BY GENE L. OSOFSKY, ESQ.

Special to the Times

Q: My mother recently died after spending two years in a nursing home on Medi-Cal. Medi-Cal just sent us a bill for about $150,000 and says it will file a claim against her home. Yikes! We thought her home was an exempt asset. What do we do about the bill?



A: Your situation is all too common: families often confuse the Medi-Cal “eligibility” rules with the “recovery” rules.

Her home was, indeed, exempt for eligibility purposes, but that exemption expired upon your mother’s death. Her home and most other exempt assets then became exposed to a Medi-Cal “payback” claim. This is called “estate recovery.” Let’s review the basic rules to see if any might give you some relief:

1. You and your siblings do not have a personal obligation to pay back Medi-Cal from your own assets. Only your mother’s assets, including her home, are subject to recovery, whether held in her own name, in her Living Trust or in joint tenancy. However, you cannot transfer her home or other assets to her beneficiaries until the recovery claim is satisfied. Exception: her IRA, if left to named persons, is not subject to recovery.

2. If your mother were survived by a spouse, then her Medi-Cal recovery claim would be deferred until the death of her surviving spouse.

3. Medi-Cal will withdraw its claim entirely upon proof that your mother was survived by a blind, minor or disabled child, usually established by proof that the child is receiving Social Security disability benefits. Here, it does not matter whether the disabled child is an adult, nor whether they lived in your mother’s home or even relied upon her for support.

4. Medi-Cal will waive its claim if the surviving family members can prove “hardship,” based on any of six specific grounds. One ground is a showing that a child lived in the parent’s home and provided care for at least two years, thereby delaying the parent’s entry into a nursing home. Another is a claim that allowing the surviving child or other beneficiary to receive their inheritance would enable them to go off public benefits and be self-supporting. Unfortunately, Medi-Cal construes the hardship claims strictly and has turned down most of them.

5. If there is no basis to seek waiver or deferment of the claim, you might seek a “Voluntary Post-Death Lien.” This lien allows the survivors to continue to reside in the home while paying an agreed monthly installment against the amount of the Medi-Cal claim, which accrues interest at 7 percent per year. The balance of the claim would be paid when the home is sold. To qualify, the survivors must be residing in the home, be unable to pay the claim in full and be unable to obtain financing to do so.

Unfortunately, all of the above exceptions and limits to Medi-Cal recovery require specific fact patterns, and many families will not qualify.

However, if these same families had taken steps during the parent’s lifetime, in many cases lawful steps could have then been taken to protect the parent’s entire estate from Medi-Cal recovery. Once the parent dies, it is often too late and the survivors must rely upon the limited options discussed above.

For families with a loved one currently on Medi-Cal, we urge seeking the advice of an elder law attorney to determine whether steps can be taken now to avoid a later Medi-Cal recovery claim and thereby preserve assets for the benefit of surviving family members.

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

BY MARK UNDERWOOD

Special to the Times

Like many people, as you grow older one of your concerns may be about forgetfulness. You may not recall where you put things and there’s that nagging worry that your mental capacity may not be what it was when you were younger.

We all experience age-related changes and forgetfulness, like misplacing our car keys from time to time, but some people find these changes interrupt their daily life.

Across many households in America, many items on to-do lists and grocery lists are forgotten. Sometimes people have to go back to the grocery store more than once to get all the items on a list.

It’s frustrating to be at the store and have a feeling that you’re forgetting something. You wrote down what you need here but now you can’t find the list or remember what’s on it.

How to Stop CRS — “Can’t Remember Stuff”

If you’d like to change this pattern of forgetfulness, don’t just sit back and continually feel frustrated. You can stop “can’t remember stuff.” Resolve to have a healthier brain and make your life simpler in the process.

Say goodbye to the frustrations of arriving home without all your shopping list items. Say goodbye to the equally frustrating experience of finding your shopping list in a coat pocket long after you need it.

Some activities, like playing the piano, can decidedly improve the more a person practices. The same is true of your brain power. Many people sharpen their memory skills with crossword puzzles and board games or by taking classes, socializing with friends, and traveling to new places that may involve learning language skills.

Others train their brain to better remember lists of items, with and without the list in front of them. These are some ways you, too, can improve your retention skills.

Tips for Remembering What You Want, When You Need It

A small grocery list is a good place to start honing your memorization skills. It doesn’t matter what you want to remember or whether it is 10 items on your grocery list, 30 words of a speech or a 4-part recipe. Your mind is ready and able to remember more than we often understand.

Like an athlete, you’ll need to train your mind to remember more and more items. Start small and exercise your mind to meet your abilities.

Short list retention tips:

•Try the link method. The idea is to link a word to something else that is similar. This helps the brain make associations from one object to another.

•Try linking unrelated items. If you are trying to memorize a list of items from the lumber yard, for example, you may want to remember the items by associating them with something ridiculously unrelated such as fruit. The 2x4s you need on the list are pictured as “apples” (you need 3); the nails become “mangoes” and so on.

•Break up usual patterns. Powerful bonds are created when you use your memory to retain unrelated items or topics. What you’re doing is breaking the patterns your mind uses to file memories away.

•Take “virtual photos” of what you want to remember. Visualize what you want to remember as if it were a photo. It will help you more easily retrieve these items when you want to bring it out and “look at it.”

Mark Underwood is a neuroscience researcher, president and co-founder of Quincy Bioscience, a biotech company located in Madison, Wisconsin.

Games include golf, archery, swimming, softball, etc.

Seniors looking to test their physical endurance can do so at the “Feats of Strength” competition, part of the Bay Area Senior Games, on Saturday, May 18.

Entrants ages 50 to 88 can compete in five events, including pull-ups or chin-ups, maximum weight chin-ups, standing long jump, farmers’ walk and a dynamometer hand squeeze.

“People are grateful because they can’t find any exercises like these,” said 76-year-old Dale Harder, who has hosted the event in his Castro Valley backyard for three years.

At 76, Harder explains he continues to do his exercises to stay healthy and not become a couch potato.

Athletes can enter in the official Bay Area Senior Games competition by visiting www.bayarea-seniorgames.org for $59 plus $10 for the Harder event. Entrants are encouraged to register as soon as possible.

Senior Games competitions include golf, archery, table tennis, swimming, soccer, softball, volleyball and bocce, among others.

— Robert Souza

CAPTION: Diana Dominick, 72, carried 75 pounds of iron for 50 meters in 47.46 seconds.

PHOTO COURTESY OF DALE HARDER

BY JIM MILLER

Special to the Times

When it comes to planning for retirement, most Americans could stand to brush up on their financial knowledge a bit, but it’s especially important for unmarried women. Here’s what you should know.

Retirement Struggles: It’s an unfortunate reality that most unmarried women — whether they’re divorced, widowed or never married — face much greater financial challenges than men in retirement.

Why? Because women tend to make less money (about 78 cents for every dollar a man makes) and have shorter working careers (due to raising children and/or caring for aging parents) than men. And, less money earned usually translates into less money saved and a lower Social Security benefit when you retire.

In addition, women also live an average of five years longer than men which requires their retirement income to stretch farther. And, according to studies, women tend to be less knowledgeable and more intimidated about financial issues than men, which means they don’t always handle their money as well as they should.

Because of these issues, it’s very important that women educate themselves on financial matters. Listed below are some good resources that can help.

Financial Education: A good place to start is with the Women’s Institute for a Secure Retirement, a nonprofit organization dedicated to financial education for women.

At wiserwomen.org you can read and download for free a wide variety of easy-to-understand publications on retirement planning, money management, saving and investing, as well as Social Security, health care, annuities, and more.

If you don’t have a computer or internet access, you can call 202-393-5452 and order hard copies of their publications and have them mailed to you for a few dollars.

Another resource you should tap into is mymoney.gov, a U.S. government website dedicated to financial literacy and education that provides free information, resources, publications, financial calculators, checklists, budgeting worksheets and more, to help you make informed decisions.

You can also call 888-696-6639 and order a free “My Money” tool kit that includes a variety of publications on saving, investing and getting the most for your money.

The Employee Benefits Security Administration, a part of the U.S. Department of Labor, is another agency that offers a variety of publications, including the 62-page booklet “Taking the Mystery Out of Retirement Planning” and “Women and Retirement Savings” brochure. You can see them online at www.dol.gov/ebsa/publications, or call 866-444-3272 and have them mailed to you for free.

Also, visit choosetosave.org, a website developed by the Employee Benefit Research Institute that offers the Ballpark Estimate retirement planning worksheet, more than 100 online calculators, brochures, savings tips and links to resources to help you manage your finances.

Social Security Help: You also need to get up to speed on Social Security. To help with this, the Social Security Administration has an online resource specifically designed for women that covers how marriage, divorce, widowhood, work, caregiving and other life or career events can affect your benefits. It also offers information on SSI, Medicare benefits and provides calculators to help you figure out your future earnings at different retirement ages.

You can access this information at ssa.gov/women, or call 800-772-1213 and order their free pamphlet entitled “What Every Woman Should Know.”

Financial Advice: If you need some hands-on help, consider getting a financial assessment or tune-up with a fee-only financial advisor. Costs for these services will vary from around $150 to $300 per hour, but it can be very beneficial to help you set-up a retirement plan you can follow. See napfa.org or garrettplanningnetwork.com to locate an advisor in your area.

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

BY DAVID SAYEN

Special to the Times

For years, Medicare beneficiaries and taxpayers have been paying too much for home medical equipment such as wheelchairs and oxygen supplies.

To reduce costs and the fraud that results from excessive prices, Medicare has introduced a competitive bidding program.

Round 1 of the program successfully reduced costs for certain products and services by more than 42 percent in nine areas of the country. Now, the program’s benefits are coming to the Bay Area.

Round 2 of the program is scheduled to begin on July 1, in Alameda, Contra Costa, Marin, San Francisco and San Mateo counties. It’s projected to save people with Medicare in these Bay Area counties an average of 47 percent on certain products.

The products include oxygen, oxygen equipment and supplies, power and manual wheelchairs, scooters, respiratory assist devices, hospital beds, and walkers and related accessories.

Medicare also is launching a nationwide mail-order program for diabetic testing supplies on July 1. Beneficiaries will save an average of 72 percent on those supplies.

Prior to competitive bidding, the costs for most of these items were based on historical charges, adjusted for inflation over time. Many studies have shown that the prices Medicare pays are excessive, sometimes three or four times higher than retail prices or amounts commercial insurers pay.

Since Medicare is paying less, coinsurance costs will be less, too. Medicare generally pays 80 percent of the cost of supplies used in the home under Part B. People with Medicare pay the remaining 20 percent.

If you have Original Medicare and you use items in one of the program categories, you generally must use a Medicare contract supplier in order for Medicare to help pay for the item.

If you currently receive oxygen or oxygen equipment, or rent certain other items from a non-contract supplier, you may be able to continue renting these items from your current supplier after July 1 if the supplier chooses to become a “grandfathered” supplier.

Medicare has resources to help you understand the new program, including www.medicare.gov and 1-800-633-4227. TTY users call 1-877-486-2048. You can also call your local State Health Insurance Counseling and Advocacy Program, at 1-800-434-0222.

If you’re in a Medicare Advantage Plan (like an HMO or PPO), your plan will notify you if your supplier is changing. Contact your plan for more information.

David Sayen is Medicare’s regional administrator for California.

BY JIM MILLER

Special to the Times

With so many choices and options available today, shopping for a hearing aid that meets your needs, lifestyle and budget can be challenging. Here are some tips that can help you locate a good hearing aid provider and choose an appropriate aid.

Choose a Provider

The first step in buying a hearing aid is to choose a good provider. The best option — as recommended by Consumer Reports — is an otolaryngologist (an ear, nose and throat doctor) who employs an audiologist that fits and dispenses hearing aids.

An otolaryngologist will first examine your ears and rule out any medical conditions such as a tumor, bacterial infection or ear wax that can affect your hearing. Medicare will cover the medical exam and an audiologist’s test if ordered by a physician.

If you can’t find a conveniently located doctor’s office that dispenses aids, an independent audiologist or hearing instrument specialist is a good alternative. To search for these professionals in your area, see howsyourhearing.org and ihsinfo.org.

Big box retailers like Wal-Mart and Costco also sell hearing aids.

Or, if you’re a veteran, be sure to check with your nearest VA health facility. Eligible veterans may be able to get hearing aids for free.

During Your Visit

After you locate a provider, when you go in for your first visit you need to be prepared to discuss your lifestyle and hearing needs.

For example: Do you just want to hear the TV, or other people speaking? Do you talk on the phone a lot? Do you need to hear in a lot of noisy places, like restaurants?

Knowing your priorities will help your provider determine what style and hearing aid technology is best for you.

You’ll also be given a hearing test in a soundproof booth to determine what type of hearing loss you have. After the test, your provider should give you a choice of hearing aid brands, features and styles to consider.

To help you decide, ask for a demonstration. Many providers are able to put a disposable plug on the tip of a behind-the-ear hearing aid and program the device to your hearing loss so you can experience how it works.

Also ask about popular add-on features like “telecoils” that helps with phone conversations, “directional microphones” that can help you hear in noisy places, and “feedback cancellation” that prevents the aid from squealing when you get too close to other audio equipment. But, keep in mind that the extra features will drive up the price.

At the Fitting

After you buy your hearing aid, don’t leave the office without making sure it physically fits your ear and that it does what you want it to do. To help with this, ask to have a “real-ear” test which measures the match between your hearing loss and the response of your hearing aid.

Also get a signed copy of a contract that outlines the hearing aid you’re buying, along with the price, trial period, any nonrefundable fees and the warranty.

Most manufacturers allow a 30- to 60-day trial period to be sure you’re satisfied, and provide follow-up visits to help you with needed adjustments or questions.

Resources

You also need to know that digital hearing aids are expensive, typically costing between $1,000 and $3,500 per ear, and they’re not covered by traditional Medicare or most private insurance companies. To look for help, call the National Institute on Deafness and Other Communication Disorders at 800-241-1044 and ask them to mail you their list of financial resources for hearing aids.

For more hearing aid information, get a copy of the “Consumer’s Guide to Hearing Aids” for $5.50 plus shipping at hearingloss.org, or call 301-657-2248.

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

BY MARY GRODIN, ChFC, CFS

Special to the Times

Q: I am planning on retiring in the next year but am not quite sure if I can afford to or not. How should I go about figuring this out?

A: You are not alone; many people have the same question. The first thing to do is make a list of all your fixed and discretionary expenses as they pertain to retirement.

I teach pre-retirement classes and always ask the class how many believe they can retire on 50 percent, 75 percent or 100 percent of what they are making now. A few years ago, half the class said 50 percent. Now, most of the classes say 100 percent. You might have less transportation costs or not have to purchase as many nice work-type clothing but other costs will probably go up. After all, you now will have the time to do things that you didn’t have time for when working.

Some of the fixed expenses might be food, utilities, mortgage, insurance, property taxes, etc. Discretionary expenses could be entertainment and travel. If you will be receiving a pension and/or Social Security, will that be enough to cover your fixed expenses?

For those of my clients who don’t have a pension we might use a portion of their retirement savings (401(k)s, IRAs) to create a guaranteed stream of income which is enough, along with their Social Security, to pay the fixed expenses every month. The remainder of their assets could be invested — some for a mid-term time horizon and some for a longer-term time horizon. It’s never too soon to start developing a strategy that will work for your situation.

Q: I am a recent widow. I always handled the household bills but was never involved much with our investments. This is overwhelming to me. What should I do?

A: I understand. The investment world is a lot more complicated than years ago. I have helped many widows in your situation.

I suggest you start by finding all your statements from bank accounts, CDs, investments, etc. Then make a list showing the location of the account, the type and the value. Now make a list of your income. Remember, you won’t be getting two Social Security checks anymore, just one, whichever one was larger.

Did your husband receive a pension? If so, your widow’s pension might be less, perhaps only 50 percent of what your husband received.

You probably have a good idea of your monthly expenses since you had been paying them yourself for many years.

Lastly, does your reduced monthly income cover your monthly expenses? If not, or if you just don’t understand what you have, I suggest you get some help. The goal is to do the best with what you have, understand enough so that you can’t be taken advantage of and to simplify your financial life.

Mary Grodin holds the designations of Chartered Financial Consultant, Chartered Special Needs Consultant, CLTC and CFS. Submit questions to Mary at Grodin Financial Services, (510) 357-3715 or email her at This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

BY JIM MILLER

Special to the Times

Most people don’t realize that when you travel, your risk of identity theft increases.

Here are a few simple steps you can take to protect yourself while you’re away.

Alert credit card companies

Before you leave, let them know when, where and how long you’ll be traveling. This helps their fraud departments stop bogus charges. And, it reduces the risk that your card will be frozen when you use it far from home.

Secure your mail

Get a friend or neighbor to pick up your mail every day while you’re gone, or stop your mail at the post office. A full mailbox can be very inviting to identity thieves and burglars. Also, stop the newspaper, and don’t broadcast your travel plans on social networking websites.

Clean out your wallet

Pickpockets love tourist destinations, so take only essential identifiers, like your driver’s license, and just two credit cards — carry one with you, and lock the other one in a hotel room safe in case your wallet gets stolen.

Protect your smartphone

These are gold mines for ID thieves. If you use a smartphone, protect your personal information by using the security settings to lock your screen with a password. Then, install a GPS location tracking app on your phone. You can also set up your phone so that if it does get stolen, you can remotely erase its data.

Use safe ATMs

If you need cash while you’re away, use ATMs that are located at banks. These are more secure than stand-alone ATMs which can be rigged to capture your card information that thieves can steal.

Safeguard your hotel

Never leave your wallet, passport, credit cards or other valuables lying around your hotel room. Either keep them with you or lock them up in the hotel safe.

Also, be careful with hotel computers and free Wi-Fi networks. Don’t access your personal accounts or disclose any of your financial information on hotel or other public computers.

Freeze your credit

A temporary freeze denies access to your credit history, so ID thieves can’t open accounts in your name while you’re away. To set up a freeze, contact each of the three credit bureaus — Equifax (equifax.com, 800-685-1111), Experian (experian.com, 888-397-3742) and TransUnion (transunion.com, 877-322-8228). It typically costs around $10 per credit bureau to freeze your account, and $10 to unfreeze it.

BY GENE L. OSOFSKY, ESQ.

Special to the Times

Q: My IRA is a significant part of my assets, and I wonder if there are any special considerations when planning my affairs?

A: Remember to name both primary and contingent beneficiaries. If you are married, the primary beneficiary would typically be your spouse, but name back-up beneficiaries as well.

If you and your spouse were to die around the same time, or if your spouse predeceased you and you had neglected to name contingent beneficiaries, your IRA would then go to your estate and be subject to probate.

“Stretch” Your IRA: If you do not need the funds in your IRA for retirement, but would rather preserve them for the younger beneficiaries, consider “stretching” your IRA. You can defer the start of your own minimum required distributions (MRDs) until age 70.5, your mandatory start date, and then take out only the required minimums each year thereby leaving more in your IRA to grow tax-deferred.

When you die, your beneficiary can stretch distributions over his or her lifetime and even designate a second-generation beneficiary to continue the MRDs.

The younger the beneficiary, the smaller each distribution can be under IRS rules, allowing the remaining funds to grow tax-deferred. This is called “stretching” an IRA and can result in several generations enjoying the fruits of your IRA legacy.  However, make sure that your IRA custodian permits your first and second-generation beneficiaries to stretch-out their own distributions and also permits them to name their own beneficiaries. If yours does not, you might consider moving your IRA to a new custodian who is friendly to the stretch option.

If Beneficiary Is a Spouse: If you are married, let your spouse know that he or she has options:  upon your demise, he or she can either (a) roll your IRA over into his or her own IRA and defer the start of MRDs until your spouse’s own age of 70.5, or (b) transfer the funds to an inherited IRA and begin MRDs within a year of when you would have turned age 70.5.

In either case, your spouse can choose to “stretch” the MRDs over his or her own lifetime, thereby allowing the IRA to grow for the later benefit of downstream beneficiaries, e.g. your children.

Another option: If your spouse doesn’t need the IRA to live on, he or she can disclaim all or part of it, allowing that portion to pass immediately to your children who can then stretch the MRDs over their longer lifetimes.

Designate Separate Accounts for Each Beneficiary: If you designate, say, your three children as your contingent beneficiaries, you should direct your IRA custodian to create a separate account for each child when distributions begin. Otherwise, the MRDs will be based upon the life expectancy of the oldest child, thereby undermining the stretch option for the younger children.

Trust As Beneficiary? In most cases, a trust would not be named as a primary beneficiary, but might be named as a contingent beneficiary. However, if your IRA is large or if you have special reasons for not wanting your beneficiaries to have unrestricted access to the IRA funds, you might ask your attorney to create a special trust, sometimes called a “conduit trust,” to be the primary beneficiary of your IRA.

An IRA can be a valuable part of your estate plan, but the rules are complicated. Consult with your financial advisor and your attorney to learn your options and encourage your beneficiaries to do likewise down the road.

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

BY JIM MILLER

Special to the Times

Dating sites have become enormously popular among the older generation in recent years. In fact, boomers and seniors make up about 20 percent of online daters today, and the numbers keep growing. Here’s what you should know.

Meeting Online

If you’re interested in dating again or are just looking for a friend to spend time with, dating websites are an easy way to meet hundreds of new single people without ever having to leave home.

If you’re feeling hesitant, a good way to ease into it is to visit a few dating sites and look around. Most services allow you to check out their members at no cost or obligation. Then, if you like what you see, you can sign up (fees typically range between $15 and $60 per month; however, some sites are free) and start emailing members you’re interested in or they can email you.

Here are some other tips to help you get started.

Choose a site: With over 1,000 matchmaking sites on the internet today, choosing can be a bit overwhelming. Depending on your preferences, here are some popular options to look into.

If you don’t want to spend any money, free sites like PlentyofFish.com and OKCupid.com are good places to start, but beware that these sites have a lot of ads.

If you’re interested in lots of choices, consider mainstream sites like Match.com and eHarmony.com which have huge memberships in all demographics.

Or, if you are looking to find a specific type of person, there are hundreds of niche sites like OurTime.com and SeniorPeopleMeet.com for those 50 and older, Alikewise.com for book lovers, DateMyPet.com for animal lovers, VeggieDate.org for vegetarians, JDate.com for Jewish singles, BlackPeopleMeet.com for African Americans, and ChristianMingle.com whose slogan is “Find God’s Match for You.” Or, check out AARP’s new dating website partner HowAboutWe.com.

Create a profile: When you join a dating site, you’ll need to create a personality profile that reflects who you are, including recent photos, hobbies, interests, favorite activities and more. If you need some help, sites like eFlirtExpert.com or VirtualDatingAssistants.com can write one for you for a fee.

Use caution: When you register with a dating site, you remain anonymous. No one gets access to your full name, address, phone number or email until you decide to give it out. So, be very prudent who you give your information to; and, before meeting, chat on the phone a few times or video chat online. When you do meet in person for the first time, meet in a public place or bring a friend along.

If you want to be extra cautious, you can do a quick background check on your date for a few dollars at sites like valimate.com and mymatchchecker.com.

Don’t be naive: In an effort to get more responses, many people will exaggerate or flat out lie in their profiles, or post pictures that are 10 years old or 20 pounds lighter. So, don’t believe everything you see or read.

Make an effort: A lot of times, people — especially women — sit back and let others come to them. Don’t be afraid to make the first move. When you find someone you like, send a short note that says, “I really enjoyed your profile. I think we have some things in common.” Keep it simple.

Don’t get discouraged: If you don’t get a response from someone, don’t let it bother you. Just move on. There are many others that will be interested in you and it only takes one person to make internet dating worthwhile.

BY GENE L. OSOFSKY, ESQ.

Special to the Times

Q: My wife and I hold title to her home as joint tenants, and most of our cash assets are in the form of two large IRA accounts and one big annuity. We have basic wills which leaves everything to the other and then on to our children. Our son suggested that our wills may not control what happens to our assets when just one of us dies. Should we be concerned?

A: Perhaps, in the sense that your wills will not control what happens to your assets when one of you dies. Rather, the form of title will control as to your home, and the beneficiary designations on your IRAs and annuity will control what happens to those assets. Here is the way it works:

For your home, since you and your wife hold title in joint tenancy, when one of you dies, the other will automatically become the owner by right of survivorship. Right of survivorship is the primary feature of joint tenancy.

In essence, the form of title overrides your wills. It is only when the survivor later dies that his or her will may control who ultimately gets the home. While many couples in California do hold their home in joint tenancy, it is often not the best form of co-ownership for tax reasons.

For your IRA accounts, each will, upon the death of the IRA owner, go to the primary beneficiary named in the account agreement signed when you created your IRAs. Presumably, the primary beneficiary for each of you is the other spouse and, if deceased, your children.

However, the pattern of distribution very much depends upon who you designated as primary and contingent beneficiaries when you created your accounts. It is always wise to review these designations and retain the documentation you signed when you created your accounts.

For your annuity, the person or persons to receive your annuity would, just like the IRA, depend on who was named as the beneficiary on the annuity contract. The same would be true if you owned any other insurance products or policies. Where you have designated individuals to be primary or contingent beneficiaries, the contract or policy controls distribution, not your will.

In view of the above, whenever clients come in to see us for estate planning, we always urge a review of all beneficiary designations associated with IRA and other retirement accounts, as well as annuities and other insurance products.

Where appropriate, the beneficiary designations can then be modified so that the plan design accomplishes the clients’ goals and everything works together.

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

BY JIM MILLER

Special to the Times

Spouses who are loud snorers and who wake themselves up during sleep probably need to be tested for sleep apnea, a dangerous disorder that affects around 22 million Americans — and most don’t even know it.

Sleep apnea is a disorder that causes a person to stop breathing during sleep, dozens and even hundreds of times during the night for up to 30 seconds at a time.

Left untreated, it can cause extreme daytime sleepiness, as well as a host of serious health conditions like high blood pressure, heart attack, stroke, congestive heart failure, diabetes, depression and gastroesophageal reflux disease.

In fact, it’s estimated that every year, around 38,000 Americans die in their sleep from a heart attack or stroke because of sleep apnea.

But the good news is that sleep apnea is very treatable and most insurance companies, including Medicare, cover it.

Who Has It?

There are three types of sleep apnea: obstructive, central and mixed. Of the three, obstructive sleep apnea is by far the most common, and occurs when the throat muscles relax during sleep blocking the airway.

While anyone can have it, sleep apnea is most common in people who are overweight, male, middle-aged and older. For women, the risk rises after menopause.

The symptoms include loud snoring (however not everyone who snores has apnea), long pauses of breathing, gasping or choking during sleep and daytime drowsiness. But because most of these symptoms happen during sleep, most people don’t recognize them. It’s usually the person they’re sleeping with who notices it.

Get Help

To help you get a handle on the problem, the American Sleep Apnea Association has several quick diagnostic tests one can take at sleepapnea.org — click on “Diagnosis and Treatment.”

If you suspect a problem after taking these tests, try some self-help measures, including:

•Sleeping on your side or stomach: This will help keep your airways open. To promote side sleeping, there are products available that can help, like the Rematee Bumper Belt (antisnoreshirt.com) and Sona Pillow (sonapillow.com).

•Losing weight: Excess body weight, especially around the neck, puts pressure on the airway, causing it to partially collapse. Even a slight weight loss may help.

•Avoiding alcohol and sleeping pills: These can relax the muscles in the back of your throat, interfering with breathing.

If the problem persists, make an appointment with your primary care doctor or a sleep specialist who will probably recommend an overnight diagnostic sleep test, which can take place at a sleep center (see sleepeducation.com), or at home using a portable device.

Treatment Options

If one is diagnosed with apnea, the most commonly prescribed treatment is a continuous positive airway pressure (CPAP) device. This involves sleeping with a snorkel-like mask that’s hooked up to a machine that gently blows air up your nose to keep the passages open.

Another less-invasive treatment option is Provent therapy (proventtherapy.com). This is a small, disposable patch that fits over each nostril to improve airflow. A 30-day supply of these prescription-only patches cost $65 to $90; but, unfortunately, it’s not currently covered by insurance or Medicare.

If the CPAP or nasal patches aren’t an option, an oral appliance that fits into the mouth like a removable mouth guard or retainer may be the solution. Oral appliances work by positioning the lower jaw slightly forward to keep the airway open during sleep.

If these don’t work, there are also a variety of surgical options available to help keep the throat open and prevent blockages.

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