Healthcare’s Big Bite Out of Retiree Budgets

This year, retirees were jolted by the 14.5 percent hike in Medicare’s Part B premium for medical services. It was the second-largest percentage increase in at least 20 years.

The monthly premium, which rose to $170, will drop to $165 in 2023. But medical care is an expensive proposition that consumes a big chunk of many retirees’ income from Social Security, 401(k)s, and other sources.

According to a new analysis of 2018 health care data, typical retirees had 88 percent of their total income left to buy everything else after paying for medical care. And one in 10 retirees with inordinately large health care costs had 63 percent or less left over for living expenses, said Melissa McInerney, Matthew Rutledge, and Sara Ellen King in their study for the Center for Retirement Research.

Interestingly, Medicare does protect against the larger cost burdens that follow health declines. As retirees age or develop chronic physical or medical conditions, the researchers found, the share of income consumed by medical costs doesn’t change very much.

Medicare covers virtually all retirees, and the lion’s share of their out-of-pocket medical expenses are premiums – for Part B, Part D drug coverage, Medigap, or Medicare Advantage insurance plans. The other medical expenses included in this study were cost-sharing and copayments for basic Medicare, prescription drugs, eyeglasses, hearing aids, and visits to the doctor, dentist, and hospital. Long-term care costs were excluded.

The analysis was restricted to people who have signed up for both Medicare and Social Security.

Paying for care puts the most strain on low-income Americans, many of whom rely almost exclusively on Social Security and have few, if any, other income sources. The exception is people with such low incomes that they qualify for Medicaid; they pay only 4 percent of their income for health care. …Learn More

Keeping Your Cool in Salary Negotiations

One big problem people have when negotiating for a job or a raise is that they get in their own way. Negotiating unleashes a brew of emotions – fear of rejection, a lack of confidence, doubts – that can sabotage them. The British have coined a word for this type of anxiety: collywobbles.

Moshe Cohen, author of “Collywobbles: How to Negotiate When Negotiations Make You Nervous,” consults with companies and individuals on leadership and negotiation strategies. But his idea for the book came out of the graduate classes on negotiation he teaches at Boston University. Cohen realized that even when students are fully prepared for a negotiation, they will choke in the moment. He agreed to share some of his insights in the book, which examines negotiating from the perspective of someone who has anxiety. He recently published his second book inspired by the pandemic lockdown: “Optimism is a Choice and Other Timeless Ideas.”

What are collywobbles and how do they manifest in salary negotiations?  

Collywobbles is a British term that means butterflies in your stomach. And people get nervous when they go to negotiate. I wrote “Collywobbles” for a student who works full-time and negotiates every day for her boss but can’t negotiate with her boss because she gets too nervous. She works really hard and never gets that raise or promotion because she never asks for it. The question I answer in my book is: how does she overcome that?

Are women worse negotiators than men and why?

Yes, for two reasons. One is socialization. Generally, I think women are brought up to be more aware of and care about relationships, and they fear that if they advocate for themselves they’re going to damage relationships. Men are socialized to be much more oblivious to those things and freer to ask for things. Men will do things that might damage the relationship but aren’t aware they’re doing it.

The second thing is society’s expectations. If women are strong self-advocates, very often there’s a backlash and they get punished for it in ways that men don’t. If I, as a man, am pushy at my job, I’m seen as a go-getter. If you’re pushy, you’re seen as a bitch. The combination of how society socializes women and how it responds to women is a really intimidating factor.

How about people of color?

I’m certainly not an expert on that but here’s what I’ve observed. One exercise I give my students is that they have to go out and ask for stuff until 10 people say no. They can go to stores and ask for discounts – anything. An African student came to me and said, “How can I ask for a discount when the second I walk into a store employees start following me around?” Once again, context is important. Do people negotiate differently when they’re in a context where they feel comfortable and less likely to incur a backlash? African students negotiate very differently here than they do in Africa where they may have a societal status that entitles them to ask for more. When they’re in this country, they’re just seen as a minority. …
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Oregon’s Retirement IRA is Making Progress

Left to their own devices, Americans who lack a retirement savings plan at work do not usually take the initiative to set up an IRA and save on their own.

Oregon lawmakers decided to do something about that, and a new study finds that their approach of requiring employers without a plan to automatically enroll their workers in a state-sponsored IRA is reaching the right people.

Nationwide, lower-income workers are much less likely to have a retirement plan, and the typical employee enrolled in the program, OregonSaves, earns only $22,600. They also tend to work in high-turnover industries like food service and healthcare where constant job changes make it difficult to save consistently. When an Oregon worker finds another job in the state, he can take his IRA with him to the next employer.

Private-sector 401(k)s with auto-enrollment match some of the workers’ contributions and have nearly universal participation. In OregonSaves, the share of people with positive account balances in their IRAs, which don’t have a match, is lower.

But these are the types of workers who don’t usually save, and the vast majority told their employers they had not been saving prior to being enrolled in OregonSaves. The program “has meaningfully increased employee savings,” concluded a new study funded by the U.S. Social Security Administration.

At the end of May, the average balance in about 114,000 IRA accounts was $1,324. The employees have saved a total of $151 million.

Auto-enrollment gets these low-paid workers into the IRA. But an important reason they choose not to opt out – as they are permitted to do at any time – is that they’ve probably known they should be saving for retirement and OregonSaves made it easier. …
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Job Ads Signal Young Workers are Preferred

The Age Discrimination and Employment Act states that job ads “may not contain terms and phrases that limit or deter the employment of older individuals.”

Yet some job ads do just that. One ad posted in 2014 sought applicants with “3 to 7 years (no more than 7 years) of relevant legal experience.” More often, employers use subtle language in their ads, asking, for example, that the applicants be “energetic.”

This subtle strategy is highly effective, according to researchers at the University of Liverpool and the University of California at Irvine.

In their field experiment using fake job ads that contained subtly discriminatory language, older workers submitted applications at significantly lower rates than younger workers. Job ads designed to deter older applicants “can have roughly as large an impact on hiring … as direct age discrimination in hiring,” the study concluded.

This research may have less relevance at the moment since unemployment is at historic lows and employers have been desperate for workers. But the economy has slowed in recent months and age discrimination in hiring is a well-established issue in the labor force.

The goal of this new study departs from past research on age discrimination in hiring, which focused on employers that get ample applications from older workers but then discount them as candidates. This new study highlights a different concern – that job ads with subtly discriminatory language discourage them from applying in the first place. …Learn More

People Can Spot a Scam After Seeing Fakes

The old and the young are most susceptible to scammers using fake identities to extract money from their victims. People in their 50s who went to college are in the sweet spot and are much better at resisting them.

The question is how to prevent the vulnerable from falling prey to imposter scams, which account for a third of the dollars Americans report to the FTC they’ve lost in frauds every year. A new study finds that exposing people to a watered-down version of a scam they might see in the real world teaches them to recognize an actual scam that comes across the transom.

In the imposter scams that are the focus of this study, someone pretends to represent a trusted organization like the Social Security Administration, the Red Cross, or online retailer Amazon. The goal is to coax either money out of the victim or personal information that can be used to make money. Imposters arrive in many forms – phone calls, emails, or texts.

To educate the 1,000-plus people recruited to this study, the researchers assigned them to one of four different online training programs. The only training that worked was designed to effectively inoculate the participants against fraud by exposing them to simulated scams on an email platform.

After reading each email, they were asked to decide whether it was a fraudulent appeal under the guise of a trusted organization or a copy of a legitimate communication from the organization. To figure this out, they could inspect the source of the email or click on links.

One example of a legitimate Social Security email was “Need a replacement card?” One of the frauds that came from socialsecurity.org – the agency’s actual website is ssa.gov – asked the email’s recipient to “review your Social Security statement.” …Learn More

Problem? Medicare Rights Center Can Fix it

He is a one-time heart surgery patient and vulnerable to COVID. She has to take her medication religiously twice a day to prevent a blood pressure spike.

Image of Mr. and Mrs. Quader.

Mr. and Mrs. Quader.
Source: Medicare Rights Center.

During the pandemic, Mr. and Mrs. Quader of Brooklyn, New York, got a notice that the health care subsidy they had been receiving through the Medicare Savings Program for low-income retirees had been terminated.

Luckily, counselors on the Medicare Rights Center’s telephone hotline solved the couple’s problem – just like they have helped tens of thousands of retirees nationwide every year that the center’s New York City helpline has been operating.

“They knew where to go. They knew what to do,” Mrs. Quader said in one of several video testimonials posted to the Medicare Rights Center’s website. “They stood by us every time.”

She made the call to the center because she had just happened to hear about it. It turned out the Quadar’s paperwork had been lost in the system, and the couple’s counselor got the benefits restored.

Rose. Source: Medicare Rights Center.

Rose.
Source: Medicare Rights Center.

The Medicare Rights Center’s services, which are free of charge, cover myriad problems retirees encounter under Medicare, such as how to appeal insurance company denials of coverage for treatments or medications. The counselors also solve unique problems like that of a 66-year-old woman named Rose. The Plant City, Florida, resident needed a replacement wheelchair but had received one she was unable to use, rendering her immobile. The center got her a chair that worked for her.

“When I sat down in that chair for the first time, it was nice and cushy,” she said in a Medicare Rights Center video. “I could finally go [outdoors] and see the light.”

Many people who call the center need help with simpler issues like enrolling in Medicare Parts A and B or sorting out their options for additional coverage. Bill’s enrollment problem was much more complicated. …Learn More

Get Help with Medicare Coverage Denials

The United States has a notoriously complex healthcare system, and Medicare is no different.

In the early months of the pandemic, the Medicare Rights Center received a large number of calls to its telephone help line from people over 65 who had suddenly been laid off and lost their employer coverage. Even when there isn’t a crisis, the center’s staff and volunteers answer all manner of questions about Medicare enrollment rules, insurance options, and what to do when an insurance company denies them coverage.

Sarah Murdoch is the center’s director of client services and oversees the helpline. She spoke with Squared Away about the common issues retirees face and how they can address them.

Question: Your helpline fielded 42,000 questions about Medicare in 2020 and 2021. How does that compare to past years?

It’s in that ballpark year to year – around 20,000 questions. But we saw, within that 42,000, a shift in the actual trends.

Throughout the pandemic, particularly in 2020 when there were lockdowns and people were getting laid off left and right, we got a lot of calls from people who unexpectedly had no income. We heard from people who had insurance through their job and that was not an option anymore. Or they were already on Medicare and were trying to figure out how to pay their costs, or they were laid off and had to figure out how to get into Medicare. That has eased up but was a big thing we saw in the beginning of the pandemic.

We also had questions related to benefits for low-income people. We told people who suddenly had zero income about the income requirements for the Medicare Savings Program, Medicaid, and the state pharmaceutical assistance programs – anything that can lessen the hardship.

In 2020 and 2021, nearly a third of the complaints on your helpline were about service denials by insurers that provide Medicare Advantage or Part D drug plans. Start with Advantage plan denials – are they a big issue for retirees?

The Medicare Advantage plans often have doctor and hospital networks, whereas original Medicare doesn’t have networks. People may be denied coverage by an Advantage plan if they have an out-of-network provider. It could also be a denial of a medical service or a prescription medication. We do see it more but it’s hard to tease that out from the fact that more people are just enrolled in Medicare Advantage.

Do Medigap supplements to Medicare have similar issues with denial of coverage?

Medigap is different – the plans are never making their own claim determinations. If something is approved by original Medicare, then Medigap is going to pay for it as long as the retiree has a Medigap plan that has that type of coverage. In the Medicare Advantage policies, however, insurers are making the claims determination. All of the insurance companies have their own claims adjusters making those decisions – as opposed to contractors who process claims for the Medigap plans on behalf of the Centers for Medicare and Medicaid Services. The Medigap insurer isn’t making any decisions as to whether something is covered or not – it has already happened at the government level. …Learn More