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Medicare Primer: Advantage or Medigap?

Traditional Medicare with a Medigap plan or Medicare Advantage? My Aunt Carol in Orlando wrestled with this decision for some five hours in sessions with her Medicare adviser, which she followed up with multiple phone calls – and a raft of additional questions.

“You have to ask these questions. You really have to think about it,” she said. “It’s confusing.”

Essentially every 65-year-old American enrolls in Medicare, and many get additional coverage. One form of additional coverage is through supplements to traditional Medicare, which include a Part D prescription drug plan and/or a Medigap private insurance plan to cover some or all of Medicare’s co-payments, deductibles, and other out-of-pocket costs. The other is through Medicare Advantage, a managed care option that typically provides prescription drug coverage and other services not included in the basic Medicare program.

So which to choose? Consumer choices have proliferated since private plans were added to Medicare 40 years ago. The typical beneficiary today has about 18 Medicare Advantage options, a multitude of Medigap plans for people who choose the traditional route, and 31 prescription drug programs, according to the Kaiser Family Foundation.

This primer is for new enrollees like my aunt. A future blog will provide suggestions from leading Medicare experts about ways to think about this important decision and the financial issues at stake.

The following compares the primary advantages and disadvantages of traditional Medicare and Medicare Advantage plans. But everyone is unique, and it’s impossible to simplify a process that requires each individual to research his or her best options, based on the severity of their health issues, their preferences and financial situation, and the policies available in their state’s insurance market. …Learn More

Skyline of DC

Retirement Researchers Convene Today

Why do older workers retire before they’d planned? How has the Affordable Care Act affected retirees in particular? And what’s known about U.S. immigrants’ wealth levels and Social Security contributions?

Researchers from around the country will present their findings on these and a range of other retirement topics during the 17th annual meeting of the Retirement Research Consortium, starting today at the National Press Club in Washington, D.C.

For the meeting agenda, click here.

The Consortium’s members are the Center for Retirement Research at Boston College (which supports this blog), the NBER Retirement Research Center, and the University of Michigan Retirement Research Center. The studies being presented are all funded by the U.S. Social Security Administration through the Consortium’s members.Learn More

Tax Refunds Advanced to Low Earners

Shirley Floyd

Things are looking up for Shirley Floyd of Chicago.

Her daughter just earned a college scholarship, and Floyd has landed a better job. The new job requires the 37-year-old to stand on a concrete floor, sometimes 10 to 12 hours a day, inserting automobile gaskets into cardboard sleeves for shipping. But her earnings, including overtime, are much larger than her $216 biweekly paychecks in 2014, when she was a part-time home health aide.

When Floyd was unable to keep her head above water last year, she received a financial lifeline from a program run by the Center for Economic Progress in Chicago. Under the pilot program, which was supported and funded by the Chicago mayor’s office and housing authority, 343 low-income recipients of the federal Earned Income Tax Credit (EITC) signed up for quarterly advances on their current year’s EITC payments, which they otherwise would have had to wait to receive the following year at tax time.

“It was an awesome program,” Floyd said about the advances, which always seemed to arrive at just the right time. “That pressure is relieved – for a little while. You’re able to do what you need to do.” She also believes quarterly payments are better than a large, one-time tax refund in February, because “the entire thing is gone” by March.

Under the Periodic Payment Pilot Program, low-wage workers with at least one child could get up to 50 percent of their estimated future EITC refunds as quarterly advances, up to a maximum of $2,000 per year. Floyd used her advances of nearly $400 per quarter to pay utility bills, rent, or her daughter’s tuition at a Catholic high school. …Learn More

College Funds Depend on Family Income

How much teenagers must borrow for college often depends on whether their parents can help foot the bill – and how much they can afford.

Fresh data from a survey by Sallie Mae, the private college lender, shed light on how low-, middle- and high-income families find the money to pay for a college education. The data break down how much of students’ total costs – tuition, plus books, room and board, fees, living expenses, and transportation – come from earnings, savings, borrowing, grants or other sources.

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Here’s what stands out in the data, which are displayed in this chart:

  • In low-income families, the students themselves take responsibility for saving, earning or borrowing money to cover 32 percent of their costs, and middle-income students pay 29 percent. Students from high-income families cover just 19 percent of their costs; they tend to pay more for their education, so their total dollar costs are higher, which somewhat narrows the dollar difference between what students in each income group pay. …

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3 1/2 star illustration

Home Health Agencies Get Ratings

The Centers for Medicare & Medicaid Services just introduced a five-star rating system for home health agencies on its Medicare.gov website.

The ratings, based on patient surveys, were rolled out on the heels of recent upgrades to the government’s nursing home ratings, which had been criticized for giving high ratings to some facilities with problems.

Consumers can search, by area code, for home health agencies, or they can look up specific agencies that they’ve heard about or seen in the neighborhood.  (Some agencies listed on the website are unrated.)

Separately, Kaiser Health News also culled the government ratings to compile its own list of the lowest- and highest-ranked agencies for many states.   But according to Medicare.gov, most agencies “fall ‘in the middle’ with 3 or 3½ stars.” …Learn More

Jared Diamond: Elderly Have “Low Status”

Celebrated scholar Jared Diamond doesn’t mince words in exploring “the low status of the elderly in the United States” in the above Ted video.

An obvious example is beer, which older people are known to buy and consume. Yet, Diamond asks, “When’s the last time you saw a beer ad that depicts smiling people 85 years old? Never.”

Diamond, who is himself closing in on 80, has developed many specialties – traditional societies, geography, evolutionary biology, and physiology (to name a few) – which give him license to paint with a broad brush, as he did in his Pulitzer Prize-winning, “Guns, Germs, and Steel: The Fates of Human Societies.”

His sobering lecture on the elderly ends on a positive note as he describes their gifts – wisdom, knowledge of history, and skills refined over decades – and how society might better use them.

But the neglect, isolation, and abandonment of the elderly, or worse, he explains, are not new. They were present in some early traditional societies that could not care for them or would not spare the resources to do so. The isolation of older Americans today, Diamond believes, is a direct consequence of the changes that have come to define modern societies: the elderly’s complete separation from the labor force in retirement, the geographic dispersion of families and friends, and technology.

Even Diamond admits to feelings of uselessness. He’s a whiz on the slide rule, the precursor to a calculator, but sometimes calls his son for assistance using his 41-button television remote. …Learn More

Woman in a yoga pose

Saving Is a Lot Like Yoga

Young people in the noon yoga classes here at Boston College bend, twist, or flatten themselves more easily than their much older classmates.

But older people are better savers – 50-year-olds save at more than double the rate of 40-year-olds – and perhaps yoga can explain how this happens.

In yoga, one doesn’t immediately balance into Warrior III without toppling over or find the upper-body strength for the Crow pose shown above. It takes practice to build the balance, strength, focus, or flexibility that each pose requires. Only with time do these pretzel-like configurations become less painful and more convincing. Poorly executed poses, practiced and repeatedly improved, are the only path to perfection.

Like yoga, saving is also a practice. …Learn More

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