Medicare Advantage and Supplement Plans?

Many people are not aware of the various plans available to Medicare beneficiaries. Yes, they all complement Medicare but there are some major differences! Your personal values, finances, and health status determine which plan is the best suited for you, your family, and your lifestyle. It is important to make a wise decision due to the number of rules around changing plans. You could be trapped in a plan you do not like and may be unable to change! Speak to an independent agent for more information.

What is a Medicare Supplement policy?

• A Medicare Supplement policy – or Medigap plan – is a health insurance policy made available through private insurers designed to cover the expenses not covered by Original Medicare. These began in the early 1980s.
• Federal law mandates features and benefits of the various Medicare Supplement (Medigap) policies.
• Benefits are standardized and are the same among private insurers who make this coverage available. Monthly premium price is the only difference between the insurance carriers.
• You can see any health care provider allowed by Medicare.
• You do not need a referral to see a Specialist.
• There is no network; you are free to travel!
• Monthly premiums and plan features for Medicare Supplement (Medigap) plans can vary widely, depending on the type of plan you choose. Depending on your circumstances, you may need certain features that not all the plans offer. For example, some plans offer emergency coverage while you are traveling overseas, while other plans do not.
• Easy to budget! Premiums are entirely predictable so you can make wise financial decisions.
• Often NO billing and paperwork for you to complete at health care providers’ visit or procedure.
• A Medicare Supplement (Medigap) policy only works with Original Medicare. These policies do not work in conjunction with Medicare Advantage, group health insurance plans, or VA/TRICARE benefits.
• Prescription drug coverage is not included with these plans. You may want to purchase a stand-alone Part D Prescription Drug Plan.

What is a Medicare Advantage Plan?

• A Medicare Advantage (MA) plan is a managed care plan offered by health insurance companies, and some hospitals. These plans originated in 2006 due to new legislation regarding Part D, prescription drug laws.
• Monthly premiums start at zero dollars ($0) per month and range up to several hundred dollars per month.
• Come with co-pays and deductibles, with out of pocket maximums up to $6,700 or $10,000 per year.
• Each plan has a specific network of providers.
• Sometimes you can pay more and go outside the network.
• Typically you must have a Primary Care Physician refer you to see a Specialist
• Some come with a Part D, Prescription Drug Plan (PDP); often called a MAPD plan, some do not.
• Harder to budget because of the uncertain amount of co-pays and deductibles. You pay for what you use.
• Often there is billing and paperwork for you to complete at each health care providers’ visit or procedure.
• Growing in popularity due to extra benefits Medicare typically does not pay for such as a fitness center, hearing aids, and routine vision care benefits. More extra benefits are coming in the next year or so!
• Choose plans based upon your geographic location. Plans can be severally limited, or non-existent, in low population density or rural areas.

Whatever you do, learn as much as you can so you make a wise decision for you and your family. Talk with an independent agent who works for you not the insurance company!

Hilary Greenbaum
Howard Insurance Agency for Seniors
503-443-5923

Do you need something other than Original Medicare?

As you approach age 65, it is time to determine whether you will want additional health insurance to complement original Medicare. For most seniors who enroll in Medicare Parts A and B, buying an additional policy is a good idea. Original Medicare covers approximately 80% of the cost of many health care services and supplies. In that remaining 20%, there are substantial costs, deductibles, and co-pays that can easily cost you thousands of dollars each year in of out-of- pocket medical expenses.

A Medicare Supplement policy or a Medicare Advantage Plan provides coverage for those gaps in your Medicare coverage and can save you money and concern about finances.

You are eligible to purchase a policy at various times of the year, depending on your personal situation. It can be very complicated and there are many rules set by the Center for Medicare Services (CMS).

When you are first eligible for Medicare, selecting which plan to augment your Original Medicare is an important decision. Did you know it is also an important decision for any age Medicare beneficiary because you might be able to switch plans at a variety of times during the year?

There is a variety of enrollment periods:

Initial Enrollment Period – When you activate Part B, often at age 65, but not always.
Annual Enrollment Period – Oct. 15 – Dec. 7
Open Enrollment Period (*new in 2019) – Jan. 1 – March 31 for Medicare Advantage only.
Special Enrollment Period – Anytime an individual qualifies for special enrollment accommodations.
However, most people choose a policy around the time they turn age 65 and hope to stick with it. During this time, you have Guarantee Issue, which means insurance companies cannot deny you coverage based on your health status or claim experience. It is very important to make wise decisions when you have that Guarantee Issue opportunity! Learn more from an independent agent who works for you, not the insurance company!

Hilary Greenbaum

Howard Insurance Agency for Seniors

503-443-5923

Are you a cool kid?

 

As we grow older our expectations of what it means to live in a retirement community are evolving, dramatically. Not since the debut of “Golden Girls” 33 years ago has there been an entertaining peek into the world of community living on television. This fall audiences will see a much needed modern perspective on a new show called “Cool Kids” (on FOX). It revolves around three guy friends in a retirement community who are the top dogs until they’re blown out of the water by the newest member of the community, a female rebel who’s ready to challenge their place – it’s high school with 70somethings.

Though taking this new show’s portrayal of retirement living with a humorous grain of salt it highlights the numerous benefits many seniors may not take into consideration other than looking for care services and support. Many of our clients have been very pleased to discover new friendships, entertaining events, good food, new interests, a wide range of outing destinations, and in most cases an improved quality of life.

Retirement communities can be a little or a lot different from one another. Finding the right match for care and lifestyle by using a senior placement agency can be of invaluable assistance. A senior housing advisor will vet out the communities that best fit the needs and wants of the senior. They check for any substantiated complaints, pre-visit the community, are aware of the levels resident care capabilities and will discuss the expectations of the senior with the community representative. They are experienced professionals who will be there every step of the way providing information, education and compassion through the locations process. As of July 1, 2018 any senior placement agency doing business in Oregon must be registered with the State of Oregon through the Department of Human Resources.

Catherine Camp, Senior Placement Specialist

Autumn of Life Senior Housing and Advisory Services

503-701-5054

When it’s Time to Sell Mom’s Home

 

“My Mom is no longer able to live in her home by herself.  My siblings and I have decided it is time to sell her home to free up the equity that will provide for her care as she lives in her new retirement community.  It was our family home for over 50 years, and it is overwhelming knowing how to start the process.”

 

I hear this scenario a lot as I work with my senior clients.   It is an overwhelming task, and you would be wise to seek out the assistance of a Seniors Real Estate Specialist, (SRES).  A Realtor with this special designation has been trained to work to ensure that your Mother’s best interest is always in first position.

 

Because everyone’s financial situation is different, the first step is to contact an attorney who specializes in eldercare law and a tax professional who will analyze how the taxes will affect the sale.  

 

When the time comes to put the house on the market, your SRES will help you through all of the necessary tasks to get it ready for the market.   The first step is to meet with you at the home.  He or she will be gathering data in order to prepare a Comparable Market Analysis.    This is commonly known as a CMA.    Factors such as number of bedrooms, lot size and the condition of the property will be considered when suggesting a competitive listing price.    You will be presented with an extensive study on what surrounding homes have sold for, how they look and how long they were on the market.

 

Homes that look fresh and clean and are clutter free usually sell for top dollar.   For this reason, your SRES will talk to you about what needs to be done before it ever goes on the market.  Does is need paint?  Does it need some siding repair or a new roof?  Does it need some surface updates?  A pre-inspection might be advised to let you know what items must be addressed first.   The new buyer’s lender will have a say in what repairs are necessary for the sale to go through.  Sometimes repairs can be negotiated between the buyer and seller.

 

Staging means preparing the home for showings.   This means getting the home in tip top shape before anyone sees it.   You only have one chance to make a first impression.   Homes that are staged usually sell quicker and for top dollar.    A coat of paint in neutral tones, new kitchen countertops and stainless appliances along with a professional cleaning job will make the house shine.    The yard will need a clean-up too.   If the yard has been let go and the shrubs are all over grown, the prospective buyer might not even care to look at your home.

 

When the home is ready to be listed in the multiple listing service, your SRES Realtor will review all of the documents necessary for the sale.  This will include a seller’s disclosure.  You will be asked to answer a series of questions about the home.    The buyer will review these as a condition of the sale.

 

Once an offer comes in, your SRES will meet with you and the family to discuss the factors of the offer.   At that time your Realtor will help you decide if you should counter any offers.   You might want your attorney to review any offers before accepting any offers.

 

Once an offer is accepted, the sale will be handled through escrow or an attorney.   Documents will be prepared to transfer the ownership to the new buyer.  After you and the buyer have signed the documents, it will be recorded.  This is what is known as closing.  Once this happens, you will receive the proceeds of the sale of the home.

 

Lynn Mattecheck, RE/MAX Equity Group

Principal Broker in the State of Oregon

lynnm@remax.net

Hospice Provider is YOUR Choice!

During a discussion with business associates the other day, the subject of Hospice came up.

It appears that in some cases, families are lead to think that they need to choose a hospice provider that works within their healthcare network, or one that a provider, such as an Adult Care Home or an Assisted living, prefers to work with.

It is necessary to clear up any misconceptions – Hospice is paid for by Medicare and patients have the option to choose any hospice provider they prefer.

It is ok to engage a hospice provider based on a trusted friend or associate’s recommendation.  It is, however, a better idea to interview at least 2 providers.  I have found the difference in services, comes down to the specific individuals that will be in direct contact with the individual on hospice, such as the RN, social worker, bath assistants, not necessarily the company – though different companies, as with any industry, have different philosophies.

The bottom line is – ask around, do your research, if possible, and know that you have the choice in providers.

Cherie Henry, Senior Placement Specialist

Autumn of Life Senior Housing and Advisory Services

503-701-5054

 

A Basic Understanding of Assisted Living Part #2 What to look for when touring a community 

My perspective is two sided.  Both from the point of view of an Assisted Living Director and that of a consultant who takes clients to look at Communities to find a great fit for their loved one.

As a Director, I would complete a self-audited tour to try to see what the prospect’s experience was from the moment of driving up to the building to the end of the tour.  As a consultant, I let the person at the community give the tour and information, interjecting questions and comments as I feel necessary to ensure my client gets all the pertinent information.

So, when you are out looking at communities for placement for a loved one what should you be aware of.  What questions should you ask when interviewing and making that final decision?

Here is a checklist of key points to consider:

Curb Appeal

  • What is your immediate reaction?
  • Are the grounds and building well kept?

Entering the building

  • Were you greeted upon entering?
  • Was there someone manning the front desk?
  • Was there someone available to assist you?

Touring 

  • Is the interior of the building well maintained and has a pleasant smell?
  • Are there residents out and about? Being actively involved?
  • Does the staff appear warm, friendly and happy?
  • Did they address you as you toured with a “Hi” and a smile?
  • Did they offer you a meal to enjoy?
  • Does the food look and smell good?
  • Is the dining experience well organized, efficient and is the food presented well?
  • Does it appear that there is pride in preparing and serving meals?

Cherie Henry, Senior Placement Specialist

Autumn of Life Senior Housing and Advisory Services

503-701-5054
info.autumnoflife@gmail.com
www.autumnoflife.net

Loneliness

As we age, our experiences change. Some we prepare for while others are completely unexpected. Moments of forgetfulness, muscle weakness or unsteadiness on our feet may begin to appear. Though these slight changes creep up on us there’s one experience many seniors don’t realize has entered their once busy and active life: loneliness.

 

One slight, but possibly harmful change for our connectedness is the reduction in mobility which can lead to less social interaction. Add to that financial limitations or the inaccessibility of transportation and there is a great risk of isolation. Isolation can lead to mental health problems like depression, anxiety and addictions. Physical ailments have been linked to loneliness too: high blood pressure, sleep disturbances, lack of mental focus and a weakened immune system.

 

What are some steps we can take to defend against the feelings of loneliness and be healthy well into our senior years?

 

Build connections by meeting new people: join clubs, go to church, attend a group exercise, take noncredit classes at the local community college to learn about new topics, or volunteer in your community. If you are interested in volunteering, check out VolunteerMatch.org where you can view and sign up for opportunities by age, ability and type of work.

 

We’re never too old to learn a new trick. Start learning a few now!

 

Catherine Camp, Senior Placement Specialist

Autumn of Life Senior Housing and Advisory Services

503-701-5054
info.autumnoflife@gmail.com
www.autumnoflife.net

A Basic Understanding of Assisted Living Services

Assisted living communities (ALF – Assisted Living Facilities) are not the same.
Here are a couple of things you should know; each provider has their own operating procedures and financial requirements.  Most do not provide skilled nursing care and each state has their own set of rules and regulations.
Commonality of what Assisted Living Communities in the State of Oregon provide, include:
– 3 meals per day, transportation for outings to medical appointment, shop and other activities within a designated mileage radius
– Weekly housekeeping – includes changing sheets and laundry of sheets and towels – personal laundry may be done at an extra charge and as a part of the care plan
– A plethora of structured social activities and events within the community
– RN on staff
– Trained care staff on site 24/7
– The ability to service a variety of care needs including assistance with bathing, dressing, transferring from a wheelchair to a bed or the bathroom, Medication management, and other common daily needs, or Activities of Daily Living (ADL’s)
The goal of an Assisted Living Community is to assist their residents to be as independent as possible, with the ability to have as little or as much assistance as needed to help them stay safe and comfortable.  It can be viewed as living in an independent or traditional apartment building, with meals and transportation provided and staff available, 24/7.
Cherie Henry, Senior Placement Specialist

503-701-5054

Won’t Medicare and my health insurance pay for long-term care services?

Long-Term Care Insurance provides funds to help you cover long-term care costs in the same manner Health Insurance provides financial coverage for doctor’s visits and hospital bills. However, it is very important to understand that Long-Term Care Insurance and Health Insurance are two distinctly different types of insurance. Health Insurance would likely provide coverage for doctor visits, hospitalization, and maybe even some prescription medicines. But if the individual’s condition progresses to the point where he or she requires long-term care or constant supervision and assistance with daily activities, Health Insurance would likely not provide coverage for that care.

Health insurance was not designed to cover the long-term care expenses for those who may have suffered permanent paralysis from an accident or stroke, developed Alzheimer’s, or perhaps need care as a natural result of aging.

This is where Long-Term Care Insurance comes in. Long-Term Care Insurance has been designed to pick up and provide coverage where Health Insurance leaves off. So in the case where the individual’s condition has progressed to the point where he or she requires assistance carrying out basic activities of daily living (like bathing, eating, toileting, dressing and moving about), Long-Term Care Insurance would provide funds to help cover the insured’s long-term care expenses, in support of any care the family is able to provide.

Those who have purchased Long-Term Care Insurance share that it has also helped them maintain their independence and freedom of choice over how and where their care services are provided. Long-Term Care Insurance can allow you to protect your assets and help ensure that your long-term care needs will not create a physical, financial or emotional burden on your family.

Becky Wehrli
Long-term Care Insurance Specialist
503-758-5725
info@BeckyLTC.com
www.BeckyLTC.com

Transitions

Although you may not frequently move from one home to another, you may go through mini-moves within your living spaces. Perhaps a better term to describe it would be a transitioning.

There are a variety of housing transitions that can occur throughout our lives. There might be a time when you have to change the way your home is set up to accommodate a baby arriving, a young adult returning from college or an aging parent coming to live with you. Another transition might be the blending of two households and the struggle of knowing how to combine everything that is important without having too much. Maybe someone in your home is limited to living only on the first floor due to a short term or long term physical ailment. These transitions require us to rethink the use of our homes, to move and reorganize our possessions to meet our current needs. How do you transition your present space to fit your new specific needs?

Create a list – Begin by writing down the specific new needs for your space. This list may take some time to compile and will require repeated communication with everyone involved in the transition. Often when someone states a need, such as a first floor bathroom, they are making the assumption that you will see other parts of that need that are connected. In this example, it really means a full bath with shower because they aren’t able to climb stairs. Take time to talk through each need, discussing what is involved, why it is important and how it can be addressed.
Think outside the box – Sometimes it is hard to do this in our own homes. When the living room has always been the living room, it can be a challenge to be view the space differently. However, transitioning may require some creative repurposing. You may have always had the dining room where it is now, but perhaps the room could be changed into an office, a bedroom or a family room to fit your needs better. A fresh set of eyes or a new perspective may be needed to see the different possibilities for your space and furniture. In addition, you may find that one change may create a shuffling effect of other rooms or items. This is a part of the transition process, and though it may require some extra effort, working through this cascade of changes will help to make life run much more smoothly.
Stay flexible – Although you may have put a lot of thought into this space transition, you may find there is an aspect of it that doesn’t work well. Take note of this and be ready to adapt. Perhaps your transition was that someone is in a wheel chair and cannot reach the upper cabinets. You shuffled everything to the countertop and lower cabinets, only to find out that the things at the back of the countertops are still out of reach. Be willing to continue to make changes to optimize your space, and remember: transitioning is a process not just a one-time event.

No transition is easy, but with a little bit of planning and work, you can make your home transition so that it is able to meet your new needs.

© Beth Giles

Senior Move Manager/ Professional Organizer – NWOrganizingSolutions.com