by on November 4, 2021
                                    <h1>Unvaccinated? Don’t Count on Leaving Your Family Death Benefits</h1> <div>    <span class="byline">Michelle Andrews</span>         <time class="posted-on" datetime="2021-11-03T05:00:00-04:00">             November 3, 2021        </time>         </div> <p>These days, workers who refuse to get vaccinated against covid-19 may face financial repercussions, from higher health insurance premiums to loss of their jobs. Now, the financial fallout might follow workers beyond the grave. If they die of covid and weren’t vaccinated, their families may not get death benefits they would otherwise have received.</p>    <p>New York’s Metropolitan Transportation Authority no longer pays a $500,000 death benefit to the families of subway, bus and commuter rail workers who die of covid if the workers were unvaccinated at the time of death.</p><p>“It strikes me as needlessly cruel,” said Mark DeBofsky, a lawyer at DeBofsky Sherman Casciari Reynolds in Chicago who represents workers in benefit disputes.</p><p>Other employers have similar concerns about providing death or other benefits to employees who refuse to be vaccinated.</p><p>In Massachusetts, the New Bedford City Council sought to extend accidental death benefits to city employees who died of covid, but the mayor didn’t sign that legislation because, among other things, it didn’t prohibit payment if the worker was unvaccinated.</p><p>President Joe Biden has leaned hard on businesses to make sure their workers are vaccinated. In September, the <a href="https://www.whitehouse.gov/covidplan/#vaccinate">administration announced</a> all employers with 100 or more workers would be required to either ensure they’re vaccinated or test employees every week for covid.</p><p>Among employers, “there’s a frustration level, particularly at this point when these vaccines are fully approved,” said Carol Harnett, president of the Council for Disability Awareness, an industry group. “You’re trying to protect yourselves and your employees, both from themselves and the general public.”</p><p>The New York transportation authority is the highest-profile employer to take this action. Since the pandemic crisis began in 2020, 173 MTA workers have contracted covid and died. Five of those deaths occurred after June 1 of this year, when the policy changed, according to the MTA.</p><p>“We are not aware they have been vaccinated,” an MTA spokesperson said of the five workers who died since the policy took effect.</p><p>The transit authority’s policy was a shift from an earlier pact with workers. In April 2020, as covid ravaged New York, transit officials and the labor unions representing employees reached agreements that workers who died of covid would be eligible to receive a <a href="http://www.twulocal100.org/story/families-transit-worker-heroes-killed-covid-19-receive-500000-death-benefit-payments">$500,000 lump-sum death benefit</a>, just like payments to which families of MTA workers who have other job-related deaths are entitled. The program will continue through the end of this year.</p><p>But with covid vaccines now widely available and fully approved by the Food and Drug Administration, the MTA Board determined that, starting June 1, workers who died of covid had to have been vaccinated for their families to be eligible for the payment.</p><p>The change comes as the MTA has struggled to improve vaccination rates among its roughly 67,000 workers. More than 70% of transit employees are estimated to be vaccinated, according to MTA officials.</p><p>A spokesperson for the MTA stressed that the program remains in effect, and noted that it has been extended past its original one-year term. The only change is the vaccination requirement.</p><p>“The program is not being revoked,” the MTA spokesperson said in an email. “In fact, the MTA has twice extended it.”</p><p>Local 100 of the Transport Workers Union, which represents roughly 38,000 MTA workers, pushed hard to negotiate the benefit. “No other workforce in the city, probably the country, secured what TWU secured: a $500,000 payment from the employer to the families of workers who died after getting covid,” said Pete Donohue, a union spokesperson. “We look at it that during a terrible time, we got [the benefit] for people.”</p><p>It’s not unusual for employers of workers in risky occupations — such as police, firefighters, utility company workers and transit workers, who could succumb to an industrial accident or get hit by a train on the tracks — to offer extra insurance coverage that pays if they die on the job. The coverage is often provided in addition to a regular life insurance policy.</p><p>These so-called line-of-duty or accidental death and dismemberment policies typically don’t pay out if someone dies of a disease. How can it be proved that someone picked up a deadly infection at work rather than at the supermarket?</p><p>But with covid, some front-line workers have been considered eligible for accidental death benefits because they are <a href="https://www.debofsky.com/articles/covid-brings-disability-accidental-death-coverage-questions/">presumed to have gotten sick on the job</a>, DeBofsky said.</p><p>Workers may be denied death benefits, however, if they didn’t follow established safety protocols, said John Ehrlich, the national lead consultant at Willis Towers Watson on group life insurance. Failing to wear a bulletproof vest, a helmet or other safety equipment, for example, might make their families ineligible for payment under a policy.</p><p>Now that vaccines are widely available, some employers have considered limiting other benefits paid to unvaccinated workers, including reducing short-term disability payments, said Rich Fuerstenberg, a senior partner at benefits consultant Mercer. But Fuerstenberg said he had not heard of other employers eliminating death benefits for unvaccinated workers.</p><p>In the New Bedford case, the City Council unanimously passed a petition in August stating the covid death of any city employee would be considered to have occurred in the line of duty, enabling family members to receive accidental death benefits.</p><p>Mayor Jon Mitchell, however, objected for several reasons — the question of vaccination among them.</p><p>“As I am certain the Council would agree, it would be inappropriate to extend accidental death benefits where the employee refused to take a vaccine that had been found to be nearly 100% effective,” Mitchell said in a letter to the council. The proposal has been tabled for further negotiation, according to a spokesperson for the mayor.</p><p>For more than 17 years, Joseph Fletcher worked for the MTA in Brooklyn, doing body work and other maintenance on buses.</p><p>When he <a href="http://www.twulocal100.org/story/flatbush-bus-maintainer-joseph-fletcher-dies-virus">died of covid</a> on April 11, 2020, at age 60, he left behind his wife, Veronica, a former high school teacher who was disabled after a car accident, and three children, now 9, 13 and 16.</p><p>Coping with his death was hard enough, but looking toward the future has been overwhelming, Veronica said.</p><p>“How am I going to keep afloat financially?” she worried. “Everything about this journey is terrifying.”</p><p>The $500,000 death benefit helped cover the family’s regular bills and pay the mortgage on their Brooklyn home. But she’s aware it will go only so far, and her three children need to go to college.</p><p>If the MTA vaccination requirement had been in place when her husband died, it wouldn’t have been a problem, Fletcher said.</p><p>“I wish that my husband were able to have been vaccinated,” she said. “Knowing my late husband, he would have taken the opportunity to protect himself and his family.”</p><p><a href="https://khn.org/about-us">KHN</a> (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at <a href="https://www.kff.org/about-us/">KFF</a> (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.</p><h3>USE OUR CONTENT</h3><p>This story can be republished for free (<a href="https://khn.org/news/article/new-health-plans-offer-twists-on-existing-options-with-a-dose-of-buyer-beware/view/republish/">details</a>).</p><p><a href="https://khn.org/morning-briefing/">Subscribe</a> to KHN's free Morning Briefing.</p><img src="https://ssl.google-analytics.com/collect?v=1&t=event&ec=Republish&tid=UA-53070700-2&z=1636038065066&cid=cb6c66e2-5475-4adc-bd45-20c652871f2e&ea=https%3A%2F%2Fkhn.org%2Fnews%2Farticle%2Funvaccinated-workers-death-benefits%2F&el=Unvaccinated%3F%20Don%E2%80%99t%20Count%20on%20Leaving%20Your%20Family%20Death%20Benefits"/>             For more postings by Kaiser Health News, click Here                   Source Website
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by on July 9, 2021
If you’re a landlord and the income you get from tenants paying rent payments is the way you pay your own mortgage, taxes, insurance, and other costs, then when the rent comes in short—or not at all—you might find yourself struggling to make ends meet. Help is available. State and local governments are distributing billions of dollars in federal emergency rental assistance, and you may have a right to apply for it. Rental assistance isn’t just for tenants. Rental assistance can help you recoup lost rent. If you’re a landlord, you may think of rental assistance as help for renters. But at the moment, most programs require landlords to apply for assistance first. Payments are usually made to you directly. State and local programs are delivering money straight to landlords, utility companies, and other providers. You have a role to play. You may be able to apply for your tenants. Where tenants can apply, they may need your help to complete the application process. They usually Talso need your information in order to pay you. Learn more about rental assistance and help for landlords, and share this information with your tenants and professional networks. About the Bureau The Consumer Financial Protection Bureau is a 21st century agency that helps consumer finance markets work by making rules more effective, by consistently and fairly enforcing those rules, and by empowering consumers to take more control over their economic lives. Learn more at consumerfinance.gov. 
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by on January 16, 2021
By Jeff D. Opdyke If you're looking to get your hands on a second passport without having to buy or inherit it, then consider this less-costly, more-organic, nearly assured path: Move somewhere and gain citizenship—and a passport—via the naturalization process. That's not as difficult as it might sound. While lots of countries require that you live within their borders for a decade or longer before you can apply for citizenship, several impose a much-shorter timeline of between two and five years. And as a U.S. expat who's lived in Prague now for nearly two years, I can tell you those years fly by quickly. So, if you've ever given consideration to securing citizenship and a second passport, here are several countries where the process of citizenship-by-naturalization is relatively quick. Source:  https://internationalliving.com/a-second-passport-without-having-to-buy-or-inherit-it-trl/ For more International Living content, click HERE
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by on December 30, 2020
Check Your Bank Account. Your $600 Stimulus Check Could Already Be There by Robin Hartill, CFP® Senior Editor The waiting is the hardest part. Fortunately, for the second stimulus check, it will be incredibly short. The IRS announced Dec. 29 that the first direct deposit payments would be made that night — just two days after President Trump signed legislation approving the checks — and will continue throughout the week. Paper checks will start to be mailed today, Wednesday, Dec. 30. By comparison, the first round of checks arrived a little over two weeks after Trump signed the CARES Act into law in late March. The official payment date for the checks is Jan. 4, 2021. You may see the deposit listed as pending until then, according to the IRS news release. The IRS is under a tighter deadline to disburse the money this time around. While the process for getting the first payments out spanned several months for people getting checks by mail, this time payments must be made by Jan. 15, 2021. If you don’t receive your check by then, you can still get one if you’re eligible. But you’ll have to file a 2020 tax return and get the money as a refund recovery rebate. When to file? What to claim? Can I deduct that expense? Answer your tax questions -- and a lot more -- with The Penny Hoarder Daily newsletter What Do I Have to Do to Get My Payment? Nothing. The IRS has everything it needs to get your 600 bucks to you if: You filed a 2019 tax return You used the non-filer tool at IRS.gov to get your first check. (The tool is no longer available.) You receive Social Security, SSI, SSDI, Railroad Retirement System or VA benefits. This is important enough that it bears repeating: You do not have to do anything to claim your stimulus check. If anyone emails, texts or calls you claiming they need your information to get your stimulus check to you, it is a scam. A good rule of thumb is that if you got the first check, you’re all set to get the second one. If your bank account has changed since the first round, there’s no way to update it. Your bank will reject your deposit and the IRS will mail you your payment. If for some reason you didn’t get the first payment or you don’t get the second one, you’ll still be able to get both by filing a tax return. As of Dec. 30, the Get My Payment tracker at IRS.gov was offline, but the IRS says it will be available again in a few days. Are the Checks for $2,000 or $600? The payments are $600 for adults who can’t be claimed as a dependent and children 16 and younger. They’ll phase out at 5 cents for every $1 of income above $75,000 for single filers, $112,500 for heads of household and $150,000 for married couples who file a joint return. The House of Representatives approved a bill that increased the payments to $2,000, which President Trump was pushing for. But Senate Majority Leader Mitch McConnell blocked a vote on that bill. The only payments that have been approved are for $600, not $2,000, so don’t be surprised when your payment arrives. The IRS says if a higher amount is approved, payments that have been made “will be topped up as quickly as possible.” Robin Hartill is a certified financial planner and a senior editor at The Penny Hoarder. She writes the Dear Penny personal finance advice column. Send your tricky money questions to DearPenny@thepennyhoarder.com. Source:  https://www.thepennyhoarder.com/taxes/stimulus-checks-arriving/?aff_sub2=homepage
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by on December 19, 2020
People invest in gold because, in times of inflation and extraordinary amounts of money printing, gold and silver have a tendency to rise.   But do they? Astute investors see what precious metals are really doing… and that is maintaining purchasing power. Gold doesn’t go up in value, the dollar drops when priced in gold. Unfortunately, Uncle Sam doesn’t think that way... The way the IRS sees it, the dollar is not worth less – gold went up. And, if you want to realize that relative gain, you must pay taxes on it. And here’s the rub: real physical gold and silver get the short end of the stick on taxes... When you’ve held gold for a long time either in anticipation of a financial crisis or simply to preserve wealth… All looks good until you file your taxes and find out that – unlike equities and other capital gains, which get a favorable tax treatment – gold held for more than one year is taxed as collectibles, not investments. That means precious metals are taxed as high as 28%, much higher than long term capital gains. That’s a sizable bite out of your gains – just at the time you probably want to use that money for another investment. Thankfully, there is a simple way, open to every American, to change that. You just have to make one simple move... If you invest in gold inside a retirement account you could greatly reduce, or even eliminate, your tax bill on that investment.   You are probably already aware: investments inside a qualified retirement account in the US grow tax deferred, and in some cases they can even be withdrawn tax free. But did you realize this has a bigger impact on precious metals than on say stocks or bonds? That’s because if you sell your gold or silver for a profit inside an IRA, you don’t get hit with that large collectible tax bill. You can control when and how you are taxed. For example, because that cash stays in your retirement account – tax-deferred until you need to take it out – it can be reinvested in full, with no need to hold anything back for the tax man. If you post $100,000 in gains, for example, instead of paying taxes and then reinvesting the $75k or so left over into stocks, bonds, oil, or whatever is next for you… you get to invest the full lot, compounding the speed at which your investments grow. If you need to withdraw the money to live in retirement, there are still benefits. For example, because retirement gains are taxed as income when withdrawn, then taking your earnings out in smaller chunks over a few years can help keep your tax bracket down and minimize what you pay. And those examples are just if you are using a “traditional” or pre-tax retirement savings account – the run of the mill IRA or funds you rolled over from an old 401(k). If you are eligible for and savvy enough to have invested some dollars in a “Roth” account, then any of the gains you make on your gold will be tax free when you withdraw them, too. Same benefit to compounding growth and no taxes to worry about on the far end. The point is, investing in gold through an IRA gives you options... You get the flexibility and liquidity of a brokerage account with your choice of tax advantages for holding what many people view as the ultimate safe haven asset: physical precious metals. And ultimately, if the value of your gold rises and you want to rebalance when other assets are relatively cheaper, you get more hedge for your dollar. Perhaps no asset is more suited to an IRA than gold. That’s why Hard Assets Alliance has launched a new, easy and secure way to open a gold IRA and start enjoying all its benefits right away. Open a Gold IRA in 5 Minutes • Invest in physical gold or silver for retirement • Ability to enjoy tax benefits including income deductions and tax-deferred or tax-free distributions • Easily rollover from a 401k, or transfer from an existing IRA • With help from our expert custodian partners at Equity Trust available every step of the way • Get more hedge for your dollar invested by combining gold with an IRA For more postings by Hard Asset Alliance, click HERE Website:  https://www.hardassetsalliance.com/?aff=TWC WealthCare Connect may receive a referral fee from Hard Asset Alliance for purchases make through these links.
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by on January 4, 2021
Do you know how to win before trial? Lawyers drag out cases so they can bill for more time. You don't have to wait for trial to win! You aren't billing for your time! Many pro se litigants fail to do things "the right way" as JurisDictionary® explains. Then they get trapped into going through a full-blown trial where time constraints and nervous pressure makes winning difficult. If you have a winnable case, my course shows you how to win before trial. Do you have the winning facts and law on your side? Then learn how to win before trial! 1.    There is no evidence you cannot get in before trial. 2.    There are no witnesses you cannot question under oath before trial. 3.    There are no documents or things you cannot get in before trial. 4.    There are no legal arguments you cannot make before trial. 5.    There is nothing going to happen at trial that cannot be made to happen before trial. The "trying" of your case with the first pleading and continues with discovery and motions before trial. Common reasons cases go to trial are: 1.    Lazy lawyer didn't do the pre-trial work he could have done. 2.    Stupid lawyer didn't know how to do the pre-trial work he could have done. 3.    Greedy lawyer didn't want to do the pre-trial work he could have done. 4.    No lawyer had no idea how to do the pre-trial work that could have been done ... pri-trial work you will learn in this case-winning tactics course.. Don't wait for trial! 1.    Trial is uncertain, especially with unpredictable juries and crooked lawyers. 2.    Trial is "think on your feet" with opponent trying to throw you off with objections. 3.    Trial is a nasty battle against lawyers' willing to cheat if they can. 4.    Trial is a last bite at the apple, with no take backs and no retreats. Win before trial ... and do it without a lawyer! It's easier than you may imagine! Learn How to Win in Court – For information on the “How to Win in Court” online course, click HERE   For more JurisDictionary content, click HERE Website:  https://www.howtowinincourt.com?refercode=SR0094 WealthCare Connect may receive a referral fee from Juris Dictionary for purchases make through these links.
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by on December 16, 2020
** ‘AN ARM AND A LEG’: SHOPPING FOR HEALTH INSURANCE? HERE’S HOW ONE FAMILY TRIED TO PICK A PLAN ------------------------------------------------------------ Dan WeissmannDecember 16, 2020 _Can’t see the audio player? Click here to listen. (https://armandalegshow.com/) _ When host Dan Weissmann and his wife set out to pick a health insurance plan for next year, they realized that keeping the plan they have means paying $200 a month more. But would a “cheaper” plan cost them more in the long run? It depends. And the COVID pandemic makes their choice a lot more complicated. After trying to puzzle it out, Weissmann debriefs with Karen Pollitz, a health insurance expert at KFF, who knows about the angst of medical bills from personal experience. Health insurance can be painful, but the alternative ― not having health insurance ― is so much worse. If you want to go deeper on health insurance, you might want to check out these episodes from the first season of the podcast:     * In “Why You (and I) Will Likely Pick the Wrong Health Insurance (https://armandalegshow.com/episode/why-you-and-i-will-likely-pick-the-wrong-health-insurance-plan/) ,” we learn: Smart economists have proved it’s actually super hard — even they aren’t sure they’ll pick correctly.     * In an episode (https://armandalegshow.com/episode/why-health-insurance-actually-sucks/) inspired by KHN reporter Jenny Gold, we learn about insurance companies’ price-gouging. And often we end up paying the price.     * Inthe first-ever episode of this show (https://armandalegshow.com/episode/this-is-water-and-it-sucks-lets-talk/) , Weissmann’s family confronts the big puzzle: Can we even get insurance that’ll work for us?     * In “A ‘Deal’ on Health Insurance Comes With Troubling Strings (https://armandalegshow.com/episode/is-it-ever-appropriate-to-fudge-a-little/) ,” we go on a journey with a kinda-famous “financial therapist” who says she gets rattled when it comes to picking health insurance. And she’s pretty uncomfortable — morally, personally — with some of the choices she’s made. (Also, Weissmann’s family makes another cameo.) And here are some other helpful big-picture takes:     * Listener Anna Jo Beck made a really great booklet explaining how health insurance works (https://issuu.com/annajobeck/docs/bbbs8_issuu) . You can read it online.     * Weissmann borrowed some core insurance-picking advice — consider what a health plan does for you if you get hit by a bus — from this story by Zachary Tracer at Business Insider (https://www.businessinsider.com/how-to-pick-choose-health-insurance-plan-2018-10) , spelling out how he picked his insurance. Want to go a lot deeper? Especially if you’re actually looking at buying health insurance, maybe on the Obamacare exchange? Weissmann found healthcare.gov (https://www.healthcare.gov/) to be super usable this year, way better than the last time he checked. “I punched in the answers to a few questions, and got to quickly tell it which doctors our family sees (and what meds we take) … and it provided a clear list that showed which plans cover our docs, how much they would cost us, etc.,” he said.     * Subsidies are available for Affordable Care Act plans. KFF has this explanation of how they work (https://www.kff.org/health-reform/issue-brief/explaining-health-care-reform-questions-about-health-insurance-subsidies/) . It’s a slog, but thorough. Print it out, grab a snack and settle in. This bit of research explains that a lot of people qualify for a plan with no premium. (KHN, which co-produces “An Arm and a Leg,” is an editorially independent program of KFF.)     * KFF has a whole database of frequently asked questions about the ACA. (https://www.kff.org/faqs/faqs-health-insurance-marketplace-and-the-aca/?view=1) Hundreds of Q’s and A’s, including 180-plus in Spanish.     * Also great, also very thorough: The Georgetown University Center on Health Insurance Reforms has a whole site full of resources for navigating the ACA. (https://navigatorguide.georgetown.edu/) (It’s actually for “navigators” — folks who help civilians understand the sign-up process.) That’s a lot, right? Picking a plan can be overwhelming. But don’t let it get you down. “An Arm and a Leg” is a co-production of Kaiser Health News and Public Road Productions. To keep in touch with “An Arm and a Leg,” subscribe to the newsletter (https://armandalegshow.com/newsletter/) . You can also follow the show on Facebook (https://www.facebook.com/armandalegshow/) and Twitter (https://twitter.com/armandalegshow) . And if you’ve got stories to tell about the health care system, the producers would love to hear from you (https://armandalegshow.com/contact-us/) . _To hear all Kaiser Health News podcasts, click here (https://khn.org/news/tag/podcast/) ._ _And subscribe to “An Arm and a Leg” on iTunes (https://itunes.apple.com/us/podcast/an-arm-and-a-leg/id1438778444) , Pocket Casts (https://play.pocketcasts.com/web/discover/podcast/6e9e33e0-b911-0136-7b93-27f978dac4db) , Google Play (https://www.google.com/podcasts?feed=aHR0cHM6Ly9hcm1hbmRhbGVnc2hvdy5jb20vZmVlZC9wb2RjYXN0Lw%3D%3D) or Spotify (https://open.spotify.com/show/3wBgLSbYPKT3gnd9KGjz5t?si=jEMzB2soS_ayOsYbK0cmnQ) ._ Subscribe (https://khn.org/morning-briefing/) to KHN's free Morning Briefing. For more postings by Kaiser Health News, click HERE Website:  https://khn.org/          
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by on January 4, 2021
                                    Seniors Face Crushing Drug Costs as Congress Stalls on Capping Medicare Out-Of-Pockets     Harris Meyer              January 4, 2021                                                           This story also ran on Fortune. It can be republished for free.     Sharon Clark is able to get her life-sustaining cancer drug, Pomalyst — priced at more than $18,000 for a 28-day supply — only because of the generosity of patient assistance foundations. Clark, 57, a former insurance agent who lives in Bixby, Oklahoma, had to stop working in 2015 and go on Social Security disability and Medicare after being diagnosed with multiple myeloma, a blood cancer. Without the foundation grants, mostly financed by the drugmakers, she couldn’t afford the nearly $1,000 a month it would cost her for the drug, since her Medicare Part D drug plan requires her to pay 5% of the list price. Every year, however, Clark has to find new grants to cover her expensive cancer drug. “It’s shameful that people should have to scramble to find funding for medical care,” she said. “I count my blessings, because other patients have stories that are a lot worse than mine.” Many Americans with cancer or other serious medical conditions face similar prescription drug ordeals. It’s often worse, however, for Medicare patients. Unlike private health insurance, Part D drug plans have no cap on patients’ 5% coinsurance costs once they hit $6,550 in drug spending this year (rising from $6,350 in 2020), except for very low-income beneficiaries. President-elect Joe Biden favors a cap, and Democrats and Republicans in Congress have proposed annual limits ranging from $2,000 to $3,100. But there’s disagreement about how to pay for that cost cap. Drug companies and insurers, which support the concept, want someone else to bear the financial burden. That forces patients to rely on the financial assistance programs. These arrangements, however, do nothing to reduce prices. In fact, they help drive up America’s uniquely high drug spending by encouraging doctors and patients to use the priciest medications when cheaper alternatives may be available. Growing Expense of Specialty, Cancer Medicines Nearly 70% of seniors want Congress to pass an annual limit on out-of-pocket drug spending for Medicare beneficiaries, according to a KFF survey in 2019. (KHN is an editorially independent program of KFF.) The affordability problem is worsened by soaring list prices for many specialty drugs used to treat cancer and other serious diseases. The out-of-pocket cost for Medicare and private insurance patients is often set as a percentage of the list price, as opposed to the lower rate negotiated by insurers. For instance, prices for 54 orally administered cancer drugs shot up 40% from 2010 to 2018, averaging $167,904 for one year of treatment, according to a 2019 JAMA study. Bristol Myers Squibb, the manufacturer of Clark’s drug, Pomalyst, has raised the price 75% since it was approved in 2013, to about $237,000 a year. The company believes “pricing should be put in the context of the value, or benefit, the medicine delivers to patients, health care systems and society overall,” a spokesperson for Bristol Myers Squibb said via email. As a result of rising prices, 1 million of the 46.5 million Part D drug plan enrollees spend above the program’s catastrophic coverage threshold and face $3,200 in average annual out-of-pocket costs, according to KFF. The hit is particularly heavy on cancer patients. In 2019, Part D enrollees’ average out-of-pocket cost for 11 orally administered cancer drugs was $10,470, according to the JAMA study. The median annual income for Medicare beneficiaries is $26,000. Medicare patients face modest out-of-pocket costs if their drugs are administered in the hospital or a doctor’s office and they have a Medigap or Medicare Advantage plan, which caps those expenses. But during the past several years, dozens of effective drugs for cancer and other serious conditions have become available in oral form at the pharmacy. That means Medicare patients increasingly pay the Part D out-of-pocket costs with no set maximum. “With the high cost of drugs today, that 5% can be a third or more of a patient’s Social Security check,” said Brian Connell, federal affairs director for the Leukemia & Lymphoma Society. This has forced some older Americans to keep working, rather than retiring and going on Medicare, because their employer plan covers more of their drug costs. That way, they also can keep receiving financial help directly from drugmakers to pay for the costs not covered by their private plan, which isn’t allowed by Medicare. ‘This Is a Little Nuts’ All this has caused financial and emotional turmoil for people who face a life-threatening disease. Marilyn Rose, who was diagnosed with chronic myeloid leukemia three years ago, until recently was paying nothing out-of-pocket for her cancer drug, Sprycel, which has a list price of $176,500 a year. That’s because Bristol Myers Squibb, the manufacturer, paid her insurance deductible and copays for the drug. But the self-employed artist and designer, who lives in West Caldwell, New Jersey, recently turned 65 and went on Medicare. The Part D plan offering the best deal on Sprycel charges more than $10,000 a year in coinsurance for the drug. Rose asked her oncologist if she could switch to an alternative medication, Gleevec, for which she’d pay just $445 a year. But she ultimately decided to stick with Sprycel, which her doctor said is a longer-lasting treatment. She hopes to qualify for financial aid from a foundation to cover the coinsurance but won’t know until  sometime this month. “It’s just strange you have to make a decision about your treatment based on your finances rather than what’s the right drug for you,” she said. “I always thought that when I get to Medicare age I’ll be able to breathe a sigh of relief. This is a little nuts.”                                                                                  Given the sticker shock, many other patients choose not to fill a needed prescription, or delay filling it. Nearly half of patients who face a price of $2,000 or more for a cancer drug walk away from the pharmacy without it, according to a 2017 study. Fewer than half of Medicare patients with blood cancer received treatment within 90 days of their diagnosis, according to a 2019 study commissioned by the Leukemia & Lymphoma Society. “If I didn’t do really well at scrounging free drugs and getting copay foundations to work with us, my patients wouldn’t get the drug, which is awful,” said Dr. Barbara McAneny, an oncologist in Albuquerque, New Mexico, and past president of the American Medical Association. “Patients would just say, ‘I can’t afford it. I’ll just die.’” The high drug prices and coverage gaps have forced many patients to rely on complicated financial assistance programs offered by drug companies and foundations. Under federal rules, the foundations can help Medicare patients as long as they pay for drugs made by all manufacturers, not just by the company funding the foundation. But Daniel Klein, CEO of the PAN Foundation, which provides drug copay assistance to more than 100,000 people a year, said there are more patients in need than his foundation and others like it can help. “If you are a normal consumer, you don’t know much about any of this until you get sick and all of a sudden you find out you can’t afford your medication,” he said. Patients are lucky, he added, if their doctor knows how to navigate the charitable assistance maze. Yet many don’t. Daniel Sherman, who trains hospital staff members to navigate financial issues for patients, estimates that fewer than 5% of U.S. cancer centers have experts on staff to help patients with problems paying for their care. Sharon Clark, who struggles to cover her cancer drugs, works with the Leukemia & Lymphoma Society counseling other patients on how to access helping resources. “People tell me they haven’t started treatment because they don’t have money to pay,” she said. “No one in this country should have to choose between housing, food or medicine. It should never be that way, never.” This article is part of a series on the impact of high prescription drug costs on consumers made possible through the 2020 West Health and Families USA Media Fellowship. Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation which is not affiliated with Kaiser Permanente. USE OUR CONTENT This story can be republished for free (details). Subscribe to KHN's free Morning Briefing.                                  
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by on January 15, 2021
Are you ready for an inflationary storm? Inflation had already entered the system courtesy of the Fed printing over $3 trillion last year while the U.S. federal government paid out over $2 trillion in stimulus checks. Then Joe Biden won the presidency. Last week President Biden suggested a stimulus program that will be in the “trillions” with a price tag that will be “twice as high.” Democrats are also proposing massive infrastructure spending, healthcare programs, as well as the Green New Deal and other climate change policies. I’m not saying I’m for or against any of this. I’m simply pointing out that all of it involves printing TRILLIONS of dollars. And that is going to unleash inflation. The Fed’s own research shows that food inflation is the best predictor of future inflation. Take a look at what agricultural food prices are doing and you’ll see a decade-long bear market that is ending. Then of course there’s Gold which has already hit new all-time highs: Not to mention emerging markets. The writing is on the wall. All three of those asset classes are inflationary in nature. All three of them are exploding higher. Simply put, inflation is already in the financial system. And as history has shown us, the longer it’s there, the worse it gets. Those investors who are well positioned to profit from it could see literal fortunes. Regards, Graham Summers Editor, Money & Crisis For more postings by Hard Asset Alliance, click HERE Website:  https://www.hardassetsalliance.com/?aff=TWC WealthCare Connect may receive a referral fee from Hard Asset Alliance for purchases make through these links.
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by on December 15, 2020
This is the strangest holiday season of a lifetime, isn’t it? We get warnings about not visiting during holidays of all kinds and the rates of infection keep going up. Given that it’s inarguable now that the rates of infection by Covid-19, hospitalizations and ICU admissions are worse that ever, we have to consider the painful question before us: is it worse to visit our elders this season or is it worse to stay away? It’s individual, as situations vary. We see our aging parents, perhaps on Zoom, lonely and in need of company. We can talk on the phone with them, but there are many limitations. One 98 year old client of ours at AgingParents.com can speak on the phone but he’s quite hard of hearing. Calls tend to be brief. And he gets confused by Zoom. His company is his caregivers. At least they can come to his home and he can afford to pay for in-home care. Some seniors have little contact with others now in person. Technology is sometimes difficult enough for Boomers, and imagine how odd it feels for those Boomers’ parents, many of whom are in their 80s and 90s or older. For those with dementia, it is even worse. Difficulty learning new information is a characteristic of dementia and learning how to be on a video call is definitely new information for many. Yet, the emotions aging parents with dementia or other conditions feel are just as real as they are for anyone else. No one likes to be lonely and cut off from whatever fun they used to enjoy before the pandemic. Lonely aging parents need to be protected from exposure to Covid-19 When anyone asks me for advice about which is worse, possible exposure to Covid-19 from an asymptomatic person or serious depression and loneliness, I say possible exposure to disease. At least we have some ways we can address loneliness, as well as depression. We can make those phone calls to aging loved ones who are away from us, even if they’re very short because of hearing loss, confusion or anything else. We can try video calls when anyone in the house is capable of helping with logging on or using technology like FaceTime. We can coordinate with our aging parents’ physician, in the event that they are looking so depressed you are very worried about it. Medication does work for most depressed folks and Medicare pays for standard medications to treat depression. Adult children may need to be advocates for their loved ones about this. It’s unlikely that an aging person is going to tell their family they’re depressed and need medication to get by during isolation. Family can step up and ask for an evaluation of depression symptoms from the doctor. It makes sense to take the edge off painful feelings when we can, even temporarily, as current isolation finally has an end in sight. Pharmaceuticals for treating depression are readily available and they work with medical supervision for kind, dosage and eventually getting off the medications. What we know about Covid-19 now is what we knew early on when the disease ravaged nursing homes. Elders are by no means the only ones getting sick, but they have the worst mortality rate of any age group. Exposing them is not worth the risk of a holiday visit, painful as it is to forego it. They are just too vulnerable. For families who can’t bear the thought of not seeing Mom, Dad, or a grandparent during times when families always try to be together, consider that you could be saving lives if you refrain from the visit you want to have with them. I take comfort in knowing that apart from healthcare workers and those on the front lines of the fight against Covid-19, elders will be among the first to get the vaccine. That means that they have a better chance to get in front with protection and can avoid this life-threatening illness sooner than younger people can. The takeaway is that this holiday season is the time to grit your teeth and stay away from your aging parents unless you already live with them. It will not be long before we can use the first vaccines to save them from getting Covid-19. Meanwhile, do the best you can with the phone, gifts sent in the mail, flowers, cards, letters, and possibly video calls with them. Importantly, contact your aging loved one’s doctor and ask for an evaluation if what you see looks like serious depression. Appropriate medications can lift the spirits, help people function better, and help them feel more inclined to participate in whatever is offered to keep them engaged. And for all of us with elders in our lives, hang on a little longer. The vaccine will help us end this pandemic and enable us to look forward to a much better holiday season with aging parents next time around. You can feel good about staying away, as it is truly a responsible and loving act to protect those most vulnerable in our families. Carolyn L. Rosenblatt, R. N, Elder Law Attorney, co-founder of AgingParents.com and AgingInvestor.com
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by on January 5, 2021
                                    <h1>Hospital Prices Just Got a Lot More Transparent. What Does This Mean for You?</h1> <div>    <span class="byline">Julie Appleby, Kaiser Health News</span>     <time class="posted-on" datetime="2021-01-05T05:00:00-05:00">         January 5, 2021    </time>     </div> <p>Hospitals face the new year with new requirements to post price information they have long sought to obscure: the actual prices negotiated with insurers and the discounts they offer their cash-paying customers.</p><p>The move is part of a larger push by the Trump administration to use price transparency to curtail prices and create better-informed consumers. Yet there is disagreement on whether it will do so.</p><p>As of Jan. 1, facilities must publicly post on their websites prices for every service, drug and supply they provide. Next year, <a href="https://www.federalregister.gov/documents/2019/11/27/2019-24931/medicare-and-medicaid-programs-cy-2020-hospital-outpatient-pps-policy-changes-and-payment-rates-and">under a separate rule</a>, health insurers must take similar steps. A related effort to <a href="https://www.cms.gov/CCIIO/Resources/Regulations-and-Guidance/Downloads/CMS-Transparency-in-Coverage-9915F.pdf">force drugmakers to list their prices</a> in advertisements was struck down by the courts.</p><p>With the new hospital rule, consumers should be able to see the tremendous variation in prices for the exact same care among hospitals and get an estimate of what they will be charged for care — before they seek it.</p><p>The new data requirements go well beyond the previous rule of requiring hospitals to post their “<a href="https://healthcaremba.gwu.edu/blog/chargemaster-hospital-administrators-need-know/">chargemasters</a>,” hospital-generated list prices that bear little relation to what it costs a hospital to provide care and that few consumers or insurers actually pay.</p><p>Instead, under the new rule put forward by the Trump administration, “these are the real prices in health care,” said Cynthia Fisher, founder and chairman of Patient Rights Advocate, a group that promotes price transparency.</p><p>Here’s what consumers should know:</p><p><strong>What’s the Scope of the Intel?</strong></p><p>Each hospital must post publicly online — and in a machine-readable format easy to process by computers — several prices for every item and service they provide: gross charges; the actual, and most likely far lower, prices they’ve negotiated with insurers, including de-identified minimum and maximum negotiated charges; and the cash price they offer patients who are uninsured or not using their insurance.</p><p>In addition, each hospital must make available, in a “consumer-friendly format,” the specific costs for 300 common and “shoppable” services, such as having a baby, getting a joint replacement, having a hernia repair or undergoing a diagnostic brain scan.</p><p>Those 300 bundles of procedures and services must total all costs involved — from the hardware used to the operating room time, to drugs given and the fees of hospital-employed physicians — so patients won’t have to attempt the nearly impossible job of figuring it out themselves.</p><p>Hospitals can mostly select which services fall into this category, although the <a href="https://www.beckershospitalreview.com/finance/the-70-cms-mandated-services-hospitals-must-post-online-next-year.html#:~:text=Hospitals%20are%20required%20to%20publicize,230%20services%20they%20post%20online">federal government has dictated 70</a> that must be listed — including certain surgeries, diagnostic tests, imaging scans, new patient visits and psychotherapy sessions.</p><p><strong>Will Prices Be Exact?</strong></p><p>No. At best, these are ballpark figures.</p><p>Other factors influence consumers’ costs, like the type of insurance plan a patient has, the size and remaining amount of the annual deductible, and the complexity of the medical problem.</p><p>An estimate on a surgery, for example, might prove inexact. If all goes as expected, the price quoted likely will be close. But unexpected complications could arise, adding to the cost.</p><p>“You’ll get the average price, but you are not average,” said <a href="https://www.jhsph.edu/faculty/directory/profile/11/gerard-anderson">Gerard Anderson</a>, a professor of health policy and management at the Johns Hopkins Bloomberg School of Public Health who studies hospital pricing.</p><p>Tools to help consumers determine in advance the amount of deductible they’ll owe are already available from many insurers. And experts expect the additional information being made available this month will prompt entrepreneurs to create their own apps or services to help consumers analyze the price data.</p><p>For now, though, the hospital requirements are a worthy start, say experts.</p><p>“It’s very good news for consumers,” said <a href="https://business.lehigh.edu/directory/george-nation-iii">George Nation</a>, a professor of law and business at Lehigh University who studies hospital pricing. “Individuals will be able to get price information, although how much they are going to use it will remain to be seen.”</p><p><strong>Will Consumers Use This Info? Who Else Might?</strong></p><p><a href="https://zackcooper.com/">Zack Cooper</a>, an associate professor of public health and economics at Yale, doubts that the data alone will make much of a difference for most consumers.</p><p>“It’s not likely that my neighbor — or me, for that matter — will go on and look at prices and, therefore, dramatically change decisions about where to get care,” he said.</p><p>Some cost information is already made available by insurers to their enrollees, particularly out-of-pocket costs for elective services, “but most people don’t consult it,” he added.</p><p>That could be because many consumers carry types of insurance in which they pay flat-dollar copayments for such things as doctor visits, drugs or hospital stays that have no correlation to the underlying charges.</p><p>Still, the information may be of great interest to the uninsured and to the increasing number of Americans with high-deductible plans, in which they are responsible for hundreds or even thousands of dollars in costs annually before the insurer begins picking up the bulk of the cost.</p><p>For them, the negotiated rate and cash discount information may prove more useful, said Nation at Lehigh.</p><p>“If I have a $10,000 deductible plan and it’s December and I’m not close to meeting that, I may go to a hospital and try to get the cash price,” said Nation.</p><p>Employers, however, may have a keen interest in the new data, said James Gelfand, senior vice president at the ERISA Industry Committee, which lobbies on behalf of large employers that offer health insurance to their workers. They’ll want to know how much they are paying each hospital compared with others in the area and how well their insurers stack up in negotiating rates, he said.</p><p>For some employers, he said, it could be eye-opening to see how hospitals cross-subsidize by charging exorbitant amounts for some things and minimal amounts for others.</p><p>“The rule puts that all into the light,” said Gelfand. “When an employer sees these ridiculous prices, for the first time they will have the ability to say no.” That could mean rejecting specific prices or the hospital entirely, cutting it out of the employer plan’s insurance network. But, typically, employers can’t or won’t limit workers’ choices by outright cutting a hospital from an insurance network.</p><p>More likely, they may use the information to create financial incentives to use the lowest-cost facilities, said Anderson at Johns Hopkins.</p><p>“If I’m an employer, I’ll look at three hospitals in my area and say, ‘I’ll pay the price for the lowest one. If you want to go to one of the other two, you can pay the difference,’” said Anderson.</p><p><strong>Will Price Transparency Reduce Overall Health Spending?</strong></p><p>Revealing actual negotiated prices, as this rule requires, may push the more expensive hospitals in an area to reduce prices in future bargaining talks with insurers or employers, potentially lowering health spending in those regions.</p><p>It could <a href="https://www.nytimes.com/2019/06/24/upshot/transparency-medical-prices-could-backfire.html">also go the other way</a>, with lower-cost hospitals demanding a raise, driving up spending.</p><p>Bottom line: Price transparency can help, but the market power of the various players might matter more.</p><p>In some places, where there may be one dominant hospital, even employers “who know they are getting ripped off” may not feel they can cut out a big, brand-name facility from their networks, no matter the price, said Anderson.</p><p><strong>Is the Rule Change a Done Deal?</strong></p><p>The hospital industry went to court, arguing that parts of the rule go too far, violating their First Amendment rights and also unfairly forcing hospitals to disclose trade secrets. That information, the industry said, can then be used against them in negotiations with insurers and employers.</p><p>But the U.S. District Court for the District of Columbia disagreed with the hospitals and upheld the rule, prompting an appeal by the industry. On Dec. 29, the U.S. Court of Appeals for the District of Columbia <a href="http://www.steamboatinstitute.org/app/uploads/2020/12/AzarvsAHA_AppealsOpinion.pdf">affirmed</a> that lower-court decision and did not block the rule.</p><p>In a written statement last week, the American Hospital Association’s general counsel cited “disappointment” with the ruling and said the organization is “reviewing the decision carefully to determine next steps.”</p><p>Apart from the litigation, the American Hospital Association plans to talk with the incoming Biden administration “to try to persuade them there are some elements to this rule and the insurer rule that are tricky,” said Tom Nickels, an executive vice president of the trade group. “We want to be of help to consumers, but is it really in people’s best interest to provide privately negotiated rates?”</p><p>Fisher thinks so: “Hospitals are fighting this because they want to keep their negotiated deals with insurers secret,” she said. “What these rules do is give the American consumer the power of being informed.”</p><p><a href="https://khn.org/morning-briefing/">Subscribe</a> to KHN's free Morning Briefing.</p><img src="https://ssl.google-analytics.com/collect?v=1&t=event&ec=Republish&tid=UA-53070700-2&z=1609865513213&cid=d00b2cf1-c1ee-4755-84a1-fdb1dfde4eed&ea=https%3A%2F%2Fkhn.org%2Fnews%2Farticle%2Fhospital-prices-just-got-a-lot-more-transparent-what-does-this-mean-for-you%2F&el=Hospital%20Prices%20Just%20Got%20a%20Lot%20More%20Transparent.%20What%20Does%20This%20Mean%20for%20You%3F"/>                               
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by on December 30, 2020
Well known radio host and author Dave Ramsey has come out strongly against reverse mortgages. The truth is, Dave only likes 15 year fixed mortgages, or preferably cash when buying a home. For the sake of full disclosure, I am a Dave Ramsey fan, having facilitated his flagship program Financial Peace University in two different churches. And, I do offer reverse mortgages to senior homeowners. Dave is against debt. However, many wealthy people have become so because of leveraging debt on real estate, President Donald Trump being one of them. Baby boomers are the first generation that had to fund their own retirement. They survived the dot.com bust of the late 1990s and have recovered from the real estate correction and the Great Recession of 2008-9. They sent their kids to college and incurred the most student loan debt of any generation (parent plus loans). So, they are entering their golden years with more debt than their parents did. The silent generation was taught to pay off your home and pass it on to your kids. However, only 1% of children want their parents home, as they have homes of their own. For many senior homeowners, a reverse mortgage can help them: 1. remain at home; 2. retain ownership; 3. maintain their independence and 4. increase their cash flow. Recently someone sent me a clip about Dave ranting against reverse mortgages as a senior was being foreclosed on and going to lose their home. As I listened to this Dave says this senior didn’t pay their property taxes. Newsflash! If you don’t pay your property taxes you will ultimately lose your home to foreclosure, whether you have a mortgage, reverse mortgage or no mortgage. The county will get their money one way or another eventually. Now in a perfect world, Dave is right. Cash is king. However, most people don’t have $200,000-$700,000 cash laying around to buy a home. Also, with all the challenges they have faced in life, and not batting .1000 when it comes to their finances, there have been mistakes made. Rather than punish people, or be their financial judge, I want to give people a break and allow them to unlock and access their home equity, tax-free. Clients have told me they sleep better at night knowing they can remain in their home and not worry about making a mortgage payment on a fixed income. Here’s what retirement for a senior homeowner could look like. No mortgage payment Line of credit on a portion of their home equity that earns 4-6% a year compound interest guaranteed and protected from a real estate market correction A healthier 401k or IRA if they take the amount of their mortgage payments they are no longer making and fund their retirement account AND/OR they can buy a life insurance policy to replace any equity they may lose with a reverse mortgage, and if healthy enough add a long term care rider on it to protect their assets and leverage insurance for health care they may need  While they continue to work, possibly to age 70, they delay taking Social Security and then at age 70 they receive the maximum benefit  This is why I wrote my book, The Swiss Army Knife of Retirement Cash Flow, to show people that a reverse mortgage is a financial tool with many uses. Why would anyone, including Dave Ramsey, be against helping a senior increase their cash flow, have more certainty and sleep better at night in their golden years? 
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