How to Find Affordable Dental Care

Dear Savvy Senior,
Where can seniors turn to find affordable dental care? I had dental insurance through my work for many years but lost it when I retired. What can you tell me?
Flossing Frank

Dear Frank,
Very few U.S. retirees have dental insurance today. Without coverage from traditional Medicare, and with private dental insurance typically costing too much to be feasible, most seniors are stuck paying full out-of-pocket prices every time they visit a dentist. While there's no one simple solution to affordable dental care there are a variety of options that can help cut your costs. Here's what you should know.

Dental Discounts
One way you may be able to trim your dental care cost is by simply asking your dentist for a senior discount, especially if you're paying up front. Out-of-pocket payers save the dentist office the cost and hassle of filing an insurance claim, so asking for a small 10 percent discount is not unreasonable.

Another cost-effective way to reduce your dental expenses is to join a dental discount network. How this works is you pay an annual membership fee – roughly $80 to $200 a year – in exchange for 15 to 50 percent discounts on service and treatments from participating dentists. To find a network, go to dentalplans.com (or call 888-632-5353) where you can search for plans and participating dentists by zip code, as well as get a breakdown of the discounts offered.

Brighter (866-893-1694), which launched in May in all states except Florida, Montana and Vermont, is another discounted dental service to check out. It gives subscribers access to a network of 25,000 dentists offering 20 to 60 percent discounts on cleanings, crowns, implants, root canals and other procedures. You can sign up for a free one-month plan or opt for the premium plan, which costs $79 per year for individuals and families.

Low-Cost Care
Another way to get dental care at a lower price is at a dental school clinic. Almost every dental school in the U.S. offers affordable care provided by dental students who are overseen by experienced, qualified teachers. You can expect to pay as little as a third of what a traditional dentist would charge and still receive excellent, well-supervised care.

And for low-cost teeth cleanings, check with local colleges that offer dental hygiene programs. For training purposes, many programs provide teeth cleanings by their students for a fraction of what you'd pay at a dentists office. To locate dental schools or dental hygiene programs in your area visit www.ada.org/267.aspx.

Low Income Care
If you're strapped for cash there are other resources that provide dental care to seniors at a reduced rate or for free. Here's where to look:

• Health centers: Federally-funded by the Health Resources and Services Administration (HRSA), there are thousands of health centers around the U.S., many of which provide discounted or free dental care to people based on financial need. To find a center near you visit findahealthcenter.hrsa.gov or call 877-464-4772.
• Local services: There are a few states, as well as some local programs or clinics that offer discounted dental care to those with limited means. To find out what may be available in your area, check with your state dental director (see astdd.org for contact information), or your state or local dental society (see ada.org/statelocalorg.aspx).
• Dental Life Network: Offers several programs that provide free dental care for elderly and disabled people who can't afford to pay. To learn more or to apply for care in your state, visit nfdh.org or call 888-471-6334.

Savvy Tip: The best way to keep your dental costs down is through prevention and good oral hygiene. So remember to brush your teeth at least twice a day using fluoride toothpaste, floss daily and get routine checkups every six months or at least once a year.

Resources for Job-Hunting Seniors

Dear Savvy Senior,
Can you recommend some good resources to help job hunting seniors? I'm 60 years old and have been out of work for nearly six months now and need some help. What can you tell me?
Seeking Employment

Dear Seeking,
The tough employment market over the past few years has been particularly hard on people over the age of 55. Fortunately, there are a number of online tools and in-person training centers scattered across the country today that can help. Here's what you should know.

In-Person Help
A good first step to get help finding a job is at a Career One-Stop center. Sponsored by the U.S. Department of Labor, these are free job resource centers that can help you explore career options, search for jobs, find training, write a resume, prepare for an interview and much more. There are around 3,000 of these centers located throughout the country. To find one near you, call 877-348-0502 or go to careeronestop.org.

Depending on your financial situation, another program that may help is the Senior Community Service Employment Program (SCSEP). Also sponsored by the Department of Labor, SCSEP offers access to training and part time job placements in a wide variety of community service positions such as day care centers, senior centers, governmental agencies, schools, hospitals, libraries and landscaping centers. To qualify, participants must be over 55, unemployed and earning less than 125 percent of the federal poverty level – $13,600 a year. Unfortunately, 2011 federal budget cuts have significantly reduced this program funding, but it's still a viable option. To learn more or locate a program in your area visit www.doleta.gov/seniors or call 877-872-5627.

In addition to the national resources, some states, communities and local nonprofit organizations may offer their own senior employment programs. For example, in certain areas in Indiana, Louisiana, Maine, Maryland, Michigan, Pennsylvania, Texas, Vermont, Washington state and Wisconsin there are Aging Worker Initiative programs to help local job seekers 55 and older. To find out if your community offers any locally-based senior employment programs, contact the Area Agency on Aging – call 800-677-1116 or see www.eldercare.gov to get your local number.

AARP WorkSearch
Another resource that offers free job help is the AARP Foundation WorkSearch Virtual Job Coach program. This is a volunteer-run program that helps any job-seeker (you don't need to be an AARP member), age 40 and older, by connecting you with a trained volunteer to help you search for jobs and get training. The coaching is typically done via e-mail or over the phone. Call 877-659-0969 or visit aarpworksearch.org to find help.

In addition, AARP also offers a jobs search engine that you can access at jobs.aarp.org. Or, if you want in-person assistance, AARP has 23 WorkSearch facilities around the country that provide free face-to-face help. To search for a facility, contact your state AARP office. See aarp.org/states or call 888-687-2277 for contact information.

Online Resources There's also a wide array of online employment networks that can help you connect with companies that are interested in hiring older workers. One of the best is retirementjobs.com, which offers a job search engine that lists more than

30,000 jobs nationwide from companies that are actively seeking workers over the age of 50. It also provides job-seeking tips and advice, helps with resume writing and allows you to post your resume online for companies to find you.

Some other 50-plus job seeking sites worth a look are seniors4hire.com, workforce50.com, retiredbrains.com, retireeworkforce.com, wiserworker.com, seniorjobbank.com, enrge.us (a site devoted to retired government employees) and yourencore.com (an online recruitment firm that connects retired scientists, developers and engineers with companies that offer consulting assignments).

Start a Business
If you're interested in starting a small business but could use some help getting started, turn to the U.S. Small Business Administration which offers tips, tools and free online courses that you can access at sba.gov. Also see score.org a nonprofit association that provides free business advice for entrepreneurs.

Social Security Help for Those Nearing Retirement

Dear Savvy Senior,
Can you recommend some good resources that can help me decide when to start my Social Security retirement benefits? I'll be 62 early next year and want to carefully weigh all my option, but could use some help.
Nearing Retirement

Dear Nearing,
Figuring out the best age to start claiming your Social Security retirement benefits is an important financial decision. The difference between a good decision and a poor one could cost you tens of thousands of dollars over your retirement, so doing some homework and weighing your options now is a very smart move.

What to Consider
As you may already know, you can claim Social Security any time from age 62 to 70, but the longer you wait, the larger your monthly check. But there are actually many factors you need to take into account to help you make a good decision, including your current financial needs, your health and family longevity, whether you plan to work in retirement, whether you have other retirement income sources, and if you're married, your spouse's situation.

To help you compare your options and make an informed decision, there are a number of resources and services available depending on how much assistance you need.

SSA Tools
A good place to start is at the Social Security website. Just go to socialsecurity.gov and click on the "Retirement" tab at the top of the page and access their "Plan for Retirement" tools where you can estimate your benefits at different ages and get guidance based on your personal situation.

Or, if you would rather have face-to-face assistance, call 800-772-1213 and schedule an appointment to visit with a claims representative at your nearby Social Security office.

The Social Security Administration also offers a bevy of free publications that you can have mailed directly to you. "Retirement Benefits," "When To Start Receiving Retirement Benefits" and "How Work Affects Your Benefits" are three popular publications for those nearing retirement.

Other Resources
If you need help in addition to what the government offers, some good resources include the "Social Security Claiming Guide" which is published by the Center for Retirement Research at Boston College. This easy-to-read 24-page guide sorts through all the options, spells out how much you can get, and answers frequently asked questions. Go to socialsecurityclaimingguide.info to read it online or to print a copy for free.

Another good publication is "When to Take Social Security Benefits: Questions to Consider". Offered by the National Academy of Social Insurance, a nonprofit research and educational group, this 16-page booklet uses a question-and-answer format to guide you through the key issues. To get a free hardcopy mailed to you, call 202-452-8097.

You can also get help online at websites like analyzenow.com, which offers a free tool called "Social Security Planner" that helps singles and couples calculate the best time to take their retirement benefits. And AARP's new Social Security Benefits Calculator, which lets you estimate how much you'll receive in monthly and lifetime benefits, based on your salary and your age when you file. Or, for a $40 annual fee, maximizemysocialsecurity.com provides a comprehensive new tool to help retirees, spouses and survivors make decisions to maximize their benefits.

If, however, you'd like more personalized help, there are financial advisors and investment advisor firms that for a fee can assist you by taking you through the specific claiming strategies. One such firm is Social Security Solutions (866-762-7526), which offers three levels of service including their "Premium Plus" plan that runs multiple calculations and comparisons, recommends a best course of action in a detailed report, and gives you a one-on-one session with a Social Security specialist over the phone to discuss the report and ask questions. Fees for their services range between $20 and $125.

Benefits for Older Veterans and Their Families

Dear Savvy Senior,
I would like to find out what kinds of veterans benefits are available to older vets and their spouses? My dad served four years in the Army during the Korean War, and I'm curious to see if there are any VA benefits that he or my mom may qualify for. What can you tell me?
Searching Son

Dear Searching,
That's a great question. There are actually millions of older veterans and their families who don't take advantage of the VA benefits they're entitled to because they either don't know they exist or they don't think they would qualify for them. Here's what you and your parents should know.

Underused Benefits
While the VA provides a wide range of commonly-known benefits and services for its veterans – like health care, education support through the GI Bill and home loans – they also provide a bevy of lesser-known benefits that were specifically created to help senior veterans and their family members, as well as their survivors.

To be eligible, however, your parent's income and assets in most cases will need to be below certain limits, and your dad's discharge from the military must have been under conditions other than dishonorable. Here's a breakdown of four benefits that are often overlooked by older vets and their families.

Veterans Pension: This is available to limited-income veterans that are age 65 and older or are totally disabled, who served at least 90 days of active military service with at least one day of service during a period of war (stateside or overseas). To be eligible, your parent's assets will generally need to be under $80,000 not counting their house and vehicle, and their annual "countable income" must be under $15,493 or $11,830 for a single veteran. Countable income includes earnings, disability and retirement payments, interest and dividends, and net income from business or farming, minus medical expenses if they exceed at least 5 percent of their total income.

Death Pension: This is available to low-income surviving spouses and dependents of wartime veterans whose death was not related to military service. To receive this benefit, a surviving spouse's annual income must be under $7,933, or under $9,696 if she is housebound (minus medical expenses), with cash assets under $80,000.

Aid and Attendance: This little known benefit can help elderly veterans and their spouses pay for in-home care, an assisted living facility or nursing home care. It pays up to $1,949 per month, in addition to the monthly pension benefits. To qualify, the veteran must be 65 or older (or permanently disabled), have served during wartime and meet certain financial and medical requirements.

To qualify medically, one of your parents would need assistance with basic everyday living tasks like eating, bathing, dressing or going to the bathroom. Being blind or in a nursing home or assisted living facility for mental incapacity also qualifies.

And to qualify financially, your parent's annual income as a couple (minus medical and long-term care expenses) cannot exceed $23,396; $19,736 for a single veteran; or $12,681 for a surviving spouse. And their assets must be less that $80,000, excluding their home and car.

Burial Benefits: Regardless of income and assets, this benefit provides all veterans, spouses and dependents a free burial at a national cemetery and a free grave marker. Unfortunately, funeral or cremation costs are not covered. However, some veterans may qualify for a $300 funeral allowance and $300 for a plot if they choose to be buried in a private cemetery. To learn more see www.cem.va.gov.

VA Resources
A good place to learn about all types of veterans benefits is at the online at www.ebenefits.va.gov or www.vba.va.gov. Or, contact your regional VA office or local veterans service organization, where you can get personalized help and assistance in filing claims. See www.va.gov/statedva.htm for contact information or call the VA benefits helpline at 800-827-1000.

How to Keep Up With Your Medications

Dear Savvy Senior,
What devices can you recommend to help forgetful seniors keep up with their medications? My 76-year-old mother takes nine different prescription drugs and that doesn't include all the vitamin supplements or over-the-counter medicines she takes. Any suggestions?
Concerned Daughter

Dear Concerned,
The challenge of juggling medications can be a problem for anyone, especially seniors who take multiple drugs for various health conditions. Here are some different solutions that can help.

Medication Helpers
Getting organized and being reminded are the two keys to helping your mom stay on top of her medication regimen. To help achieve this, there are a wide variety of inexpensive pill boxes, medication organizers, vibrating watches, beeping pill bottles and even dispensers that talk to you that can make all the difference. To find these types of products go to epill.com (800-549-0095) and forgettingthepill.com (877-367-4382) where you'll find dozens of affordable options.

If your mom needs a more comprehensive medication management system there are several good options here too. One of my favorites is the Maya from MedMinder (888-633-6463), a computerized pill box that will beep and flash when it's time to take her medication, and will call her if she forgets. It will even alert her if she takes the wrong pills. This device can also be set up to call, e-mail or text family members or caregivers letting them know if you miss a dose, takes the wrong medication or miss a refill. Maya is available at BestBuy for $180 with a monthly service fee is $30. Or you can rent it for $40 per month at medminder.com.

Some other good medication management systems worth a look at are TabSafe (877-700-8600) and the Philips Medication Dispensing System (888-632-3261), both of which will dispense her medicine on schedule, provide reminders and will notify caregivers if her pills aren't taken. These systems run under $100 per month.

Reminding Services
Another option that can help your mom keep on top of her meds is with a medication reminding service. These are services that will actually call, e-mail or text your mom reminders of when it's time for her to take her medicine and when it's time to refill her prescriptions. Some even offer extra reminders like doctor and dentist appointments, wake-up calls and more.

Companies that offer such services include mymedschedule.com, which provides free medication reminders via text message or e-mail. Their website can also help you make easy-to-read medication schedules that you can print out for your mom to follow. Other similar companies worth a look are rememberitnow.com which also offers free text message and e-mail reminders and pillphone.com which charges around $4 per month.

If, however, your mom doesn't text or use a computer, OnTimeRx (866-944-8966), Snoozester or Daily Pill Calls (866-532-6855) may be the answer. With starting prices ranging between $4 and $10 per month, these services will call your mom on her home or cell phone (they can send text messages too) for all types of reminders including daily medications, monthly refills, doctor appointments and other events.

Or, if you're looking to keep closer tabs on your mom, services like Care Call Reassurance (602-265-5968) or CareCalls (888-275-3098) may be a better fit. In addition to the call reminders to your mom's phone, these services can be set up to contact you or a designated caregiver if she fails to answer or acknowledge the call. Care Call Reassurance costs $15 per month if paid a year in advance, and CareCalls costs $39 per month plus a one-time activation fee of $99.

Savvy Tip: If you have questions or concerns about the medications your mom is taking, gather up all her pill bottles (including all prescription drugs, over-the-counter medications, vitamins, minerals, and herbal supplements) and take them to her primary physician or pharmacist for a drug review so he or she can look for any potential problems.

How Much Do You Need to Retire?

Dear Savvy Senior,
Is there an easy way to figure out how much savings a person needs to retire? I'm 52 years old – about 10 years from when I would like to retire – and I want to see where I stand.
Planning Ahead

Dear Planning,
How much money you need to retire comfortably is a great question that all working adults should ask themselves. Unfortunately, far too few ever bother thinking about it.

But calculating an approximate number of how much you'll need to have saved for retirement is actually pretty easy and doesn't take long to do. Here's a quick, simple three-step approach that can help you find your magic retirement number.

Estimate Expenses
The first step is the trickiest – estimating your future retirement expenses. If you want a quick ballpark estimate, figure around 75 to 85 percent of your current gross income. That's what most people find they need to maintain their current lifestyle in retirement.

If you want a more precise estimate, track your current expenses on a worksheet and deduct any costs you expect to go away or decline when you retire, and add whatever new ones you anticipate.

Costs you can scratch off your list include work related expenses like commuting or lunches out, as well as the amount you're socking away for retirement. You may also be able to deduct your mortgage if you expect to have it paid off by retirement, and your kids college expenses. Your income taxes should also be less.

On the other hand, some costs will probably go up when you retire, like health care, and depending on your interests you may spend a lot more on travel, golf or other hobbies. And, if you're going to be retired for 20 or 30 years you also need to factor in the occasional big budget items like a new roof, furnace or car.

Tally Income
Step two is to calculate your retirement income. If you contribute to Social Security, estimate how much your monthly benefit will be at the age you want to retire. You can get a personalized estimate at www.ssa.gov/estimator. If you're married, remember to count your spouse's benefits too.

In addition to Social Security, if you have a traditional pension plan from an employer, find out from the plan administrator how much you are likely to get when you retire. And, figure in any other income from other sources you expect to have, such as rental properties, part-time work, etc.

Calculate the Difference
The final step is to do the math. Subtract your annual expenses from your annual income. If your income alone can cover your bills, you're all set. If not, you'll need to tap your savings, including your 401(k) plans, IRAs, or other investments to make up the difference.

So, let's say for example you need around $45,000 a year for retirement and you expect to receive $25,000 a year from Social Security and other income. That leaves a $20,000 shortfall that you'll need to pull from your nest egg each year ($45,000 – $25,000 = $20,000). Multiple your shortfall by 25, and that's how much you'll need to have saved.

In the case above, you would multiple $20,000 by 25 and come up with $500,000.

Why 25? Because that would allow you to pull 4 percent a year from your savings, which is a safe withdrawal strategy that in most cases will let your money last as long as you do – at least 30 years.

If you find that your savings are lacking, you might want to go back to your worksheet and cut some costs. Or, you may need to consider part-time work during retirement or postponing retirement so you can boost your savings.

Savvy Tip: If you need help figuring out how much you'll need to retire, there's a variety of free online calculators that can assist you. Some top tools are offered by Analyze Now, T. Rowe Price and AARP.

Downsizing Solutions

Dear Savvy Senior,
What tips can you recommend to help seniors with downsizing? I have been thinking about moving to a retirement community, but in order to move I need to get rid of a lot of my stuff. I have a four bedroom house as well as an attic and basement that are full. Any tips would be appreciated.
Overwhelmed Senior

Dear Overwhelmed,
The process of weeding through a house full of stuff and parting with old possessions can be difficult and overwhelming for many seniors. Most people in your situation start the downsizing process by giving their unused possessions to their kids or grandkids, which you can do up to $13,000 per person per year before you're required to file a federal gift tax return. Beyond that, here are a few extra tips and services that may help you.

Downsizing for Dollars
Selling your stuff is one way you can downsize and pad your pocketbook at the same time. If you're willing, have the time and access to the Internet, online selling at sites like Craigslist and eBay is the best way to make top dollar. Craigslist.org is a huge classified ads site that lets you sell your stuff for free. And eBay.com lets you conduct your own online auction for a small listing fee, and if it sells, 9 percent of the sale price, up to $100. Or, if you don't want to do the selling yourself you can get help from an eBay trading assistant who will do everything for you. They typically charge between 33 and 40 percent of the selling price. Go to ebaytradingassistant.com to search for trading assistants in your area.

Some other popular selling options are consignment shops, garage sales and estate sales. Consignment shops are good for selling old clothing, household furnishings and decorative items. You typically get half of the final sale price. Garage sales are another option, or you could hire an estate sale company to come in and sell your items. Some companies will even pick up your stuff and sell them at their own location – they usually take around 50 percent of the profits.

Donate It
If you itemize on your tax returns, donating your belongings is another way to downsize and get a tax deduction. Goodwill (800-741-0186) and the Salvation Army (800-728-7825) are two big charitable organizations that will come to your house and pick up your donations. If your deduction exceeds $500, you'll need to file Form 8283, "Noncash Charitable Contributions." You'll also need a receipt from the organization for every batch of items you donate. And be sure you keep an itemized list of donated items. See IRS Publication 526 for more information.

Disposal Services
If you have a lot of junk you want to get rid of, contact your municipal trash service to see if they provide bulk curbside pickup services. Or, depending on where you live, you could hire a company like 1-800-Got-Junk (800-468-5865) or Junk-King (800-995-5865) to come in and haul it off for a moderate fee. Another good option is Bagster by Waste Management (877-789-2247). With this service, you buy the bag (it measures 8 feet by 4 feet by 2.5 feet) at your local home-improvement store like Lowes or Home Depot for around $30. Fill it to a limit of 3,300 pounds and schedule a pickup which costs between $80 up to $205 depending on your location.

Get Help
You can also hire a professional "senior move manager" to do the entire job for you. These are organizers who will sort through your stuff and arrange for the disposal through an estate sale, donations or consignment. Costs for these services usually range between $1,000 and $5,000. See nasmm.com or call 877-606-2766 to search for a senior move manager in your area. Or, you can hire a professional organizer through the National Association of Professional Organizers at napo.net.

How to Find and Research Doctors Who Accept Medicare

Dear Savvy Senior
What resources are available to help seniors locate and research Medicare doctors? My husband and I are approaching age 65 and need to find a new internist or primary care doctor who accepts Medicare. Our current doctor is not enrolled with Medicare and will not continue seeing us as Medicare patients.
Looking For Care

Dear Looking,
Depending on where you live, finding a new primary care doctor or specialist that accepts Medicare patients can be challenging. Because of low reimbursement rates and greater paperwork hassles, many doctors today have opted out of Medicare or they're not accepting new patients with Medicare coverage.

With that said, Medicare is now offering a service that makes finding Medicare-approved doctors a little easier. And, there are a number of good resources available today that can help you check up on prospective doctors for free. Here's what you should know.

Medicare Doctors
The government's new online "Physician Compare" tool is one of the easiest ways to locate doctors in your area that accept traditional Medicare. Just go to www.medicare.gov/find-a-doctor where you can do a search by physician's name, medical specialty or by geographic location. Or, if you don't have Internet access you can also get this information by calling 800-633-4227.

Keep in mind, though, that locating a Medicare-approved doctor doesn't guarantee you'll be accepted as a patient. Many doctors limit the number of Medicare patients they accept while others have a full patient roster don't accept any new patients. You'll need to call the individual doctor's office to find out.

Another option you may want to consider is to join a Medicare Advantage plan. These are government approved, private health plans (usually HMOs and PPOs) sold by insurance companies that you can choose in place of original Medicare. These plans may have more doctors available than original Medicare does. See www.medicare.gov/find-a-plan to research this option.

Doctor's Check Up
After you've found a few Medicare-approved doctors that are accepting new patients, there are plenty of resources available today that can help you research them. Some of the best include HealthGrades, Vitals and RateMDs. These are free doctor-rating websites that provide important background information as well as consumer comments and ratings from past patients. Here's a breakdown of what each site offers:

• Healthgrades.com provides in-depth profiles on around 750,000 U.S. physicians including their education and training, hospital affiliations, board certification, awards and recognitions, professional misconduct, disciplinary action and malpractice records. It also offers a 5-star ratings scale from past patients on a number of issues like communication and listening skills, wait time, time spent with the patient, office friendliness and more.
• Vitals.com provides some basic background information on around 720,000 U.S. doctors along with unedited comments from past patients and ratings on things like promptness, bedside manner, accurate diagnosis and more.
• Ratemds.com primarily offers ratings and anonymous comments from pastpatients.

It's a good idea to check out all three doctor-rating sites so you can get a bigger sampling and a better feel of how previous patients are rating a particular doctor.

Fee-Based Help
Another good resource to help you gather information is at angieslist.com (888-888-5478). This is a fee-based membership service that also offers doctors ratings and reviews from other members in your area for $7.60 for one month or $25 for the year.

Or, consider purchasing a copy of the "Consumers' Guide to Top Doctors." Created by Consumers' Checkbook, a nonprofit consumer organization, this book will help you find top-rated doctors that have been recommended by other doctors. Their database lists 24,000 physicians, in 35 different fields of specialty, in 50 metro areas. The cost for this guide is $25 plus shipping and handling (call 800-213-7283 to order a copy), or you can view the information online at checkbook.org/doctors for $25.

Discount Options for Retirees Headed Back to School

Dear Savvy Senior,
Are there any financial resources available to retirees who are interested in going back to college? Since I retired, I've been thinking about going back to school to study some topics of interest to me, but living on a fixed income I could use some financial help.
College-Bound Senior

Dear Senior,
There are actually numerous discounts, tuition waivers, tax credits and other deals that can help retirees go back to school a little cheaper. Here's what you should know.

Back to School
From continuing education and enrichment classes to graduate school, more and more retirees are heading back to the classroom looking to pursue their interest, connect with other people or retool for a new career. But with the high cost of college these days, paying tuition, fees and books can be a big strain for many older adults living on a fixed income. Here are some tips that can help you save.

Discounted Tuition
Your first step is to contact your nearby college to find out what, if any, deals they offer retirees. Many community colleges and some four-year colleges for example, allow senior citizens to audit classes for free and many offer significantly discounted tuition rates for those who take them for credit. In fact, according to Fastweb, a college financial aid resource, 21 states and Washington, D.C., offer free tuition for senior citizens at some or all of their public colleges. (Textbook costs and sometimes fees are however not covered.)

Credits and Deductions
Uncle Sam can offer some assistance too in the form of tax credits and deductions. For credits, check out the Lifetime Learning tax credit that allows students of any age to claim up to a $2,000 credit each year for college or other post-secondary school expenses. And the American Opportunity credit, which allows an annual tax credit up to $2,500. The government also provides tuition and fees deductions for students that can cover up to $4,000 in expenses. But, you can choose only one of these three tax breaks – Lifetime Learning credit, American Opportunity credit, or the tuition and fees deduction. To learn more about these benefits, visit the IRS's Tax Benefits for Education Information Center, which you can access at TaxBenefitsForEducation.info.

Scholarships
While most scholarships are aimed at traditional undergraduates, there are a number of scholarships offered specifically to adult and non-traditional students. Two good websites to help you find them are fastweb.com and scholarships.com, both of which offer huge scholarship databases and easy-to-use search tools.

Lifelong Learning
Beyond college classes, another popular and inexpensive option for retirees is Lifelong Learning Institutes (LLIs). These are noncredit educational programs that involve no tests or grades, just learning for the pure joy of it.

Usually affiliated with colleges and universities, LLIs offer a wide array of academic courses in such areas as literature, history, religion, philosophy, science, art and architecture, economics, finance, computers, lifestyle issues and more.

To find an LLI, call your closest college or search the websites of the two organizations that support and facilitate them – Osher and Elderhostel. Together they support more than 500 LLI programs nationwide.

If you don't find an LLI in your area, depending on where you live, there are other organizations that offer non-credit older adult education courses like Oasis (314-862-2933), Shepherd's Centers of America (816-960-2022), and SeniorNet (571-203-7100), which offers computer courses at learning centers around the country. Also, be sure to contact your local public library to see if it offers any programs for seniors.

How to Prevent Falls

Dear Savvy Senior
Can you write a column on fall prevention tips for elderly seniors? My 81-year-old father, who lives alone, has fallen several times over the past year. What can you tell us?
Concerned Daughter

Dear Concerned,
Falls are a big concern for millions of elderly Americans and their families. In the United States, roughly one-third of the 65-and-older population will suffer a fall this year, often with dire with consequences. But many falls can be prevented. Here are some steps you can take to help keep your dad up on his feet and reduce his risk of falling.

Check his meds: Does your dad take any medicine or combination of medicines that make him dizzy, sleepy or lightheaded? If so, gather up all the drugs he takes – prescriptions and over-the-counter – and take them to his doctor or pharmacist for a drug review.

Schedule an eye exam: Poor vision can be another contributor to falls. If your dad wears glasses, check to see if he's wearing the correct prescription and beware of bifocals. Multifocal glasses can impair vision needed for detecting obstacles and judging depth.

Check his balance: Balance disorders – which can be brought on by a variety of conditions like inner ear problems, allergies, a head injury or problems with blood circulation – are also a common cause of falls. If you dad is having some balance issues, make an appointment with his doctor to get it checked and treated.

Start exercising: Improving balance through exercise is one of the best ways to prevent falls. Strength training, stretching, yoga, tai chi are all great for building better balance. Some simple exercises that he can do anytime are walking heel-to-toe across the room, standing on one foot for 30 seconds or longer, or getting up from a chair and sitting back down 10 to 20 times. For more balance exercise tips, call the National Institute on Aging at 800-222-2225 and order their free exercise DVD and free exercise book or you can see it online at go4life.niapublications.org.

Modify his home: Because about half of all falls happen around the home, some simple modifications can go a long way in making your dad's living area safer. Start by picking up items on the floor that could cause him to trip like newspapers, books, shoes, cloths, electrical or phone cords. If he has throw rugs, remove them or use double-sided tape to secure them. In the bathroom put a non-slip rubber mat or self-stick strips on the floor of the tub or shower, and have a carpenter install grab bars inside the tub and next to the toilet. Also, make sure the lighting throughout the house is good, purchase some inexpensive plug-in nightlights for the bathrooms and hallways, and if he has stairs, consider putting hand rails on both sides. And in the kitchen, organize his cabinets so the things he uses most often are within easy reach without using a step stool. For more tips, call the Eldercare Locater at 800-677-1116 and order a free copy of their "Preventing Falls at Home" brochure.

Other pitfalls: Believe it or not, the improper use of canes and walkers sends around 47,000 seniors to the emergency room each year. If your dad uses a cane or walker, be sure it's adequately adjusted to his height and that he's using it properly. A physical therapist can help with this, or see the Mayo Clinic slide show on how to choose and use a cane and a walker. Another possible hazard is pets. If your dad has a dog or cat, he needs to be aware that – because they can get under foot – pets cause a lot of falls. Shoes are another issue to be aware of. Rubber-soled, low-heeled shoes are the best slip/trip proof shoes for seniors.

Savvy Tip: Consider getting your dad a home monitoring system which is a small pendent-style "SOS button" that he wears that would allow him to call for help if he fell. Available through companies like lifelinesys.com and lifealert.comthese systems cost around $1 per day.

How Work Can Affect Your Medicare Decisions

Dear Savvy Senior,
Dear Savvy Senior,
I'll be turning 65 this fall and I'm planning to work for a few more years. Do I have to sign up for Medicare if I am still working and receiving health insurance through my employer?
Working Retiree

Dear Retiree,
The rules for enrolling in Medicare can be confusing. But when you postpone retirement past age 65, as many people are doing these days, it becomes even more complicated. Here's what you should know.

The Basics
Let's start with a quick review. Remember that traditional Medicare has two parts: Part A which provides hospital coverage and is free for most people. And Part B, which covers doctor's visits and other medical services and costs $115.40 per month for new enrollees in 2011. If you're collecting a Social Security check, your Part B premium will be deducted automatically every month. If you are waiting to collect Social Security, however, your Part B premium will be billed to you quarterly.

Enrollment Rules
If you plan to continue working past the age of 65 and have insurance from your job, your first step is to ask your benefits manager or human resources department how your employer insurance works with Medicare. In most cases, you should at least take Medicare Part A because it's free. But to decide whether to take Part B or not, will depend on the size of the company you work for.

If there are fewer than 20 employees in the company, Medicare will be your primary insurer and you should enroll in Medicare Part B during your initial enrollment period – a seven-month period that includes the three months before, the month of, and the three months after your 65^th birthday. You can sign up online at socialsecurity.gov, or call 800-772-1213. If you miss the seven-month sign-up window, you'll have to wait until the next general enrollment period, which runs from Jan. 1 to March 31 with benefits beginning the following July 1. You'll also incur a 10 percent penalty for each year you wait beyond your initial enrollment period, which will be tacked on to your monthly Part B premium.

If, however, there are 20 or more employees in your company, your employer's group health plan will be your primary insurer. If this is the case, you don't need to enroll in Part B when you turn 65 if you're satisfied with the coverage you are getting through your job. But if you do decide to enroll in Medicare, it will supplement your employer insurance by paying secondary on all of your claims. In most cases, you should probably not drop employer coverage for Medicare. If you choose to take Medicare and drop your employer insurance, it may be very difficult for you to re-enroll in your employer plan should you decide to do so later.

In either case, you'll qualify for a special enrollment period, which will allow you to enroll in Medicare without penalty as long as you sign-up within eight months after you lose your group health coverage or you stop working, whichever comes first.

Drug Coverage
You also need to verify your prescription drug coverage. Call your benefits manager or insurance company to find out if your employer's prescription drug coverage is considered "creditable." (Creditable prescription drug coverage is one that is considered to be as good as or better than the Medicare prescription drug benefit.) If it is, you don't need to enroll in a Medicare Part D prescription drug plan. If it isn't, you should purchase a plan during your initial enrollment period or you'll incur a premium penalty (1 percent of the average national premium for every month you don't have coverage) if you enroll later.

Savvy Tips: For additional help, call Medicare at 800-633-4227 or contact your State Health Insurance Assistance Program (see shiptalk.org or call 800-677-1116) who offers free Medicare counseling. The Medicare Rights Center is another great resource that provides assistance at 800-333-4114.

Funeral Planning On a Budget

Dear Savvy Senior,
I just turned 75, and have been thinking about getting my funeral and burial arrangements taken care of so my kids won't have to. What funeral preplanning tips can you offer a senior with little money?
Not Dead Yet

Dear Not,
Planning your funeral in advance is a wise move. Not only does it give you time to make a thoughtful decision on the type of service you want, it also allows you to shop around to find a good funeral provider, and it will spare your kids the stress of making these decisions at an emotional time. Here are some tips to help you find affordable services.

Compare Providers
Choosing a quality funeral home is your first step and most important decision in preplanning your funeral. No matter what type of funeral or memorial service you envision for yourself, it's wise to talk with several funeral homes because prices and services can vary. Websites like funeraldecisions.com and funeralpricefinder.com can help you compare.

When comparing, be sure you take advantage of the "funeral rule." This is a federal law that requires funeral home directors to provide you with an itemized price list of their products and services so you can choose exactly what you want. Be sure to ask for it.

Money Savers

With the average cost of a "full-service" funeral running around $10,000, there are ways to save that few people know about. For example, if a traditional funeral and burial is what you're interested in, you can save big – at least 50 percent – by purchasing your casket from a store versus the funeral home, and your funeral provider must accept it. Two good casket shopping resources that may surprise you are Walmart (visit walmart.com and type in "casket" in their search engine) and Costco who offers its members a large variety of caskets and urns at discounted prices.

Another way to cut your funeral bill is to request a "direct burial" or "direct cremation." With these options your body would be buried or cremated shortly after death which skips the embalming and viewing. If your family wants a memorial service they can have it at the graveside or at later without the body. These services usually cost between $1,000 and $2,000, not counting cemetery charges.

Should You Prepay? Be aware that preplanning your funeral doesn't mean you have to prepay too. But if you are considering paying in advance, be cautious. Prepaid plans are not regulated by federal law and state regulation is uneven. Before you sign anything, here are some areas you need to be very clear on:

• Be sure you know exactly what you're paying for before committing.
• Are the prices locked in or will an additional payment be required at the time of death?
• What happens if you move to a different area or die while away from home? Some prepaid funeral plans can be transferred, but often at an added cost.
• Are you protected if the funeral home goes out of business or if it's bought out by another company?
• Can you cancel the contract and get a full refund if you change your mind?
• If you do decide to prepay, get all the details of the agreement in writing, have the funeral director sign it, and give copies to your family so they know what's expected.

Other Payment Option
There are other ways to set aside money for your funeral, rather than giving it to a funeral home. You can set up a payable-on-death, or POD account at your bank, naming the person you want to handle your arrangements as the beneficiary. With this type of account, you maintain control of your money, so if you need funds for medical expenses or something else, you can withdraw it at any time. This type of fund is also available immediately at the time of your death without the delay of probate.

New Flu Vaccine for Seniors Provides Better Protection

Dear Savvy Senior,
I've read that there is a new extra-strength flu vaccine being offered to seniors this year. What can you tell me about it, where can I find it, and does Medicare cover it?
Flu-Conscious Connie

Dear Connie,
The new extra-strength flu vaccination you're inquiring about is called the Fluzone High-Dose, and it's designed specifically for seniors, age 65 years and older. Here's what you should know.

Fluzone High-Dose
Manufactured by Sanofi Pasteur Inc., the Fluzone High-Dose vaccine was approved by the U.S. Food and Drug Administration in Dec. 2009, and was first made available last flu season on a limited basis.

The main difference between the Fluzone High-Dose and a regular flu shot is its potency. The High-Dose vaccine contain four times the amount of antigen (the part of the vaccine that prompts the body to make antibody) as a regular flu shot does, which creates a stronger immune response for better protection. This extra protection is particularly helpful to seniors who have weaker immune defenses and have a great risk of developing dangerous flu complications. The CDC estimates that the flu puts more than 200,000 people in the hospital each year and kills around 24,000 – 95 percent of whom are seniors.

As with all flu vaccines, Fluzone High-Dose is not recommended for seniors who are allergic to chicken eggs, or those who have had a severe reaction to a flu vaccine in the past.

To locate a vaccination site that offers the Fluzone High-Dose, ask your doctor or pharmacist, or check the online flu-shot locator at flu.gov for clinics or stores offering flu shots. Then, contact some in your area to see whether they have the High-Dose vaccine. CVS, Walgreens, Safeway, Kmart, Rite Aid and Kroger are among some of the chains offering the High-Dose shot.

You'll also be happy to know that if you're a Medicare beneficiary, Part B will cover 100 percent of the cost of your High-Dose vaccination. But if you're not covered the cost is around $50 to $60 – that's about double of what you'd pay for a regular flu shot.

Pneumovax
Another important vaccination the CDC recommends to seniors – especially this time of year – is the pneumococcal polysaccharide vaccine for pneumonia and meningitis (the vaccine is called Pneumovax 23). Pneumonia causes more than 40,000 deaths in the U.S. each year, many of which could be prevented by this vaccine. If you're over age 65 and haven't already gotten this one-time-only shot, you should get it now before flu season hits. Pneumovax 23 is also covered under Medicare Part B, and you can get it on the same day you get your flu shot. If you're not covered by insurance, this vaccine costs around $75 to $85 at retail clinics.

This vaccine is also recommended to adults under age 65 if they smoke or have certain chronic conditions like asthma, heart disease, lung disease, kidney disease, diabetes, sickle cell disease, have had their spleen removed, or have a weakened immune system due to cancer, HIV or an organ transplant.

Savvy Tips: In addition to getting vaccinated, the CDC reminds everyone that the three best ways to stay healthy during flu season is to wash your hands frequently with soap and water, cover your mouth and nose when you cough or sneeze and stay home if you're sick. For more information on the recommended vaccines for older adults see cdc.gov/vaccines.

Elder Mediation Can Help Adult Families Resolve Conflicts

Dear Savvy Senior
What can you tell me about elder mediation for resolving family conflicts? My mother has Alzheimer's disease, and to make matters worse, my three siblings and I have been perpetually arguing about how to handle her care and finances. Would this type of service be helpful to us?
Tired of Fighting

Dear Tired,
If your siblings are willing, elder care mediation may be just what your family needs to help you work through your disagreements. Here's what you should know.

Elder Mediation
While mediators have been used for years to help divorcing couples sort out legal and financial disagreements and avoid court battles, elder care mediation is a relatively new and specialized field designed to help families resolve disputes that are related to aging parents or other elderly relatives.

Family disagreements over an ill or elderly parent's caregiving needs, living arrangements, financial decisions and medical care are some of the many issues that an elder care mediator can help with. But don't confuse this with family or group therapy. Mediation is only about decision-making, not feelings and emotions.

The job of an elder mediator is to step in as a neutral third party to help ease family tensions, listen to everyone's concerns, hash out disagreements and misunderstandings, and help your family make decisions that are acceptable to everyone.

Good mediators can also assist your family in identifying experts such as estate-planners, geriatric care managers, or health care or financial professionals who can supply important information for family decision making.

Your family also needs to know that the mediation process is completely confidential and voluntary, and can take anywhere from a few hours to several meetings depending on the complexity of your issues. And if some family members live far away, a speaker phone or Webcam can be used to bring everyone together.

If you're interested in hiring a private elder care mediator, you can expect to pay anywhere from $100 to more than $400 per hour depending on where you live and who you choose. Or, you may be able to get help through a nonprofit community mediation service which charges little to nothing.

Since there's no formal licensing or national credentialing required for elder mediators, make sure the person you choose has extensive experience with elder issues and be sure you ask for references and check them. Most elder mediators are attorneys, social workers, counselors or other professionals who are trained in mediation and conflict resolution.

To locate an elder mediator, start by calling your area aging agency (call 800-677-1116 or see www.eldercare.gov to get your local number) which may be able to refer you to local resources. Or try websites like eldercaremediators.com and mediate.com. Both of these sites have directories that will let you search for mediators in your area. Or, use the National Association for Community Mediation website to search for free or low-cost community-based mediation programs in your area.

Savvy Tip: The Center for Social Gerontology provides some good information on their website including an online brochure titled "Caring for an Older Person and Facing Difficult Decisions? Consider Mediation."

How Seniors Can Stop Junk Mail and Prevent Mail Fraud

Dear Savvy Senior
How can I reduce the junk mail my elderly mother gets? She gets around 25 pieces of junk mail each day, and I just discovered that she's given away nearly $2,000 over the past year to many of the sleazy groups that mail her this junk. How can I stop this?
Frustrated Daughter

Dear Frustrated,
Millions of seniors get bombarded with unwanted junk mail these days, including mail fraud schemes that you and your mom need to be particularly leery of. Here's what you can do to help.

Senior Alert
While junk mail comes in many different forms – credit card applications, sweepstakes entries, magazine offers, coupon mailers, donation requests, political fliers, catalogs and more – the most troublesome type that all seniors need to beware of is mail fraud. This is the junkiest of junk mail that comes from con artists who are only trying to take your money.

Mail fraud can be tricky to detect because there are many different types of schemes out there that may seem legitimate. Some of the most common mail scams targeting seniors today are fake checks (see fakechecks.org), phony sweepstakes, foreign lotteries, free prize or vacation scams, donation requests from charities or government agencies that don't exist, get-rich chain letters, work-at-home schemes, inheritance and investment scams, and many more. If your mom is getting any type of junk mail that is asking for money in exchange for free gifts or winnings, or if she's receiving checks that require her to wire money, she needs to call the U.S. Postal Inspector Service at 877-876-2455 and report it, and then throw it away.

Unfortunately, once a person gets on these mail fraud mailing lists it's very difficult to get off. That's because these criminals regularly trade and sell mailing lists of people who they believe to be susceptible to fraud, and they won't remove a name when you request it. Knowing this, a good first step to help protect your mom is to alert her to the different kinds of mail fraud and what to watch for. The Postal Inspection Service offers some great publications and videos (see postalinspectors.uspis.gov) that can help with this. Another option is to see if you mom would be willing to let you sort her mail before she opens it so you can weed out the junk. You may want to have the post office forward her mail directly to you to ensure this.

If your mom feels compelled to donate to certain charities, ask her to let you check them out to make sure they're legitimate. You can do this through your state's attorney general or charity regulator's office – see nasconet.org for contact information. Or, at charity watchdog sites like charitywatch.org, give.org and charitynavigator.org.

Reduce Junk Mail
While scam artists aren't likely to take your mom's name off their mailing lists, most legitimate mail-order businesses will. To do this, start with the Direct Marketing Association which offers a consumer opt-out service at dmachoice.org. This won't eliminate all her junk mail, but it will reduce it. The opt-out service is free if you register online, or $1 by mail.

Then, to put a stop to the credit card and insurance offers she gets, call the consumer credit reporting industry opt-out service at 888-567-8688, and follow the automated prompts to opt her out for either five years or permanently. Be prepared to give her Social Security number and date of birth. You can also do this online at optoutprescreen.com. If you choose the permanent opt-out, you'll have to send a form in the mail.

Some other resources that can help are the National Do Not Call Registry (888-382-1222) which will cut down on your mom's telemarketing calls. And catalogchoice.org, a free service that lets you opt her out of the unwanted catalogs she receives.

Savvy Tip: If you don't want to hassle with stopping the junk mail yourself, you can hire a private company (like 41pounds.org or stopthejunkmail.com) to do it for you for a small fee.

Specialty Services for Seniors on the Move

Dear Savvy Senior
Are there organizations or businesses that specialize in helping seniors sell their house, find a new home and help them relocate to it? My wife and I are interested in downsizing from our home of 35 years, but need some help with the entire process. What can you tell us?
Slow Movers

Dear Slow,
The process of selling a house and moving to a new home, or downsizing to a condo or an apartment, is a huge job that can be physically and emotionally exhausting, especially for seniors. Fortunately, there are a variety of specialized services available today that can help make it a little easier. Here's what you should know.

Buying and Selling
To get help selling your home and finding a new one, a good place to start may be with a Seniors Real Estate Specialists (SRES). These are realtors that have received special training, making them better equipped to help older clients through major financial and lifestyle transitions involved in relocating, refinancing, or selling the family home.

SRES designees are educated and knowledgeable in such areas as reverse mortgages, senior housing options, downsizing, universal design, as well as ways to use pensions, 401k accounts and IRAs in real estate transactions. They can also help you steer clear of loan scams that victimize older borrowers. And if you need help from other professionals, a SRES can put you in touch with qualified home inspectors, movers, attorneys, CPAs and other experts.

To learn more or to search for a SRES in your area, visit sres.org or call toll-free 800-500-4564. The SRES Council also offers a free "Moving On" guide to help seniors with the decisions and transitions that come with moving. To get a copy, call their previously listed toll-free number or visit their website.

Making the Move
To help you get packed-up and move, another specialty service you should know about is "senior move managers." These are organizers who assist older people with the challenges of relocating, and can minimize the stress of this major transition by doing most of the work for you. They can help you pare down your belongings, decide what to take and what to dispose of, recommend charities for donations and help sell your unwanted items. They also get estimates from moving companies, oversee the movers, arrange the move date, supervise the packing and unpacking, have the house cleaned and just about anything you need related to your move. Costs vary depending on the services and size of the move, but you can expect to pay between $1,000 and $5,000, not including the cost of movers.

To locate a senior move manager visit the National Association of Senior Move Managers website or call 877-606-2766. But before you hire one, be sure you ask for references from previous clients and check them. Also find out how many moves they have actually managed, and get a written list of services and fees. And make sure they're insured and bonded.

If you can't find a senior move manager in your area, another option is to hire a certified professional organizer – many of whom offer moving/relocating services for seniors. To find one, check the National Association of Professional Organizers.

Social Security Benefits: What's taxable, what's not?

Dear Savvy Senior
Do I have to pay income tax on my Social Security benefits? I just turned 62 and am seriously considering early retirement. What can you tell me?
Ready to Retire

Dear Ready,
When you start collecting your Social Security retirement benefits, a portion of it might be taxable depending on your total income level and marital status. Here's what you should know.

Crunch Your Numbers
About one-third of people who get Social Security have to pay income taxes on their benefits. To figure out if your benefits will be taxable, you'll need to add up all of your taxable income from pensions, wages, interest, dividends and other sources, plus any tax exempt interest you earned (such as interest on municipal bonds) and one-half of your Social Security benefits. (You'll receive an SSA-1099 form in the mail each January reporting your Social Security benefits for the previous year.)

To help you with the calculations, get a copy of IRS Publication 915 "Social Security and Equivalent Railroad Retirement Benefits," which provides detailed instructions and worksheets. Worksheets can also be found in the IRS 1040 and 1040A instruction booklets. To receive any of these publications via mail, call the IRS at 800-829-3676 and order them.

Taxed or Not
After you do the math, Uncle Sam says that if you're single and your total income from all of the listed sources is:

• Less that $25,000, your Social Security will not be subject to federal income tax.
• Between $25,000 and $34,000, up to 50 percent of your Social Security benefits will be taxed at your regular income-tax rate.
• More than $34,000, up to 85 percent of your benefits will be taxed.

If you're married and filing jointly and the total from all sources is:

• Less that $32,000, your Social Security won't be taxed.
• Between $32,000 and $44,000, up to 50 percent of your Social Security benefits will be taxed.
• More than $44,000, up to 85 percent of your benefits will be taxed.

If you're married and file a separate return, you probably will pay taxes on your benefits.

How to File
If you find that part of your Social Security benefits will be taxable, you'll need to file using use Form 1040 or Form 1040A. You cannot use Form 1040EZ. You also need to know that if you do owe Uncle Sam, you'll need to make quarterly estimated tax payments to the IRS or you can choose to have it automatically withheld from your benefits.

To have it withheld, you'll need to complete IRS Form W-4V, Voluntary Withholding Request, and file it with your local Social Security office. You can choose to have 7 percent, 10 percent, 15 percent or 25 percent of your total benefit payment withheld. If you subsequently decide you don't want the taxes withheld, you can file another W-4V to stop the withholding.

State Taxes
In addition to the federal government, 14 states – Colorado, Connecticut, Iowa, Kansas, Minnesota, Missouri, Montana, Nebraska, New Mexico, North Dakota, Rhode Island, Utah, Vermont and West Virginia – tax Social Security benefits to some extent too. For details, check with your state tax agency or visit retirementliving.com – click on "Taxes by State."

Savvy Tip: For more information on taxable Social Security benefits call the IRS help line at 800-829-1040, or visit an IRS Taxpayer Assistance Center (see www.irs.gov/localcontacts) where you can get face-to-face help.

Eye Care Coverage and Services for Retirees

Dear Savvy Senior
Does Medicare cover eye care? I had excellent vision insurance through my employer for many years but lost it when I retired, and now am confused as to what Medicare actually covers. What can you tell me?
Living on a Budget

Dear Living,
Many retirees are confused with what Medicare will and won't cover when it comes to eye care. Here's a breakdown of how Medicare handles different types of vision care services, along with some additional tips that can help you get affordable care when needed.

Medicare Coverage
If you have original Medicare (Part A and B), it's important to know that "routine" vision care like eye exams, eye refractions, eyeglasses or contact lenses are generally not covered. But, "medically necessary" eye care usually is. Here's a list of what is covered:

• Eye surgeries: Any surgical procedure that helps repair the function of the eye like cataract removal, cornea transplant, glaucoma surgery, etc.
• Eyeglasses or contacts: Only if you've had cataract surgery.
• Medical eye exams: Only if you're having vision problems that indicate a serious eye condition like macular degeneration, retinopathy, glaucoma or dry eye syndrome.
• Glaucoma screenings: Annual screenings for those at high risk (have diabetes, a family history of glaucoma, are African-American or Hispanic).
• Diabetic eye exams: If you have diabetes, yearly exams for diabetic retinopathy.
• Macular degeneration: Certain treatments are covered.

You also need to be aware that of the eye care services that are covered by Medicare, you're still responsible for 20 percent of the cost – Medicare pays the other 80 percent. To help with this out-of-pocket expense, some Medigap supplemental policies provide gap coverage. Or, if you have Medicare Advantage, some plans provide eye care benefits. Be sure you check with your plan administrator.

Ways to Save
If you find your eye care needs aren't covered, or you can't afford the 20 percent out-of-pocket that Medicare doesn't cover, there are other ways to save. For starters, if you need a refractive eye exam or a new pair of eyeglasses, many optometrists and eyeglass dealers offer discounts – usually between 10 and 30 percent – to seniors who request it. Memberships in groups like AAA and AARP can also provide lower rates.

Another way to get low-cost eye care is at an optometry school. Many offer affordable care provided by students that are overseen by their professors. See opted.org for a directory of schools and their contact information.

Assistance Programs
Depending on where you live, there may also be some local clinics or charitable organizations that provide free or discounted eye care or eyeglasses. Put in a call to your local Lions Club to see what's available in your area. To reach your local club, visit lionsclubs.org or call 800-747-4448 to get the number to your state Lions Club office, which can refer you to your community representative.

Or, if you need medical eye care, check into EyeCare America. This is a national program that provides comprehensive medical eye examinations to seniors age 65 and older, and up to one year of treatment at no cost. They accept Medicare or other insurance as full payment. And if you don't have insurance, care is free. To learn more or to find out if you qualify, visit eyecareamerica.org.

If you're under age 65, some other services that can help include Mission Cataract USA, which provides free cataract surgery to low-income people who don't have insurance. Vision USA (800-766-4466), which provides free vision care to uninsured and low-income workers and their families. And the Knights Templar Eye Foundation (214-888-0220), which provides financial assistance for eye surgeries to low income people who don't have private insurance.