Communication difficulties between patients and their doctors are nothing new. Many patients feel as if doctors are dismissing their concerns, which can be frustrating and potentially lead to missed diagnoses and delayed care. If you believe your doctor is not listening to you, here are some tips offered by the National Institute on Aging that may help.

Prepare for your appointment: Before your exam, make a written prioritized list of any questions and concerns you want to discuss with your doctor. If you have done any online research, print it out and bring it to your appointment to ensure all information gets discussed. If it is a diagnostic visit, you should prepare a detailed description of your symptoms, when they started and what makes them worse.

Be honest and upfront: Even if the topic seems sensitive or embarrassing, it is important to be honest and upfront with your doctor. You may feel uncomfortable talking about memory loss or bowel issues, but these are all important to your health. It is better to be thorough and share detailed information than to be quiet or shy about what you are experiencing or feeling. Remember, your doctor is trained to talk about all kinds of personal matters.

Ask specific questions: If you and your doctor are not communicating well, ask specific questions that require a response. For example: What might have caused the problem I am dealing with? What is the specific name of my diagnosis? Is the problem serious? Will it heal completely or require ongoing management? What future symptoms might suggest the need for emergency care or a follow-up visit? When and how will test results be received? If you do not understand something, do not hesitate to ask, “Can you explain that in simpler terms?” or “Can you give me more details about that?”

Take someone with you: Bring a family member or friend to your appointment. Your companion can help you ask questions or raise concerns that you may not have thought of, help you understand the doctor’s advice and provide you support.

Be persistent: If your doctor is not addressing your questions, repeat them or rephrase them. If there is still no progress, follow up by saying, “I am worried that we are not communicating well. Here is why I feel that way.” or “I need to talk with you about X, but I feel like I cannot. Can we address this together?” If you feel as though you are being dismissed, ask your doctor to include in the notes that they are declining to provide care of the particular symptoms.

After your appointment, if you are uncertain about any instructions or have other questions, call or email your health care provider. Do not wait until your next visit to make sure you understand your diagnosis, treatment plan or anything else that might affect your health.

For more tips, the National Institute on Aging offers a free booklet called “Talking with Your Doctor: A Guide for Older Adults” that can help you prepare for an appointment and become a better and more informed patient. To order free copy or see it online, visit order.nia.nih.gov/publication/talking-with-your-doctor-a-guide-for-older-adults.

Consider moving on: If the communication problem with your doctor persists, it may be time to start looking for a new provider. Depending on how unsatisfied you are with your care, you could also notify your doctor’s medical group and your insurance company or leave feedback on their online profile. If you are dealing with a serious issue – like a doctor who prescribes the wrong medication or fails to provide test results in a timely manner – it might be appropriate to file a complaint with the state medical board.

Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of "The Savvy Living” 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.

The Centers for Medicare and Medicaid Services recently announced the cost-of-living adjustments for 2025. While premium and out-of-pocket cost increases will be moderate for most beneficiaries, high income earners will pay significantly more. Here is what you can expect to pay in 2025.

Part B Premium

Medicare Part A, which covers hospital care, is premium-free for most beneficiaries. Medicare Part B, which covers doctor visits and outpatient services, has a monthly premium.

Starting in January, the standard monthly Part B premium will be $185, up from $174.70 in 2024. The $10.30 difference represents an increase of 5.9%, which is more than double the recent Social Security cost-of-living adjustment of 2.5%.

If you are a high-earning beneficiary, a group that comprises approximately 8% of all Medicare recipients, you will have to pay more. Medicare surcharges for high earners, known as the income-related monthly adjustment amount (IRMAA), are based on adjusted gross income (AGI) from two years earlier. This means that your 2025 Part B premiums are determined by your 2023 AGI, which is located on line 11 of Form 1040.

If your 2023 income was from $106,000 to $133,000 ($212,000 to $266,000 for joint filers), your 2025 Part B monthly premium will be $259. For individuals with an income over $133,000 to $167,000 (over $266,000 to $334,000 for joint filers), the monthly premium will rise to $370. Individuals earning more than $167,000 up to $200,000 (more than $334,000 up to $400,000 for joint filers) will see their monthly Part B premium increase to $480.90. Those with incomes above $200,000 up to $500,000 (above $400,000 up to $750,000 for joint filers) will pay $591.90 per month in 2025. Individuals with income more than $500,000 (more than $750,000 for joint filers) will pay $628.90 per month.

Part D Premium

If you have a stand-alone Medicare (Part D) prescription drug plan, the average premium in 2025 will be $46.50 per month for most beneficiaries, down from $53.95 in 2024. For high earners with annual incomes above $106,000 ($212,000 for joint filers), you will pay a monthly surcharge between $13.70 to $85.80 (based on your income level) in addition to your regular Part D premiums.

How to Contest Income

Beneficiaries who fall into any of the high-income categories and have experienced certain life-changing events that have reduced their income since 2023, such as retirement, divorce or the death of a spouse, can contest the surcharge. For more information on how to do this, see “Medicare Premiums: Rules for Higher-Income Beneficiaries” at SSA.gov/benefits/medicare/medicare-premiums.html.

Other Medicare Increases

In addition to the Part B and Part D premium increases, there are other cost increases you should take into consideration. For example, the annual deductible for Medicare Part B will be $257 in 2025, which is $17 more than the 2024 deductible of $240. In addition, the deductible for Medicare Part A, which covers hospital services, will increase to $1,676 in 2025. This amount is $44 more than the 2024 deductible of $1,632. There are no surcharges on Medicare deductibles for high earners. For more information on all the Medicare costs for 2025 visit Medicare.gov/basics/costs or call 800-633-4227.

Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of "The Savvy Living” 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.

There is an exception to the December 31 deadline for traditional IRA owners who turned 73 in 2024. Those individuals may delay their first RMD until April 1, 2025. However, if they delay the first RMD, they will also need to take a second RMD by December 31, 2025.

RMDs are generally required for most qualified retirement plans. This rule applies to three types of IRAs. Specifically, they apply to Individual Retirement Arrangements, Simplified Employee Pension (SEP) IRAs and Savings Incentive Match PLan for Employees (SIMPLE) IRAs.

RMDs also apply to traditional 401(k), 403(b) and 457(b) plans. An exception to the RMD withdrawal requirement is a Roth IRA, Roth 401(k) or Roth 403(b) – there are no distribution requirements for these plans if the original owner is living.

Most taxpayers take the RMD based upon the Uniform Lifetime Table in IRS Pub. 590-B. This table assumes there is a beneficiary 10 years younger than the IRA owner and calculates a distribution amount based on both ages. If the IRA owner has a spouse more than 10 years younger, a special calculation is applied.

Owners of multiple IRAs must calculate the RMD for each plan. However, the owner can elect to withdraw the total RMD amount from any IRA plan.

Some employees over age 73 who are still working and are not major owners of a business may be able to defer RMDs until after retirement. You should consult your tax advisor to see if you think this exception applies to you.

Many online calculators are available to help determine your RMD. Most large financial companies offer an online determination of the correct amount. RMDs start at approximately 3.8% of your prior year December 31 IRA balance.

The RMDs increase each year after age 73. Your RMD is approximately 4.2% at age 76, 5.0% at age 80, 6.3% at age 85, 8.2% at age 90 and 11.2% at age 95.

Editor’s Note: An excellent way to fulfill an RMD is to give part or all of the IRA payment to a qualified charity. Qualified charitable distributions (QCDs) are available for individuals over age 70½ and may fulfill part or all of your RMD. The QCD is a transfer directly from the IRA custodian to a qualified charity. Up to $105,000 may be transferred in 2024. If you are planning ahead, the 2025 QCD limit will be $108,000. It is important to act quickly if you plan to make a QCD gift this year. The QCD must be completed by December 31, 2024.

• Interest on Tax Refunds — If you received a federal tax refund in 2024, you may also have received additional interest. The IRS will send Form 1099-INT to anyone who received interest with a refund. This interest is taxable income and must be reported.
• Charitable Deductions — With the increase in the standard deduction, the number of taxpayers who itemize declined from approximately 30% to about 10%. If you itemize, you may deduct cash and appreciated property gifts to qualified charitable organizations. The normal cash contribution limit is 60% of adjusted gross income (AGI). The limit for gifts of appreciated stock, land and other property is 30% of AGI. You can combine both cash and property gifts in a single taxable year. If you are over the gift limit, the extra deduction may be used over the next five years. Gifts over $250 will require a receipt from the charity before you file your return. There is more information on charitable deductions in IRS Publication 526, Charitable Contributions.
• Tax refunds in 2025 — Some taxpayers plan to file in January of 2025 and hope to receive a prompt refund. The IRS cautions that some refunds may require a longer period for processing. Delays may be related to IRS efforts to protect against identity theft and refund fraud. The IRS is also required to delay refunds for tax returns that claim an Earned Income Tax Credit (EITC) or an Additional Child Tax Credit. These refunds will likely be issued on or after the middle of February.
• Best Refund Option — The IRS reminds taxpayers that the safest and most convenient way to receive a refund is to use the electronic filing options. Many taxpayers use the IRS Free File or IRS Direct File program. After you file, you may track a refund with the “Where’s My Refund?” Tool on IRS.gov.

Editor's Note: Many individuals with substantial state and local tax deductions, mortgage interest and charitable gifts will itemize deductions. The charitable gifts must be made prior to December 31 of this year. IRA owners over age 70½ and older, may choose to make a qualified charitable distribution (QCD) up to $105,000 in 2024. Plan to contact your IRA custodian as soon as possible to ensure the gift is made before December 31.