Money in the Middle

Sandwich Generation Talking About Money Up, Down and Across Generations

Posts Tagged ‘aging parents

Adult children and aging parents: enable or safety in driving?

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In a week of horrific front page news, it’s the story about an elderly couple who got lost driving home and froze to death that haunts me.

For anyone in the delicate balance of respecting the wishes of aging parents who want to keep driving and trying to make sure they are safe, the story captures our greatest fear.  We’ll miss a critical sign that can mean the difference between life and death..The headline reads:

Elderly Couple found Frozen To Death After Getting Lost During Drive

The daughter was quoted as saying: “We didn’t realize it was time to do more. We didn’t realize it was time. . . . Oh, the second-guessing that is running through our minds.”

They had taken precautions – gathering in places where the drive would be short and familiar; providing a cell phone; checking in to make sure they arrive — things many of us have done to help honor our parent’s wish to keep driving, at the same time hoping we are keeping them safe enough.

Maybe it’s just that I returned from driving my mother down to Florida — taking the 14 hour drive off her, but giving her the freedom to get around on her own there for the next few months.

I sometimes worry about becoming an enabler – that is, helping continue a routine that really needs to be altered in realistic response to aging issues.  When actually the discussion should be about how we adjust to a change and find new ways to accomplish the activities that keep us feeling independent.  There is so much fear wrapped up in the ability to no longer drive.

There are many resources available about the issue of aging and driving.  Some great websites about how to have the conversation and options available to help transition to a non-driver.  Here are a couple of those website if you are tackling the driving and aging issue.  I also find them helpful in beginning to think about how I want to handle this situation as I age.

Family conversations about driving from The Hartford

Older Drivers by AAA

Such a horrific story.   But  one that reminds us all that sometimes we have to push the balance between respect and safety even more than we’re comfortable with when it comes to aging parents and driving (among other issues).  My heart goes out to the family who tried so hard to find that right balance between respecting wishes and taking away the keys.  It’s so hard to know what’s right.

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Written by Laura Rossman

January 14, 2011 at 7:18 pm

Get Ready to Help with Medicare Insurance Decisions

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This is the time of year when people on Medicare prepare for open enrollment.  And you thought you were done with that when you left the workforce.  But, Medicare has an open enrollment period each year for Medicare beneficiaries who want to enroll or change Medicare Advantage and Medicare Part D plans.

 For many of us in the sandwich generation, it’s a time when we lend a hand to an aging parent or family member to figure out if they need to change plans – either for cost reasons or because their medical needs have changed.  It can be pretty confusing no matter what your age.  But it really is worth taking the time to compare plans and make sure you’ve got the right plan and the right price.

 The good news is that prices for Medicare Advantage and Medicare Part D plans won’t be changing much from 2010 to 2011. 

Plan prices will be about 1 percent lower, according to the Centers for Medicare & Medicaid Services. 

You may still have to shop for a new plan during open enrollment – if the plan has changed benefits, health care needs have changed or the plan is exiting the business. It’s also smart to check and make sure the plan you’ve got is still the right plan.  During this special period you can switch plans without having to worry about health conditions limiting your choices.  This period doesn’t apply to Medicare Supplement Plans.

 Those who have Medicare Advantage plans or Medicare Part D plans can change their plans during the Annual Enrollment Period (AEP) from Nov. 15 – Dec. 31. 

Longevity Alliance, a national insurance brokerage, is offering an AEP Reminder service.  You can sign up to receive an email when most of the 2011 plan information is available.  That way you won’t have to keep calling to find out about rates for 2011 and you won’t let it slip!  You can sign up for the free service by clicking here.

Rate and plan comparison tools are available at www.medicare.gov.  But the 2011 rates usually aren’t loaded into the system until mid-late October.  So keep checking back and make sure you are looking at 2011 rates. 

“Even with the lower costs, all beneficiaries should take time this Fall to compare their current health and drug plan coverage with what’s available and best meets their needs for next year,” said Jonathan Blum, deputy administrator and director of CMS’ Center for Medicare.  “Medicare will continue to provide a wide-range of consumer tools to help beneficiaries make the best possible choice of coverage.”  

Rates and benefits for specific 2011 plans are generally released between Oct. 15 and Nov. 1.  The government rules say you can’t buy a plan until Nov. 15, but you can start shopping and comparing rates so you don’t end up in a last-minute rush.  And you’ve got to shop to save and/or make sure you’ve got the right plan for your current medical needs.

 Don’t wait too long. The companies handling this business get very busy.  You’ll get more attention and assistance, if you need it, if you look early in November and apply as soon as you can – November 15.  And make sure you compare plans and fully understand the co-pays and network limits since a low-cost premium may just shift costs  and you’ll find you’re paying more at the doctor and the pharmacy.

Written by Laura Rossman

September 23, 2010 at 1:17 pm

Preparing for the Medicare Shopping Season

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Medicare Part D Covers Prescription Drugs

 

Medicare Part D Prescription Drug plans will cost about the same in 2011 as they did in 2010 according to information released yesterday by CMS (Centers for Medicare and Medicaid Services).   

Good news for Medicare beneficiaries.  And good news for sandwich generation adult children who assist senior family members or aging parents with making Medicare plan selections. Maybe fewer will face the confusion of changing plans.   

But don’t assume the 2010 plan is still the best plan for your health care needs.  You’ll still want to shop and compare plans – and watch out for changes in the co-pays that can boost out-of-pocket expenses.     

This announcement marks the start of the Medicare shopping season also known as Annual Enrollment Period (AEP).  Medicare beneficiaries can change Part D and Medicare Advantage plans only from Nov. 15 – Dec. 31 for plans effective in 2011.  You can’t do much with the information yet.  But come mid-October there will be specific plan information available on the government website so you’ll be able to compare you current plan with 2011 plans.  

Here’s the schedule leading up to AEP:   

September –Information about premium and benefits for each Part D and Medicare Advantage plan  

October – More detailed plan information is available so that you can begin comparing plans  

Nov. 15- Dec. 31 – applications for plans effective in 2011 can be accepted  

 Here’s the statement from Medicare on part D premiums for 2011.   

 “Most Medicare prescription drug plan premiums should remain relatively stable next year, and all beneficiaries should compare their coverage under their current plan with the plans that will be offered in 2011 when that information becomes available in October,” said Jonathan Blum, deputy administrator of CMS’ Center for Medicare. “The Affordable Care Act improves the value of drug coverage people with Medicare will receive next year, providing discounts on brand name drugs and coverage of generics in the coverage gap, or donut hole.”

Written by Laura Rossman

August 19, 2010 at 3:33 pm

When Your Long-term Care Insurance Rates Rise

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Over the past several months, many long-term care insurance policy holders have received unwanted news from their LTC insurance company:  your rate is going up.

There are a number of reasons prices on policies issued years ago are going up now.  The current low-interest rate environment; more people are holding onto their policies rather than lapsing (stop paying); and people are living longer so more are expected to use their benefits than originally projected. 

But raising rates?  Can they do that?  You probably don’t remember it, but your policy includes language that the rate can be increased in the future.  And many companies have held off on increases.  But to maintain a financially stable program, the rates have to support potential claims.  Those insurance through the Federal government employees long-term care insurance program found that out last year when some rates increased as much as 25%.

It’s also important to recognize that the increase does not reflect anything about you as an individual.  When companies make these changes they do so for an entire class of policy owners, i.e. people who bought a certain policy during a certain period of time.  So you aren’t being singled out. 

You’ll receive a letter from the insurance company telling you when the rate is going to increase and the options you have if you don’t’ want to pay more.  

So, what are your options?  

Cancelling should be the last resort.  Unless you have a provision in your contract that lets you stop the policy and receive the benefits you’ve accrued to date, you will lose all the money you have paid in for the insurance.  Work with the insurer to find a benefit level that you can afford. 

Buying a new policy at a lower cost usually isn’t an option.  LTC insurance is priced by the age at the time you apply – the older you are, the more it costs.  So switching probably won’t save you money if you’ve had your policy more than a few years. 

If you are happy with the policy and you can afford the rate increase that solves the problem. 

But, if you can’t afford the increase, you can change the benefits.  The letter will outline what you can change and the impact it will have on your price. 

A good place to start can be the additional “riders” you purchased.  See if they are still as important to you as they were when you bought the policy.  Be careful about cutting inflation protection if you have it (the percentage at which the daily benefit increases each year — for example, 5% compound growth.  That’s what keeps your pool of money growing to keep pace with the costs of care when you need it in the future. 

Then take a look at the core benefits: daily benefit, policy years, and elimination period (deductible).  Your agent or the company can help you work through the tradeoffs.  Ask about the average costs of care in your area.  That can help you determine how far your coverage will go.

For those in the sandwich generation, if your parent is finding it difficult to pay the higher amount you might want to consider chipping in and paying the difference.  Continuing the level of coverage may be a huge financial relief in the future for all of you.

Don’t wait until the last minute to make the decision.  Give yourself time to review and consider the financial tradeoffs.

Written by Laura Rossman

August 13, 2010 at 3:28 pm

Long-term care crisis looming-time to talk

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5 Generations

If we needed long-term care tomorrow, most of us are not financially prepared. 

If our parents needed long-term care tomorrow, most of us have no idea what financial resources they have or their expectations and desires for where to live, who will care for them.

Statistically, 72% of Americans will need some level of care later in life. 

The crisis in long-term care is coming.  For many of us, it is already here.  So what do we do about it? 

I attended a session on Women and Aging 2010:  America’s Emerging Crisis last week in Washington sponsored by the Volunteers of America.  They have a robust senior housing program including a program that helps those who want to stay in their home or community (Aging with Options program at Volunteers of America). 

Good research, good discussion by a good panel – but no answer to the question of how do we even begin to have the family conversation about long-term care and finances.  Parents – especially the GI Generation _ don’t want to talk about money.  Baby boomers are generally in denial that they will ever need care.

Everyone agreed we need to have family discussions about this topic.  But, no one had an answer on how to have that conversation before crisis mandates it. and that, of course, is the worse time to try to make any decisions about money or long-term care.

Michelle Singletary, a finance columnist from the Washington Post (her column on the panel)  recommended starting the conversation with children now – hopefully once you need care, they’ll know what you have and what you want.  She also joked that her long-term care plan is that she has 3 daughters (and long-tem care insurance.)

But what do you do if you are caring for a parent now?  As a friend said to me today after her 92-year old mother went to the hospital with a hip fracture – “If I just knew what to plan for now –how long, what resources, what’s next. ”  But as those of us who have found ourselves in caregiving mode, planning need to happen a long time ago.  We just bump from crisis to crisis now – juggling life and catching our breath when we can.

This is a particularly important topic for women because we live longer and generally have lower incomes to support ourselves as we age.  The Volunteers of America survey said that among women caregivers, almost half (48%) say the recent economic downturn has made it harder for them to care for older loved ones.

And this is a middle class problem. As panel members noted — lots of money and you can pay for care, no money and you’ll qualify for government programs.  But a pension, Social Security and some savings and you’ll be figuring out how to pay for this care on your own.

 It’s not just the conversations at home – it’s flexibility in the workplace.  Almost half of the women surveyed (ages 45-65) expect to be called on to provide care to an older family member at some point in the future.  Yet elder-care doesn’t get the same flexibility in the workplace.  And the nature of eldercare giving is different – lots of doctor’s appointments and crisis events.

Volunteers of America says this is the beginning of a year-long discussion about women and aging.  That’s a good thing.  Because we’ve got a lot to talk about – and hopefully it can begin at home with a conversation today – or around Father’s Day if you need an event – to begin to talk about long-term care before the crisis hits.  It’s not just about money (though it’s an important part of the conversation)  it’s gaining the emotional intelligence so when the time comes you feel like you are on the preferred path.

 Michelle Singletary begins her column:  “The time has come.” 

Yes, it has.

America’s Caregiving and Aging Challenges, Volunteers of America research

video of Women and Aging panel discussion

Aging with Options program

Written by Laura Rossman

May 18, 2010 at 7:08 pm

Too High Cost of Caregiving

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If your solution to long-term care is, “my kids will take care of me,” there’s new research that shows just how high a price your children may pay in compromising their own health.

 Employees in the U.S. who are caring for an older relative are more likely to report health problems like depression, diabetes, hypertension or heart disease.

 That costs employers an estimated $13.4 billion per year, according to a MetLife Study of Working Caregivers and Employer Health Care Costs.  And some of those health care costs are borne directly by the employee.

 Here are some more findings:

 * Younger caregivers (18-39 years old) demonstrated significantly higher rates of cholesterol, hypertension, COPD, depression, kidney disease, and heart disease compared to non-caregivers of the same age.

 * Caregivers tend to skip their own preventive health screenings such as mammograms.

 * Caregivers are more likely to miss days of work and often switch from full-time to part-time to care for their elder.

 * Employees providing eldercare were more likely to report fair or poor health in general.

 * Female employees reported higher stress levels at home than non-caregivers.

 * Eldercare may be closely associated with high-risk behaviors like smoking and alcohol.

If you know anyone who is or has been a caregiver, you know this first-hand. 

While eldercare is often thought of as an issue you hit in your 50s, this survey shows caregiving responsibilities across all age groups, with some of the heaviest health toll taken by those ages 18-39.

The report, directed toward employers, calls for better coordination of wellness and eldercare programs, more work time flexibility and stress reduction seminars, among other benefits.  And while reducing employer health care costs is a lofty goal, we can’t help but wonder if in the current economic environment the call for more resources will fall on deaf ears.

But, this report can be a wake-up call to anyone thinking that having their children care for them as they age is a long-term care solution with no consequences.

It’s good reason to figure out now how to finance your own long-term care, whether though your own assets or long-term care insurance. I know the current economy makes that difficult for many of us. 

But after all the years of keeping them healthy, getting them to eat their vegetables, and get exercise — the loss of their good health for elder caregiving is too high a price  to pay.

Written by Laura Rossman

February 3, 2010 at 7:53 pm

Signs of Financial Help for the Sandwich Generation

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The White House yesterday introduced new sandwich generation initiatives.  While it’s a long way from being reality, it’s a welcome nod to the financial challenges of baby boomers trying to save for their own retirement, help their children and aging parents. 

Here are the highlights from the White House statement:

  * Help Families with Soaring Child Care Costs: The administration proposes to nearly double the Child Care Tax Credit for families making under $85,000 a year; with families earning up to $115,000 a year seeing at least some increase in their credit.

  * Helping Families Pay for Care for Elderly Relatives: At the same time, middle class families in the “sandwich generation” – struggling to care for both their children and their parents – will also benefit from new initiatives to support elder care for seniors, and respite for their caregivers. 

 *Cap Payments on Student Loans: To avoid squeezing recent college graduates entering a tough job market, we will ensure that payments on federal student loans are never more than 10 percent of the borrower’s discretionary income.

 * Save for Retirement: The initiatives make it easier to save for retirement with voluntary Automatic IRAs for workers without access to existing retirement plans through their jobs, larger tax credits to match retirement savings for millions of additional workers, and new safeguards to protect retirement savings.

Details on Care for Aging Relatives.

An estimated 38 million Americans provide unpaid care to an aging relative, including approximately 23 million caregivers with jobs and 12 million who are also caring for their own children.

The $102.5 million Caregiver Initiative will ease the burden on families with elder care responsibilities and allow seniors to live in the community for as long as possible. The Initiative adds $52.5 million in funding to Department of Health and Human Services caregiver support programs that provide temporary respite care, counseling, training, and referrals to critical services. The extra funding will allow nearly 200,000 additional caregivers to be served and 3 million more hours of respite care to be provided. It also adds $50 million to programs that provide transportation help, adult day care, and in-home services, such as aides to help seniors bathe and cook, help which eases the burden for family members and helps seniors stay in their homes.

Will it happen?  In this political environment,  who knows but at least it’s recorntion of the increasing financial pressure faced by those in the middle.

Written by Laura Rossman

January 26, 2010 at 2:37 pm