Why Is Medicare Enrollment Confusing?

Seniors enrolling in Medicare experience a process with many challenges. People also have significant gaps in knowledge of plan components and are overwhelmed. This causes them to enroll in plans that fail to best reflect and support their evolving healthcare needs.

Markets Insider’s recent article entitled “New Report Reveals Significant Gaps in Medicare Knowledge Among Older Adults” reports that such issues may jeopardize the ability of seniors to make the best choices for their unique health and wellness needs. Moreover, the results may worsen as they age. That’s what the findings are in a new report, Hidden Crisis: The Medicare Enrollment Maze, issued by national healthcare consultancy Sage Growth Partners. The report is based on a survey of 1,142 individuals ages 64 and older.

The report explores the significant effect of widespread confusion and overwhelming enrollment challenges on the elderly and the entire healthcare system. There were roughly 64 million Americans enrolling in Medicare in 2021 and the U.S. Census Bureau projects more than 73 million Americans will enroll by 2030. Many think the negative effects will only get worse.

“This report shows the striking level of confusion surrounding Medicare enrollment for all ages. While there may be many better plan options, very few enrollees have the necessary knowledge to choose them,” said Dan D’Orazio, Sage Growth Partners CEO. “The level of satisfaction with shopping for Medicare plans lies below the cellar-dwellers of industry satisfaction, such as cable tv providers and internet shopping. This is very troubling considering what is at stake for older adults and their clinical and financial health.”

The report’s key findings include the following:

Only 20% of Medicare-eligible individuals have a solid understanding of Original Medicare, and less than a third (31%) have a good understanding of Medicare Advantage.
63% say they’re “overwhelmed” by Medicare advertising, with just 31% of respondents who “strongly agree” that they can make effective selection decisions.
Over half (58%) stay in their current Medicare plan each year and don’t review their plan options and enroll in the best plan for their evolving needs.

“This report confirms that most older adults find Medicare enrollment confusing and lack adequate resources or support to choose the best plan,” said Dave Francis, CEO of Healthpilot. “Enrolling in Medicare is a pivotal time for millions and the Medicare marketplace is ripe for transformation. I believe that it is possible to make health care better for individuals aged 64 and older throughout the country, but we need dynamic platforms and sincere actions to make this happen.”

Reference: Markets Insider (July 12, 2022) “New Report Reveals Significant Gaps in Medicare Knowledge Among Older Adults”

Why You Need a Digital Asset Estate Plan

Ajemian died in a bicycle accident at age 43. With no will, his estate passed to a surviving brother and sister. As the siblings began going through his assets, they realized that having Ajemian’s emails could make it easier to identify assets and accounts. They asked Yahoo for access to the email account and explained why. Yahoo said no, citing the Stored Communications Act, a 1986 federal law governing online privacy. Yahoo claimed sharing the emails would violate the federal law. The siblings sued, and the case went through the courts until arriving at the Massachusetts Supreme Court, which ruled in the Ajemians’ favor in 2017.

This scenario, discussed in the article “Your digital self will outlive you” from Morning Brew, is a perfect example of how difficult managing digital assets can be. It also raises another question: do you want your family members reading every email you’ve ever sent or seeing every post you’ve created?

We live digital lives today: photos are stored in the cloud, social media records our personal history, digital wallets contain cryptocurrency and creative works may be password protected. If there is no digital estate planning, those assets will live forever on the web, could easily be accessed by hackers and thieves, or be erased if platforms detect inactivity for an extended period of time.

Amid the rise of digital estate planning startups are ethical debates about what should happen to digital lives living on the cloud. These private and sometimes intimate exchanges will live on, long after their creators have passed. Do you want your descendants to get to know you through a chatbot created by using social media, messages and voice recordings? The technology exists already, although even Microsoft deemed it too creepy to bring to market. At least, for now.

Digital accounts are vulnerable to hackers, difficult to identify and easy to disappear. Executors trying to settle estates are often locked out of accounts by default. Forty-seven states have adopted some version of the Revised Uniform Fiduciary Access to Digital Assets Act, or RUFADAA, which provides a legal framework to allow people to designate someone to take over their digital assets when they die—but only if a person actively picks someone to do it.

Given how few Americans have an estate plan, the number who have made plans for online assets is even smaller. Some big tech companies have added features to allow a legacy contact to take over accounts when users die, but not many. Facebook allows a person to let a legacy contact see and download posts, but the contact cannot go into Messenger history.

Unless you make plans to address it, your digital life will outlive you. Not making digital assets part of your estate plans could also make your estate more vulnerable to scammers. A better way forward is to place your traditional and digital assets under the protection of a comprehensive estate plan, created by an experienced estate planning attorney.

Reference: Morning Brew (July 1, 2022) “Your digital self will outlive you”

When Should I Hire an Estate Planning Attorney?

Kiplinger’s recent article entitled “Should I Hire an Estate Planning Attorney Now That I Am a Widow?” describes some situations where an experienced estate planning attorney is really required:

Estates with many types of complicated assets. Hiring an experienced estate planning attorney is a must for more complicated estates. These are estates with multiple investments, numerous assets, cryptocurrency, hedge funds, private equity, or a business. Some estates also include significant real estate, including vacation homes, commercial properties and timeshares. Managing, appraising and selling a business, real estate and complex investments are all jobs that require some expertise and experience. In addition, valuing private equity investments and certain hedge funds is also not straightforward and can require the services of an expert.

The estate might owe federal or state estate tax. In some estates, there are time-sensitive decisions that require somewhat immediate attention. Even if all assets were held jointly and court involvement is unnecessary, hiring a knowledgeable trust and estate lawyer may have real tax benefits. There are many planning strategies from which testators and their heirs can benefit. For example, the will or an estate tax return may need to be filed to transfer the deceased spouse’s unused Federal Estate Unified Tax Credit to the surviving spouse. The decision whether to transfer to an unused unified tax credit to the surviving spouse is not obvious and requires guidance from an experienced estate planning attorney.

Many states also impose their own estate taxes, and many of these states impose taxes on an estate valued at $1 million or more. Therefore, when you add the value of a home, investments and life insurance proceeds, many Americans will find themselves on the wrong side of the state exemption and owe estate taxes.

The family is fighting. Family disputes often emerge after the death of a parent. It’s stressful, and emotions run high. No one is really operating at their best. If unhappy family members want to contest the will or are threatening a lawsuit, you’ll also need guidance from an experienced estate planning attorney. These fights can result in time-intensive and costly lawsuits. The sooner you get legal advice from a probate attorney, the better chance you have of avoiding this.

Complicated beneficiary plans. Some wills have tricky beneficiary designations that leave assets to one child but nothing to another. Others could include charitable bequests or leave assets to many beneficiaries.

Talk to an experienced attorney, whose primary focus is estate and trust law.

Reference: Kiplinger (July 5, 2022) “Should I Hire an Estate Planning Attorney Now That I Am a Widow?”

Did Former NFL Tackle and Fox Sports Commentator Tony Siragusa have an Estate Plan?

In June 2022, former NFL tackle and Fox Sports commentator Tony “The Goose” Siragusa died at the age of 55. The death of the popular athlete was confirmed to TMZ Sports by Siragusa’s former teammate Jamal Lewis. Lewis also played on the Baltimore Ravens Super Bowl winning team in 2001.

MSN’s recent article entitled “What Was NFL Legend Tony Siragusa’s Net Worth When He Died?” says that no cause of death was included with the announcement of Siragusa’s passing.

Siragusa was first drafted by Indianapolis and played a dozen years in the NFL before working more than 10 years on the sidelines for Fox Sports.

In a 2012 interview with Howard Stern, he revealed that his father died young from a heart attack at the age of 48, and that heart disease runs in the Siragusa family.

As a success both before and after his playing career, Tony left behind a sizable net worth when he died.

At the time that Siragusa died in 2022 his net worth was $6 million, according to Celebrity Net Worth. He also earned a $500,000 annual salary for his on-camera work with “Fox on Sunday.”

In addition to the money Siragusa made through football both in the game and on the sidelines, he was also an actor. Siragusa had a role in the hit HBO TV series “The Sopranos,” as well as other parts. Siragusa also hosted “Man Caves” on the DIY Network, as well as other TV appearances.

As news of Siragusa’s death spread, Indianapolis Colts owner Jim Irsay tweeted that Siragusa was the strongest player he’d ever seen in Irsay’s’ half-century in football. Siragusa was drafted by Indianapolis in 1990.

“I’m heartbroken as is all of Colts Nation,” Irsay also tweeted.

Siragusa is survived by his wife, Kathy Siragusa, and their three children.

Referring to the death of his former teammate, Jamal Lewis said, “It’s a sad day to be a Raven.”

Reference: MSN (June 22, 2022) “What Was NFL Legend Tony Siragusa’s Net Worth When He Died?”

Do I Need All Insurance after 65?

Seniors should be cautious about canceling their insurance policies. Consider your future insurability and your individual circumstances and life goals. There’s no one answer that fits everyone.

The primary purpose of life insurance is to replace lost income. Retirees may still want to keep their coverage because it can be an important tool in wealth transfer to the next generation.

US News’ recent article entitled “The Only Insurance Policies You Need After Retirement” advises that these guidelines can help determine which policies are essential and which could be a waste of money. Let’s look at how to decide which policies you need and which you can skip after age 65.

Must-Have Policies for Seniors. These two types of insurance are necessary for seniors.

Medical Insurance. The increasing cost of health care that comes with advanced age is a big reason to buy medical insurance. The Affordable Care Act requires everyone to maintain coverage. Most seniors 65+ are eligible for Medicare, and those still working may have benefits through their job. Note that Medicare doesn’t cover all medical costs, so look at buying a supplemental plan, such as Medigap and Part D coverage, to help pay for services not fully covered by Original Medicare. A Medicare Advantage Plan offered by private insurers is another way to fill in coverage gaps.
Homeowners or Renters Insurance. Seniors with valuable jewelry or other items may need to add a rider to their policy to fully insure these possessions. Mortgage lenders require homeowners to maintain coverage, but once the loan is paid off, it’s not required. It may be tempting to save money by canceling the policy, but that could be a costly mistake. That’s because a big loss would have to be replaced with savings.

Some Smart Options. There are other types of insurance that could be helpful to seniors.

Travel Insurance. Those who plan to travel extensively may want to buy travel insurance. Find a policy that includes features, such as emergency medical and medical evacuation services along with trip delay or cancellation insurance.
Auto Insurance. Auto insurance is required in almost every state. Any senior who is still driving and owns a vehicle should insure it properly.
Umbrella Insurance. This insurance provides additional liability coverage above and beyond what’s included in homeowner and car insurance. Your volunteer activities could put you at risk for a liability claim and warrant added insurance coverage.
An immediate annuity can help guard against outliving savings by providing a guaranteed source of income. Annuities can be purchased for a lump sum amount and provide monthly payments that are based on a person’s age and the purchase price.
Long-Term Care Insurance. Medicare won’t pay for ongoing custodial care in a nursing home or assisted living facility, and Medicaid is only available after a person has depleted almost all their assets.

One Type of Insurance to Cancel. Seniors who aren’t working don’t have a need for disability insurance.

Reference: US News (Feb. 27, 2020) “The Only Insurance Policies You Need After Retirement”

How Can I Save on Medicare Drugs?

New research by the Senior Citizens League shows comparing plans also works for Medicare Part D plans, which cover prescription drugs for those with Medicare health insurance. The advocacy group found that the price of a particular drug can vary by hundreds or even thousands of dollars from one Medicare Part D plan to another. So, shopping around for the best plan could save you hundreds, says Money Talks News’ recent article entitled “How to Save Hundreds of Dollars on Medicare Drug Costs.”

The best time to do comparison shopping is during the annual Medicare open enrollment period that starts October 15 and ends on December 7.

The Senior Citizens League’s analysis identified several reasons for which drug prices can vary so much for Medicare recipients, including the fact that most people on Medicare rarely shop around during open enrollment. each Part D plan also has its own formulary, a list of prescription drugs that a plan covers. The federal government, which runs the Medicare program, doesn’t negotiate drug prices on behalf of Medicare recipients. Each private insurance company that offers Medicare drug coverage does its own negotiating.

There are two main types of Medicare health insurance: Original Medicare, which is offered directly by the federal government, and Medicare Advantage plans, which are offered by private insurers that contract with the federal government’s Medicare program. Note that original Medicare doesn’t include prescription drug coverage. Seniors on Original Medicare who want drug coverage must buy a separate Medicare Part D plan from a private insurer.

Here’s a checklist for the process:

Review your current coverage. Look at the Annual Notice of Change (ANOC) that you get from your Medicare Part D plan or Medicare Advantage plan. This will include changes to your current plan that take effect in the new year, if you stay on that plan.
Do an inventory of your prescriptions. Make a list of all prescription meds you take. For each drug, include the name, dose, quantity taken per day and quantity required per month. You’ll need it to compare drug plans. It is also handy to take with you on each visit to your physician.
Consider getting help. Medicare recipients have access to free, one-on-one Medicare insurance counseling from State Health Insurance Assistance Programs (SHIPs). To find the SHIP for your state, visit the national SHIP website.
Narrow down your options. When you know what your Medicare Part D plan or your Medicare Advantage plan will cover next year, and you have a detailed list of your medications, compare that coverage with other drug plans to determine if they’d provide better or cheaper drug coverage. To compare plans, use the Medicare Plan Finder feature at Medicare.gov, the federal government’s official Medicare website.

If you choose to switch to a new plan, go through the Medicare website rather than the insurer.

Reference: Money Talks News (Nov. 11, 2019) “How to Save Hundreds of Dollars on Medicare Drug Costs”

How to Plan in a Time of Uncertainty

There’s a saying in estate planning circles that the only people who pay estate taxes are those who don’t plan not to pay estate taxes. While this doesn’t cover every situation, there is a lot of truth to it. A recent article from Financial Advisor entitled “Estate Planning In This Particular Time of Uncertainty” offers strategies and estate planning techniques to be considered during these volatile times.

Gifting Assets into Irrevocable Trusts to Benefit Family Members. If done correctly, this serves to remove the current value and all future appreciation of these assets from your estate. With the federal estate tax exemption ending at the end of 2025, the exemption will drop from $12.06 million per person to nearly half that amount.

Combine this with a time of volatile asset prices and it becomes fairly obvious: this would be a good time to take investments with a lowered value out of the individual owner’s hands and gift them into an irrevocable trust. The lower the value of the asset at the time of the gift, the less the amount of the lifetime exemption that needs to be used. If assets are expected to recover and appreciate, this strategy makes even more sense.

Spousal Limited Access Trust (SLAT). This may be a good time for a related technique, the SLAT, an irrevocable trust created by one spouse to benefit the other and often, the couple’s children. Access to income and principal is created during the spouse’s lifetime. It can even be drafted as a dynasty trust. Assets can be gifted out of the estate to the trust and while the grantor (the person creating the trust) cannot be a beneficiary, their family can. Couples may also create reciprocating SLATs, where each is the beneficiary of the other’s trust, as long as they are careful not to create duplicate trusts, which have been found invalid by courts. Talk with an experienced estate planning attorney about how a SLAT may work for you and your spouse.

What about interest rates? A Grantor Retained Annuity Trust (GRAT), where the grantor contributes assets and enjoys a fixed annuity stream for the life of the trust, may be advantageous now. At the end of the trust term, remaining assets are distributed to family members or a trust for their benefit. To avoid a gift tax on the calculated remainder, due when the trust is created, most GRATs are “zeroed out,” that is, the present value of the annuity stream to the grantor is equal to the amount of the initial funding of the trust. Since you get back what’s been put in, no taxable gift occurs. The lower the interest rate, the higher the value of the income stream. The grantor can take a lower annuity amount and with decent appreciation of assets in the trust, there will be a larger amount as a remainder for heirs. Interest rates need to be considered when looking into GRATs.

Qualified Personal Residence Trust (QPRT) is a trust used to transfer a primary residence to beneficiaries with minimal gift tax consequences. The grantor retains the right to live in the house at no charge for a certain period of time. After the time period ends, the property and any appreciation in value passes to beneficiaries. The valuation for the value of the initial transfer into the trust for gift tax purposes is determined by a calculation relying heavily on interest rates. In this case, a higher interest rate results in a lower present value of the remainder and a lower gift value when the trust is created.

Reference: Financial Advisor (July 8, 2022) “Estate Planning In This Particular Time of Uncertainty”

Can Traveling Help Seniors’ Mental Health?

A study to be published in the October 2022 edition of Tourism Management presents the thoughts of a cross-disciplinary team of experts in both dementia and tourism. Medical News Today’s recent article entitled “’Travel therapy’ may offer treatment for dementia and benefit mental health” reports that the research hasn’t yet been peer-reviewed, but experts think there may be significant benefits of travel for people with dementia, particularly in the areas of mental health and well-being.

Dementia currently has no cure, but some medications and treatments may help control symptoms.

Care is often supportive, including helping those with dementia do as much as they can on their own and helping them have a better quality of life.

Researchers are still working on how to best help those with dementia. One area of interest is how traveling may benefit people with dementia.

The researchers say that the potential benefits of tourism in treating people with dementia are called “travel therapy.” One definition of tourism the researchers used was “visiting places outside one’s everyday environment for no longer than a full year.” They note that the experience of tourism has four main components to it:

Affective Experience: how it impacts feelings, emotions and mood
Cognitive Experience: how it affects thoughts and memories
Conative Experience: how it impacts behavior; and
Sensorial Experience: how it impacts the senses.

The authors concluded that tourism may have a potentially positive impact on well-being and quality of life through a variety of components. However, the literature supporting this in the treatment of dementia is limited.

The study authors also noted that focusing on components of positive psychology, such as what people can do, positive experiences, and well-being may also benefit people with dementia.

They proposed a few options to implement components of tourism to help people with dementia, such as group travel that promotes social interactions or traveling to locations that stimulate the senses.

Reference: Medical News Today (June 30, 2022) “’Travel therapy’ may offer treatment for dementia and benefit mental health”

How to Make Home Caregiving Easier

New tools and techniques can improve the safety of a home, which can make caregiving a little easier. AARP’s recent article entitled “9 Items That Make Home Caregiving Easier” provides us with some tools designed to help caregivers ease the burden of daily challenges.

Sit-to-stand toilet. A quarter of falls happen in the bathroom, so assistive toilet seats with adjustable handlebars and seat heights — for safe and stable toilet transfers — are great for those with weakness and instability issues.
Adjustable beds. Although pricey, they’re a real investment in helping to adjust comfort levels with the push of a button. These beds can help create an upright position for eating and are a good tool for preventing bedsores. They also allow for fast repositioning, and safer and faster transfers in and out of bed.
Walk-in shower with handrails. These make it easier for caregivers to get someone with dementia or other challenges to bathe. Walk-in showers have more room for a seat or bench and grab bars. Anti-slip flooring and faucets that regulate water flow and temperature to prevent scalding should also be added.
Motion-sensor lights. Wireless motion-sensor lights can illuminate dim areas, such as stairs and long hallways. These lights are battery-operated, have built-in magnets and double-sided adhesives and shut off after a short amount of inactive time, usually from 15 to 30 seconds.
In-home cameras. Cameras can prevent a loved one from leaving a home or wandering off without a caregiver’s knowledge.
GPS trackers. These devices let loved ones live an independent life, while letting caregivers know exactly where they are. This technology allows for real-time tracking, the setup of safe zones and custom alerts to let caregivers know someone has wandered off. They also may have two-way communication and the ability to give others, like additional family members, access to the same information.
Monitoring apps. There are many digital apps that can be used as monitors, reminders and providers of useful information.
Customizable digital clocks. Choose clocks with large, easy-to-read displays, or voice capabilities. Some clocks let caregivers set reminders, such as “It is now Saturday afternoon.” Caregivers can program alarms, events, birthdays and holidays. Models with personalized voice reminders — for medication, appointments, and tasks — let the person being cared for hear the comforting voice of the caregiver.
Large erasable whiteboards and calendars. Place these in commonly frequented parts of the house, like the kitchen and family room. These can be easier to use and more legible for people with dementia.

Reference: AARP (Dec. 21, 2021) “9 Items That Make Home Caregiving Easier”

Suggested Key Terms: Disability, Caregiving, Dementia, Senior Health, Aging at Home

Addressing Vacation Home in Another State in Estate Planning

Many families have an out-of-state cabin or vacation home that’s passed down by putting the property in a will. While that’s an option, this strategy might not make it as easy as you think for your family to inherit this home in the future.

Florida Today’s recent article entitled “Avoiding probate: What is the best option for my out-of-state vacation home?” explains the reason to look into a more comprehensive plan. While you could just leave an out-of-state vacation home in your will, you might consider protecting your loved ones from the often expensive, overwhelming and complicated process of dealing both an in-state probate and an out-of-state probate.

There are options to help avoid probate on an out-of-state vacation home that can save your family headaches in the future. Let’s take a look:

Revocable trust: This type of trust can be altered while you’re still living, especially as your assets or beneficiaries change. You can place all your assets into this trust, but at the very least, put the vacation home in the trust to avoid the property going through probate. Another benefit of a revocable trust is you could set aside money in the trust specifically for the management and upkeep of the property, and you can leave instructions on how the vacation home should be managed upon your death.
Irrevocable trust: similar to the revocable trust, assets can be put into an irrevocable trust, including your vacation home. You can leave instructions and money for the management of the vacation home. However, once an irrevocable trust is established, you can’t amend or terminate it.
Limited liability company (LLC): You can also create an LLC and list your home as an asset of the company to eliminate probate and save you or your family from the risk of losing any other assets outside of the vacation home, if sued. You can protect yourself if renting out a vacation home and the renter decides to sue. The most you could then lose is that property, rather than possibly losing any other assets. Having beneficiaries rent the home will help keep out-of-pocket expenses low for future beneficiaries. With the creation of an LLC, you’re also able to create a plan to help with the future management of the vacation home.
Transfer via a deed: When you have multiple children, issues may arise when making decisions surrounding the home. This is usually because your wishes for the management of the house are not explicitly detailed in writing.
Joint ownership: You can hold the title to the property with another that’s given the right of survivorship. However, like with the deed, this can lead to miscommunication as to how the house should be cared for and used.

Plan for the future to help make certain that the property continues to be a place where cherished memories can be made for years to come. Talk to a qualified estate planning attorney for expert legal advice for your specific situation.

Reference: Florida Today (July 2, 2022) “Avoiding probate: What is the best option for my out-of-state vacation home?”

Estate Planning Blog Articles

Estate & Business Planning Law Firm Serving the Providence & Cranston, RI Areas

Why Is Medicare Enrollment Confusing?

When Should I Hire an Estate Planning Attorney?

Did Former NFL Tackle and Fox Sports Commentator Tony Siragusa have an Estate Plan?

Do I Need All Insurance after 65?

How Can I Save on Medicare Drugs?

How to Plan in a Time of Uncertainty

Can Traveling Help Seniors’ Mental Health?

How to Make Home Caregiving Easier

Addressing Vacation Home in Another State in Estate Planning

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Why Is Medicare Enrollment Confusing?

When Should I Hire an Estate Planning Attorney?

Did Former NFL Tackle and Fox Sports Commentator Tony Siragusa have an Estate Plan?

Do I Need All Insurance after 65?

How Can I Save on Medicare Drugs?

How to Plan in a Time of Uncertainty

Can Traveling Help Seniors’ Mental Health?

How to Make Home Caregiving Easier

Addressing Vacation Home in Another State in Estate Planning

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