Retirement: A Full-Time Job

Can I Still Retire if I Hate Golf?

(Photo Details:  Hawaii--Doug without his clubs)

I receive a lot of requests from people wanting me to write a guest post on their blog.  I know I will never get around to that, I barely get around to posting on my own blog!  So I have learned from experience to just say no to that.  

I also receive many requests to publish guest posts on my blog.  Usually from investment companies or insurance companies, or someone else trying to sell something to my readers.  I also say no to that.  But I will usually publish a guest-written post to introduce a new retirement blogger.

The following is a guest post by Jared Scharen.  Jared is an MBA student at Northwestern who has started a website dedicated to helping boomers figure out where they want to retire.  His website eRetirements has a fun quiz to help you pick a place to retire, and also a retirement blog.  It's fun, but truth be told, that's not why I agreed to a guest post.  When he introduced himself to me he said that his parents read my blog.  And that made me happy.

So here is Jared's post: Healthy Hobbies for Retirement:  Active Alternatives to Hitting the Links.

It comes as no surprise that many people associate the word “retirement” with “golf.” Early tee times with friends followed by a midday lunch at the clubhouse seems to be a common stereotype of how retirees spend much of their free time.  This is a common fallacy that forces many people to unwillingly pick up the game and end up finding absolutely no pleasure in it. So what should you do if golf isn’t your thing?

Despite the common perception of golf as being the main hobby for retirees across the country, there are tons of other activities that offer a unique combination of exercise, shared connection, and most importantly, satisfaction. They can also shape your decision on where to retire. A few of them include:

Softball: Softball is great way to be outdoors while staying active and competitive. It is also a sure way to engage in social bonding, especially if you miss the comradery of your office team. 

Swimming: Swimming offers multiple benefits for your body including improved flexibility, built up endurance, and stronger heart muscle. It also provides the social benefit of meeting others during exercise classes or general lap swims.

Hiking or Walking: According to a report published in the Journal of the American Medical Association, a steady routine of walking can greatly reduce the chances of disability at old age. Walking or hiking also helps prevent or manage certain conditions like heart disease and high blood pressure, and can be done with your friends or significant other in remote areas of nature. 

Yoga: One of the many benefits of yoga is that it can help protect you from injury by increasing your muscle strength and tone. It also enhances your respiratory and energy levels in addition to being a huge stress reliever.

All of these exercises can improve your quality of life by enhancing your strength and improving your overall mood, both of which can be attributed to a longer, healthier life. Exercise classes offered at various community centers provide manageable training with specialized teachers who understand the limitations of your body. It is therefore crucial to explore these avenues when selecting your eventual retirement location.

So you have already heard this advice from your doctor…over and over again. And quite frankly, you just don’t care. Well, you are not alone in that mindset. According to a report conducted by the Merck Manual, at least 75% of people over the age of 65 do not exercise at recommended levels despite the known health benefits of exercise. Whether it is an issue of ignorance or more practically a problem of physical limitation, there are still ways to maintain your welfare outside of simply moving your arms and legs.

One of the beauties of retirement is that it allows you to finally undertake those projects that previously seemed impossible due to prior commitments to “the job.” It gives you an opportunity to pursue something exciting and fresh. So maybe that means a trip to Europe? Or a quick excursion across the country to see relatives? Or possibly the start of your memoir? You certainly do not have to pick up a golf ball or put on a bathing suit to stay active. Instead, try considering personal projects like the following:

Home Projects: Build a garden in your new home or decorate your backyard porch so you can invite friends over for dinner or drinks. Often, retirees have commented on how much gratification they receive from projects around the house.

We talked with Kathleen from Chicago, IL who could not agree more, “I’d really like to challenge myself during retirement by finally taking an advanced class in horticulture or possibly joining a local gardening club. This would keep me active while not forcing me to travel too much either. And it would impress all my new guests!”

Volunteering: Volunteering is another excellent activity that can bring you satisfaction while benefiting those within the community. This could involve tutoring children in academics or arts and crafts, or assisting patients in hospital outreach programs, just to name a few.

Theater and Arts: Reengage your artistic side and audition for a play or musical at the local arts center. This would allow you to make new friends while displaying your talents in front of a local audience. And anyone who has experience in theater knows that on stage performances are a workout in their own.

Regardless of the hobby that you choose, it is essential to always be cautious with your body as you decide on what new activities to begin, or what sports and games to continue to engage in.  It is important to do something that does not overly strain your body or your mind.  Instead, find something that is safe, manageable, and allows you fully enjoy the free time that you’ve worked so hard to attain. 

eRetirements.com is devoted to solving the problem that millions of baby boomers face each year: Where should I retire?  Our users enjoy a personalized retirement quiz, comprehensive location info, and a variety of blogs and advice to assist in discovering, and enjoying their ideal retirement location.

 

Related Posts:

Am I Really Getting Old Like Everyone Else?

Middle-Age Fitness

What Does Yard Work Have to do with Retirement?

 

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The Three Phases of Aging

(Photo Details:  Subway home from the Yankee's game two years ago, back when I was actually young.)

 

Only seven years ago, people used to say, upon hearing that I was retired, “Wow, you are so young to be retired.”

At some point over the last seven years, that stopped happening.  Maybe a couple of years ago, I’m not sure.  But no one really says that anymore when I mention that I am retired.

Last year, when I was here in New York with my friend Kendra and her daughter Taylor, there was an incident on the subway.  An incident.  I thought it was a fluke.  We were riding the Lexington Avenue Express down to The Stand comedy club--forgive me if I’ve already told you this story, that sometimes happens with us old people.  As the subway pulled out of the 86^th Street station, a woman--who had to be in her mid-to late-60’s--leaned past Taylor, past Kendra and said, directly to me, “Would you like to sit down?”

I looked around.  She was definitely talking to me.  She was offering her seat to me.  She wasn’t just offering it to me, she was leaning all the way across the subway car to get my attention--around Taylor, and around Kendra--who by the way is only one year younger than I am.  Did I mention, I was only 50 at the time?  I was at least a decade younger than this woman. 

She had some nerve.

New Yorkers are very polite in this respect.  I often see someone giving their seat to a pregnant woman, a disabled person, and yes, the elderly.  I’ve done it myself.  But when did I become that elderly person?  (Trust me, she didn’t think I was pregnant.)

I kind of forgot about this incident, even wrote it off as just a whacky New York experience, of which I’ve had many.  But then two nights ago, Doug and I went down to dinner at Bond Street, a hip sushi restaurant we both love.  The 6 train was under some construction this weekend, so it was not making stops between 14^th Street and Brooklyn Bridge.  Although we had already walked seven miles of Manhattan streets that day, we decided to walk from 14^th street.  That’s how young and vibrant we are.

At the restaurant, the hostess asked us to wait in the bar—our table would be ready in about 10 minutes.  So we squeezed around some people and found a place out of the way of the front door and—here it comes—a young woman offered me her seat in the bar!  At least this woman was actually younger than I am--by several decades.  But still . . .

Last night we went to the Comedy Cellar.  And after the show, we walked over to another cool Chinese restaurant that we love in the West Village. 

When we used to come to New York, before we started using home exchange, we always stayed downtown.  We hardly ever ventured above 14^th Street.  Maybe to go to a Broadway show, or to go to our favorite jazz venue in Columbus Circle.  But that was it, all the action is below 14^th  Street:  the late-night dining scene, the jazz clubs, the comedy clubs, the vibe, the buzz.

We only started staying in the Upper East Side (a neighborhood I had previously written off as too old for us) because that’s where we found home exchange partners that wanted to exchange with us for a month every year in August.

But last night, while sipping my shiso cucumber martini and enjoying the Katz’s pastrami eggroll at RedFarm, I looked around.  Doug and I were the oldest people in the restaurant.  By a lot.  Given the chance, these people would likely offer their seat to me in the subway. 

I realized that sometime over the last five years of our home exchanges to New York, it happened.  We actually belong in the Upper East Side now.  How did this happen?   I still feel young.  I still feel healthy.  In fact I am healthy--my cholesterol is low, my blood pressure is low, and no, I don’t need your seat on the subway!

But there it is.  I’m a person that defines healthy with words like cholesterol and blood pressure.  These are terms that wouldn’t even occur to an actual young person.

So now I know, there are three phases of aging.  The first phase is where you feel young because you actually are young.  The third phase is where you feel old because you actually are old.  And the phase in-between is where you feel young but everyone thinks you need to sit down.

Related Posts:

            Am I Really Getting Older Like Everyone Else Is?

            Why I Love New Yorkers

            Fifty is the New 28

 

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Why the Apple Watch is for Me

I have been so entertained lately reading how much people who don’t have the new Apple Watch hate it. 

The best one was watching Harris Faulkner’s show on the Fox New Network this weekend.  (First, a disclaimer that I don’t watch Fox “News” because I like it.  I hate-watch it because I’m a masochist.)  You would think a news organization could at least get the price right.  But after their review of several smart watches, they deemed Apple’s watch not worth its $650 starting-price tag.  I wonder if they would have thought it was worth it if they got the price right at $349.

I am not really a gadget geek.  I owned the original iPhone until five upgrades passed me by.  And even then, at the sixth generation, I only upgraded by inheriting Doug’s iPhone 5 when he upgraded to the 5S--and only because the calendar wasn’t supported on my original phone anymore. 

I use my phone to initiate calls, texts, and emails.  But most people know that if they actually try to call or text me on it, they probably won’t reach me.  Usually I forget to turn the ringer back on after going out to dinner or the to the symphony. 

And even if the ringer is on, the phone is usually buried in my purse in a completely different room of the house than I am in.  This may be a situation more common among women—men tend to carry their phones around in their pockets.  In any case, if you text or call me on my cell phone, I might not discover it for several days.

One gadget I have really enjoyed, though, is the Fitbit.  It counts your steps, your calories burned, even your sleep efficiency.  And it’s interactive--you can compete remotely with your friends, and that competition gets you moving more.  At least it did for me.  But I did always think it was strange to be wearing a device on my arm that didn’t even tell me what time it is.  For that, I still had to dig the iPhone out of the bottom of my purse. 

Just as Fitbit was coming out with a new band that actually does tell time, news of Apple’s release of their smart watch was getting out.  So I decided to wait and check that out.   And now I’m wearing one.

Cons

The big drawback to me is with the fitness apps.  It does not integrate at all with Fitbit, so I can no longer play with my friends unless I’m willing to wear two devices on my arm.  (I’m not).  And Fitbit was able integrate with calorie counting apps, so you could see how you were doing each day on calories in vs. calories out.  Apple can’t do that yet.

Apple’s watch has an activity tracker, but the data won’t post to Fitbit or to meal-tracking apps unless you manually enter a workout on another app, the Workout app.  If you happened to walk eight miles around New York City sightseeing, that activity wouldn’t transfer those extra calories to your other apps.  There’s also a Health app that shows your activity but it doesn’t track the calories you eat either.  In fact I’m not even sure what the Health app does that isn’t already being done in the other two apps.  Why you need three apps to not even be able to do what one Fitbit app can do, I don't know.

So Fitbit is far superior in this area.  (Note to Fitbit:  If you were to offer an app for the Apple Watch, I would pay you the cost of one of your lower end trackers for it.  I just don’t want to wear two bands on my wrist!  Just an idea . . .)

Many reviewers complain about the steep learning curve.  Believe me, if I’m telling you this is ridiculous, it really is.  I am not one to take to new technologies well.  But this one is a breeze.

And most reviews complain incessantly about the short battery life.  It only lasts about a day.  This is another one that I think is a non-issue.  I always take my watch off before I got to bed; I think most people do.  So when you take it off, you just connect it to your charger right next to your bed.  Who cares if it doesn’t last longer—I don’t think most people sleep in their watches.  (For the record, my battery has never been lower than 50% by the time I turn in at night.)

Pros

Apple Pay:  Yesterday, I went to Peet’s Coffee to write.  I ordered a cappuccino, extra hot.  When the barista asked me for $3.25, I didn’t dig around in my purse for my wallet, or for my iPhone to use Apple Pay—I double clicked the button on the side of my watch and held it up to the reader.  That was it.  No keypunching, no signatures.  And the vendors do not actually get your credit card data—so it’s one step safer than actually using your card.

Music:  When I go for a walk around my neighborhood, I usually carry my iPhone to listen to music.  It’s not really a big deal, but I’d rather carry nothing.  I’d rather not have to negotiate the tether to my ears when I take off my sweatshirt either.  Well now, the watch that I already have on holds music.  No phone necessary.  Of course you need Bluetooth earphones, but no more cord swinging around getting tangled in my sweatshirt.

Directions:  While driving to San Francisco to meet friends for dinner, I lifted my wrist and said “Hey Siri—Directions to Commissary.”  She found the restaurant and the watch tapped my wrist a few hundred feet before each turn I was supposed to make.  No programming the car’s cumbersome navigation system—no fumbling with Google Maps on my phone.

Texts:  So now, when I’m playing the piano, or gardening, or cleaning the house and a friend texts me (remember, my phone is no where near me and my ringer is probably off), a vibration lets me know I’ve got a text.  And if I want to answer it, I just talk to my watch.  So far, on dozens of texts I haven’t even had one typo.  Which is much better than my actual experience typing responses on my iPhone. 

Calendar:  The watch face tells me what my next appointment is and when I swipe to the map, it tells me that I’m 20 minutes away--another tap navigates me there.

Airline Boarding Passes:  I already loved the fact that airline boarding passes can be loaded on phones nowadays.  But that still requires fishing out your phone while wheeling you carryon, while holding your coffee cup.  Now it just requires lifting my arm—even if it’s the one holding the coffee cup. 

But wait there’s more:  I can hail an Uber with a tap, read a Yelp review of nearby restaurants, see the Zillow value of homes I’m driving by, hold my wrist up to identify a song using Shazam, check the stock market and the weather, pay a parking meter, even talk on the phone James Bond style in a pinch—all without actually touching my phone.

Oh yeah, and it actually tells the time.

It’s funny because I’ve always been the very last person to come around on new technologies.   It’s embarrassing to say now, but I initially didn’t see the value in voicemail, email, iPods, mobile phones, and more recently Uber’s services.  I am truly the last adopter.  But I wouldn’t be surprised if in another decade, these phone devices we find in the bottom of our purses go the way of the Sony Walkman, the rotary phone, and the VHS player.  By that point we might only be using devices that we can actually wear.

Related Posts:

            Don’t Blame the Fat Lady

            Middle-Age Fitness

            Racing to a Milestone

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How Not to Be a Burden on Your Kids

I'm very excited to report that I have been asked to join the Wall Street Journal's esteemed panel of experts who write about retirement topics on WSJ's blog, The Experts.

I'm taking an adult education class this quarter called "Roadmap to 100," about the keys to longevity.  We've only had one class meeting, and already I've got tons of tidbits I want to share with you all.  

It continues to amaze me how some people seem so old at 62, while others seem so young at 92.  Our professor, an 84-year old former doctor, who runs one marathon a year and is taking no medications, is exploring with us what accounts for those differences in how we age.  The great news is you have more influence than you might think.

Anyway, the focus is not so much on making it to a particular age like 100, but to make it to whatever age you're going to make it to in the best condition possible.  Increasing the healthy years and minimizing the years spent with debilitating conditions.

Because the goal for most of us is to live independently, on our own terms, for as long as we can.  That's the subject of my first post, How the Elderly Can Stay Independent Longer.   Hope you'll take a moment to head over there and peruse the posts of all the experts!

Related Posts

    Living to 100

    Am I Really Getting Older Like Everyone Else    

    Fifty is the New 28

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Fifty is the New 28

(Photo Details:  Sydney turning 50 in Hawaii--December 2013)

Ok, since we’ve already established that we retirees are at a higher risk of death from a falling injury than from Ebola, let’s do something proactive to reduce that risk.  The great thing is that anything you can do to increase your fitness level helps prevent injury from falls and helps reduce the risk of the even greater probability of heart disease.

The thing is, we already know how to improve our fitness level.  We’ve got to get more exercise.  And that’s not fun for everyone.  So I’ve got some ideas on how to make that more fun, or at least make it less of a chore.

First, go find out your “fitness age.”  This was really fun for me because my fitness age turned out to be 28.  According to researchers in Norway, a person’s fitness age is a better predictor of longevity than his or her chronological age.  New York Times’ Gretchen Reynolds explains that fitness age “is determined primarily by your VO2max, which is a measure of your body’s ability to take in and utilize oxygen. VO2max indicates your current cardiovascular endurance.” 

But most people don’t know their VO2max.  That’s where the Norwegian researchers come in.  It turns out that there is a strong correlation between VO2max and the answers to a few key questions.  You can take the test here to find out your fitness age.

The good news is you can improve your fitness age with just about any exercise.  As my chronological age has increased, I am more drawn to lifestyle exercise, such as walking or biking around my neighborhood, doing housework and yard work, or home-improvement projects like painting my house.  I’m less interested in high-intensity organized fitness classes or gym workouts.  

These lifestyle activities can be just as good.  But when you do a workout at the gym, the little readout on the machine gives you instant feedback:  how many calories you burned, how many miles you walked, or how many stairs you climbed.  Cleaning the house results in a clean house, but not very much insight into how much exercise you achieved.

Which is why I love my Fitbit.  For far less than a gym membership (as low as 60 bucks), you can buy one of these fun little gadgets that counts your steps, tells you how many calories you are burning, and even tells you how well you slept.  And you get this feedback from all the things you do in daily life, not just the time you spend at the gym.

What makes it even more fun though, is that you can play with your friends.  I have about a dozen friends with Fitbits and each day we can see who gets the most steps.  Believe me, this does change your behavior.  Even my husband Doug has us walk the long way to our destination or go on a little bonus walk in the evening if his steps are falling behind some of our friends.

And if you have an iPhone 5S or higher, you don’t even need to buy a Fitbit gadget, you can just download the free app.  Although it will only count steps when you are actually carrying your phone, which will impact your ranking among your friends, of course.  Besides the fact that I don’t have the right phone, I am too competitive for that to work for me.

Turns out you don’t have to have a competitive personality for this to motivate you though.  According to this article, every single participant of one small study increased their activity when using a fitness tracker:

Can trackers really change behavior in people? Last year, Dr. Rajani Larocca, a primary care physician at Massachusetts General Hospital, conducted a six-week lifestyle program for 10 patients with diabetes ages 50 to 70 that included weekly sessions to encourage exercise and healthful eating; each participant also was outfitted with a Fitbit Zip tracker.

“Every single person increased their activity,” Dr. Larocca said. “People felt more knowledgeable.” Eight months later, about half the patients from the group still wear a tracker.

Increasing your level of fitness not only helps prevent falls, it helps to prevent injury even if you do fall.  According to this article, you can also reduce the risk of a fall by getting adequate vitamin D and staying properly hydrated.  It also helps to integrate balance exercises into daily life--for example brushing your teeth while standing on one foot.  I recommend flossing while standing on the other foot.  Some evidence suggests a link between dental health and heart health so you might get double the benefit for this one.

Now it’s your turn, how do you stay motivated to exercise?

Related Posts:

            Exercise Like a Kid

            Middle-Age Fitness

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The Real Epidemic

First, some perspective:

-There have been nine cases of Ebola treated in the U.S. so far. 

-In six of the nine cases, the patients contracted the virus in their line of work-- working with Ebola patients in West Africa. 

-The only two to have contracted the disease in the U.S were nurses treating Thomas Duncan--the Liberian man who came to the U.S. having already been infected with the virus.

-The only Ebola patient in the U.S. that has died from the virus was Mr. Duncan, who was incorrectly diagnosed when he first sought treatment at an emergency room in Dallas, and was sent home.  (It is instructive that none of the family members Mr. Duncan was staying with in that small apartment became infected.  And they weren’t even wearing those protective space suits!)

-Doctors Without Borders has sent 700 doctors and aid workers to Ebola-stricken countries and three have become infected.  By the way, we’ve been sending aid workers since this outbreak in March.  There has been no huge outbreak here despite the fact that healthcare workers have been going there and coming back since early this year, long before the media started to sink their teeth into this story.

-Scientific modeling predicts between 1 and 130 cases before yearend in the U.S.  That’s at most less than 1 per 2 million people.

-The Ebola survival rate in developed countries is far higher than in underdeveloped nations.  It’s not the virus, it’s the medical treatment.  Guinea has about a 30% survival rate compared to our track record so far in the U.S. of between 80%-90% depending on how the doctor in New York fares.

Ok, so we’re all going to die from something at some point, right?  The thing is, we'd just like to put that off as long as possible.  Now the odds are overwhelming that Ebola is not going to be the thing that does you in.  If you really want to put off death as long as possible focus here--according to this article, in the U.S.:

-Tens of thousands of people die each year in auto accidents, over half of them were not wearing their seatbelts. 

-Skin cancer kills 10,000 people per year.

-During last flu season only 46% of Americans got vaccinated.  Flu kills between 3,000 and 50,000 in this country each year depending on the year.

Of course the leading cause of death in the U.S. is heart disease, killing 600,000 each year.

And finally, I know you won’t see this one splashed across all the networks tonight even though 75 million baby boomers will be at increased risk over the coming years for this epidemic.  In 2012, more than 2.4 million people were treated in emergency rooms for this ailment, almost 24,000 of them died.  In any case, we are all at risk for this one—it’s the number one injury related death for those over the age of 65:  falls.

I know it’s not as sensational as Ebola, but if we are all lucky enough to put off death from flu, car accidents, heart disease, skin cancer, and of course Ebola, we will be fortunate enough to have to worry about falling. 

The good news, according to today’s New York Times:

Though the risk of a fall increases significantly once people reach their 80s, researchers have found that people 85 and older in excellent health have no greater risk than someone 20 years younger.

So get a flu shot, wear sunscreen, put on your seatbelt, drop those excess pounds, and exercise.  And by all means reduce stress--stop watching all that Ebola coverage!

Related Posts:

            Living to 100

            Am I Really Getting Older Like Everyone Else?

            How Long Will You Live?

 

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If You Like Your Health Insurance

(Photo Detail:  The auto ferry to World Heritage Site, Fraser Island--Australia)

If you like your health insurance plan, you can—wait a minute!  Is there anyone out there that actually likes her health insurance?  I’d like to meet her.

I mean I guess you could say I’ve always liked my health insurance “plan.”  The problem is that it is delivered to me by an actual insurance company, and I’ve never met one of those that I like.

I think most people would have just gone ahead and paid the 19 bucks.  But it’s the principle--and the fact that I’m two and one-half hours into this project already, I’m not giving up now.  Furthermore, I think that’s exactly what they are counting on—in fact, I think that’s part of the business strategy of health insurance carriers.  Most importantly, I pay Blue Shield $879 each month for health insurance—I think they can afford to pay $19 when they are supposed to be paying it.  If only they didn’t make it so hard.

I’m not trying to single out Blue Shield.  I used to have Aetna and had to fight for every dime with them too.  That’s why I think it’s built into the business plan.  In fact, it’s about the only business I can think of where the company providing services doesn’t have to treat you very well because they know there’s nothing you can do about it.

I was just at my bank last week getting a document notarized.  They were so nice to me.  We had an appointment, for which our banker was right on time.  She smiled and made pleasant small talk.  She even asked how my day was going so far.  Unfortunately, I had just been on hold for an hour and 15 minutes with my insurance company over a stupid $19 dollar charge, so I think she’s sorry she asked.  But she didn’t act sorry that she asked; she was really sympathetic.  And she gave me a lollypop from the bowl sitting on her desk.

The bank knows I can go to any bank, so they try to be nice to me.  Even when Doug calls our cable company to cancel HBO or Showtime because it’s too expensive, they try and do something nice for us, like letting us have it for another six months for only $10 a month.  When we were in LA last weekend, all the people at the hotel were really nice, they even sent up a bottle of champagne to our room because they had it in their records that it was Doug’s birthday this month.  They know there are many hotels we can choose from, so they need to actually do something to earn our business.

Not so with the insurance company.  I’m not saying they are not nice, I’m just saying they really seem like they want to make it as hard as possible for me to receive the service for which I am paying them $879 a month.  I didn’t mean to imply that the individual people are not being nice to me.  It’s just that the institution itself seems to be against me.

Last month, Doug and I went to get our first-ever flu shots.  By the way, we chose our health plan specifically because it was the only insurer whose network covered our wonderful, local medical facility.  So we made a date of it, off to lunch and then to the clinic for shots.  The experience did not disappoint.  All of the parking right in front of the entrance says, “Reserved for Patients Only.”  How about that for customer service?

Then when you get off the elevator, there are two smiling silver-haired volunteers to point you in the right direction.  They warned us there would probably be a line for flu shots.  But then there was no waiting at all!

I told the nurse I had never had a flu shot before, so she took a few minutes to tell me all about it and what I might experience in the next couple of days.  All in all, it took about 10 minutes.

Unlike my old individual high-deductible policy, my brand new ACA-conforming policy now covers flu shots 100%.  BUT ONLY IF YOU CALL THE  INSURANCE COMPANY AND WAIT ON HOLD FOR AN HOUR AND FIFTEEN MINUTES.  And even then, you still have to jump through a few more hoops.

When we got the bill for our two shots, the service to inject the shot for $31 was covered for each of us.  But the $19 charge for the actual vaccine was applied to our deductible. 

So I called our doctor’s office and they said they didn’t know why the vaccine wouldn’t be covered.  It should be covered as preventive care just like the cost to inject it into our arms.  The billing department referred me to my insurance company.

So then I waited on hold for an hour and 15 minutes.  The agent, who was perfectly nice, looked into it and told me that the hospital coded the vaccine with the wrong billing code.  He couldn’t tell me what the right code is but he said the provider would have to re-submit the claim with a “preventive diagnostic code.”

So I called my doctor’s office back and the billing gal said it was coded with a preventive code:  V04.81.  I’m not an expert in billing codes, so I just have to take her word for it.  So I asked if she could tell me the code for the $31 charge that was covered, and guess what, it was V04.81!

So, when the Blue Shield agent called back to answer a question for my husband on his prescriptions charges, I hijacked the phone.  I told him what the billing department told me, and he said they did not use the correct code, but “if my healthcare provider was unwilling to help me,” he would take matters into his own hands and override the charge.

Yesterday, the billing supervisor from my hospital called to say that she had also looked into the matter and the code was indeed already correct.  She was going to “escalate” the matter and call the insurer directly to handle it for us.  I’m happy to get out of the middle of this, since I wouldn’t know the difference between a billing code and a building code. 

It just seems to me like at the very front end, my insurance company should have had some person that looks at the bills and says, “Oh my goodness, this is for a flu shot, and logic tells me that irrespective of the code that was used, I’m so smart that I know a vaccine and a shot go hand in hand, so we will cover the whole thing.”

And if an agent does have the ability to override a charge, shouldn’t they do it the first time I call, after I have waited on hold for an hour and 15 minutes, and before I talked to my doctor’s office two more times to find out that each one is pointing the finger at the other, neither responsible for the fact that I’m being billed $19 for something that should be covered by my $879 monthly premium?

Unfortunately, this experience is nothing new.  Even when I had a great insurance plan at my former employer, I spent hours and hours on the phone fighting for them to cover the stuff they were supposed to cover.  I suppose the good news is that now that I’m retired, I have the time to hold them accountable, even for a tiny $19 charge--something I simply would not have had the patience for when I was still working.

(For a really great read about trying to find out the price of a medical procedure in New York City read this Wall Street Journal article.  Its author had to make 46 phone calls, was placed on hold 56 times, and wound up with 19 pages of typewritten notes—only to receive price quotes from 6 of the 10 hospitals she contacted.)

Related posts:

            Comparing Health Insurance Deductibles

            Health Insurance for the Early Retiree

            Shopping for Health Insurance on the Exchange

 

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Living to 100

I guess it’s a question of quantity versus quality.

Here’s a little follow-up to my post last week about those studies showing that if you retire later you’ll live longer.  Now I know for sure.  Despite the headline touting this amazing benefit of working longer--it’s a bad deal. 

From MarketWatch today:

Studies and research by actuaries — the professional mathematicians who advise pension funds — show that working longer and retiring later improves life expectancy. In a report appearing on British website The Telegraph a year ago, Andrew Gaches, a longevity consultant for actuaries Club Vita, said that "retiring at age 70 rather than 60 adds around 13 months to men's life expectancy — and 12 months to women's longevity — even after allowing for differences in individuals' health, wealth and lifestyle.”

So by working TEN more years (until you’re 70) you can get another 12 months of life (13 if you are a man).  Sorry that just doesn’t sound like a good deal to me.

A woman in the U.S. can expect to live to about 82.  That means she’d get to 83 if she stayed at her job until she was 70 instead of 60.  By living that extra year, she’d get 13 years of retirement—from age 70 to 83.  But if she retired at 60, she’d get 22 years of retirement.  I think you have to really like your job for that to be worth it.

As for me, I just took this longevity quiz (try it here, it’s fun).  It says I’m going to live to 102—and it knows I’m already retired.  But perhaps they were not aware of this recent research, so maybe I should assume 101.   The retirement study didn’t say what happens if you retire at 44, but even assuming I get docked a year for each decade before 70, kicking the bucket at 99 seems long enough for me.  My retirement spreadsheet only gets me to 100 anyway. 

Related Posts:

            Am I Really Getting Old Like Everyone Else?

            How Long Will You Live?

            Quality of Life

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Navigating the New Health Law

I just renewed my driver’s license on-line yesterday.  It was a breeze.  At the same time, I still haven’t been able to actually sign up for the health insurance plan of my choice on California’s exchange; it keeps crashing when I push the button to buy.  Doug laughed when I said hopefully someday Covered California will work as well as the DMV.  Who ever thought someone would compare something to the DMV and the DMV would win!

We still have until December 15^th to get insurance in place for January 1st, so I’ll try not to be too critical yet as I see how it all fleshes out over the coming months. 

But I wanted to write a few posts going into more detail about aspects of the new health law that might be of value to you.  This one is intended for the folks that the new health care law was actually intended to help—those that don’t have currently have insurance because either they couldn’t afford it, or because they were previously denied coverage for a pre-existing condition.

Mandate

Starting next year, everyone is required to carry health insurance.  If you already have insurance at work, are on Medicare or Medicaid, or have retiree benefits through your previous employer, you probably already meet that requirement for insurance.

But most people without health insurance after March 31, 2014, will face a penalty for not having it.  The penalty is relatively minor in 2014, $95 or 1% of your income, whichever is higher.  So if you make $50,000 next year and are not covered by insurance, you would likely owe penalty of $500.

I think in most cases, the penalty for not carrying insurance is cheaper than the cost of actually purchasing insurance.  But not all cases, as I will show you.   The penalty increases each year until 2016, so that same individual making $50,000 would pay a penalty of $1,250 if he didn’t have insurance in 2016.

Of course, the catch is that you don’t have insurance if you opt for the penalty instead of insurance.  So if you get sick, you’ll have to cover the costs of your medical care yourself.  Even though the new law requires insurance companies to accept everyone, even people with pre-existing conditions, if you don’t sign up during the enrollment period, you won’t be able to get covered until the next open enrollment period, which will run from October 15^th through December 7^th in future years.  So if you have a heart attack in May, you’ll have to pay for it yourself.

For more details on the penalty for not having insurance read here.

Subsidies

For some people though, for just a little more than the cost of the penalty, you can actually avoid the penalty all together and have health insurance too.  That’s because if you earn under 400% of the federal poverty level (FPL) ($45,960 for a single person, $62,040 for a couple) there is a cap on how much of your income you are expected to devote to health insurance premiums.  That is the “affordable” part of the Affordable Care Act. 

The subsidies work on kind of a sliding scale.  For example, if you make up to 133% of the FPL, the theory is that you shouldn’t have to spend more than 2% of your income on health insurance premiums.  At 400% of the FPL, that threshold increases to 9.5% of your income.

To find out if you qualify for a subsidy and exactly how much it would be, you’ll need to go on your state’s health insurance exchange (start here to find it).  That’s because the calculation of the amount of the subsidy is based in part on the cost of the second-cheapest “Silver” plan in the exchange for your area.  (For a refresher course on the various “metal” levels of health insurance go here.)  To the extent that the cost of the second-cheapest Silver plan in your area exceeds the applicable percentage of your income, you get a subsidy for the difference to buy insurance.

In certain circumstances, you can use the subsidy to directly offset the cost of the monthly premium you pay.  Or you can pay the full premium price and file for a refund on your tax return if you meet the applicable income level by the end of the year.  To reiterate, you are only eligible for the subsidy if you purchase insurance on the exchange, not if you buy it directly through your insurer or a broker.

Warning:  If you estimate your income too low and receive a credit subsidy credit against your monthly premium, you will owe some of it back, and perhaps even a penalty, if your income comes in higher at the end of the year.  You are expected to notify your exchange if your income changes during the year.  But if you don’t notify them, they will catch up with you anyway when it’s time to file your taxes. 

How it all works

This morning a very nice man woke me from my deep sleep to deliver some wine that Doug had ordered on-line.   He started his deliveries early today because he needed to rush back to his company; they were holding a seminar for employees on the new health insurance exchange.  He was a little miffed that his girlfriend, who makes minimum wage at 7-Eleven, would now be required to get health insurance.  He wondered how on earth she would pay for it.

Here’s how:

Assuming his girlfriend works full-time, she makes about $16,000 per year at California’s current minimum wage.  Our delivery guy looked to be in his mid-40’s so I’m going to guess his girlfriend is 45 and lives in my county.   If she opted out of insurance all together, her penalty could be $160 (1% of her income).  For less than that, she could have health insurance.

The second cheapest silver plan for a 45-year old in my zip code is about $5,400/year.  But because she makes 145% of the FPL, she is only expected to pay a maximum of 4% of her income toward health insurance or $640.  The difference of $4,700 is a credit that she can apply to any policy she wants, she is not limited to the Silver plan.

She doesn’t have any insurance now, so I’m thinking that even the Bronze level is going to look pretty good to her.  The cheapest Bronze plan would be a little over $4,000/year.  After applying her $4,700 credit, she doesn’t have to pay anything for insurance.  So she could either pay the $160 penalty and not have insurance or pay nothing and have insurance.

Now of course, the more you make, the more you are expected to pay, but that was the intent after all. 

Retirees

I’ve been reading that more and more people expect to work way beyond age 65.  But most of the research shows a large number of people retiring before they really expect to, mostly because of health issues or layoffs.  For people that found themselves retired before they were really prepared to be, the subsidies may come in handy.  While you are waiting to reach Medicare age, or Social Security age, or even the age at which you can start taking retirement plan distributions, the income you’re generating on your taxable assets might be low enough to qualify you for a subsidy.  And that might be just the life-line you need to bridge the gap before you can tap into retirement plans, Social Security, and especially Medicare coverage.

For me the mandate doesn’t mean much.  Sure, I’d save a lot of money just paying the fine instead of getting health insurance, but here’s the thing:  I want insurance.  And I think I’m probably not alone.

Note about comments on this post

I’ve been receiving about a dozen spam comments every day for the last several weeks, so I’ve had to resort to moderating comments.  Up to now, any comment that is not spam I have published though.

This post is intended to convey information about how you might be able to save money on insurance under the new rules and what your penalties could be if you fail to get insurance.  It is not intended to generate a political debate on the merits or short-comings of the new healthcare law.  So in addition to deleting spam comments, on this post, I will also be deleting comments that are purely political commentary or that resort to name-calling to make a point.

Related Posts:

Shopping for Health Insurance on the Exchange

How to Get Health Insurance in Retirement

Health Insurance for the Early Retiree

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Shopping for Health Insurance on the Exchange

(Photo Details:  Last weekend, celebrating my friend's 50th birthday on the Lagoon at Stinson Beach, CA.  Can anyone guess the relevance to Obamacare?)

Last week, I thought I’d be blogging about my experience shopping for health insurance on the exchange.  In what I interpret as a good sign, it’s taken me one week to be able to get to the “apply” section of my state’s health insurance exchange.  It looks like a lot of people are looking to get themselves insured, and I’m glad about that.  Apparently I was one of over five million people shopping on the California exchange last week.

From the second day, I was able to review my choices, compare prices and coverage, and select the plan that I wanted.  But until yesterday I was unable to actually submit my application.   Yesterday, my application was accepted, but I haven’t been able to purchase the policy of my choice just yet.  Maybe later today—I’ve still got a couple months, so I’m not worried. 

Here’s what I’ve learned so far.

Should you even care?

If you have health insurance at work, no, you shouldn’t care.  Don’t bother reading any further.

If you are retired and on Medicare, you shouldn’t care either.  Stop reading here.

If you are retired and have retiree health insurance through your former employer, you don’t care either.  Go read a good book.

If you are on Medicaid, you shouldn’t care either.  Follow the instructions above.

That doesn’t leave many people who still care, I know.  But for those of you that are retired or are thinking about retiring before you are eligible for Medicare, read on.

Old rules

Up to now, when you retired (or otherwise found yourself without a job), I would have advised you to sign up for health insurance through COBRA.  It’s an expensive option, but it was the only way to guarantee that you could get health insurance.  Then, while you had the safety net of COBRA coverage, you could shop for an individual policy on your own.

Two problems existed if you went out on the open market to buy an individual policy outside of COBRA.  The first was that you wouldn’t know the actual price of your policy until you went through underwriting.  The second was that at the end of the lengthy underwriting process, the insurer could decide not to insure you anyway.  So it was a cumbersome process, to say the least.

New rules

Now you can shop for an individual policy, compare the actual prices, and actually wind up with a policy at the end of your application process.

Do I have to buy my insurance on the exchange?

No.  You don’t have to buy insurance on the exchange.  In fact if you wish, you can shop and compare providers, coverage, and prices on the exchange.   Then when you find coverage you like, you can go directly to that insurer and buy it through them, avoiding the exchange application process all together.

Or you can go through a broker (or on-line broker like ehealthinsurance.com) and do the same thing. 

However, if you qualify for subsidies under the new law, you must buy your insurance on the exchange.  On the other hand, even if you don’t qualify for a subsidy, you can still buy your insurance on the exchange, if you have the patience to wait a week or two.

Here is where you should start if you will be shopping on the exchange.

I assume this is the same in all states, but all of the policies I found on the exchange are the exact same policies I found on the individual carrier websites: same policies, same prices, same provider networks.

Can I still go to my doctor?

This issue was the most important factor to us, even over price.  When you shop on the exchange, you can filter results by which policies carry the network with your doctors.  While there are five insurers I can choose from in my region, only one of them includes the network with our doctors. 

How much will it cost?

This is the part that requires the most work.  As I’m sure you’ve heard by now, new policies are grouped into categories:  Bronze, Silver, Gold and Platinum.  Bronze level carries the lowest premiums, but those policies are designed to cover only 60% of your total health care costs.  Platinum plans are designed to cover 90% of your costs, but carry very high premiums as a result. 

We don’t use much health care right now, so the Bronze level works out to be the lowest cost overall.  When you consider costs, don’t just look at premium cost, but at how much out-of-pocket you expect to spend under each plan for the types of services you use, or expect to use regularly.

The carrier that covers our doctors offers an HSA-compatible plan in the Bronze level.  That way, we can still take advantage of the tax deduction for funding our Health Savings Account (HSA).  

While our premium will be higher with this new policy than our old one, our out-of-pocket expenses will be lower for a typical year’s health care expenses.  Most of our health care is preventative in nature, which is 100% covered under the new plan.  So overall, the line item for medical expenses in our budget remains unchanged, even though the breakdown is different.  Basically we are pre-paying for preventive care, so maybe I won’t boycott my doctor this year after all. 

You really have to sit down and run the numbers—if you have some ongoing health issues, you may save money by actually purchasing a more expensive policy.   It’s all going to depend on your individual situation. 

Do I qualify for a subsidy?

If your annual income falls between 138% 100%-400% (correction--the range can begin as high as 138% if your state expanded Medicaid) of the federal poverty level, you will qualify for some amount of subsidy to purchase health insurance.  You can elect to offset your premium as you pay it if you qualify.   If you turn out to be wrong about your income at the end of the year, you will have to true it up on your tax return and either pay back some of it if your income was higher, or get a refund if your income was lower.

You can also elect to pay the full cost of the premium each month, and then if your income turns out to be low enough to qualify at yearend, get the credit on your income tax return.  But as I said earlier, you can only get the subsidy credit if you purchased your insurance directly through your state’s insurance exchange, not if you purchased through a broker or directly through the insurance company.

If your state’s exchange isn’t working properly yet, here’s a link to the Kaiser Family Foundation’s subsidy calculator to see if you qualify for a premium subsidy,

What if I make the wrong decision?

At the end of the year, if you feel like you chose the wrong plan, you can change plans at the next open enrollment period.  So don’t think of this as a life-long decision.  This is another advantage over the old rules.  Previously, we could not change plans without going through underwriting again.  

If you opt out of insurance all together, and instead decide to pay the penalty, you can opt in at open enrollment as well.  But if you get cancer in May, you’ll have to pay your own way until you can get into coverage the following year.  Not that I’m expecting cancer next year, but that’s not a gamble I’m willing to take.

Related Posts:

            How to Get Health Insurance in Retirement (Part One)

            Are Retirees More Financially Agile?

            The Scary Impact of Inflation on Your Budget

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