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Need help for grandma? New book offers some answers

Getting old doesn't have to be a burden, as author Jim Miller points out in his new book, "The Savvy Senior: The Ultimate Guide to Health, Family, and Finances for Senior Citizens." Miller was invited to appear on “Today” to discuss the book and share some of his tips for making the golden years a little brighter. Read an excerpt of the book here:

Most people don’t ever think about senior issues until they’re staring them in the face. Let’s face it. Social Security, Medicare, hardening of the arteries and assisted-living centers aren’t the most pleasant subjects for party conversations. Yet wouldn’t it be nice to have a seniors’ resource guide to help you cut through the maze of information overload and give you the answers and resources you’re looking for?

My goal for The Savvy Senior is to do just that: provide senior citizens and the families who support them access to information and resources in one, easy-to read book. The topics covered in The Savvy Senior are based on the thousands of questions the “Savvy Senior” newspaper column receives. In this book you will learn about the many different programs, services and discounts available to senior citizens as well as the need-to-know basics of Medicare, Social Security, estate and retirement planning, senior health issues, caregiving, grandparenting, senior housing options and much more.

People often ask me, What does an MTV-generation guy know about senior issues? Well, to that I say, I didn’t know much in the beginning, but I know plenty now! I didn’t start out to be a columnist or an author. In October 2000, my parents died within three weeks of each other. Feeling devastated and lost, I took a temporary job working at a retirement community to help me work through the grief. I though being around people my parent’s age would make me feel better. While I was there, I started writing a question/answer information column for senior citizens in the local newspaper, and the response was immediate. That’s when it hit me; senior citizens and their families need help. Thus, the “Savvy Senior” was born and is now published in over 400 newspapers nationwide and offers an interactive web site, along with The Savvy Senior book.

I hope you find The Savvy Senior a useful resource that is fun to read and easy to understand. But most of all, my hope is that all this information will help you become a savvy senior too.

Medicare and more:
Many seniors think that Medicare is a complicated topic. It is! And you really can’t get around it, but in this section you’ll learn the need-to-know basics that can help you better understand the ABCs of this program. Beginning with the basics of Medicare Part A and B, we also cover the new Medicare prescription drug benefit, Medicare Choice, Medigap supplemental insurance, Medicaid and nursing-home care, hospice and Medicare and more, as well as tell you where to get more help on theses issues.

How about some help with your overpriced prescription medications? Beginning on page 171, The Savvy Senior, with the help of the Medicare Rights Center, provides you with a complete list of available discount options, programs and Web sites that might be able to help cut your prescription costs.

The basics of medicare
We all know what Medicare is, but do we actually understand it?

The Medicare program is a federal health-insurance program for people 65 years of age and older, and certain disabled people under age 65. to be eligible for Medicare you must be a U.S. citizen or permanent resident of the united states who is eligible to receive benefits from Social Security.

Medicare part A
Medicare has two parts, Part A and Part B. Medicare Part A (hospital insurance) helps pay for inpatient hospital care, inpatient care in a skilled-nursing facility, home health care and hospice care.

Savvy Note: The Medicare Part A deductible for inpatient hospital care per benefit period is $876 in 2004, and increases every year. The term “benefit period” is a period of time that begins the day you enter the hospital or skilled-nursing facility and continues until you have been out for 60 consecutive days.

Medicare part B
Medicare Part B (medical insurance) helps pay for doctor services, some preventive services, outpatient hospital and emergency room services, medical equipment and supplies, laboratory services, X-rays, physical therapy, ambulance services and a number of other medical services and supplies that are not covered by Medicare Part A.

Medicare Cost
Medicare Part A is free, but Medicare Part B is a voluntary program (which may be refused) and costs $66.60 a month in 2004. Medicare Part B pays 80 percent of services covered under Part B after a $100 deductible.

Savvy Note: In 2005 the Medicare Part B deductible will increase to $110 and rise yearly afterward.

Medicare and nursing-home care
To qualify for Medicare nursing-home benefits you must have been an inpatient in a hospital for at least three days and discharged no more than 30 days before entering the nursing home. A physician must also “certify” that you require skilled-nursing care or rehabilitation that can only be provided in a skilled-nursing facility. If you qualify, Medicare pays 100 percent of the charges for the first 20 days. From day 21 to day 100, the patient must pay $109.50/day while Medicare picks up the difference. After day 100, Medicare pays nothing.

What medicare does not cover
Other medical services and products not covered by Medicare include outpatient prescription drugs, private hospital room, hospital telephone and TV, routine physicals, most dental care, dentures, routine foot care, hearing aids, routine eye care, acupuncture, health care outside the United States and cosmetic surgery.

Savvy Tip: For detailed information on what Medicare covers in your area, visit the Medicare coverage database at www.cms.hhs.gov/med

Supplemental health care
It is savvy advice to purchase a Medicare supplemental or Medigap policy (see Medigap Insurance, page 155) at the time you apply for Medicare services. This type of policy (regulated by state insurance departments and sold by many companies) is designed to fill in the health-care expenses not covered by Medicare. Ever new Medicare recipient who is age 65 or older has a guaranteed right to buy a Medicare supplement policy. A company cannot reject you for any policy it sells, nor can it charge you more than anyone else your age. You must, however, purchase the supplement policy within the six-month window after enrolling in Medicare Part B for the first time. If you apply for a policy after your six-month period, some companies may refuse coverage for health reasons.

Savvy Note: If you are age 65 and not eligible for the free Medicare Part A, you can still get it, but you’ll have to pa a steep monthly premium. Medicare Part B is also available (for $66.60/month in 2004). You can enroll in Part B without getting Part A, but if you choose to enroll in Part A you are required to get Part B too.

The new medicare prescription drug benefit:

How will it affect you?
Containing the most extensive changes to the Medicare program since it began in 1965, the new $400 billion prescription drug benefit will offer some help to its beneficiaries, but how much?

Currently, Medicare covers 40 million elderly and disabled Americans. Of those, more than 10 million are without any form of prescription drug coverage and 14 million are low-income seniors, Here’s a preview of what you can expect from the new prescription drug benefit, which will be known as Medicare Part D. This information was obtained in part from the Department of Health and Human Services and the Associated Press.

Interim discount card
From June 2004 through 2005 a discount card will be available for Medicare recipients to buy for $30. This card will reduce drug costs by 15 percent or more.

Medicare drug benefit
Beginning in 2006, Medicare beneficiaries can sign up for a drug plan or join a private health plan that offers drug coverage. Under the Medicare plan, you will be charged a $25-a-month premium per person, or $420 a year. After you pay a $250 deductible, insurance will cover 75 percent of your drug costs up to $2,250. You would thus pay up to $750 out of pocket. (The $250 deductible plus 25 percent of the cost from $251 to $2250, or $500.) This does not count your $420-a-year premium.

Coverage gap
After you have incurred a $2,250 in total drug costs, Medicare will pay nothing more until you have paid $3,600 out of pocket, meaning you would have to pay $2,850 more out of pocket in addition to the $750 already paid. This does not count your $420 annual premium

Limited-income subsidies
In 2004 and 2005, low-income recipients earning less than $12, 124 a year, or $16,363 for married couples, will receive an annual subsidy of $600 credited to their drug discount card to help defray drug costs.

Beginning in 2006, people eligible for Medicaid and Medicare will pay no premium or deductible and have no gap in coverage. They will pay $1 per prescription for generics and $3 for brand names. Copays are waived for those in nursing homes.

Members with limited income below the federal poverty line — around $13,000 for individuals and $17,600 for couples, with assets under $6,000 for individuals and $9,000 for couples-will be entitled to different benefits: They will pay no premium or deductible, nor will they face a gap in coverage. For generic drugs there is a $2 copay and a $5 copay for all other drugs, up to the out-of-pocket limit.

Members with savings and incomes below the federal poverty level-between $13,000 and $14,400 for individuals and $20,000 for couples — will be entitled to the following benefits: a monthly premium based on a sliding scale; a %50 deductible; no gap in coverage; co insurance of 15 percent, up to the out-of-pocket limit; and copayments of either $2 or $5 after reaching the out-of-pocket expense limit.

Retiree coverage
Tax-free subsidies, worth more than $70 billion over 10 years, will be provided to employers who maintain drug coverage for retirees once the Medicare drug benefit begins in 2006. But some employers may still drop their drug coverage. You’ll need to check!

Generic drugs
The ability of pharmaceutical companies to block cheaper equivalents will be limited, which should help speed generic drugs to the market.

Drugs from Canada
The ban on importing prescription drugs from abroad will be maintained, but such drugs will be allowed from Canada is the Department of Health and Human Services certifies their safety, which the department has thus far refused to do. Also, a study of safety issues will be authorized.

Medicare + Choice Plan:
Are you ready to experience the Medicare alphabet in a whole new way? There is Medicare Part A, Part B, and now C, also called the Medicare + Choice Plan.

Congress created the Medicare + Choice program to provide you with more choices and sometimes extra benefits by letting private companies offer you your Medicare benefits.

Original medicare plan
It’s important to be clear on the Original Medicare Plan, also known as Medicare Part A and B, because this will affect your Medicare + Choices. Simply put, Part A is the hospital insurance, and Part B, referred to as medical insurance, helps pay for doctor visits or medical equipment that you may need. At age 65 (if eligible) , you automatically get Part A when you sign up for Medicare, although Part B is optional. If you sign up for Part B, you pay a monthly premium, but if you don’t, you won’t be eligible for Medicare + C.

Think c, for choice
Medicare + Choice is offered by private companies that contract with the Medicare program to offer services. It is still part of Medicare, and depending on your circumstances and where you live, it certainly may be worth a look.

Medicare + Choice plans include:-Medicare managed-care plans (like HMOs), and-Medicare private fee-for-service plans.

The real advantage of Medicare + Choice is that it goes beyond traditional Medicare coverage. It may pay for a general annual physical, for example, or for prescription drugs, which are not covered under traditional Medicare (A and B). And while there is a monthly premium, there may be a lower out-of-pocket costs with such things as deductibles and copays. But Medicare + Choice options are not offered everywhere, and while there are some limited fee-for-service packages available, most Medicare + Choice programs are managed-care plans like HMOs, PPOs, PSOs and PFFs, in which the patient/member agrees to receive care from specific doctors, hospitals and others — called a network — in exchange for reduced overall health-care costs. That’s the part of the plan that many people don’t like, especially if it means they can no longer continue to see their own doctor or use the hospital of their choice. But your doctor may already participate in a plan for your area. You’ll have to check.

Excerpted from "The Savvy Senior," by Jim Miller. Copyright ©2004 by Jim Miller. All Rights Reserved. Reprinted by permission of Hyperion Books. To learn more about the book, you can visit:

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