The year was 1983: The U.S. invaded Granada. A gallon of gas cost 96 cents. Michael Jackson’s ‘Thriller’ video premiered. That year was also the last time that Social Security recipients saw a cost-of-living increase steeper than the one just announced for 2022. This year, Social Security benefits will rise 5.9 percent, the sharpest upsurge since 1983’s 7.4 percent jump. 

Cost-of-living increases are tied to the consumer price index, and rising inflation rates and gas prices caused by the ongoing coronavirus pandemic mean Social Security recipients will get a large boost in 2022. The 5.9 percent increase dwarfs last year’s 1.3 percent rise, and over the past decade hikes have averaged just 1.65 percent. The average monthly benefit of $1,565 in 2021 will go up by $92 a month to $1,657 a month for an individual beneficiary, or $19,884 yearly. 

The cost-of-living change also affects the maximum amount of earnings subject to the Social Security tax, which will grow from $142,800 to $147,000.

For 2022, the monthly federal Supplemental Security Income (SSI) payment standard will be $841 for an individual and $1,261 for a couple.

Part of the increase will be eaten up by higher Medicare Part B premiums, however. The standard monthly premium for Medicare Part B enrollees has not been announced yet, but it is projected to rise $10 a month to $158.30. 

Most beneficiaries will be able to find out their specific cost-of-living adjustment online by logging on to my Social Security in December 2021. While you can still receive your increase notice by mail, you have the option to get the notice online instead.

For more on the 2022 Social Security benefit levels, click here.

While it is preferable to conduct long-term care planning well in advance of needing care, if you haven’t planned ahead, there are some strategies available to avoid spending all your assets. Three so-called “half a loaf” approaches allow a Medicaid applicant to give away some assets while still qualifying for Medicaid. 

In order to be eligible for Medicaid benefits a nursing home resident may have no more than $2,000 in “countable” assets (the figure may be somewhat higher in some states) in addition to the home, and the resident cannot have recently transferred assets. (A spouse living at home may keep more.)

Congress has imposed a penalty  on people who transfer assets without receiving fair value in return. This penalty is a period of time during which the person transferring the assets will be ineligible for Medicaid. The penalty period does not begin until the person making the transfer has (1) moved to a nursing home, (2) spent down to the asset limit for Medicaid eligibility, (3) applied for Medicaid coverage, and (4) been approved for coverage but for the transfer. 

If a Medicaid applicant has excess assets, he or she must spend down those assets in order to qualify for Medicaid. However, Medicaid applicants who want to preserve some assets have a few options: 

• Gift and cure. The nursing home resident transfers all of his or her funds to the resident’s children (or other family members) and applies for Medicaid, receiving a long ineligibility period. After the Medicaid application has been filed, the children return half the transferred funds, thus “curing” half of the ineligibility period and giving the nursing home resident the funds he or she needs to pay for care until the remaining penalty period expires.
• Promissory note. The nursing home resident gives half of his or her funds to the resident’s children (or other family members) and lends them the other half under a promissory note that meets certain requirements in the Medicaid law. The resident uses monthly repayments of the loan, along with his or her income, to pay nursing home costs during the penalty period.
• Annuity. The nursing home resident gives half of his or her funds to the resident’s children (or other family members) and uses the remaining assets to buy an immediate annuity. In most states the purchase of an annuity is not considered a transfer that would make the purchaser ineligible for Medicaid. Income from the annuity can be used to help pay for long-term care during the Medicaid penalty period that results from the transfer. In such cases, the annuity is usually short-term, just long enough to cover the penalty period.

These strategies may not work in every state and none of them should be attempted without the help of an attorney. To find an attorney near you, click here.

 

Individuals who are researching nursing homes can now see staff and resident vaccination rates along with other quality and safety measure information at Medicare’s Nursing Home Compare website. 

The official Medicare website includes a nursing home rating system. Nursing Home Compare offers up to five-star ratings of nursing homes based on health inspections, staffing, and quality measures. Users can search for nursing homes by location and directly compare how they measure up. 

In order to make COVID-19 vaccination information more available to the public, the Centers for Medicare & Medicaid Services (CMS) has added staff and resident vaccination rates to the system. The compare site now shows what percentage of staff and residents are vaccinated against COVID-19 at each nursing home and lists the state and national averages, so users can see how the facility stacks up. According to the site, nationally, 84.1 percent of nursing home residents and 63.7 percent of staff are vaccinated. The information will be updated on a bi-weekly basis. 

To visit the site and compare nursing homes, click here.

The Social Security trustees are projecting that due to the economic downturn caused by the pandemic the Social Security trust fund will be depleted in 2033 — one year earlier than the previous estimates. Once the fund is depleted, Social Security benefits will be reduced unless Congress acts in the interim. 

Social Security retirement benefits are financed primarily through dedicated payroll taxes paid by workers and their employers, with employees and employers splitting the tax equally. Employers pay 6.2 percent of an employee's income into the Social Security system, and the employee kicks in the same. Self-employed individuals pay the entire 12.4 percent Social Security payroll tax. This money is put into a trust fund that is used to pay retiree benefits. 

The trustees of the Social Security trust fund now predict that if Congress doesn’t take action, the fund’s balance will reach zero in 2033. The coronavirus pandemic has caused job losses, lowered wages and interest rates, and a drop in gross domestic product, which means payroll taxes declined. Sadly, an increase in deaths of older Americans due to Covid helped to keep Social Security from losing as much money as some had feared.  The impact of the pandemic over the longer term is still unclear, and the trustees said they are making no long-range assumptions “given the unprecedented level of uncertainty.”

Once the fund runs out of money, it does not mean that benefits stop altogether. Instead, retirees’ benefits would be cut. According to the trustees’ projections, the fund’s income from payroll taxes would be sufficient to pay retirees 76 percent of their total benefit (or 78 percent if the Disability Insurance fund is included).

The trustees recommend that Congress take immediate action to address the problem, but Social Security reform is not a top priority in Washington right now. Steps Congress could take to shore up Social Security include eliminating the cap on income subject to tax. Right now, workers pay Social Security tax only on the first $142,800 of income (in 2021). That amount can be increased, so that higher-earning workers pay more in taxes. The Social Security tax or the retirement age could also be increased.

For more on what the trustee’s report means, click here.  

Every year Medicare gives beneficiaries a window of opportunity to shop around and determine if their current Medicare plan is still the best one for them. During Medicare's Open Enrollment Period, which runs from October 15 to December 7, beneficiaries can freely enroll in or switch plans. 

During this period you may enroll in a Medicare Part D (prescription drug) plan or, if you currently have a plan, you may change plans. In addition, during the seven-week period you can return to traditional Medicare (Parts A and B) from a Medicare Advantage (Part C, managed care) plan, enroll in a Medicare Advantage plan, or change Advantage plans. 

Beneficiaries can go to www.medicare.gov or call 1-800-MEDICARE (1-800-633-4227) to make changes in their Medicare prescription drug and health plan coverage.

According to the New York Times, few Medicare beneficiaries take advantage of Open Enrollment, but of those who do, nearly half cut their premiums by at least 5 percent. Even beneficiaries who have been satisfied with their plans in 2021 should review their choices for 2022, as both premiums and plan coverage can fluctuate from year to year. For example: 

• Are the doctors you use still part of your Medicare Advantage plan’s provider network? 
• Have any of the prescriptions you take been dropped from your prescription plan’s list of covered drugs (the “formulary”)? 
• What are your total out-of-pocket costs? 
• Could you save money with the same coverage by switching to a different plan?

For answers to questions like these, carefully look over the plan's “Annual Notice of Change” letter to you. Prescription drug plans can change their premiums, deductibles, the list of drugs they cover, and their plan rules for covered drugs, exceptions, and appeals. Medicare Advantage plans can change their benefit packages, as well as their provider networks. For more about entering and leaving Medicare Advantage plans, click here.  

Remember that fraud perpetrators will inevitably use the Open Enrollment Period to try to gain access to individuals' personal financial information. Medicare beneficiaries should never give their personal information out to anyone making unsolicited phone calls selling Medicare-related products or services or showing up on their doorstep uninvited. If you think you've been a victim of fraud or identity theft, contact Medicare. For more information about Medicare fraud, click here.  

Here are more resources for navigating the Open Enrollment Period:

• Medicare Plan Finder, which helps you find a plan to match your needs: www.medicare.gov/find-a-plan 
• Medicare coverage options: www.medicare.gov/medicarecoverageoptions/
• The 2022 Medicare & You handbook, which all Medicare beneficiaries should have received. The handbook can also be downloaded online at:  medicare.gov/forms-help-resources/medicare-you-handbook/download-medicare-you-in-different-formats
• The Medicare Rights Center: www.medicareinteractive.org
• Your State Health Insurance Assistance Program, which offers independent counseling: www.shiptacenter.org

The Biden administration is calling on Congress to pass proposals to lower prescription drug prices, including allowing Medicare to negotiate with drug companies and capping out-of-pocket spending by Medicare beneficiaries. 

Americans spend on average about $1,500 per person per year on prescription drugs, far higher than any other comparable nation, according to a new report by the U.S. Department of Health and Human Services (HHS). The report was issued in response to an executive order from President Biden asking HHS to look into how to lower drug costs through increasing competition.

The report recommends passing legislation to allow Medicare to negotiate drug prices. Under the proposal, HHS would directly negotiate drug prices with drug companies for Medicare Parts B and D, something it currently lacks the authority to do. Those prices would be available to private insurance and employer plans as well, thereby bringing down prices for everyone. 

The report also recommends capping the amount that Medicare beneficiaries spend on drugs. While Medicare Part D provides “catastrophic” coverage for prescription drug costs, there is no limit on beneficiaries’ out-of-pocket costs. Once Medicare beneficiaries’ total spending on drugs reaches $6,550 (in 2021), they pay a small (usually 5 percent) coinsurance percentage. This may not seem like a lot, but the 5 percent can add up to thousands of dollars in payments, especially if the beneficiary has a chronic condition that requires an expensive drug. According to Kaiser Family Foundation, in 2019, nearly 1.5 million Medicare Part D enrollees had out-of-pocket spending above the catastrophic coverage threshold and spent a total of $1.8 billion during that time. The HHS report doesn’t give a recommendation on what to cap spending at, but proposals in Congress have ranged from $2,000 to $3,100. 

These proposals will likely be included in the president’s budget bill, which is currently being negotiated in Congress. 

To read the report, click here.

For more information about the report and proposals, click here and here.

All older Americans are vulnerable to financial abuse, but there are certain circumstances that make someone more likely to be scammed. An online survey can help older adults (or their caregivers) assess their risk of being exploited based on how they make financial decisions. 

It is hard to ascertain the exact number of people affected by financial exploitation because studies show that elder abuse is underreported. However, one study found that monetary loss from financial elder abuse could be close to $3 billion a year. 

Experts have found that there are certain risk factors that can help indicate when someone is more likely to fall prey to a financial scam.  Peter Lichtenberg, director of the Institute of Gerontology at Wayne State University, found that older adults’ physical and mental health, along with their family and friend network, help predict their financial vulnerability. 

Lichtenberg has created a website (www.olderadultnestegg.com) with resources for professionals, older adults, and family members to assess whether someone is at-risk. He provides trainings for caregivers on how to determine if a loved one is experiencing cognitive decline and how to spot financial mismanagement. The website also includes a financial vulnerability survey that assesses a person’s risk of exploitation by asking 17 targeted questions. At the end of the survey, participants get a low, moderate, or high risk assessment. There are also resources to direct older adults and caregivers on how to get help. 

To take the survey and see the resources, click here.  

For tips on preventing, detecting, and reporting financial abuse, click here.

 

As COVID-19 cases start to rise again due to the highly contagious Delta variant, nursing homes are considering requiring staff members to be vaccinated. Only 59 percent of nursing home staff are partially or fully vaccinated nationwide, and the percentages are much lower in some states.

While 81 percent of nursing home residents are fully vaccinated, the numbers are much lower for staff. Louisiana and Florida have the lowest percentages of vaccinated staff at 43.17 percent and 44.22 percent vaccinated, respectively.  Moreover, staff with the closest contact with residents are the least likely to be vaccinated, according to new research. 

All this could leave elderly vulnerable to infection, even if they are vaccinated themselves. While the vaccines are very effective, breakthrough infections are possible. And due to weakened immune systems, some elderly individuals may not respond fully to the vaccine. 

According to the Centers for Medicare and Medicaid Services, more than 133,000 nursing home residents and nearly 2,000 staff members have already died of COVID-19, and this is likely an undercount because facilities did not begin reporting data until May 2020. While cases began declining when vaccines became available, they are inching up again due to the Delta variant, which has been found to be more transmissible than the common cold. Unvaccinated staff are being blamed for an outbreak in a Colorado nursing home that led to 16 infections and four deaths. There have been similar outbreaks in other states. 

Health care organizations had been resistant to vaccine requirements for fear that they would cause lawsuits and staff defections, but in light of the low vaccination rates among staff and the risks to nursing home residents, some senior living organizations have begun requiring employees to get vaccinated. The number two nonprofit senior living organization in the United States, Good Samaritan Society, is the largest care organization to require a COVID-19 vaccine as a condition of employment. 

“Nearly all new COVID-19 cases, hospitalizations and deaths are among unvaccinated people, and the overwhelming data confirms that the vaccines are not only safe, but the best and most reliable way to prevent transmission of the virus,” Jeremy Cauwels, M.D., Chief Physician of Good Samaritan’s parent company, Sanford Health, said in a statement. 

According to McKnight’s Long-Term Care News, at least 20 other senior living companies have also instituted vaccine requirements. And more are following suit as health care leaders increase the pressure for vaccine mandates, including a joint statement from the American Medical Association and 54 other health care organizations in support of vaccine requirements for health care and long-term care personnel.

The Senate Democrats proposal for a $3.5 trillion spending plan includes expanding Medicare to provide dental, vision, and hearing benefits. The proposal is now being negotiated in Congress. 

Currently Medicare does not offer much in the way of dental, vision, and hearing benefits. Medicare Part A will cover certain emergency or necessary procedures that are received in the hospital. For example, if you are hospitalized after an accident and require jaw reconstruction, Medicare Part A will pay for the dental work required as part of that procedure. 

Medicare Part B offers very limited coverage of some vision and hearing services. For example, while Medicare Part B won’t cover routine eye exams, it does cover yearly glaucoma screenings for people at high risk and cataract surgery, among a few other limited exceptions. Part B will also cover some diagnostic hearing and balance exams if they are ordered by a doctor, but it will not cover routine hearing exams or hearing aids. There is no coverage at all for routine dental work.

Many people choose Medicare Advantage plans, which are run by private insurers, instead of traditional Medicare because it is possible to get some dental, vision, and hearing benefits in most plans. According to the Kaiser Family Foundation, 79 percent of people in Medicare Advantage plans have vision coverage, 74 percent have dental coverage, and 72 percent have hearing aid coverage. 

Under the Democrats’ proposal, Medicare beneficiaries would be able to receive dental, vision, and health benefits through traditional Medicare. The exact details of the proposal are unknown, but in a 2019 bill that passed the House, Medicare beneficiaries would have paid 20 percent of the cost for basic dental coverage and routine eye and hearing exams. Democrats want to pass the spending bill through the reconciliation process, which requires all 50 Democrats to agree to the plan. Negotiations are currently underway to craft a bill that has the support of all the Democratic senators.

For more information about the Democrats’ proposal, click here.