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What types of mental health services does Medicare cover? I struggle with anxiety and depression, and my primary care provider recommended that I see a therapist or psychiatrist.

Medicare provides coverage for both outpatient and inpatient mental health care services and programs to help beneficiaries with anxiety, depression and other mental health needs. Here is what you should know.

Outpatient Coverage

If you are enrolled in original Medicare, your Part B coverage will pay 80% of the costs for mental health services after you have met the annual Part B deductible of $257. The covered services include counseling and mental health care provided outside a hospital. This includes visits to a doctor’s or therapist’s office, hospital outpatient departments or community health centers. These services can also be received via telehealth providers. The remaining 20% of costs will be the beneficiary’s responsibility or may be covered by a Medicare Supplemental (Medigap) Policy.

Medicare also gives the expanded option of getting treatment through a variety of health professionals such as psychiatrists, psychologists, clinical nurse specialists, clinical social workers, nurse practitioners, physician assistants, marriage and family therapists and mental health counselors. To be eligible for this coverage, you must choose a participating provider that accepts Medicare assignment, which means they accept Medicare’s approved amount as full payment for a service.

If you choose a nonparticipating provider who accepts Medicare but does not agree to Medicare’s payment schedule, you may be responsible for up to 35% of costs. Additionally, if you choose a provider that has opted out of Medicare, you will be responsible for the entire cost.

To locate a mental health care professional in your area that accepts Medicare, go to Medicare.gov/care-compare, click on “Doctors & clinicians” and type in your location, followed by “clinical psychologist” or “psychiatry” in the Name or Keyword box. You can also get this information by calling Medicare at 800-633-4227.

Inpatient Coverage

If you need mental health services provided in a general or psychiatric hospital, original Medicare Part A covers these services after you have met your Part A deductible of $1,676. Your doctor will determine which type of hospital setting you will need. If you receive care in a psychiatric hospital, Medicare covers up to 190 days of inpatient care for your lifetime. If you have reached your 190-day limit but need additional care, Medicare may cover additional inpatient care at a general hospital.

Additional Coverage

In addition to outpatient and inpatient mental health services, Medicare will pay for one depression screening per year which can be done in a primary care doctor’s office or clinic. If you have a Medicare prescription drug plan, most medications used to treat mental health conditions are covered too.

Medicare Advantage Coverage

If you get your Medicare benefits through a private Medicare Advantage plan, the plan will provide the same coverage as original Medicare but may impose different rules and will likely require you to see an in-network provider. You should contact your plan directly for details.

For more information, call Medicare at 800-633-4227 and request a copy of publication #10184 Medicare & Your Mental Health Benefits, or read it online at Medicare.gov.

Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of “The Savvy Senior” book. Any links in this article are offered as a service and there is no endorsement of any product. These articles are offered as a helpful and informative service to our friends and may not always reflect this organization’s official position on some topics. Jim invites you to send your senior questions to: Savvy Living, P.O. Box 5443, Norman, OK 73070.

 

Published January 17, 2025

Can excessive earwax cause serious health problems? What can you tell me about this?

Excessive amounts of earwax can cause health problems including hearing loss or ringing in the ear. This can exacerbate other issues since hearing loss has been linked to cognitive decline and an increased risk of depression. Earwax buildup can also cause individuals to experience vertigo, which increases the risk of falls.

Earwax is a substance called cerumen that binds with dirt, dust and debris that is normally produced by the body to cleanse and protect the ears. For most individuals, the self-cleaning process is sufficient. But in others, including more than 30% of elderly and disabled individuals, earwax accumulates to the extent that it entirely blocks or impacts the ear canal.

The most affected are the elderly, with higher risks associated with individuals living in nursing homes or assisted living centers. Those who use hearing-aids are considered at highest at risk because the devices can push wax down into the canal.

Earwax Removal

Usually, earwax moves up and out on its own so the best way to control it is to leave it alone. However, that advice can sometimes backfire for those who accumulate excessive amounts of earwax.

The symptoms of an earwax problem can include an earache, a feeling of fullness in the ear, hearing loss, tinnitus, dizziness, an ear infection, ear itchiness or a cough due to pressure from the blockage stimulating a nerve in the ear. If you experience any of these symptoms, consult with your doctor about using a softening agent to help the wax leave the ear or to remove it more easily.

If you prefer a milder approach, talk with your doctor about using baby oil or mineral oil. Using an eyedropper, place a drop or two into your ear, tilt your head so the ear is pointing up toward the ceiling and stay in that position for a minute or two to let the fluid flow down to the buildup. Once that is done, tilt your head in the opposite direction to let the fluid and wax drain.

Alternatively, try an over-the-counter earwax removal solution or kit, which are sold in most pharmacies. Most solution contain a form of peroxide, and some kits include a bulb syringe that you squeeze to flush your ear with warm water, if needed.

You may need to repeat this wax-softening and irrigation procedure several times before getting rid of the excess earwax. If the symptoms do not improve after a few treatments, you should see your healthcare provider or an ear, nose and throat (ENT) doctor to have the wax removed. Earwax removal is one of the most common ENT procedures performed. They have a variety of tools that can remove hard, stubborn earwax.

It might be tempting to poke a cotton swab, bobby pin, pencil or finger into your ear to get the gunk out, but it is best to refrain. While doing so could remove some of the wax, it may also push the wax deeper into the ear canal and increase the risk of injuring your eardrum and making the problem worse.

Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of “The Savvy Senior” book. Any links in this article are offered as a service and there is no endorsement of any product. These articles are offered as a helpful and informative service to our friends and may not always reflect this organization’s official position on some topics. Jim invites you to send your senior questions to: Savvy Living, P.O. Box 5443, Norman, OK 73070.

 

Published January 10, 2025

Jacqueline Kennedy Onassis was diagnosed with cancer in January 1994. She signed a will in the New York offices of a large law firm on March 22, 1994. She passed away just two months later on May 19 at the age of 64.

Because a will is a public document, her will is available on the internet. In the will she remembered family members and several friends and planned to make a substantial transfer to a charitable lead trust. However, because her two children received the family personal property and promptly sold the items for the unexpectedly large sum of $35,000,000, the residue of the estate was used to pay the estate taxes on this large transfer of value to children and the charitable trust was not funded.

Bing Crosby passed away on October 14, 1977, with a trust. When his first wife Dixie Lee passed away from cancer in 1952, she had a will that transferred her separate and community property. Bing Crosby was very upset that his financial circumstances were disclosed to the public through the probate process. After marrying his second wife Kathryn, Crosby created several trusts for the children from his first marriage, for Kathryn and for children from his second marriage. He greatly appreciated the privacy benefit of creating a living trust.

You may not have the fame of Jacqueline Onassis or the assets of Bing Crosby (along with Lawrence Welk and Bob Hope, he was one of the wealthiest actors at the time of his death), but you can learn from both of them in deciding whether or not to create a will or a living trust.

When Wills are a Good Choice

There are a number of reasons why a person frequently starts the estate planning process with a will. These include youth, cost, the estate size, the ability to transfer assets outside of probate and a hesitation to select a trustee.

Young and Healthy

If you are in your 30s or 40s and have good health, a will is a common starting point for estate planning. A will is much simpler than a living trust. The property subject to a will goes through probate, but that could be many decades in the future.

As you acquire other property, it can be covered by your will. You can modify your will at any time, and you save the effort necessary to retitle and track property inside a living trust.

For a young person, the cost savings are significant. Wills frequently cost from $400 to $800, while a living trust may involve costs of $1,000 to $3,500. A young person may be reluctant to spend the funds necessary to create a living trust, but can start his or her estate plan quite reasonably with a will.

Modest or Moderate Estate

A second characteristic of people who choose a will is that they have a modest or moderate estate. As the estate becomes larger and more complicated, a trust is more important. For individuals who have more moderate assets, the will is a good starting point. As the estate grows, they can use some of the increase in resources to add a living trust to their plan.

Using Transfer Methods that Avoid Probate

Another option is to create a will, but transfer most assets without probate. Your IRA, qualified pension plan, life insurance and property held in joint tenancy with right of survivorship all avoid the probate process. For individuals who have a modest or moderate estate and are willing to transfer most assets through contract or property law methods that avoid probate, a will is a good solution.

Do Not Want to Select a Trustee

With a living trust, it is necessary to select a trustee to manage your property. This trustee frequently will end up managing your assets during the senior years of your life and after you pass away.

Some people do not like the concept of a trustee managing their property. They would rather own the property themselves outright during life and transfer the property outright to family members. For this person, a will is often a preferred planning method.

When a Living Trust is a Good Choice

For those individuals who can afford a living trust, it is a good choice. The living trust facilitates management of property during life, protection of the grantor, transfer of assets and income to family members and management of real estate.

Senior Care

What if I become too ill to manage property? One of the concerns you may have is that you may eventually become a senior person with a major illness. For medical reasons, you may be unable to manage your property. A major benefit of a living trust is that you select a successor trustee. If you are no longer able to serve as trustee and manage the property, your successor trustee can manage your property. He or she can make certain that the expenses of your medical care or long-term care needs are covered through trust payments.

Larger Estate or Real Estate

If you have a more substantial estate, a living trust can have multiple benefits. The living trust may include various provisions for handling the management of real estate or personal business interests. Particularly if you have real estate in multiple states, it is advantageous to transfer that property to a living trust. This property can then be managed for the benefit of both you and your heirs.

If you have property in multiple states and pass away with a will, it is necessary to conduct a probate administration in each state where you own property. This entails hiring professionals to manage the probate in each state and considerably increases the total cost. With a living trust holding real estate in different states, there is no need for multiple and expensive probate proceedings.

Bypassing Probate

One of the major benefits of a living trust is that the trust assets bypass the probate process. In most states, this may mean savings in probate costs up to many thousands of dollars.

Not only are there savings in probate costs, but your estate may also avoid the delays that frequently occur in the probate process. If there are claims against the estate, the probate process can take from two to ten years. While some large estates have been tied up in probate for many years, other similarly sized estates with a living trust can continue to manage the property and pay income and principal to beneficiaries.

Privacy

As Bing Crosby discovered, a living trust is generally a private document. While wills are public documents (the wills of Jacqueline Kennedy Onassis and many other famous individuals are readily available through internet search sites), a living trust is a private document. Even if a financial institution requests the trust in order to invest property owned by the trust, generally only a small portion of the trust is required to be disclosed to the institution. For most purposes the living trust is private.

Reduced Risk of Estate Contest

Larger estates are understandably more vulnerable to a probate contest. When the document and a large estate are public, as is the case with the will, the target is very tempting. Distant relatives come out of the woodwork to determine whether they have a potential claim against the estate.

One of the most disheartening aspects of a will contest is that there frequently are lifelong hard feelings among family members. In many cases, the bitterness from a will contest is carried by children, grandchildren, cousins, nephews and nieces to their graves.

A living trust is a private document. Because it is a private document and does not have to meet the specific standards for signature and witnesses that are applicable to a will, it is less likely to be attacked.

With a large estate, the living trust is generally safer. In addition, if a senior person needs someone to manage the estate, the successor trustee has been previously designated. The successor trustee frequently protects the senior person from potential undue influence of heirs or caregivers. Therefore, the living trust reduces the probability of an estate contest.

My parent is struggling to afford groceries and would like to know if they are eligible for food stamps or any other type of assistance program?

There are several food assistance programs that can help low-income individuals with their grocery costs. However, what is available to your parent will depend on their income level. Here is what you should know.

SNAP Benefits

The largest hunger safety net program in the U.S. is the Supplemental Nutrition Assistance Program (SNAP), formerly known as Food Stamps. Your state may use a different name for their version of SNAP. While there are millions of people who are eligible for SNAP, only approximately 40% or 4.8 million take advantage of this benefit.

For older adults to qualify for SNAP, their net income must be under 100% of the federal poverty guidelines. Households that have at least one person aged 60 and older, or who are disabled, must have a net monthly income less than $1,255 per month for an individual or $1,704 for a family of two. These amounts are higher in Alaska and Hawaii. Households receiving Temporary Assistance for Needy Families (TANF) or Supplemental Security Income (SSI) are also eligible.

Net income is calculated by subtracting allowable deductions from gross income. Allowable deductions include a standard monthly deduction, out-of-pocket medical expenses that exceed $35 per month, rent or mortgage payments, utility costs, taxes and other eligible expenses.

In addition to the net income requirement, some states also require that a senior’s assets be below $4,500, excluding home, personal property and retirement savings. In some instances, vehicles are also excluded although the rules vary by state. Most states, however, have much higher asset limits or they do not count assets at all when determining eligibility.

To apply for SNAP benefits, complete a state application form, which can be done by mail, by phone, or online, depending on your parent’s state of residence.

If eligible, your parent’s benefits will be provided on a plastic Electronic Benefits Transfer (EBT) card that is used like a debit card and accepted at most grocery stores. The average SNAP benefit for 60-and-older households is around $105 per month.

To learn more or apply, contact your local SNAP office by visiting fns.usda.gov/snap/state-directory or calling 800-221-5689.

Other Programs

In addition to SNAP, there are other food assistance programs that can help lower-income individuals like the Commodity Supplemental Food Program (CSFP) and the Senior Farmers’ Market Nutrition Program (SFMNP).

The CSFP is a program that provides supplemental food packages to those with income limits at or below the 150% poverty line. The SFMNP offers coupons that can be exchanged for fresh fruits and vegetables at farmers’ markets, roadside stands and community supported agriculture programs in select locations throughout the U.S. To be eligible, your parent’s income must be below the 185% poverty level. To learn more about these programs and find out if they are available in your parent’s area, visit fns.usda.gov/programs.

There are also many Feeding America member food banks that host grocery programs that provide free food boxes to older adults. Contact your local food bank to find out if a program is available nearby.

In addition to food assistance programs, there are also various financial assistance programs that may help your parent pay for medications, health care, utilities and more. To locate these programs, and learn how to apply for them, go to BenefitsCheckUp.org.

Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of "The Savvy Senior” book. Any links in this article are offered as a service and there is no endorsement of any product. These articles are offered as a helpful and informative service to our friends and may not always reflect this organization’s official position on some topics. Jim invites you to send your senior questions to: Savvy Living, P.O. Box 5443, Norman, OK 73070.

 

Published January 3, 2025

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