Archive for February 2012
So Who Can You Talk To?
We all heard the outcry over end-of-life counseling described in earlier versions of legislation that ultimately became The Affordable Care Act. The drafters wanted private insurance and Medicare to pay for a doctor’s visit for the purpose of discussing end-of-life issues. Patients could then make informed decisions about what medical care they would or would not want should they be diagnosed as terminally ill and unable to communicate for themselves.
These are big decisions that are multi-faceted and variable. For example, you might want every possible effort undertaken to revive you if you had a car accident on the way to work, but you might feel differently about what should be done if you slipped into a coma following a long and painful illness.
In addition, the terminology is not always easily understood or well defined. What is a terminal condition? Who is unlikely to recover? Even if it is a chronic condition with no known cure, what is the prognosis for long-term quality of life? Does artificial feeding and hydration mean a feeding tube, or does it just mean that someone has to feed me? Is the thickening of liquids that I drink considered “artificial”?
These are all legitimate medical questions. And since the average doctor’s appointment is about seven minutes, the drafters of the Affordable Care Act wanted to allow for at least one appointment when this type of discussion was not squeezed onto the end of a physical exam. Unfortunately, opponents of the law characterized these appointments as “death panels,” during which the doctor would determine that care would somehow not be given to someone who is old or terminally ill, and it was dropped from the final bill.
While this meant that insurers were not required to cover an exam exclusively for this purpose, I continued to believe that a person could schedule an appointment for this purpose at his own expense. Unfortunately, this may not be true.
A client told me last week that he and his wife, who are both in their 60s and currently in good health, knew they needed to get their advance directives in place. They obtained appropriate forms and called to schedule an appointment with their family doctor to discuss the meaning of the various provisions contained in them. However, after consulting with the physician, the scheduler informed the couple that he would not make an appointment for this purpose. Instead, they should make their own decisions, and then bring the completed forms in for their file.
Apparently, this physician finds it easier to sleep at night when he refuses to answer his patients’ legitimate questions than he would if he thought he had in some way contributed to a decision for which he might be held accountable.
Social Security Q & A
Sandra R. Perez, Public Affairs Specialist for the Social Security Admiistration, has passed along the following Frequently Asked Questions about Social Security and Medicare:
GENERAL
Question: I lost my Social Security card, should I get a new one?
Answer: If you know your Social Security number, you may not need a replacement card. You can replace your Social Security card for free if it is lost or stolen, but you are limited to three replacement cards in a year and 10 during your lifetime. Learn more at www.socialsecurity.gov/ssnumber.
Question: I worked for the last 10 years and I now have my 40 credits. Does this mean that I can stop working and get the maximum Social Security retirement benefit when it’s time to retire?
Answer: The 40 credits are the minimum number you need to qualify for retirement benefits. However, we do not base the amount of the benefit on those credits; we base it on your earnings over your working lifetime. To learn more about Social Security retirement benefits and how your benefit amount is figured, read our online publication, Retirement Benefits, at www.socialsecurity.gov/pubs/10035.html.
RETIREMENT
Question: I want to estimate my retirement benefit at several different ages. Is there a way to do that?
Answer: Use our Retirement Estimator at www.socialsecurity.gov/estimator to get an instant, personalized retirement benefit estimate based on current law and your earnings record. The Retirement Estimator, which also is available in Spanish, lets you create additional “what if” retirement scenarios based on different income levels and “stop work” ages.
Question: If both my spouse and I are entitled to Social Security benefits, is there any reduction in our payments because we are married?
Answer: No. We calculate lifetime earnings independently to determine each spouse’s Social Security benefit amount, and couples are not penalized simply because they are married. When each member of a married couple meets all other eligibility requirements to receive Social Security retirement benefits, each spouse receives a monthly benefit amount based on his or her own earnings. If one member of the couple earned low wages or failed to earn enough Social Security credits to be insured for retirement benefits, he or she may be eligible to receive benefits as a spouse. Learn more about earning Social Security credits by reading our publication on the subject at www.socialsecurity.gov/pubs/10072.html.
DISABILITY
Question: I am receiving Social Security disability benefits. Is there a way for me to try working and not lose my benefits?
Answer:We have special rules called “work incentives” that help you keep your benefits and Medicare while you test your ability to work. For example, there is a “trial work period” during which you can receive full benefits regardless of how much you earn, as long as you report your work activity and continue to have a disabling impairment. For more information about work incentives if you collect disability benefits and want to return to work, we recommend that you read the leaflet, Working While Disabled-How We Can Help at www.socialsecurity.gov/pubs/10095.html.
Question: I currently receive Social Security disability benefits. Is there a time limit on how long you can collect Social Security disability benefits?
Answer: Your disability benefits will continue as long as your medical condition has not improved and you cannot work. We will review your case at regular intervals to make sure you are still disabled. Learn more by reading our publication, Disability Benefits, at www.socialsecurity.gov/pubs/10029.html.
Answer:
Yes. A person who owns a home and lives in that home can be eligible for SSI benefits. Although there is an asset limit for people to qualify for SSI, some things don’t count toward that limit, such as a house, a vehicle, and some funds set aside for burial expenses. To learn more about SSI and the eligibility requirements, browse our booklet, Supplemental Security Income at www.socialsecurity.gov/pubs/11000.html.
MEDICARE
Question: I want to apply for Medicare Part B medical insurance this year. When is the deadline to apply?
Answer: If you didn’t sign up for Medicare Part B medical insurance when you first became eligible for Medicare, you now have an opportunity to apply — but time is running out. The deadline for applying during the general enrollment period is March 31. If you miss the deadline, you may have to wait until 2013 to apply. Medicare Part B covers some medical expenses not covered by Medicare Part A (hospital insurance), such as doctors’ fees, outpatient hospital visits, and other medical supplies. You can learn more about Medicare by reading our electronic booklet, Medicare at www.socialsecurity.gov/pubs/10043.html.
Ms. Perez also offers a link for an electronic fact sheet linking you to all of our online services. Click here
Seniors Saved Money on Prescription Drugs in 2011
As reported in today’s Los Angeles Times, the Department of Health and Human Services has announced that 3.6 million people in the Medicare program saved $2.1 billion on prescription drugs in 2011. This is the result of both enhanced use of generic drugs and the closing of the Medicare Part D “donut hole,” which is one of the few aspects of the Affordable Care Act that went into effect before 2014. Assuming the law is allowed to stand, the savings will continue to increase, as the payment gap diminishes each year before closing entirely in 2014.
Medicare coverage for pharmaceuticals under Part D (including the “donut hole”) was originally created under President George W. Bush.
Source/more: Los Angeles Times
