Determining Medicare Health Costs in Retirement

Author

Crystal Manning Medicare Advisor

Posted on

Nov 11, 2022

Book/Edition

Pennsylvania - Greater Pittsburgh Area

As we approach retirement, one of the greatest concerns is determining the cost of health care, which will likely be your biggest expense during the golden years.

 

Obviously, these costs are a tough number to nail down and one that will vary by person. Since 1966, the government’s Medicare program, also known as Medicare Part A and Part B, has helped millions of Americans obtain health care. It includes coverage at the hospital (known as Medicare Part A) and at the doctor’s office (known as Medicare Part B).

Most people don’t pay a premium for Medicare Part A, which covers hospital visits. But you will pay monthly premiums for Part B (doctor services and outpatient care), Part D (prescription drugs), and supplemental coverage which may cover the cost for deductibles, co-pays and medications. Some of these premiums may be deducted from your Social Security checks.

The premium for Part B is tied to inflation. You may have to pay more if you do not receive Social Security because you receive a government pension, or if your annual income is more than $85,000. The premiums for Part D and supplemental insurance are set by your provider and vary by plan and by where you live. You can expect these to take up a big chunk of your expenses and are big drivers of rising health care costs. 

You’ll still have to pay for some expenses out of pocket. Medicare doesn’t cover things like long-term care, or dental and vision insurance. Studies show that Medicare patients’ satisfaction with their coverage depends on whether they were enrolled in traditional Medicare supplemental plans or in Medicare Advantage plans that are offered by private insurance companies. People with Medicare Advantage plans also were more likely to have trouble affording their medical care than those with traditional Medicare. 

Health care costs are a major concern in retirement and should be an integral part of your retirement planning.  The role of a Licensed Medicare Advisor is to advise those approaching retirement to understand Medicare coverage and the affordability of comprehensive coverage.  

 

Editor’s Note:  This article was written by Crystal Manning, Licensed Medicare Advisor.  If you would like my consult at no cost to you, please contact me by phone at 412-716-4942.

Other Articles You May Like

Medicare Skilled Benefits

Medicare-A skilled benefits are available to Medicare beneficiaries in a skilled nursing setting if beneficiary has a 3-midnight hospital stay and requires skilled therapy in a skilled nursing home setting.Beneficiaries are allowed up to 100 Medicare-A skilled days of therapy if actively participating and progressing. Medicare pays for the first days completely. The next 80 days are co-payment days. Medicare pays 80% of the cost. The other 20% is paid by co-insurance, Medicaid or private pay. Medicare-B benefits can be used for ongoing therapy after 100 days are used until annual cap amount is reached.

5 Useful Tips To Improve Bath Time For Aging Loved Ones

Personal grooming for seniors is challenging for adults with dementia, and for their caregivers. Since many seniors in cognitive decline also experience bouts of incontinence, it is even more important for their caretakers to ensure that they are bathed and cleaned daily. In addition, people with dementia may forget to bathe on their own without reminders or may sometimes lash out at caregivers for reminding them to get clean, making bath time a fight. Or, if they do remember how to bathe themselves, they may not recall why its so important. Seniors living in an assisted living or memory care facility may balk at shower help because of privacy or modesty concerns.Reduce the struggle with your loved one by incorporating some of these caregiver tips into your daily shower or bath routine.Make Showers Part of Their Daily RoutineEstablishing a predictable routine is an important part of treating dementia and helping people with dementia enjoy a better quality of life. Bathing or showering may already be part of this routine, but if you or your loved ones caregivers are having difficulty getting your loved one to participate in bathing, it may be time to change how this activity is presented to them.Reprimanding an older adult for not bathing, scolding them, or shaming them isnt going to get the desired results. Its demeaning, and can often make them more resistant to showering, especially if they dont like their caregiver sometimes, people with dementia may provoke a disliked caregiver on purpose, and refusing to shower is one way they do so.Instead, take a positive approach with the unwilling bather. Schedule one of their favorite activities right after shower time, and offer rewards for getting in without a fight and thoroughly cleaning themselves.Prepare All Bathing Supplies in AdvanceIf your senior has a favorite towel, have that ready to go, hanging on the shower rod or by the tub. Learn what kind of body-cleaning tool, like a loofah, poof, washcloth, or sponge, and have that ready for them, too. Smell is a powerful memory tool, so its important that the scent of whatever bath products and shampoo you use are soothing or brings back pleasant memories. Lavender is a soothing scent, for example.Seniors are more sensitive to water temperature and pressure than people of other ages, so ensure that the temperature and pressure of the water are comfortable. You may need to adjust the settings on your water heater or consider purchasing a showerhead with adjustable pressure and water flow. If the bathroom is colder than your senior would like, consider placing a small bathroom-safe space heater in the room, too. Warm towels straight from the dryer can be a warm, comforting option, as well. Place a couple of extra towels in the dryer before starting the shower so they are ready when you need them.Include your senior in buying shower and bath supplies. The two of you can look online for new, fluffy towels in their favorite color or go to the store to pick up shampoo and body wash. If your senior is able, you can make an adventure out of it, such as going to a smaller soap store and smelling different products or touching the different loofahs until they find something they like. If your loved one is involved in selecting their bathing supplies, they may be more amenable to showering.Work With Your Senior to Preserve as Much Independence and Modesty as PossibleEncourage your loved one to wash as much of themselves as possible and give them as much privacy as possible while doing so without compromising their safety. Shower accessories, like a grip on the floor or a shower chair, can help them bathe with less help from you.If your senior has significant cognitive decline or is mostly unable to bathe themselves, you can still involve them in their shower. Give them a washcloth to hold while you clean them it may make them feel as though they are doing something, reducing the chances that they will strike out while being washed.If you or a caregiver must do most of the cleaning for your senior, consider washing them in sections and covering the rest of their body with a towel while you wash each section. This can preserve their modesty and help keep them warmer.Install an Adjustable ShowerheadA showerhead with adjustable pressure and a detachable nozzle helps caregivers and seniors better bathe themselves. The nozzle provides greater targeted control over where the water goes, and the showerhead and nozzle can be adjusted to produce a bigger or smaller stream. Some showerheads have adjustable pressure, too, which can help lower the pressure to reduce the loud sounds that may upset some people with dementia. An adjustable showerhead also makes bathing in a shower chair easier.Installing an adjustable showerhead may be a better option than adjusting the building water heater for seniors who share a home with others, whether its their family or in an assisted living home. Sometimes, Supplemental Medicare plans to cover certain showering aids for those who otherwise could not bathe independently without them, so look at your loved ones coverage to see if they have a plan like this.Narrate Each Step of the ShowerNarrating each step of the shower adds to the predictability of the process for people with dementia or others who thrive on routine. Talk through the bathing process with your senior, stating what you will do and what they will do. This may spark a memory for some people in cognitive decline. They can participate more and give others more security in knowing what will come next.You may use the shower narration to encourage your senior to do each step themselves and only take over if they are unable or unwilling.ConclusionIf you are concerned about your loved ones ability to shower or bathe on their own, consult a senior living advisor in your area for help finding the right memory care or assisted living facility in helping them keep clean and take care of other personal care tasks and activities of daily living. Assisted Living Locators senior care advocates help families locate a good fit for a loved one who needs a little more help to care for themselves or those who cannot live independently.

What is Spousal Impoverishment?

Spousal impoverishment is a concern for older couples when one spouse needs long-term care and applies for Medicaid. If one spouse requires care in a skilled nursing facility and the other remains at home, the spouse at home might face significant financial hardships. The high costs of nursing homes combined with Medicaids strict income and asset requirements risk leaving the community spouse with little income and assets. Medicaids Spousal Impoverishment RulesBefore the federal government enacted spousal impoverishment protections in 1988, many healthy spouses experienced poverty when their partners went on Medicaid. Medicaid has strict income and asset restrictions. Yet nursing home care is expensive, with monthly care fees ranging from $5,000 to $8,000. Many couples didn't meet Medicaids income and asset requirements, but couldn't afford care. Before receiving Medicaid, many families had to spend down their assets, leaving few assets for the spouse at home. Prior to qualifying for Medicaid, many couples paid nursing home fees out-of-pocket. Only when they could no longer pay would government assistance become available. Once all their funds went to long-term care expenses, the spouse living at home had little support. Medicaids 1988 spousal impoverishment provisions responded to these concerns, protecting spouses from loss of money and resources when their partners require long-term care. The spousal impoverishment rules rest on the principle that both spouses have a duty to provide for each other. Although the spouse at home must support the spouse receiving long-term care, the spouse receiving care also has a responsibility to the community spouse. The regulations allow the community spouse to keep a certain proportion of the couples combined resources and income, preventing impoverishment. MMNA and CSRAPer the spousal impoverishment rules, the Minimum Monthly Maintenance Needs Allowance (MMNA) and Community Spouse Resource Allowance (CSRA) permit the healthy spouse to keep a portion of the couples assets and income. The Minimum MMNA applies when one spouse is the primary earner. When the spouse with an income applies for Medicaid, the individual can transfer a portion of the monthly payment to the healthy partner.The CSRA protects some of the couples assets for the community spouse. Generally, to be eligible for Medicaid, a person cannot have more than $2,000 in assets. However, when one spouse applies for Medicaid and the other is healthy, the healthy spouse can keep more than $2,000 in resources. The federal government determines the minimum and maximum Community Spouse Resource Allowance yearly. Some assets, such as the couples home, car, furnishings and appliances, and personal possessions, don't count toward Medicaids assets requirements. Home and Community-Based Services The original spousal impoverishment protections only applied to married couples where a spouse needed nursing home care. In 2014, Section 2404 of the Affordable Care Act extended Medicaids spousal impoverishment protections so that when one spouse applies for home and community-based services, the other can retain some funds to support themselves.

Local Services By This Author

Crystal Manning Medicare Advisor

Medicare Insurance 10008 Pine Ridge Dr, Wexford, Pennsylvania, 15090

As we approach retirement, one of the greatest concerns is determining the cost of health care. Health care will likely be your biggest expense during the golden years. Obviously, these costs are a tough number to nail down and one that will vary by person, but there are estimates available. Remove the fear, uncertainty, and costly mistakes from the Medicare enrollment process. Call for a one-to-one, no charge consultation.