California?

A: If they were properly prepared and signed under the laws of Ohio, the short answer is “yes,” But, it would still be wise to have them reviewed — and perhaps revised — by a California lawyer.

Even though prepared in Ohio, they might be interpreted under the laws of California, perhaps with unanticipated results. Here are some examples:

• Bequest to Caregiver: Under California law, a bequest to a person who is a caregiver, or who is acting as a fiduciary to the will-maker, is generally presumed to be invalid unless an independent attorney has evaluated the planned bequest, and issued a Certificate of Independent Review affirming that the bequest was made voluntarily and not under duress.  Otherwise, the bequest will generally fail.

That may not be the same rule in the state where the will was originally prepared. So, even though an out-of-state will may be deemed valid in other respects, it is possible that any bequest to a caregiver or a fiduciary may fail if the will is offered for probate in California. Presumably, such a result was not what the will-maker intended.

• Witness Authentication: Generally speaking, before a will can be admitted to probate in most states, two witnesses must have signed a sworn statement reciting that they were present, observed the will-maker sign the will, and affirm that he or she was in possession of his mental faculties and not acting under duress.

In some states, and I believe Ohio is one, this sworn statement is typically not included in  the original will. Instead, when the testator later dies and the will is offered for probate, the witnesses must then be located and their sworn statements secured before the will can be offered for probate.

Sometimes, they must appear in court and give testimony about the signing of the will. If the witnesses cannot then be located, or if they have predeceased the testator, the matter of proving the validity of the will becomes problematic.

California law avoids this problem by permitting the original will, itself, to contain the sworn statement immediately above the witness’ signatures. This is called a “self-proving” will, and allows the will to be admitted to probate without any additional evidence. This avoids the need to locate the witnesses and secure their sworn statements, sometimes years later.

That sworn statement usually reads something like the following: “Each of us declares, under penalty of perjury, that the foregoing recitals [about the signing of the will] are true and correct”.

• Real Property: If the will disposes of real property in another state, the will should comply with the laws of both states. I would advise the same if the realty is held in a Living Trust.

The question as to which state’s laws govern any particular legal issue concerning  a will may vary. It is therefore wise to have your Ohio wills reviewed, and perhaps revised, if you have relocated to California. An ounce of prevention is worth a pound of cure.

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

Many Mistake Shortness of Breath as Part of Aging But it Could be COPD PDF  | Print |  E-mail
Thursday, 21 January 2016 13:48

By Jim Miller • Special to the Times

Chronic obstructive pulmonary disease (COPD) is a serious lung disease that, over time, makes it hard to breathe. What’s more, an estimated 24 million people have COPD today, but about half of them don’t know it.

Many people mistake shortness of breath as a normal part of aging, or a result of being out of shape, but that’s not necessarily the case. COPD — a term used to describe a variety of lung diseases including emphysema and chronic bronchitis — develops slowly, so symptoms may not be obvious until damage has occurred.

Common symptoms include: an ongoing cough or one that produces a lot of mucus; shortness of breath, especially during physical activity; wheezing; and chest tightness.

Those most at risk are smokers or former smokers over age 40, and people who have had long-term exposure to other lung irritants like secondhand smoke, air pollution, chemical fumes and dust.

If you’re experiencing any of those symptoms, you need to get tested by your doctor. A simple breathing test called spirometry can tell if you have COPD, and if so, how severe it is. Early screening can also identify COPD before major loss of lung function occurs.

If you have COPD, there are things you can do to help manage symptoms and protect your lungs from further damage, including:

Quit smoking: If you smoke, the best thing you can do to prevent more damage to your lungs is to quit. To get help, the National Cancer Institute offers a number of smoking cessation resources at or call 1-800-QUIT-NOW. Or ask your doctor about prescription antismoking drugs that can help reduce your nicotine craving.

Avoid air pollutants: Stay away from sources of dust, allergens and strong fumes. Also, to help improve your air quality at home, remove dust-collecting clutter and keep carpets clean; run the exhaust fan when using cleaning products, bug sprays or paint; ban smoking indoors; and keep windows closed when outdoor air pollution is high (see for daily air-quality reports).

Guard against flu: Influenza can cause serious problems for people who have COPD, so get a flu shot every fall and wash your hands frequently to avoid getting sick. Also ask your doctor about getting the pneumococcal immunizations for protection against pneumonia.

Take prescribed medications: Bronchodilators (taken with an inhaler) are commonly used for COPD. They help relax the airway muscles to make breathing easier. Depending on how severe your condition, you may need a short-acting version only for when symptoms occur, or a long-acting prescription for daily use. Inhaled steroids may also help reduce inflammation and mucus and prevent flare-ups.

For more information, visit the COPD Foundation at or call the COPD information line at 866-316-2673.

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

Ensure Loved Ones Inherit Your IRA PDF  | Print |  E-mail
Thursday, 07 January 2016 15:43

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

Q: I have a large, Traditional IRA, and I wish to name my wife as primary beneficiary and my children from a previous marriage as backup beneficiaries.  Can I lock in this beneficiary designation plan on the IRA Beneficiary Designation Form I sign at the bank?

A: Unfortunately, not likely. While it is always a good idea to name both primary and contingent beneficiaries when you create your IRA, those designations merely determine the identity of the new IRA owner upon your death.

Under most plan documents, once the primary beneficiary — in this case, your wife — survives you, she then becomes the owner of the IRA for all purposes, and your contingent beneficiary designations become inoperative.

Your wife would then be able to designate her own “successor beneficiaries” to take in the event that funds remain in the IRA when she dies.

If she neglects to do so, then the remaining funds would go per the default provisions of the plan document, which likely would be to her estate, potentially resulting in a probate, the distribution of the IRA to her beneficiaries, and the loss of the “stretch” payout option.

In short, most IRA custodians will not permit you to name successor beneficiaries at the time you create your account. This problem usually comes as a surprise to clients and typically arises in two contexts:

1) Your wife has given you her assurance that, if she survives you, she will re-designate your children from your previous relationship as her own successor beneficiaries. However, at your demise, she suffers from some form of dementia and cannot take the steps necessary to honor her promise; or

2) You are concerned that your wife may remarry and feel it appropriate to name her new spouse as her primary beneficiary, and her own children as contingent beneficiaries.

What to do?

In the first case, one solution is for her to sign, now, a properly designed Durable Power Of Attorney (“DPOA”), which contains specific and comprehensive powers permitting her agent to act with respect to your IRA, including the power to elect to roll your IRA into hers to achieve the “stretch out” of payments.

Caution: To achieve your goal, it would be wise to verify that the beneficiary designations on her IRA are consistent with your own beneficiary wishes.

Also, some custodians have their own DPOA forms, so if yours does, complete the custodian’s forms as well as your own attorney-drafted DPOA. Of course, if your wife has capacity at the time of your demise, she should, herself, re-designate her IRA beneficiaries as soon as possible.

In the second case, where you wish to lock-in the designation of your own successor beneficiaries, consider a stand-alone IRA Trust, sometimes called an Individual Retirement Trust (“IRT”). This is a special kind of trust and is different from the typical “Living Trust.”

Note: there are pros and cons in making a trust the beneficiary of an IRA, including the possibility that doing so may preclude the surviving spouse from rolling your IRA into hers in order to “stretch” the distributions over a longer period of years, and thereby reduce the annual tax bite while allowing the IRA to grow in value over the longer term.

These are complex matters, and seeking the advice of qualified financial and legal advisors to assist you in choosing the most suitable strategy is strongly recommended.

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

What You Need to Know About Pill Splitting PDF  | Print |  E-mail
Thursday, 17 December 2015 08:47

121715sen2By Jim Miller • Special to the Times

Q: Is pill splitting safe? I have several friends who cut their pills in half in order to save money, but I have some concerns. What can you tell me?

A: Pill splitting — literally cutting them in half — has become a popular way to save on pharmaceutical costs but you need to talk to your doctor or pharmacist first, because not all pills can be split.

The reason pill splitting is such a money saver is because of a quirk in the way drugs are manufactured and priced. A pill that’s twice as strong as another may not be twice the price.

In fact, it’s usually about the same price. So, buying a double-strength dose and cutting it in half may allow you to get two months worth of medicine for the price of one. But is it safe?

As long as your doctor agrees that splitting your pills is OK for you, you learn how to do it properly, and you split only pills that can be split, there’s really no danger.

If you’re interested in splitting your pills, talk to your doctor or pharmacist to find out if any of the medicines you use can be safely split. It’s also important to find out whether splitting them will save you enough money to justify the hassle.

The pills that are easiest to split are those with a score down the middle. However, not every pill that’s scored is meant to be split. The most commonly split include:

• Cholesterol lowering drugs, like Crestor, Lipitor, Mevacor, Pravachol and Zocor.

• Antidepressants, like Lexapro, Celexa, Serzone, Paxil, and Zoloft.

• High blood pressure medicines such as, Accupril, Zestril, Diovan, Avapro, Norvasc, Tenormin, Toprol and Cardura.

• Erectile dysfunction pills, like Viagra, Cialis and Levitra.

121715senUse a Splitter

Having the right equipment is very important. Don’t use a knife or scissors to cut. It can cause you to split them unevenly resulting in two pieces with very different dosages, which can be dangerous.

Purchase a proper pill cutter that has a cover and a V-shaped pill grip that holds the pill securely in place. You can find them at most pharmacies for $3 to $10.

For convenience, you might be tempted to split the whole bottle of pills at once. But it’s best to do the splitting on the day you take the first half, and then take the other half on the second day or whenever you are scheduled to take your next dose. That will help keep the drugs from deteriorating due to exposure to heat, moisture, or air.

It will also help ensure that any deviation in the size of one dose is compensated in the next. It’s also important to know that pills are only safely split in half, and never into smaller portions such as into thirds or quarters.

Don’t Split These

Some pills should never be split. Drugs that are time-released or long-lasting and tablets that contain a combination of drugs probably shouldn’t be split, because it’s difficult to ensure a proper amount of active ingredient in each half.

Pills with a coating to protect your stomach, and pills that crumble easily or irritate your mouth shouldn’t be split either, along with chemotherapy drugs, anti-seizure medicines, birth control pills and capsules containing powders or gels.

Again, your doctor or pharmacist will know which drugs can and cannot be split. If you’re taking a medicine that can be split, you’ll need to get a prescription from your doctor for twice the dosage you need. Then you can start splitting safely, and saving.


Will Inheritance Bounce Mom Off Medi-Cal? PDF  | Print |  E-mail
Thursday, 17 December 2015 08:39

By Gene L. Osofsky • Special to the Forum

Q: My 86-year-old mo-ther is in a nursing home and receives a Medi-Cal subsidy. We just learned that her brother died and left her $200,000 in his trust. Will the receipt of this inheritance bounce mom off of Medi-Cal? Is there anything we can do?

A: The answer to your first question is easy: Yes, the receipt of that inheritance will put her over the resource ceiling and result in the termination of her Medi-Cal nursing home subsidy. If she is unmarried, that resource ceiling is a very modest $2,000.

As to your second question, there may be things you can do. Here are some options:

1) Purchase a Prepaid Funeral Plan. If she has not already made her final arrangements, she can purchase a prepaid funeral contract or fund an irrevocable burial trust for herself and other members of her immediate family.

Most mortuaries have forms available. Those funds will then be considered exempt and will not count toward her resource ceiling.

2) Pay Debts and Expenses. If Mom has any outstanding debts or expenses, she can pay them. Pay by check and retain full documentation.

3) Reform Brother’s Trust? In some cases, it may be possible to reform her brother’s trust by court order during trust administration, so that the bequest would bypass your mother and, instead, go into a Special Needs Trust (“SNT”) for her benefit.

The SNT would then be managed by a trustee, which could be a family member or a professional trustee appointed by the court. If properly set up and administered, the funds distributed to the SNT would then not count against her $2,000 Medi-Cal resource ceiling. Instead, they could be used to pay for things that Medi-Cal does not cover, such as a companion to spend time with her or even to supplement healthcare expenses not paid by Medi-Cal.

4) Pooled SNT: If it is not possible to reform her brother’s trust, consider joining a pooled SNT. These are SNT’s set up and managed by nonprofit organizations, whereby all of the funds are invested and professionally managed as a group, but separate accounts are maintained for each individual beneficiary.

Distributions from the pooled SNT could likewise be used to pay for things that Medi-Cal does not cover. The drawback is that funds remaining in the pooled account after Mom’s death must first be used to reimburse the state to the extent of Medi-Cal benefits paid out for her, and the excess, if any, may remain in the fund for its ongoing nonprofit purposes.

5) Gifts? If mom has full capacity to consent to gifts, or if she has in place a Durable Power Of Attorney which has adequate gifting powers (most do not), consideration might be given to a very carefully designed plan of divestment in favor of children or other family members.

Caution: Gifts are frowned upon by Medi-Cal, and any gifting plan should be designed and supervised by an Elder Law attorney with expertise in this area. If gifts are not handled properly, they may result in the termination of Mom’s Medi-Cal benefits.

As to all of the options, timing is very important, and it is usually necessary to design the plan before the inheritance is actually received so that it can be fully implemented in the month of receipt. To avoid running afoul, obtaining expert advice is essential.

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


How Much Will You Pay for Medicare in 2016? PDF  | Print |  E-mail
Thursday, 03 December 2015 19:30

By Jim Miller Special to the Times

All things considered, the news regarding your Medicare costs next year is pretty good.

For about 70 percent of the nation’s 52 million Medicare beneficiaries, there will be no Part B premium increase in 2016. And, thanks to the 2015 Bipartisan Budget Act that was signed into law by President Obama on Nov. 2, the other 30 percent will pay much less than previously projected. Here’s what you can expect.

Part B Premiums

Because the Social Security Administration will not be giving out a cost-of-living increase (or COLA) in 2016, the Medicare Part B premiums for most current beneficiaries will not go up either.

Thanks to the “hold harmless” provision in the Medicare law, which prohibits Part B premiums from rising in any year that there’s no COLA, the 2016 monthly premium will remain at $104.90 for most current Medicare participants.

However, this provision does not protect new Medicare enrollees (those who enroll in 2016), beneficiaries who are directly billed for their Part B premium, or current beneficiaries who have deferred claiming their Social Security.

This includes people 65 or older who are still working but have signed up for Medicare because their employer doesn’t offer health insurance. It also hits people who have filed and suspended Social Security benefits to allow a spouse to claim.

If you fit into any of these categories, your Medicare Part B premium will increase to $121.80 a month in 2016 — which is much lower than the $159.30 that it would have been, had the budget deal fell through.

The hold-harmless rule also does not protect high-income Medicare beneficiaries who already pay higher Part B premiums because their annual incomes are above $85,000 for an individual or $170,000 for a couple. If you fit into this category, here’s what you’ll pay for your Part B premium next year, based on your 2014 tax returns.

•Individuals with incomes of $85,000 to $107,000, or married couples filing joint tax returns with incomes of $170,000 to $214,000, will pay $170.50 per month.

•Individuals earning $107,000 to $160,000 (couples $214,000 to $320,000) will pay $243.60.

•Individuals with incomes of $160,000 to $214,000 (couples $320,000 to $428,000) will pay $316.70.

•Individuals over $214,000 or couples above $428,000 will pay $389.80.

Another increase high-income beneficiaries (those with incomes over $85,000, or $170,000 for joint filers) need to be aware of is the surcharge on Part D premiums. Affluent seniors that have a Medicare Part D prescription drug plan will pay an additional $12.70 to $72.90 per month, depending on their income, on top of their regular Part D premiums.

Deductibles and Co-Pays

Other changes you need to know about that will affect all Medicare beneficiaries include the Part B deductible, which will increase to $166 in 2016 (it’s currently $147); and the Part A (hospital insurance) annual deductible which will go up to $1,288 (it’s currently $1,260) for hospital stays up to 60 days. That increases to $322 per day for days 61-90, and to $644 a day for days 91 and beyond. And the skilled nursing facility coinsurance for days 21-100 will also increase to $161 per day (it’s currently $157.50).

For more information on all the Medicare costs for 2016, visit and click on “Your Medicare Costs” tab at the top of the page, or call 800-633-4227.

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

Guard Against Aortic Aneurysms PDF  | Print |  E-mail
Monday, 23 November 2015 22:29

111915senBy Jim Miller • Special to the Times

Stomach aneurysms, also known as “abdominal aortic aneurysms,” are very dangerous and the third leading cause of death in men over 60.

They also tend to run in families, so if you’ve had a parent with this condition you are much more vulnerable yourself.

An abdominal aortic aneurysm (or AAA) is a weak area in the lower portion of the aorta, which is the major artery that carries blood from the heart to the rest of the body.

As blood flows through the aorta, the weak area bulges like a balloon and can burst if it gets too big, causing life-threatening internal bleeding. In fact, nearly 80 percent of AAAs that rupture are fatal, but the good news is that more than nine out of 10 that are detected early are treatable.

Who’s At Risk?

Around 200,000 people are diagnosed with AAAs each year, but estimates suggest that another 2 million people may have it but not realize it. The factors that can put you at increased risk are:

• Smoking: Ninety percent of people with an AAA smoke or have smoked. This is the No. 1 risk factor and one you can avoid.

• Age: Your risk of getting an AAA increases significantly after age 60 in men, and after age 70 in women.

• Family history: Having a parent or sibling who has had an AAA can increase your risk to around one in four.

• Gender: AAAs are five times more likely in men than in women.

• Health factors: Atherosclerosis, also known as hardening of the arteries, high blood pressure and high cholesterol levels also increase your risk.

Detection and Treatment

Because AAAs usually start small and enlarge slowly, they rarely show any symptoms, making them difficult to detect. However, large AAAs can sometimes cause a throbbing or pulsation in the abdomen, or cause abdominal or lower back pain.

The best way to detect an AAA is to get a simple, painless, 10-minute ultrasound screening test. All men over age 65 that have ever smoked, and anyone over 60 with a first-degree relative (father, mother or sibling) who has had an AAA should talk to their doctor about getting screened.

You should also know that most health insurance plans cover AAA screenings, as does Medicare to beneficiaries with a family history of AAAs, and to men between the ages of 65 and 75 who have smoked at least 100 cigarettes during their life.

If an AAA is detected during screening, how it’s treated will depend on its size, rate of growth and your general health. If caught in the early stages when the aneurysm is small, it can be monitored and treated with medication. But if it is large or enlarging rapidly, you’ll probably need surgery.

AAA Protection

While some risk factors like your age, gender and family history are uncontrollable, there are a number of things you can do to protect yourself from AAA. For starters, if you smoke, you need to quit – see or call 1-800-quit-now for help.

You also need to keep tabs on your blood pressure and cholesterol levels, and if they are high you need to take steps to lower them through diet, exercise and if necessary, medication.


Medicare To Pay for End-of-Life Counseling PDF  | Print |  E-mail
Monday, 23 November 2015 22:27

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

Q: I hear that Medicare will now pay for me to discuss my end-of-life wishes with my doctor. Is this true?

A: Yes, beginning Jan. 1 of 2016, Medicare will begin reimbursing physicians for time spent in counseling patients regarding their end-of-life wishes.

This  development, just announced Oct. 31, 2015, by the Center for Medicare and Medicaid Services (“CMS”), was 6 years in the making and has been supported by the American Medical Association and many other groups and individuals.

Originally a part of the Affordable Care Act, this provision was removed in 2010, just before passage, to avoid the political controversy which arose when some individuals, notably former Vice Presidential Candidate Sarah Palin, accused the Obama administration of supporting “death panels.” Since then, the mood of the country has changed and the desire to encourage end-of-life counseling has gained broad support.

Until this announcement, Medicare only paid physicians for end-of-life counseling if the counseling occurred during the one time “Welcome to Medicare” examination that occurred within a beneficiary’s first 12 months of Medicare enrollment.

The problem with that arrangement was that many beneficiaries were neither interested nor prepared to discuss this matter with their physician during that very first Medicare visit.

Beginning Jan. 1, 2016, patients may now schedule a visit with their physician for the sole purpose of advance care planning, and the physician may now bill Medicare for that counseling. Alternatively, the patient may choose to discuss advance planning as part of his visit to address other healthcare issues.

In either event, the physician may now bill Medicare for separate reimbursement, using one of two new billing codes added to the Medicare Physician Fee Schedule, effective in 2016.

One tip: If the discussion takes place during the Annual Wellness Visit, you will typically have no co-pays and the doctor will still get fully reimbursed. However, if the discussion takes place during any other visit, you may then have the usual co-pays just as for other Medicare services.

Another tip: If you have a Medicare Advantage Plan, be sure to first check with your plan to see whether it covers this counseling and, if it does not, ask if the plan can still bill Medicare for your advance planning visit.

Once you have these discussions with your physician, be sure to take the next steps and create or update your Advance Health Care Directive and discuss your wishes with your family and designated health care agent.

Just as you may prepare a will or trust to plan for your assets, so, too, must you plan for your end-of-life healthcare.

In doing so, you will be doing a service, not only for yourself, but also  for your loved ones who may one day take comfort in knowing that your own wishes were honored.

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

How to Fight Medicare Fraud PDF  | Print |  E-mail
Monday, 23 November 2015 22:23

By David Sayen • Special to the Times

It’s an unfortunate truth, but health care fraud drives up costs for everyone in the health care system.

Fraud schemes often depend on identity thieves getting hold of people’s Medicare numbers. So guard your Medicare number. Treat it as you would a credit card.

•Don’t share your Medicare number or other personal information with anyone who contacts you by phone, email, or by approaching you in person, unless you’ve given them permission in advance. Medicare will never contact you and ask for your Medicare number or other personal information.

•Don’t ever let anyone borrow or pay to use your Medicare number.

•Review your Medicare Summary Notice to be sure you and Medicare are only being charged for services you actually received.

•Be wary of salespeople who knock on your door or call you uninvited and try to sell you a product or service.

•Don’t accept items received through the mail that you didn’t order. You should refuse the delivery and/or return it to the sender. Keep a record of the sender’s name and the date you returned the items.

Fraudsters often surface during Medicare’s open enrollment season, which runs from Oct. 15 to Dec. 7. So if you’re planning to enroll in a Medicare Part C health plan (Medicare Advantage) or Part D prescription drug plan:

•Be suspicious of anyone who contacts you about Medicare plans unless you gave them permission to do so.

•There are no “early bird discounts” or “limited time offers” for Medicare plans.

•Don’t let anyone rush you to enroll by claiming you need to “act now for the best deal.”

•Be skeptical of free gifts, free medical services, discount packages, or any offer that sounds too good to be true.

•Any promotional items you’re offered to enroll in a Medicare plan must be worth no more than $15. And these items can’t be given on the condition that you enroll in a plan

A common ploy of identity thieves is to say they can send you your free gift right away – they just need your Medicare number to confirm. Decline firmly.

If you suspect a health care fraud, report it by calling 1-800-MEDICARE (1-800-633-4227). You can learn more about protecting yourself from health care fraud by visiting or by contacting your local Senior Medicare Patrol (SMP).

SMP is a nonprofit organization made up of highly-trained volunteers such as doctors, nurses, accountants, investigators and attorneys who teach others about health care fraud.

To find the SMP in your state, go to the SMP Locator at

David Sayen is Medicare’s regional administrator for California. You can always get answers to your Medicare questions by calling 1-800-633-4227.



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