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Testimony given by NJFA Executive Director Melissa Chalker to the inaugural meeting of the Assembly Senior Services Committee, 1/27/2020

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The New Jersey Foundation for Aging’s Executive Director, Melissa Chalker, was invited to testify at the inaugural meeting of the Assembly Senior Services Committee on January 27, 2020. The committee includes Chair Valerie Vainieri Huttle, Vice-Chair Shanique Speight and members BettyLou DeCroce, DiAnne C. Gove, Angela V. McKnight and P. Christopher Tully. This was Melissa’s testimony. To read more about the meeting, see the NJ Spotlight coverage here.

“Good afternoon, Assemblywoman Vainieri Huttle and members of the Assembly Senior Services Committee. Thank you for this opportunity to speak with you today. I am Melissa Chalker and I’m the Executive Director of the nonprofit New Jersey Foundation for Aging (NJFA).

NJFA was founded in 1998 by four County Office on Aging Directors. They wanted to create a statewide organization that would address public policy issues related to the changing and diverse needs of our growing aging population. Since then, we have worked with a wide variety of partner organizations, as well as state government officials, to enable older adults to live with independence and dignity in their communities.

Today, I would like to tell you about NJFA’s advocacy priorities and present some current data related to older adults.

FINANCIAL INSECURITIES

NJFA developed the state’s first Elder Index Report — a cost-of-living table — in 2009. In 2015, the NJ State Legislature passed a bill that mandated the use and updating of the report by the Dept. of Human Services — specifically the Div. of Aging Services, which I am sure my friends from the Division can tell you more about.

From the first report in 2009, through the national database update that was unveiled last week, this Elder Index data allows us to look at the cost of living for seniors in NJ, determine how many fall below the Elder Index Benchmark ($29,616 a year for a single elder renter) and focus on how they can be supported by public benefits and other programs to fill the gap.

Because of the Elder Index research, we know that 8% of New Jersey’s older adults live at or below the federal poverty level. Those seniors are among our most vulnerable — both financially and medically.

Additionally, Social Security is the only source of income for 30% of older adults in New Jersey. The average annual Social Security benefit for a retired elder in NJ is $18,065. We know that number is even lower for women, plus there are many other seniors who receive far less than the average benefit. We have received calls and letters from older adults seeking help, stating that they are trying to get by on their monthly Social Security benefit of $700. After paying their rent and health care premiums, they are often left with $100 or less for groceries, co-pays and other expenses.

In addition to those seniors living below the federal poverty level, there are older adults who may be above that benchmark, but still struggling to meet all their basic needs. In fact, the most recent NJ Elder Economic Security Index indicates that more than half (54%) of New Jersey’s seniors do not have the annual income needed to provide for their basic needs. This is what is referred to as New Jersey’s statewide Elder Economic Insecurity Rate (EEIR). These are the older adults that we refer to as being “in the gap.” That gap is having income too high to qualify for government programs, but too low to adequately cover basic expenses.

The Elder Index statistics influence much of NJFA’s advocacy work, including, but not limited to, affordable and accessible homes, nutrition and food security, and access to quality healthcare. However, this data should serve as a reminder that the state must also consider older adults when discussing tax relief programs — including property taxes — and review the structure of retirement income taxes, compared to that of neighboring states.

HOUSING INSECURITIES

Ensuring that New Jersey’s aging population has safe and affordable housing is also imperative. Two years ago, we convened a stakeholder group, which developed a policy recommendation report. I have provided a copy for each of you to review [see the report here].

In the 10 recommendations listed, you will see that we are suggesting increases in vouchers and units for older adults within existing housing programs. We also identified ways to streamline the process and implement incentives to provide more housing to older adults that is safe, affordable and accessible.

When we consider the housing needs of seniors, we must consider every senior — there is no one-size-fits-all for older adults. When implementing policies and programs, we need to recognize seniors with chronic health conditions and those who are facing economic insecurity.

Additionally, there are middle-income seniors who struggle to find appropriate, accessible places to live in their communities of choice, and worry about being able to afford all their retirement expenses — including the potential need for long-term care services, which can add up to $50,000 a year to their costs depending on the level of care. Along with our partners, we’re engaged in discourse about age-friendly communities, particularly how social and wellness services can better be incorporated.

FOOD INSECURITIES

Much like anyone in any age category, the nutritional needs of seniors are a priority. Protecting the SNAP [Supplemental Nutrition Assistance Program] program from Federal cuts would ensure that those who rely on the program will still be able to access healthy foods. What we have learned from partners doing outreach with seniors is that often an older adult on SNAP is better able to follow a doctor’s dietary guidelines because of this benefit.

One area of need, though, is finding and educating seniors who do not know about the SNAP program, or those who fear the stigma of public benefits and the stories about the difficulty in applying for the program. My friends at the Division of Aging Services can confirm that there has been under enrollment of seniors in SNAP for quite some time.

An improvement to SNAP program would be a Standardized Medical Deduction for seniors applying for SNAP, which would make it easier for seniors to take advantage of the medical deduction provision. Having one max deduction amount that all seniors could utilize would make it easier for them to apply for, and receive, SNAP.

FAMILY CAREGIVERS

The issues and struggles surrounding informal, unpaid family caregivers have been well documented. Family members provide most of the care for older adults and individuals with disabilities here in NJ. Our healthcare system will need to respond to the continued growth of the 65+ demographic over the next decade. Relying on family caregivers to fulfill all facets of care is unrealistic; but we know that it will become a necessity for many. Therefore, we need to not only look at policy changes to the healthcare system, but also the support of caregivers.

There is an urgent need to bring greater public awareness to this issue and to advocate for caregivers. Expanding access to home-based, long-term care services for NJ’s older adults would provide some relief in that area. The state has done a great job increasing the number of people who receive home- and community-based services through the state’s MLTSS [Managed Long Term Services and Supports] program.

Therefore, NJFA continues to participate in dialogue around the need for a policy or program to address those who fall in the gap between eligibility for Medicaid and the ability to pay privately for care.

In conclusion, there is no single answer to “how do we better serve older adults in NJ,” because there isn’t just one issue. Across our nation (and even the world), longevity is increasing, which is good news. However, that means that society’s ageist views, which place barriers on the road to aging well, need to be dismantled now. Investing dollars into housing, nutrition and healthcare services (including those that benefit caregivers) will ensure that everyone in NJ has the opportunity to live a long and healthy life.

Thank you for your time.”

MEDICARE OPEN ENROLLMENT

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MEDICARE OPEN ENROLLMENT

ARE YOU AWARE OF YOUR CHOICES?

Charles Clarkson, Esq. Jewish Family Services of Middlesex County, Project Director/VP, Senior Medicare Patrol of New Jersey

 

Every year between October 15 and December 7, during a period known as ?¢‚Ǩ?ìOpen Enrollment,?¢‚Ǩ¬ù Medicare beneficiaries can make changes in their Medicare coverage. The Senior Medicare Patrol of New Jersey (SMP), a Federally funded program of the U.S. Administration for Aging, believes that if you know your options you can avoid being scammed and make the right choices giving you the best coverage at the least cost.

Why make a change?  Whether you have Original Medicare (Part A and/or B), Part D (prescription drug plan), or a Part C Medicare Advantage Plan, your plan can change.  Premiums, deductibles  and coverages can all change.  Even if they remain the same, your health or finances may have changed. SMP encourages all beneficiaries to re-visit their coverage and decide whether or not to change during Open Enrollment.

Beneficiaries have these choices:

  1. If you are enrolled in Original Medicare, you can change to a Medicare Advantage plan with or without drug coverage. These plans are private companies approved by Medicare and give you the services of Original Medicare. If you join a Medicare Advantage plan, you do not need (and are not permitted) to have a Medicare supplement insurance plan (also known as a Medigap policy) and if your Medicare Advantage plan has drug coverage, you will not need a Part D plan.

 

  1. If you are in a Medicare Advantage Plan, you can switch to another Medicare Advantage plan or drop your Medicare Advantage Plan.  If you decide to drop a plan and not switch to another plan, you will be enrolled in Original Medicare.  You should then consider enrolling in a Medicare supplement insurance plan to cover the costs that Original Medicare does not pay for and enroll in a Part D plan for drug coverage.

 

  1. If you are in Original Medicare with a Part D plan, you can stay in Original Medicare and switch your Part D plan.

 

  1. If you are in Original Medicare and do not have a Part D plan, you can enroll in a Part D plan.¬† If you join a Part D plan because you did not do so when you were first eligible for Part D and you did not have other coverage that was, on average, at least as good as standard Medicare drug coverage (known as creditable coverage), your premium cost will be penalized 1% for every month that you did not enroll in Part D.¬† You will have to pay this penalty for as long as you have a drug plan.¬† The penalty is based on the national average of monthly premiums multiplied by the number of months you are without coverage and this amount can increase every year.¬† If you qualify for extra help (low income subsidy), you won’t be charged a penalty.

Why change Part D plans?

Beneficiaries may want to change Part D prescription drug plans (PDPs) for a number of reasons:¬† (i) the PDP has notified the beneficiary that it plans to drop one or more of their drugs from their formulary (list of available medications); (ii) the beneficiary is reaching the coverage gap (donut hole) sooner than anticipated and may want to purchase a PDP with coverage through the coverage gap, if one is available; (iii) the PDP has notified the beneficiary that it will no longer participate in the Medicare Part D program;¬† (iv) the PDP will increase its premium or co-pays higher than the beneficiary wants to pay and a less expensive plan may be available and (v) a beneficiary is not happy with the PDP’s quality of service or the plan has received low rankings for a number of years.¬† For 2018 beneficiaries in New Jersey can expect to choose from a number of¬† PDPs. The plans are announced in late September or early October, 2017.

Compare plans each year.

Beneficiaries should remember that PDPs change every year and it is recommended that beneficiaries compare plans to insure that they are in the plan that best suits their needs.  When comparing plans, keep in mind to look at the estimated annual drug costs, i.e. what it will cost you out of pocket for the entire year, from January 1 through December 31 of each year.  Plans can be compared at the Medicare web site:  www.medicare.gov.  If you do not have access to a computer, call Medicare at 1-800-Medicare to assist in researching and enrolling in a new plan. Medicare can enroll a beneficiary over the telephone.  When you call, make sure you have a list of all your medications, including dosages.  Another resource for Medicare beneficiaries is the State Health Insurance Assistance Program (known as SHIP), telephone 1-800-792-8820.  SHIP is federally funded and can provide beneficiaries with unbiased advice.  Call SHIP to make an appointment with a counselor. You do not need to use a broker or agent who may not be looking out for your best interest. Brokers and agents are usually being paid to enroll you in certain plans.  Beneficiaries can also call the Senior Medicare Patrol of New Jersey at 732-777-1940.

Medicare Open Enrollment can also be a time of fraudulent schemes that can cost you money. The SMP wants you to be on the alert for scams involving new Medicare cards.¬† Back in the spring of 2015, Congress passed the “Doc Fix”¬ù bill which mainly dealt with the long standing problem of the Physician Fee Schedule.¬† At the same time, Congress sought to remedy the problem caused by having Social Security numbers on the red, white and blue Medicare ID cards.

 

The new cards will be rolled out starting in April of ?Ǭ†2018.?Ǭ† Since it will take a period of time to mail new Medicare cards to all Medicare beneficiaries, there will be a transition period through December 31, 2018 when beneficiaries will be able to use either card.¬† All cards should be issued by April of 2019.?Ǭ† You should start using the new Medicare card once you receive it.¬† Make sure that the Social Security Administration and Medicare have your current address to insure that you get your new card.

 

This card change is both a blessing and a curse for Medicare beneficiaries.¬† By removing Social Security numbers, the change greatly decreases the financial havoc that a stolen Medicare card can cause, but it opens the door to scammers¬† presenting a golden opportunity to take advantage of Medicare beneficiaries.¬† Remember, there is never a charge for the new Medicare card.¬† Scammers already are calling¬† and scaring seniors into paying $300 or more for a new Medicare card and asking for their checking account information to pay for the new card’s fee.

What do you do when you realize that a scammer is calling?  Just hang up.  Do not be polite and just hang up.  Also, do not open any emails about the new Medicare cards even if they appear to be coming from a legitimate source, such as Medicare.  They are most likely scams.  Any questions about the new Medicare cards, call the Senior Medicare Patrol of New Jersey at 732-777-1940.

 

 

 

 

 

 

Preventing Falls at Home

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Preventing Falls at Home

Falls are not inevitable; it isn’t something that just happens as you get older. Falls are linked to a specific cause.  It could be that more than one underlying cause or risk factor is involved in a fall.

Falls can be linked to a person’s physical condition or a medical problem, such as a chronic disease. Other causes could be safety hazards in the person’s home or community environment.

What are some Risk Factors for falls?

  • Muscle weakness, especially in the legs, is one of the most important risk factors. People with weak muscles are more likely to fall than are those who maintain their muscle strength, as well as their flexibility and endurance.
  • Your balance and your gait — how you walk — are other key factors. Older adults who have poor balance or difficulty walking are more likely than others to fall. These problems may be linked to a lack of exercise or to a neurological cause, arthritis, or other medical conditions and their treatments.
  • Blood pressure that drops after you have been lying down or sitting can increase your chance of falling. This condition — called postural hypotension — might result from dehydration, or certain medications. It might also be linked to diabetes, neurological conditions such as Parkinson’s disease, or an infection.
  • Your reflexes may also be slower than when you were younger. The increased amount of time it takes you to react may make it harder to catch your balance if you start to fall.
  • Foot problems that cause painful feet, and wearing unsafe footwear can increase your chance of falling. Backless shoes and slippers, high-heeled shoes, and shoes with smooth leather soles are examples of unsafe footwear that could cause a fall.
  • Sensory problems can cause falls, too. If your senses don’t work well, you might be less aware of your environment. For instance, having numbness in your feet may mean you don’t sense where you are stepping.
  • Not seeing well or other vision problems can also result in falls. It may take a while for your eyes to adjust to see clearly when you move between darkness and light. Other vision problems contributing to falls include poor depth perception, cataracts, and glaucoma. Having poor lighting around your home can also lead to falls.
  • Confusion, even for a short while, can sometimes lead to falls. For example, if you wake up in an unfamiliar environment, you might feel unsure of where you are. If you feel confused, wait for your mind to clear or until someone comes to help you before trying to get up and walk around.
  • Some medications can increase a person’s risk of falling because they cause side effects like dizziness or confusion. The health problems for which the person takes the medications may also contribute to the risk of falls.

Most Falls Happen at Home

Although falls can happen anywhere, well over half of all falls happen at home. Falls at home often happen while a person is doing normal daily activities. Some of these falls are caused by factors in the person’s living environment. For instance, a slick floor or a poorly lit stairway may lead to a fall.

Other factors that can lead to falls at home include

  • loose rugs
  • clutter on the floor or stairs
  • carrying heavy or bulky things up or down stairs
  • not having stair railings
  • not having grab bars in the bathroom

Simple changes can help make your home safer.

If you do fall, what should you do?

Well, be sure to talk with your doctor if you fall. A fall could be a sign of a new medical problem that needs attention, such as an infection or a cardiovascular disorder. It could also suggest that a treatment for a chronic ailment, such as Parkinson’s disease or dementia, needs to be changed.

For the time immediately after a fall, here are some tips:

While you are still on the ground:

  1. Take several deep breaths to try to relax.
  2. Remain still on the floor or ground for a few moments. This will help you get over the shock of falling.
  3. Decide if you’re hurt before getting up. Getting up too quickly or in the wrong way could make an injury worse.

Once you are ready to get up:

  1. If you think you can get up safely without help, roll over onto your side.
  2. Rest again while your body and blood pressure adjust. Slowly get up on your hands and knees, and crawl to a sturdy chair.
  3. Put your hands on the chair seat and slide one foot forward so that it is flat on the floor. Keep the other leg bent so the knee is on the floor.
  4. From this kneeling position, slowly rise and turn your body to sit in the chair.

If you’re hurt or can’t get up, ask someone for help or call 911. If you’re alone, try to get into a comfortable position and wait for help to arrive.

For more information and resources, visit the NJ Dept of Human Services website: http://www.state.nj.us/humanservices/doas/services/fallprev/

 

Take the American Medicine Chest 5 Step Challenge

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Prescription Drug Safety and Disposal

Take the American Medicine Chest 5 Step Challenge

By: Angelo M. Valente

The American Medicine Chest Challenge (AMCC) is a community based public health initiative, with law enforcement partnership, designed to raise awareness about the dangers of prescription drug abuse and provide a nationwide day of disposal – at a collection site or in the home – of unused, unwanted, and expired medicine. AMCC provides a unified national, statewide, and local focus on the issue of children and teens abusing prescription medicine. It is designed to generate unprecedented media attention and challenge all Americans to take the 5 Step American Chest Challenge.

It is important for households across the state of New Jersey to understand how easy it is for children and teens to abuse prescription drugs. “AMCC encourages families throughout the state of New Jersey to take the 5-Step Challenge,” said AMCC CEO, Angelo M. Valente. “We have come so far and so much has been achieved – hundreds of permanent disposal sites have been installed and thousands of tons of prescription drugs have been collected. Yet, we are still in the midst of an opiate abuse epidemic and the need for this initiative has continued to expand ever since New Jersey held the first statewide day of disposal in the nation.”

“When AMCC began addressing this issue several years ago, the answer seemed simple, dispose of the unused medicine in your home and prevent it from being diverted and abused by the young people in your life. Safe disposal opportunities have expanded in New Jersey, and now, residents in over 200 communities from across our state have safe and convenient access to a medicine disposal location,” said Valente. “The DEA recently reinstated their Drug-Take Back Day to provide additional opportunities, and the partners we have in the media are working hard to get the message out about the dangers of abusing prescription drugs. We still know that these efforts are key steps in preventing prescription drug abuse, but now we must address the epidemic of opioid abuse on all fronts. Heroin overdoses are on the rise across the country and New Jersey is ground zero.”

According to a report released in 2015 by the Centers for Disease Control and Prevention (CDC), heroin use has increased across the US among men and women, most age groups, and all income levels. The report found that the strongest risk factor for heroin use is a history of prescription drug abuse. The greatest increases in heroin abuse have occurred in groups with historically lower rates of heroin use, including women, people with private insurance and higher incomes.

New Jersey has worked to address the issue in a 21 bill package, introduced by Senate Health, Human Services and Senior Citizens Committee Chairman, Joseph F. Vitale, to tackle the heroin and prescription drug epidemic that is sweeping our state. One measure requires practitioners to have a conversation with their patient about the risks of developing a physical or psychological dependence before prescribing. Another, which is now law, requires physicians to utilize the Prescription Drug Monitoring Program.

There are many ways we can work together to prevent opiate abuse, and stem the tide of this epidemic; we can start in our own homes. “Please encourage all of those in your community, workplace, family, and home to take the 5-Step Challenge,” said Valente.

  1. Take inventory of your prescription and over-the-counter medicine.
  2. Secure your medicine.
  3. Dispose of your unused, unwanted, and expired medicine at an American Medicine Chest Challenge Disposal site.
  4. Take your medicine(s) exactly as prescribed.
  5. Talk to your children about the dangers of prescription drug abuse… they are listening.

Information on locations to safely dispose of unused, unwanted, and expired medicine can be found on the American Medicine Chest Challenge website: www.americanmedicinechest.com or by downloading the AMCC Rx Drop mobile app.

This initiative is provided without cost to any community, government, or law enforcement agency in the country.

Income Taxes and Your Social Security Benefits

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It’s tax season, perhaps you know this because there is an accountant in your life who just got super busy or you’ve seen the increase in TV ads for Turbo Tax. Either way, we thought this timely information from our friends at the Social Security Administration might be useful.

Income Taxes and Your Social Security Benefits

Join the Millions! Create your own my Social Security account

at www.socialsecurity.gov/myaccount.

With tax season upon us, many of you have asked about Income Taxes And Your Social Security Benefits. Some people have to pay federal income taxes on their Social Security benefits. This usually happens only if you have other substantial income (such as wages, self-employment, interest, dividends and other taxable income that must be reported on your tax return) in addition to your benefits.

Note: No one pays federal income tax on more than 85 percent of his or her Social Security benefits based on Internal Revenue Service (IRS) rules. If you:

  • file a federal tax return as an “individual” and your combined income* is
  • between $25,000 and $34,000, you may have to pay income tax on up to 50 percent of your benefits.
  • more than $34,000, up to 85 percent of your benefits may be taxable.
  • file a joint return, and you and your spouse have a combined income* that is
  • between $32,000 and $44,000, you may have to pay income tax on up to 50 percent of your benefits
  • more than $44,000, up to 85 percent of your benefits may be taxable.
  • are married and file a separate tax return, you probably will pay taxes on your benefits.
  • Each January you will receive a Social Security Benefit Statement (Form SSA-1099) showing the amount of benefits you received in the previous year. You can use this Benefit Statement when you complete your federal income tax return to find out if your benefits are subject to tax.
  • If you currently live in the United States and you need a replacement form SSA-1099 or SSA-1042S, we have a new way for you to get an instant replacement quickly and easily. Using your online my Social Security account. If you don‚Äôt already have an account, you can create one online. Go to Sign In or Create an Account. Once you are logged in to your account, select the “Replacement Documents” tab.

Withholding Income Tax From Your Social Security Benefits

You can ask us to withhold federal taxes from your Social Security when you apply for benefits.

If you are already receiving benefits or if you want to change or stop your withholding, you’ll need a form W-4V from the Internal Revenue Service (IRS).

You can download the form, or call the IRS toll-free number 1-800-829-3676 and ask for Form W-4V, Voluntary Withholding Request. (If you are deaf or hard of hearing, call the IRS TTY number, 1-800-829-4059.)

When you complete the form, you will need to select the percentage of your monthly benefit amount you want withheld. You can have 7%, 10%, 15% or 25% of your monthly benefit withheld for taxes.

Note: Only these percentages can be withheld. Flat dollar amounts are not accepted.

Sign the form and return it to your local Social Security office by mail or in person.

If you need more information

If you need more information about tax withholding, read IRS Publication 554, Tax Guide for Seniors, and Publication 915, Social Security and Equivalent Railroad Retirement Benefits.

If you have questions about your tax liability or want to request a Form W-4V, you can also call the IRS at 1-800-829-3676 (TTY 1-800-829-4059).

Medicare Hospice Benefit

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Medicare Hospice Benefit

Hospice and other end of life issues are not things we often want to talk about. However, being prepared and knowing all your options is a good idea.

We should start by describing hospice. Hospice is a program of care and support for people who are terminally ill. The focus is usually on providing comfort instead of treatment. It is a choice a patient needs to make with their doctor and family. Hospice programs also offer assistance and services to family members during the process of caring for the patient.

If you have Medicare it will cover hospice services. The Medicare hospice benefit covers your care and you shouldn’t have to go outside of hospice to get care (except in very rare situations).

Once you choose hospice care, your hospice benefit should cover everything you need. All Medicare-covered services you get while in hospice care are covered under Original Medicare, even if you were previously in a Medicare Advantage Plan (like an HMO or PPO) or other Medicare health plan.

Medicare Part A (Hospital Insurance) covers Hospice care if you meet these conditions:

Your hospice doctor and your regular doctor certify that you’re terminally ill (with a life expectancy of 6 months or less).

You accept palliative care (for comfort) instead of care to cure your illness.

You sign a statement choosing hospice care instead of other Medicare-covered treatments for your terminal illness and related conditions.

Palliative care means that the medical team will focus on relieving the patient’s pain and any other symptoms, including mental stress. Only your hospice doctor and your regular doctor can certify that you’re terminally ill and have 6 months or less to live.

To start the process you meet with your doctor to discuss all options. Medicare covers a one-time only hospice consultation with a hospice medical director or doctor to discuss your care options and management of your pain and symptoms. This one-time consultation is available to you, even if you decide not to get hospice care.

Medicare will cover the hospice care you get for your terminal illness and related conditions, but the care you get must be from a Medicare-approved hospice program.

Hospice care is can be given in your home. Although depending on your needs and wishes, there are also inpatient programs available. That is one of the things you will discuss with the hospice program (and your loved ones). Together you will create a plan of care that can include any or all of these services:

Doctor services

Nursing care

Medical equipment (like wheelchairs or walkers)

Medical supplies (like bandages and catheters)

Prescription drugs

Hospice aide and homemaker services

Physical and occupational therapy

Speech-language pathology services

Social worker services

Dietary counseling

Grief and loss counseling for you and your family

Short-term inpatient care (for pain and symptom management)

Short-term respite care

Any other Medicare-covered services needed to manage your terminal illness and related conditions, as recommended by your hospice team

You can find out more information at medicare.gov or by calling them at 1-800-Medicare. Hospice specific information and resources are available at https://www.medicare.gov/coverage/hospice-and-respite-care.html

You can also talk to your physician about your options and care available in your area.

This information is meant to inform you of coverage available to you should you need it. Don’t be afraid to talk openly with your family about end of life decisions.

Medicare Coverage

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Medicare coverage

What does Medicare cover? It’s a common, but also complex question. Medicare has 2 basic parts, Part A, which is known as hospital insurance (we’ll define that in a minute) and Part B, which covers services, such as lab tests, doctor visits, etc. Part A and Part B together are known as Original Medicare.

Medicare recipients also have the choice to enroll in a Medicare Advantage plan (also known as Part C) which is delivered by an HMO. This coverage differs from Original Medicare not only in the delivery of benefits but also what is covered. There are many different plan options under Medicare Advantage and you can learn more at medicare.gov

When it comes to Original Medicare, coverage works like this:

Medicare Part A (Hospital Insurance) covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care. To sum it up, Part A covers:

  • Hospital care
  • Skilled nursing facility care or Nursing home care (as long as custodial care isn’t the only care you need)*
  • Hospice (provided by a Medicare approved program, either at home or an inpatient setting)**
  • Home health services

**Keep a look out for a blog post on Medicare Coverage of Hospice Services coming soon.

*This is where some of the complexity of Medicare comes in. When a patient is sent to a nursing home/rehab facility for rehabilitation, Medicare covers your stay on a short term basis. Medicare does not pay for “long term care” or “custodial care”. If needed, Medicare will cover your rehab stay for 20 days at 100%, on day 21 (should you still need to be there) you will be responsible for a 20% copay. The maximum amount of rehab time Medicare will pay for is 100 days, so from day 21 to day 100 you would pay 20% of the cost. If you or a loved one are in a situation where you have to be in a rehab facility for more than 20 days, you should definitely be thinking about your options and what your plan for long term care is. At that point you should have already had a meeting with the discharge planner if not an interdisciplinary team at the facility.

Medicare Part B (Medical Insurance) covers certain doctors’ services, outpatient care, medical supplies, and preventive services. Part B covers 2 types of services:

  • Medically necessary services: Services or supplies that are needed to diagnose or treat your medical condition and that meet accepted standards of medical practice.
  • Preventive services: Health care to prevent illness (like the flu) or detect it at an early stage, when treatment is most likely to work best.

Preventive services include screenings such as, mammograms, colonoscopies, bone mass measurements, and other cancer screenings, if your doctor thinks you are at risk. You also get a Welcome to Medicare visit within your first 12 months of enrollment, during this visit you can talk to your doctor about screenings and review your medical history. In addition to the Welcome to Medicare visit, you are entitled to an Annual Wellness visit. You pay nothing for most preventive services if you get the services from a health care provider who accepts assignment.

Part B covers things like:

  • Ambulance services
  • Durable medical equipment (DME)
  • Mental health
    • Inpatient
    • Outpatient
    • Partial hospitalization
  • Getting a second opinion before surgery
  • Limited outpatient prescription drugs

The fourth part of Medicare is Part D, which is prescription drug coverage. With Original Medicare prescriptions are not paid for, therefore you should obtain a separate Medicare Part D plan.

To learn more about all the parts of Medicare and to explore your options, such as, Original Medicare (Part A & B), Medicare Advantage (Part C) and Prescription Drug Coverage (Part D) visit https://www.medicare.gov/ or call 1-800-MEDICARE (1-800-633-4227).

You can also contact your local SHIP (State Health Insurance Assistance Program) through you County- find their contact information at: http://www.state.nj.us/humanservices/doas/home/sashipsite.html or call the SHIP Information Center at 1-800-792-8820.

 

medicare

NJFA Founding Trustee Given National Recognition

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NJFA Founding Trustee Given National Recognition

Trenton— The New Jersey Foundation for Aging (NJFA) is pleased to announce that founding trustee, Carl West was recently recognized by the National Association of States United for Aging and Disabilities (NASUAD). In honor of the 50th Anniversary of the Older American‚Äôs Act, NASUAD honored more than 50 advocates who are dedicated to Aging and Disability Services. Carl West, who is a Founding Trustee and first Board Chair of NJFA, is also the former Executive Director of the Mercer County Office on Aging.

The honorees that were selected are featured in a publication from NASUAD titled, Celebrating 50 Years with 50+ Fabulous Older People, which is available online at http://www.nasuad.org/. Carl was recognized for his advocacy both in New Jersey and nationally. At the time of his retirement, Carl was the longest serving area agency on aging director in the country. In addition to being a founding member of NJFA, Carl has also been involved with and founding member of numerous other organizations. Locally, Carl was an integral part of the NJ Association of Area Agencies on Aging, serving as founding director, legislative chair and president. Nationally, Carl has been a long-standing board member of the National Caucus and Center on Black Aged, where he served as the Chairman of their National Board.

Even in his retirement, Carl continues to be involved, following important proceedings, such as the recent White House Conference on Aging. NJFA joins, NASUAD in saluting Carl for his dedication to the aging network, older adults and caregivers.

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Social Security Facts

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Social Security Facts

Recently, NJFA Deputy Director, Melissa Chalker sat down with two representatives from the Social Security Administration for a taping of our half hour TV program Aging Insights.

Given all of the extensive information they shared, we thought it was time to do a blog about Social Security benefits and what you need to know. Be sure to tune into the show in September, in the meantime, here are some facts.

Social Security is a family insurance program. It is meant to be additional income for those who are retired, disabled, widowed, etc. Eligibility for retirement benefits is based on your work history (the # of credits you earned while working and paying into the Social Security system) and your age. Depending on the year you were born, your retirement age could be anywhere between 65 and 67 years of age. You can receive your benefits starting at age 62, however it will be a reduced benefit because you are choosing to receive it early. Reduction amounts are calculated based on when your official retirement age should be.

All of this information and more is available at sss.gov or by calling 1-800-772-1213. You can start a my social security account online, look up information about Social Security and/or Medicare benefits and even apply for benefits online. A my social security account is available for anyone over 18 who is working, it helps you to track your Social Security record, estimate your benefit and much more. Social Security’s website is safe and secure, be sure to sign up for your account and create your own user name and password to protect your identity.

Many people don’t know that Social Security benefits are also for family members of a retired person. If a retired individual has minor children, disabled children and/or a spouse caring for a minor child, those family members may also be eligible for a monthly benefit. More information about those benefits are available by contacting Social Security or creating a my social security account to see what benefits you and your family could receive.

Information about benefits for spouses, survivors, disabled individuals and more is available at ssa.gov or by calling 1-800-772-1213 (Mon- Fri).

 

Announcing NJFA’s 17th Annual Conference!

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Announcing NJFA’s 17th Annual Conference!

NJFA will hold its 17th Annual Conference on Wednesday, June 3rd at the Crowne Plaza Monroe. The 2015 Keynote Speakers are James Firman, CEO of NCOA and Nora Dowd Eisenhower, Assistant Director of the Consumer Finance Protection Bureau Office of Financial Protection for Older Americans. Jim Firman will address the crowd in the morning. Heis recognized leader and advocate in the field of aging. Mr. Firman will discuss a variety of topics including key aspects of the political and legislative landscape, such as the White House Conference on Aging and the Affordable Care Act. He will also talk about NCOA’s work on Elder Justice, Economic Security, Benefits Check-up, Senior Hunger and evidence based programs.

Ms. Dowd Eisenhower will be the luncheon keynote speaker and will discuss the mission and structure of the Consumer Finance Protection Bureau (CFPB) and the specific role of the Office for Older Americans. She will also talk about CFPB tools/guides on financial decisions such as reverse mortgages or choosing a financial advisor. This will include two programs from CFPB that look at preventing elder financial exploitation and guides created for powers of attorney, etc.

The 2015 conference workshop speakers will include policy makers, direct care & clinical practice specialists. Topics include Dental Health and Oral Cancer Screenings, Addiction and Gambling in Older Adults, New Models of Care, Elder Bullying and more.

More information and registration can be found on NJFA’s website at www.njfoundationforaging.org Limited vendor space and sponsorships remain, call us at 609-421-0206, email at office@njfoundationforaging.org or check out the website for details.

The New Jersey Foundation for Aging (NJFA) is a public charity with the primary goal to empower elders to live in the community with independence and dignity.slide_01