Key Takeaways:An increasing number of older Americans struggle to afford the prescriptions they need to manage their conditions and stay healthy.As part of the Inflation Reduction Act, Medicare can now negotiate prices directly with drug companies to lower costs for both enrollees and taxpayers.Learn what this and other Medicare prescription drug changes mean for you or an older adult you care for. An increasing number of older Americans cant afford the prescriptions they need to stay healthy. In a recent study, roughly 1 in 5 people age 65+ took shortcutssuch as skipping doses or delaying refillsdue to financial worries.1 Said President Biden in a statement: For many Americans, the cost of one drug is the difference between life and death, dignity and dependence, hope and fear. That could soon change as a result of the Medicare Drug Price Negotiation Program. If you have Medicare, keep reading to find out how (and when) this program may affect you or an older adult you care for. What is the Medicare Drug Price Negotiation Program? The Medicare Drug Price Negotiation Program is part of the Inflation Reduction Act (IRA) of 2022, which includes several provisions to help lower prescription drug costs for people with Medicare. This provision will allow Medicarefor the first time everto negotiate drug prices directly with pharmaceutical companies. The goal is to improve the affordability of some of the most expensive drugs covered under Medicare Part B and Part D. Part B covers drugs administered by a physician. Reduced prices from drug negotiations for the first 10 drugs will take effect starting in January 2026. Going forward, the Centers for Medicare & Medicaid Services (CMS) will then select:         Up to 15 additional drugs to negotiate for 2027         Up to 15 additional drugs (including those under Part B) for 2028         Up to 20 additional drugs for 2029 and subsequent years Todays announcement is a game changer for the millions of older adults who rely on these medications every day," said Ramsey Alwin, NCOA President and CEO, in a statement on the start of drug price negotiations. "Our research shows that the cost of chronic conditions falls heaviest on women and people of color, who have the fewest resources. Lower prices are a matter of equity." A recent KFF survey showed strong bipartisan support (83%) for allowing the federal government to negotiate drug prices. Which prescription drugs will be negotiated? The drugs that qualify for Medicare price negotiation are from a list of high-cost, brand-name, single-source drugs that have no generic competition on the market. In 2022, Medicare enrollees paid a total of $3.4 billion in out-of-pocket costs for these medications. The 10 drugs selected for the first round of Medicare negotiation:         Eliquis: For preventing strokes and blood clots         Jardiance: For type 2 diabetes and heart failure         Xarelto: For preventing strokes and blood clots         Januvia: For type 2 diabetes         Farxiga: For chronic kidney disease         Entresto: For heart failure         Enbrel: For arthritis and other autoimmune conditions         Imbruvica: For blood cancers         Stelara: For Crohns disease         Fiasp; Fiasp FlexTouch; Fiasp PenFill; NovoLog; NovoLog FlexPen; NovoLog PenFill: Insulin products for diabetes How will these changes affect me? Once fully implemented, the Medicare Drug Price Negotiation Program is expected to drop prices on negotiated drugs for up to 9 million older adults, who now pay as much as $6,497 out of pocket each year for these medications. People with Medicare will have better access to prescription drugs that help them manage chronic and life-threatening conditions. More older adults will be able to start medications, take them appropriately, and stay on them without making potentially dangerous trade-offs. Experts predict the program will also save taxpayers $160 billion by lowering Medicare costs. Other Medicare prescription drug provisions In addition to drug price negotiation, there are several other important provisions in the Inflation Reduction Act designed to lower healthcare costs for people with Medicare. Several provisions have already taken effect:         Medicare will cover a greater portion of the cost for high-quality biosimilars (drugs made from a natural source) for a period of five years, which began October 1, 2022.         Monthly out-of-pocket cost sharing for insulin is capped at $35.         Vaccines recommended by the Advisory Committee on Immunization Practices (ACIP) are 100% free.         Drug manufacturers that raise their prices at a faster rate than inflation will face a financial penalty. Starting in 2024:         The 5% coinsurance for catastrophic drug costs will be eliminated.         Eligibility for the full Medicare Part D Low-Income Subsidy (LIS, also called Extra Help) will be expanded to beneficiaries with incomes up to 150% of the federal poverty level. LIS lowers premiums and out-of-pocket costs for prescription drug coverage.         From 2024-2029, annual Part D premium increases will be capped at 6%. Starting in 2025:         There will be a $2,000 annual cap on drug out-of-pocket costs. This could save beneficiaries $400 each year on prescription drug costs. Enrollees with the highest out-of-pocket drug costs could save $2,500 per year. In addition, the Medicare Prescription Payment Plan provision will allow enrollees to pay their out-of-pocket prescription costs in the form of fixed monthly payments over the course of the plan year (instead of all at once). These key provisions will help promote equitable aging by making vital medications affordable for more older Americans, says Josh Hodges, NCOAs Chief Customer Officer. Reducing drug costs will serve to improve the Medicare program now and ensure it remains strong and solvent for future enrollees. The Inflation Reduction Act also extends premium subsidies for the Affordable Care Act (ACA) Marketplace into 2025. As a result, an estimated 10 million people will save about $700 annually on their healthcare premiums. Source 1. Stacie B. Dusetzina, PhD et al. JAMA Network. Cost-Related Medication Nonadherence and Desire for Medication Cost Information Among Adults Aged 65 Years and Older in the US in 2022. May 18, 2023. Found on the internet at https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2805012This article was written by the National Council on Aging, September 14, 2023.

Understand what the financial picture looks like.With so many senior living options at so many different price points, it can be hard to know which option is best for you and your loved one. Before making a decision, its important to understand the different types of residences available to youand their associated costs.Evaluating Your Housing NeedsWhen determining senior housing costs, your first step is to decide which type of housing your loved one needs. There are a wide range of options and care services available for senior living, including:Independent livingAssisted living communitiesAssisted living homesAlzheimers and dementia careIn-home companion careSkilled nursing careAssisted living is often less expensive than in-home care. Costs will also vary depending on unit sizefor example, a studio, versus a one or two-bedroom apartment. The average nationwide cost for a private, one-bedroom apartment in an assisted living residence is about $3,000 per month. And just like general housing, there is a wide difference in senior housing and care costs depending on which part of the country in which you live. Your local Assisted Living Locators Care Advisor can tell you about the costs in your area.Additional Senior Housing CostsWhen evaluating senior housing options, be sure to ask about:Pricing models. Most assisted living communities have a base rate for the room and a tiered pricing add-on that varies based on the level of care required. The more care that is required, the higher the care add-on price. Other residences may be all-inclusive, a la carte, or charge on a fee-for-service basis.Additional fees. The base rate for senior housing typically covers room and board, meals, housekeeping, activities and 24-hour onsite support. Additional charges may include entrance fees, deposits, and fees for other services such as transportation, laundry, pets and cable.Lease length. Most assisted living residences charge on a month-to-month basis, but some may require a more long-term arrangement.Determining Your BudgetMany senior living residents and their families pay for senior housing costs through private financial resources. Long Term Care Insurance (LTCI) is also a way families defray costs. Many communities also operate on a spend down model, where the senior pays privately for their housing and care for an agreed upon period of time, and once their financial resources are depleted, they are transitioned into state provided Medicaid assistance. These policies and procedures can vary by state; contact your local Assisted Living Locators Care Advisor in your area for the rules in your community.How Much Can You Afford?When trying to calculate what you can afford for independent retirement, assisted living or dementia/Alzheimers care, the place to start is figuring out your current expenses. When a person moves into one of these communities, almost all day to day expenses are covered. Usually, the only additional out-of-pocket costs are a phone, cable, out of pocket medical, and petty cash for entertainment, clothes or sundries.Monthly CostRent or Mortgage$Utilities$Repairs/Maintenance$House Cleaning$Property Taxes$Enhanced Cable Service/Internet$Home Insurance$Security$Food$Local Transportation$Leisure Activities$Personal Assistance$Other$Total ExpensesFinancial Assistance OptionsWe know you want the very best for your loved one. If your budget is limited, that doesnt mean that you cant afford suitable care. There are several government programs to help subsidize senior housing costs.Medicare. While neither Medicare A nor B offer coverage for assisted living, Medicare A (hospital insurance) may cover costs incurred in a skilled nursing facility for the first 100 days after being released from hospitalization for an acute illness or injury. Ask Medicare can provide more information on these benefits, plus other helpful tools to help you make informed health decisions for your loved one.Medicaid. Medicaid, which provides federal health-care assistance to lower-income Americans, is the biggest payer for room, board, nursing care, and social activities in nursing homes. Many states cover some assisted living services under their Medicaid programs. With the Assisted Living Housing Waiver, eligible low-income adults can choose to receive senior living care services in a community-based setting rather than in a nursing facility.Housing Subsidies. Seniors with annual incomes under $12,000 may qualify for U.S. Department of Housing and Urban Development 202 and Section 8 senior housing. This can provide rent subsidies to help you pay for room-and-board at either an independent or assisted living residence.Veterans Subsidies. Aid and Attendance is a benefit paid by Veterans Affairs (VA) to veterans, veterans spouses or surviving spouses. Long-term care insurance is an insurance product that helps pay for the costs associated with long-term care. Long-term care insurance covers care generally not covered by health insurance, Medicare, or Medicaid. Additionally, in certain instances an in-force life insurance policy contains an assisted living rider or can be converted into a long term care insurance product.For more information and advice on financing senior living or memory care services, you can visit the Center for Long-Term Care Financing, AARP, the National Association of Insurance Commissioners, and Americas Health Insurance Plans.

A recent survey by the American Advisors Group (AAG) finds that 55 percent of adult children say they're not financially prepared to help their Baby Boomer parents cope with rising inflation and living expenses.Americans want to see their parents age with grace and dignity and have the resources they need to live comfortably, but for many families the current economy is making that difficult, AAG Chief of Marketing Martin Lenoir said in a news release.AAG surveyed more than 1,500 adult children, ages 40 to 55, across the country. Known as the sandwich generation, this group faces the responsibilities not only of raising their children, but also of serving as caregivers for their aging parents. Among the surveys other key findings:More than a third of adult children say they worry that their parents will become a financial burden for them. Nearly 60 percent say they cannot afford any kind of professional elder care for their parents.Yet almost half admit they've never broached the subject of finances with their senior parents. A full 50 percent of them don't know how much debt their parents are carrying.1 in 3 Adult Children Already Assisting Their Parents Financially Another survey, conducted in 2020 by GoHealth, Inc., explored GenXers and millennials involvement in their parents financial and health care needs. It found that one in three GenXers and millennials are supporting their parents financially. Nearly the same number are managing, or helping to manage, their parents health care.The surveys 2,000 GenX and millennial respondents also reported the following:On average, they spend 11.5 hours per week managing their parents health care by providing transportation, scheduling doctor visits, and explaining insurance claims. They also estimate theyll spend 14 to 16 years continuing to do so.2 in 5 spent more than $10,000 of their own money supporting their parents in 2020.The vast majority (86 percent of GenXers and 82 percent of millennials) worry about having enough money to support themselves and their parents. Squeezing the Sandwich GenerationAdult children will continue to feel the pressure for the foreseeable future. Every day, on average, 10,000 Boomers (those born between 1946 and 1964) reach age 65, and another 10,000 of them turn 75. According to research by the Blackstone Group, an independent research firm, nearly 80 percent of middle-income Boomers don't have any savings designated to cover their retirement care. Meanwhile, 30 million Boomers retired from the workforce amid the COVID-19 pandemic. Saddled with college debt, as well as rising inflation and housing costs, those GenXers and millennials who still depend on their parents for financial assistance or housing may no longer be able to count on that support.Have The TalkIts important for families to have an honest and respectful financial conversation before a medical event occurs or the need for care arises. Talking about money with aging parents can be a delicate matter, but its necessary to understand both the degree of care that may be needed and the financial resources available to provide it.For help planning for the future of your Boomer parents, or for your GenXer and millennial children, consult a qualified attorney in your area.

With the holidays approaching, if your senior loved one wants to travel, get them where they need to go safely, and with minimal stress.  Below are a few tips to make holiday travel a seamless process that will keep them comfortable, relaxed and arriving at their destination with ease.Prepare documents and medicationsWhen booking flights, get as much information as possible. Having an informational packet put together will help everyone know what to expect and feel prepared.Your packet should include:       Flight departure / arrival times       Transportation options to and from the airport       Terminal maps and gate locations       Medication regulations and necessary documents       TSA safety check processLook through the TSA website to learn about which medications are allowed and how to communicate with an officer about medically necessary bottles or containers. Request copies of prescriptions and statements of medical conditions from each physician and medical center for verification. Make photocopies of passports, drivers license, insurance cards, travel tickets and the trips itinerary provides a backup in case of any unforeseen emergencies. Many seniors no longer have a drivers license, which can present a problem when going through airport security. Be sure that the individual has state ID, military ID, passport, or similar credential. Keep one set of copies with you, place a set of the documents in your seniors carry-on bag and forward a set of the documents to the destination. Consider insuranceWhen traveling, seniors are at greatest risk of being in need of a health care emergency.  The right insurance package for ones age group can protect their health and give you peace of mind.Health Insurance: If traveling within the United States, be sure to look up what hospitals accept your health insurance and if there is coverage during travel. If going abroad, look at buying a travel medical plan or vacation plan that includes medical emergencies.Trip Insurance: There are a few different options when choosing trip insurance. For seniors, there can be unexpected delays due to appointments, or medical clearance delays. Therefore, it is ideal that trip cancellation protection is provided.If your loved one is nervous about the upcoming trip, let them vent and answer their concerns.  Be calm and optimistic.  Remember that all of this preparation is worthwhile.    Editors Note:  This article was submitted by Apryl Garrett, Publisher of the Seniors Blue Book of Greater Pittsburgh.  She can be reached at 412-551-5951 or by email at Apryl@SeniorsBlueBook.com.