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Social Security: Know before you go

Social Security: Know before you go!

According to the Pew Research Center starting January 1st 2011 “Roughly 10,000 Baby Boomers will turn 65 today, and about 10,000 more will cross that threshold every day for the next 19 years.”  Most of those turning 65 and many more approaching that age are thinking about retirement.  The sad truth is that most retirees have very little understanding of Social Security benefits and can make decisions that will affect their income for the rest of their lives.  Retirement, retirement planning and strategies seem to be on the front page of Yahoo and other sites every day.  Some of the stories help; some of them are just confusing.

Fortunately, there are great tools available for free from Social Security to make the decision making process easier.  SSA offers publications and retirement tools on the www.ssa.gov website.  Make sure the page you are on is the .gov webpage, it is the official Social Security site, there are many predators on the web that will try and charge you for the information and filing of benefits.  Social Security does not charge a fee for filing for retirement benefits. If you are just beginning your plan for retirement SSA offers a great basic primer publication (www.ssa.gov/pubs/EN-05-10035.pdf).  The webpage also offers a variety of free tools that can be used to see the different monthly amounts based on your own earnings as you look at the difference between filing for early benefits at 62, 65, 67 or even 70 years old.  These tools are valuable for making the decisions for the rest of your life. You can also file for benefits on the SSA.gov webpage when you are ready. You can also file over the phone or in person at your Social Security office, but you will need to contact SSA and make an appointment well in advance. Appointments can be made by calling 1-800-772-1213.

Regardless of filing electronically or in person you are going to have to provide SSA with information and documentation to make the process go smoothly.  Using the tools SSA provides will make the process move very smoothly.

Documents you need to have in order to retire.

  • Your Social Security number;
  • Your birth certificate;
  • Your W-2 forms or self-employment tax return for last year;
  • Your military discharge papers if you had military service;
  • Your spouse’s birth certificate and Social Security number if he or she is applying for benefits;
  • Children’s birth certificates and Social Security numbers, if you are applying for children’s benefits;
  • Proof of U.S. citizenship or lawful alien status if you (or a spouse or child applying for benefits) were not born in the United States; and
  • The name of your financial institution, the routing number and your account number, so your benefits can be deposited directly into your account. If you do not have an account at a financial institution or prefer receiving your benefits on a prepaid debit card you can receive a Direct Express® card. For more information, visit www.GoDirect.org.

You will need to submit original documents or copies certified by the issuing office. You can mail or bring them to Social Security. They will make photocopies and return your documents.

Any time money and complex or confusing government programs are combined; there are people who will take advantage of the situation.  To avoid fraud many companies now offer retirement counseling as do many financial services firms.  It is important to understand that Social Security does not train or endorse anyone outside of SSA in retirement.  If you choose to use assistance in your retirement make sure you are dealing with a company or individual that at least is trained and certified is some type of financial planning recognized by major financial institutions.  By using the SSA webpage, publications and tools you will be more informed. You will know something about retirement, if the answers you are getting from your advisor do not sound like what you have read on Social Security’s documents you should be very cautious.  There are no secrets or tricks to getting the most from your retirement. No one can offer a “secret” to get more than you could on your own.  Remember you are providing very sensitive information, information that in the wrong hands could be used to steal your identity.

The key to a successful retirement is prior planning and education. SSA has made every effort to provide an easier to understand system.  Yes, it is still very complicated. Yes, it can be confusing. Yes, you can take charge of your retirement by spending some time with family or friends going over the information provided by the agency to make you better informed.  You are looking at a decision that will play a role in your life for decades, doing it fast and easy may not always be the best choice.

Resources

The Area Agency on Aging would like to thank Steve Fulton for contributing this blog.  Steve is a former Social Security Claims Representative, who is trained in both retirement and disability claims.  Steve can be reached at sfultonz72@gmail.com.

 

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Observation Status and What you need to know

Many people are confused as to what observation status is and how it can affect them.  Today we will look at what hospital admission status is and what it means in terms of hospital care and long term skilled nursing care.

When a person enters a hospital for treatment they are be placed into one of two admission categories, outpatient or inpatient.  Inpatient status means that they have been formally admitted to the hospital by a doctor’s order.  Outpatient status means that you are there for emergency department (ER) service, outpatient surgery, lab tests, X rays or observation.  When a person is  in the hospital under outpatient they do not have a doctors order for admission.

Observation status covers many different circumstances, the following are examples.  One example of observation stats: A person who has outpatient surgery but is kept at the hospital for 24 hours in order for medical staff to address any complications from surgery that may occur.  In these circumstances the patient has been told beforehand that they will be kept for 24 hours after their procedure.  Another common example is someone enters  the Emergency Department and is put under observation to determine if they are sick/injured enough to require inpatient treatment.

Observation status has been in use  for a very long time, until recently the observation status was usually short term, less than 48 hours, most often 24 hours.  But, now a person can be kept in the hospital under observation status for days.  Many people do not understand the importance of admission status and how it can significantly affect the way needed long term skilled care is paid for.

When a person requires skilled care, such as rehabilitation, in order for Medicare to pay for that care the person has to have a qualifying hospital stay.  A qualifying hospital stay is one where a person has been admitted as an inpatient to the hospital for 3 midnights.  If they have a qualifying hospital stay prior to transfer to a skilled care facility, than Medicare covers the first 20 days of rehab at no cost to patient, and covers days 21-100 with a 2014 daily co pay of $152.  If a person goes into a rehabilitation setting at a skilled care facility and does not have a qualifying hospital stay, than Medicare covers nothing.    This is why it is so very important for patients and their families to understand the patient’s admission status.  A patient may enter a hospital through the emergency department and be placed in observation status for 3 nights and then be told there is nothing more the hospital can do they need to go to rehab.  The problem is the patient will be responsible for the entire rehab bill because they did not have a qualifying hospital stay.

So, how do you know what admission status a patient is under?  You ask and keep asking until someone tells you.  A person cannot presume that they are admitted just because certain things happen.  Observation status and inpatient admission status really do not look any different from the patients view point.  In both situations the nurses ask the same question about health, lifestyle etc.  If you are told that the patient is under observation status then the patient/patients advocate has the right to ask why they are not fully admitted as an inpatient.  Never assume that someone has inpatient status, always ask.

Additionally, the way Medicare covers self-administered drugs (prescriptions that the patient normally takes at home) for patients in outpatient status is much different.  To learn more about observation status, Medicare Prevention and Wellness benefits, as well as other Medicare topics, you can go to  www.medicare.gov/publications.  You can always contact your local SHIP (Senior Health Insurance Program) Counselor.  To find your closest SHIP counselor in Southwestern Illinois you can call the Area Agency on Aging at 618-222-2561 or 800-326-3221.

 

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The Grandparents Scam…It happens more than you think.

 

You may have heard of the Grandparent Scam.  A grandparent gets a phone call or an e-mail from someone who identifies as a grandchild. “I’ve been arrested in another country,” they say “and need money wired quickly to pay my bail. And oh by the way, don’t tell my mom or dad because they’ll only get upset!” This happens to unsuspecting people every day.  At the Area Agency on Aging we have had calls related to the Grandparent Scam.  It has happened so often we wanted to warn people not to fall for this scam.  Recently the FBI reported the following incident in a press release “For example, the actual grandson may mention on his social networking site that he’s a photographer who often travels to Mexico. When contacting the grandparents, the phony grandson will say he’s calling from Mexico, where someone stole his camera equipment and passport,” Of course you would be inclined to do anything for your grandchildren.  This is what is called “The Grandparent Scam.”

The Grandparent Scam has been around since 2008.  Criminals have gotten craftier by using social media sites and learning about the person and sharing that personal information with the grandparents.  It sounds frightening and real.  If this happens to you the FBI recommends: Resist the pressure to act quickly, try contacting your grandchild or another family member to determine whether or not the call is legitimate and never wire money based on a request made over the phone or in an e-mail…especially overseas.

Western Union gives the following advice related to the Grandparent Scam:

1. If you receive a phone call or email claiming a friend or family member needs cash, take a moment to review the situation. Does it make sense? Can you verify the emergency?

2. Call the person at a known telephone number, not a number given to you by the caller. Or, call a mutual friend or another relative and find out if he or she is aware of the situation.

3. Let your friend or family member know that you have received a call or email from the person requesting help. If the request turns out to be false, contact the police immediately.

4. Regardless of whether you are contacted by phone, email or some other means, be suspicious of requests to send money to “help a friend or family member out” unless you can verify the information you’ve been given with 100 percent confidence.

5. If you did send a money transfer through Western Union, and then realize that it was for a scam, contact the Western Union Fraud Hotline at 1-800-448-1492. If the transaction has not been picked up, it will be refunded to you.

6. Never send money to someone you have not met in person.

If you every feel like you have been a victim of a scam give us a call at 1-800-326-3221 or contact the Illinois Attorney General’s Office Senior Fraud Helpline at 1-800-243-5377.

Don’t let it happen to you!

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A Checklist for Financial Fitness

Money can be a difficult issue at any age, but financial planning is especially important for your retirement years. You will want to have enough resources to enjoy your time, and to take care of any healthcare problems or other emergencies that may arise. Of course, financial planning does not end at retirement—you need to re-evaluate your plan annually.

Fortunately, useful financial tools and other resources are available on the Internet, in books, and at the public library. A variety of professionals can also assist in financial planning. Here are some issues you should consider as you plan for and enjoy retirement.

Know What You Need.

Saving for a long and productive life can be challenging, but you can and should do it. The first step is to determine how much money you will need each year to live comfortably. This will require a careful examination of your income, resources, and expenses. It will also require that you make decisions about the kind of lifestyle you want throughout your retirement.

Know What You Have.

Social Security, pensions, savings accounts, IRAs—it all counts. When planning your financial future, include all sources of income. Don’t forget rental property and bank certificates of deposit. Even your Savings Bonds count. Read all the statements you receive from your pension fund, Social Security, 401(k), and IRAs. If you see a mistake or inaccuracy on any statement, contact the plan administrator and have it corrected immediately.  On March 12, 2014 from 12-1:00 attend the Snacks and Facts to learn more about Social Security Taxation.  The seminar will be held at the Fairview Heights public Library.

Re-Evaluate Your Financial Plan.

Don’t “set it and forget it.” A lot can happen between now and your retirement, as well as throughout your retirement years. Re-evaluate your retirement savings plan each year to stay on track. You may want to consult a professional financial or investment planner to maximize your savings potential.

Increase Your Savings.

If you can, contribute the maximum amount to all of your eligible tax-deferred retirement savings, including your 401(k) plan and IRAs. To take full advantage of these tax benefits, you may have to adjust your spending habits or forego some unnecessary spending, such as weekly dinners out. But everything you can save during employment will pay off in the long run!

Track Your Expenses.

Write down everything you spend for three months. Don’t rely on memory (which can be unreliable), but make entries every day in your expenses journal. When you review your record, you might be surprised how much you spend on things you really do not need. All expenditures that you can cut from the “unnecessary” can be added to your retirement fund.

Pay Off Those High-Interest Credit Cards.

Credit cards are incredibly convenient, but carrying debt from month to month can cost you a lot of money in interest charges. Make it a priority to pay off your credit card balances every month. When you choose a credit card, look for one with a low interest rate. It can make a big difference.

Organize Your Financial Documents.

Do you know where your insurance policies are? How about your will? Take the time to organize all your important financial documents. Keep them in a safe place. Let your family members, your legal representative, or a trusted friend know where they are located and make sure they can be accessed.

Cover Your Healthcare Costs.

Longer life expectancies mean greater chances of medical problems during retirement. Be sure that healthcare is part of your retirement plan. Many employers provide health insurance for their active employees, but fewer and fewer are covering retirees. Medicare coverage begins for most Americans at age 65, but many Medicare beneficiaries choose to purchase supplemental policies to cover the gaps. You might also want to purchase insurance that would pay for long-term healthcare, such as home care and care in a long-term care facility, in case you experience an extended illness. The cost of long-term healthcare insurance will depend on your age at the time of purchase, the amount of coverage you get, and other policy features. Planning ahead can save you substantial amounts in the future.

Become An Educated Investor.

Get help from a financial professional or consider enrolling in a financial education class to better understand how to manage your money for all your retirement years. Books, magazines, Internet sites, seminars, and classes are available for the financial do-it-yourselfer. You may need to do a little research, and your local public library is a great place to start. If you decide you would rather have expert advice, a wide variety of professionals are available to help you prepare for a financially secure future.

Online Financial Resources

  • Administration on Aging: www.aoa.gov
  • American Savings Education Council: www.asec.org and www.choosetosave.org
  • My Money.Gov: www.mymoney.gov
  • Employee Benefits Security Administration, U.S. Department of Labor: www.dol.gov/ebsa
  • Federal Citizen Information Center: www.pueblo.gsa.gov
  • Financial Security in Later Life: www.csrees.usda.gov/nea/economics/fsll/fsll.html
  • Internal Revenue Service Retirement Plans Community: www.irs.gov/retirement
  • Iowa State University Cooperative Extension Retirement: Secure Your Dreams: www.extension.iastate.edu/financial/retire.html
  • Social Security Administration: www.ssa.gov and  www.ssa.gov/r&m1.htm
  • U.S. Securities and Exchange Commission: www.sec.gov
  • Women’s Institute for a Secure Retirement: www.wiser.heinz.org

This was prepared in collaboration with the American Savings Education Council.

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Optimum Balance

From the time a toddler first learns to balance, the brain automatically puts together all the elements needed to maintain that balance.  Better and faster than any computer, the brain takes information from all parts of the body, analyzes each of the thousands (if not millions) of bits of information, develops a plan and sends the message back to execute the plan by all the appropriate body parts to keep us on our feet.  Think of what it must take to keep you from actually falling when you trip, much less for the gymnast to perfectly “stick” a landing after a double flip with a twist over a pommel horse!

Balance, once learned, is accomplished through what is called a motor program.  Like a tape loop in an answering machine, once recorded, it pretty much stays there.  Walking is also a motor program.  That’s why we are able to walk and chew gum at the same time, without consciously thinking about it. Our brain just makes necessary corrections unconsciously.. and faster… then you could make them consciously.  The main reason people often have balance problems when they get older is more linked to the old adage “Use or or lose it.”

As a young person, generally our muscles are more pliable, our joints less creaky and squeaky, our posture more upright.  We walk and run confidently with our heads turned, arms and legs moving, even backwards … often while doing something else quite complex such as kicking or dribbling a ball while an opponent challenges our every move.  Then life happens….

You take a bad fall off a bike and your knee is badly hurt.  Your job requires repetitive motion and your shoulder becomes painful.  Renovating the basement results in a back injury and you change how you walk.  Then arthritis sets in.  Or you have a surgery or a prolonged illness.  Last check-up, the doctor says you’re spine is changing because you’re two inches shorter than you were five years ago.  Then your leg buckles at the bottom of the stairs and you are so thankful it was at the bottom, not the top.  But it scared you.  You could have fallen and been badly hurt!  And that fear of falling makes you more careful.  First you modify or give up activities you used to enjoy.  Then you start substituting more sedentary activities.  Then maybe you start touching the wall or furniture when you walk…just to feel more sure on your feet.  Maybe you start carrying a cane or holding on to a spouse or child’s arm.   Now you stop before you turn around when someone calls your name instead of just turning your head to see who wants you.

With all these little changes to your movement patterns, your brain forgets a little more about what is used to do automatically.  Now, granted, the information from arthritic joints is not as reliable as from those smooth, young joints.  Swollen feet with poor sensation don’t give much useful information.  Posture is less perfect so the brain’s perception of upright has changed.  And there’s all that new information from hands touching the walls and furniture or a cane or walker that actually makes the brain lazy…all that extra support requires less effort to balance.  So your brain starts to rely on other input and information for balance, from the quick, reflexive sources to the slower, less efficient sources.  Balance becomes a more conscious activity.  But the motor program is still there!

The brain can often tap back into those motor programs if you challenge it to do so …in a safe environment, of course.  The brain uses information from your feet (somato-sensory), your eyes (vision or oculo-motor) and your inner ear (vestibular system for balance, not for hearing) and integrates these inputs to formulate a plan which is then executed through your musculo-skeletal system to keep you balanced.  Some of these sources of input change with age and disease processes and cannot be returned to “normal”.  For example, if you have diabetic neuropathy resulting in decreased sensation on the bottom of your feet, you will not likely improve your sensation dramatically.  But we may be able to retrain the brain to use what information is available and/or to rely more heavily on one of the other systems because the somato-sensory system is not reliable.  Or you may be able to develop a new substitute habit to decrease your risk of falling.  For example, if you see poorly in the dark, turning on a light may greatly decrease your risk of falling.

Mederi Caretenders Home Health knows the best plan to keep you healthy is to PREVENT a fall. For that reason, our standard of care for EVERY senior includes the assessment and rehabilitation of all the systems that contribute to balance.  Under the umbrella of Optimum Balance, our clinicians help seniors maximize their ability to tap into those old balance motor programs they learned as toddlers, perfected as children and teens and used throughout their lives as adults.  The goal is to strengthen those systems that contribute to balance (the somato-sensory, oculo-motor and vestibular) as much as possible while maximizing the physical ability of the body to accomplish the “plan” the brain develops to maintain balance through strengthening, flexibility and range of motion.

If you are a senior at risk — if you are fearful of falling, have fallen or have some condition that has impacted your balance – we may be able to help!  If you are wondering if you qualify for our program under your Medicare benefits, please contact Lori Key at Mederi Caretenders Home Health – 618.792.6547.

Thank you to our Guest Bloggers from Mederi!

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Connecting Older Adults to the Services They Need

Dorothy Scott will be 79 this year, and she is as spirited, gregarious, and outspoken as she has always been! “Dot” is nothing if not an independent thinker. And thinking is not the only way that she is independent. James, her childhood sweetheart and husband for 59 years, died 3 years ago and Dot has been living by herself ever since. “When dad died, we naturally thought mom would move in with one of us,” recalls Emma, the oldest of Dorothy’s four children. “Not surprisingly, we learned mom had her own ideas.” “I have close friends that I try to get together with at least once a week and I’m pretty active in my church,” explains Dorothy. “I appreciated my children’s concerns, but they all lived at least 700 miles away. I wasn’t ready to move away from my home and friends.”

The desire of older adults to continue living in their current homes is not uncommon, but sometimes it poses challenges for caregivers and seniors themselves. Fortunately, a friend told Emma about the Eldercare Locator, a nationwide directory assistance service for aging Americans and caregivers administered by the U.S. Department of Health and Human Services’  Administration on Aging (AoA). Emma called the Eldercare Locator’s toll-free number and was greeted by a kind, caring information specialist. The specialist listened, asked questions, and transferred Emma directly to the local agency servicing her mother’s community. With the agency’s assistance, Emma was able to arrange transportation to doctors’ appointments, help with household chores, and even an occasional social visit to ensure that everything was okay in Dot’s home. Thanks to the Eldercare Locator, everybody is happy. Dorothy and Emma can both rest better.

Easier Than Ever Before Making things “a little easier” for older adults and their caregivers is at the heart of the Eldercare Locator public service. Established in 1991, the Eldercare Locator is designed to help older adults and their caregivers navigate their way through the maze of senior services and identify trustworthy local support resources. The goal is to provide users with the information they need to help aging Americans live independently and safely in their homes and communities for as long as possible. Whether it’s home health care, meal delivery, or a well-deserved break from caregiving responsibilities, the Eldercare Locator links those who need assistance with state and local area agencies on aging and community based organizations that serve older adults and their caregivers.  Gateway to a Wealth of Information The Eldercare Locator receives more than 10,000 calls a month from older adults and caregivers looking for assistance. Home health and financial issues are two of the most requested topics, with inquiries ranging from help paying for prescription drugs and managing finances to hiring a home health aide. Callers do not need to reside in the same area as the older person who needs assistance. In fact, the Eldercare Locator is specifically designed to assist caregivers who may live miles away. “As the older population continues to grow in America, more families and caregivers are facing the challenge of caring for their aging relatives,” says Josefina G. Carbonell, AoA’s Assistant Secretary for Aging. “The Eldercare Locator provides a clear path to available assistance in the area where you or your family members live, and prevents unnecessary stress.”

Andrew, an ardent devotee of the Eldercare Locator whose father lives across the country, agrees. “My father was having a problem with balance and I was worried about him having an accident,” he explains. “In just one call, I was able to find a home modification program that installed assistive devices throughout his home. Now, the Eldercare Locator is the first place I go to take care of all my father’s needs.” Knowing what senior services exist and how to use them is the first step in helping older Americans live out their golden years with  independence and respect. Let the Eldercare Locator connect you to the timely and accurate information you need. The Eldercare Locator service can be accessed toll-free Monday through Friday, between 9:00 a.m. and 8:00 p.m. EST, by calling 1–800–677–1116. An on-line version is also available at www.eldercare.gov.

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Baby it’s Cold Outside

The Metro East region of Illinois has experienced record breaking low temperatures.  We are not use to this.  Winter temperatures in the St. Louis Region range from an average high of 40 degrees and average low of 24 degrees.  When the temperature and wind chill drop below zero it seems that many residents are caught off guard.  These frigid temperatures are especially dangerous for the very old.  Older people lose body heat faster.  That is why it is critical that we are checking on our elderly relatives and neighbors.

Tips for elders in cooler temperatures

  • ·        Elders should keep their homes at 68 degrees and above.  Even a slightly colder home can lead to hypothermia.
  • ·       When inside, elders should wear long underwear under clothes and also wear socks and slippers.
  • ·       When outside hats, scarves, gloves, mittens and layers of loose clothing are a must.  Frostbite can happen in a matter of minutes.
  • ·       It important to check with your doctor to determine if any medications being taken can cause hypothermia.

For more tips on how to stay warm check out the National Institute on Aging’s publication, Stay Safe in Cold Weather.  http://www.nia.nih.gov/health/publication/stay-safe-cold-weather

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Spend Time during the Holidays Discussing Strategies to Address Financial Exploitation With Older Family Members

As financial exploitation targeting older adults continues to become more prevalent in the United States, the Area Agency on Aging of Southwestern Illinois joined a nationwide campaign to encourage older adults and their families to address the issue and to get informed about the warning signs and resources available to help prevent abuse.  Research shows that as many as 5 million older adults are victims of elder abuse each year and financial exploitation costs seniors an estimated $3 billion annually.

The Area Agency on Aging is encouraging older adults, caregivers and their families to use their time together this holiday season to discuss and get informed about strategies to prevent financial exploitation by encouraging families to take steps to prevent financial exploitation this holiday season.

The holiday season is an ideal time for families to get together and discuss issues with their older family members.  The Area Agency on Aging strongly encourages all families to take some time to learn about the warning signs so that they can ask the right questions and take the right precautions to ensure that the finances of older adult family members are safe.

There are several signs of financial exploitation for families to look out for, including financial activity that is inconsistent with an older adults past financial history; confusion about recent financial arrangements; changes to key documents that have not been authorized; a caregiver or beneficiary who refuses to use designated funds for necessary care and treatment of an older adult; and an older adult who feels threatened by a caregiver or another individual who is seeking to control their finances.

Families that are concerned about financial exploitation should report the issue to state agencies that deal with protecting the safety and well-being of older adults.  The campaign, which encourages older adults and their families to plan and be cautious, released tips to help prevent financial exploitation, some of which include:

·     Get an estate plan in place. Talk with an attorney about creating a durable power of attorney for asset management; a living will; a revocable, or living, trust; and health care advance directives.

·     Learn how to avoid fraud and scams at www.stopfraud.gov/protect.html.

·     Consult with a trusted person before making any large purchases or investments.

·     Do not provide personal information (i.e. Social Security number, credit card, ATM PIN number) over the phone unless you placed the call and know with whom you are speaking.

  • If you hire someone to help you in your home, ensure that they have been properly screened with criminal background checks completed.  Ask for certifications when appropriate.
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What We Do

“How can we help you?”  Is the most common phrase said at the Area Agency on Aging of Southwestern Illinois.  Life can be complicated and when changes occur due to health, family dynamics, finances, etc., help is needed to make good decisions.  The Area Agency on Aging can help older persons and their caregivers by providing answers on Aging.

The Area Agency on Aging is an independent not-for-profit organization that exists solely for the benefit of older persons and caregivers.  Empowering persons 60 and older and their caregivers to live safely in respectful and choice-filled communities allowing productive, secure and self fulfilled lives is the Agency’s focus.  Envisioning a world in which aging is positive is the vision of the Agency.

Services the Area Agency on Aging can help older persons with are:

Answers on Aging

Elder Abuse Investigation

Employment for Older Adults

Legal Services

Long Term Care Ombudsman

Meals on Wheels

Medicare Counseling

Nutrition Sites

Pharmaceutical Assistance

Transportation Services

No matter where you live, help is close by.  The Area Agency on Aging is part of a network of 650+ Area Agencies throughout the nation.  Every county in America has an Area Agency on Aging that can be located through the eldercare locator at www.eldercarelocator.gov or by calling 1-800-677-1116.

For local Answers on Aging call 1-800-326-3221 or visit our web site at www.answersonaging.com

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Helping to Stop Health Care Fraud

Health care fraud, waste, and abuse cost American taxpayers nearly $60 billion each year. Medicare and Medicaid consumers are an essential element in national fraud fighting efforts. Consumers are best positioned to detect and report abuse and the Senior Medicare Patrol (SMP) aims to empower them to do so through education and advocacy. The Area Agency on Aging hosts the regional SMP to help with this effort in Southern Illinois.  The goal of the SMP Program is to train seniors to recognize and report fraud. 

The national Senior Medicare Patrol program is working to strengthen Medicare by using these regional offices to recruit and train retired professionals and other senior citizens to recognize and report both health care billing errors and suspected instances of health care fraud. Each year nearly 4,500 volunteers, trained by regional SMP offices conduct community outreach and peer-to-peer training to help Medicare consumers:

             • Identify potential scams and other fraudulent activity

                • Protect their personal information including Medicare and Social Security numbers     

                • Detect errors on their Medicare Summary Notices (MSNs) or Explanations of Benefits 

            • Report suspected fraud or abuse to the proper authorities

One might wonder if fraud happens locally.  It does happen.  Recently, a local provider was sentenced to prison for fraudulent billing and money laundering and was sentenced to five years and 10 months in federal prison and three years’ probation after pleading guilty to 14 counts of health care fraud and one count of money laundering.  The provider admitted to keeping almost no records and creating fake documents to bill 14 companies or health insurance funds more than $2 million since 2006.  This provider must pay the money back and forfeit more than $900,000 in cash and property, two minivans and a BMW.  This is just one incident.  Imagine the taxpayer dollars that that can be saved by eliminating all cases of fraud. 

The Affordable Care Act of 2010 provides a number of new tools and resources to prevent fraud and strengthen Medicare. The law improves analysis of health care claims data to flag potential scams, strengthens the screening process for health care providers that wish to participate in Medicare and Medicaid, and provides increased penalties for those committing fraud. These new fraud-fighting tools will help the government identify false claims faster, prosecute health care fraud more effectively, and help prevent fraud from occurring in the first place.  If you suspect fraud contact the Area Agency on Aging at 1-800-326-3221.

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