New York Estate Planning Lawyer Blog

A recent study suggests that people with moderate to severe anxiety in middle age may be more likely to develop dementia as they get older. The study based its conclusions off of data from four previously published studies that tracked a total of 30,000 individuals over a 10-year period and clearly shows a link between living with anxiety in middle age and developing dementia later on in life.

The findings were published in the BMJ Open, a an online, open access journal, dedicated to publishing medical research from all disciplines and therapeutic areas. While the study was not a controlled experiment designed to prove whether or how anxiety might directly contribute to the development of dementia, it is nonetheless shines light on how mental health is just as important as our physical health as we age.

One of the study’s senior authors believes that dementia may develop after anxiety during middle age because of the increase in and constant elevation of stress hormones may cause brain damages across regions associated with memory. However, that same author is unsure whether treating the underlying anxiety and reducing the levels of elevated hormones would end up reducing the risk of dementia in old age.

The $1.5 trillion tax bill passed last year will likely have far reaching consequences on millions of seniors across the country, some good and some bad. While only time will truly tell how things will shape out, there are a number of areas many tax lawyers and elder law attorneys believe senior citizens and retired persons are likely to see an impact to their finances.

For the most part, the overwhelming majority of elder Americans will not see an increase to their taxes because most senior citizens have incomes that rely on Social Security which for the most part is not taxable at lower levels of income. Furthermore, because most older households do not itemize deductions they are not likely to see an impact because the new tax laws target taxpayer who have major itemized deductions on their taxes, particularly in states where there are high state and local income and property taxes.

The one proposed change to itemized deductions that did not make it into the final draft of the 2017 tax bill was the elimination of deductions for medical bills, a major deduction that would have had far reaching effects on senior citizens. An outcry from AARP, the National Academy of Elder Law Attorneys, the public, and other advocacy groups was successful in preventing any changes to itemizing medical bills and actually expands it for two-years.

High income retirees could see some of their Medicare premiums skyrocket up to 203 percent in 2018 due to shifts in the income brackets that are used to determine how much older Americans will pay for their Medicare Part B and Part D coverage. Those predictions come from an analysis by HealthView Services, a provider of health-care cost projection software used to prepare current and future retirees for the impact of health care costs which includes Medicare costs, long-term care expenses, and Social Security optimization strategies.

The additional surcharges for Medicare Part B, which covers preventive services, and Medicare Part D, which covers doctor visits, could end up diverting larger portions of the income seniors and future retirees expected to put towards their retirements. For example, a 55-year old couple earning a combined $140,000 could anticipate their lifetime Medicare surcharges rise by over $120,000 due to the changes to how the health-care program charges its beneficiaries, according to the Health View Services analysis.

The factors driving up the cost of Medicare for seniors comes from a 2015 bill known as the Medicare Access and CHIP Reauthorization Act or “DocFix” law which adjusted the way premiums are calculated for high-income individuals. The bill also lowered the range for the third, fourth and fifth-income brackets, which moved some retirees into the next higher bracket thus increasing their Medicare costs. Those changes began to take effect in 2108.

As more nursing homes and assisted living facilities begin to shift toward a more pet friendly approach to help accommodate the emotional needs of their residents, seniors and their families should begin to examine the pros and cons of living with pets where facility rules permit. In addition to accounting for size and weight restrictions of pets that facilities may impose, individuals need to consider whether or not their age and health allow them to properly care for the animal as well.

For elders who have lost a spouse, living with a pet can provide much needed companionship, emotional support, and to provide the unconditional love and support we all need. However, pets need medical attention of their own which includes trips to the vet for shots, checkups, and medical treatment. Furthermore, animals can suffer from their own health problems like arthritis, pneumonia, and even the flu.

Other issues like the health of the elder can affect whether or not it may be suitable to keep a pet in old age or in an assisted living facility as canes and walkers do not always make for a good mix with certain types of pets. Frail elders with balance issues or those with vision problems may not be safe with even small dogs that run, jump, or are otherwise rambunctious. Additionally, it is not fair to the animal if its owner cannot take it for a walk, necessitating outside care for the animal.

The U.S. Department of Labor is expected to release new guidelines that will allow small businesses to band together to purchase insurance for their workers with “association health plans” that could end up disrupting healthcare markets. The once common association health plans were attractive to scam artists that took advantage of the states’ inability to regulate these types of health care planes, leaving hundreds of thousands of patients with unpaid medical bills totaling over a quarter of a billion dollars.

Fortunately for patients, the Affordable Care Act (ACA) impose requirements on healthcare companies that effectively prevented association health plans from doing business because of the types of coverage plans needed to offer. For the most part, health insurance plans must offer coverage for the 10 essential health care benefits which include emergency services, habilitative and rehabilitative services, inpatient care, outpatient care, maternity and newborn care, mental health and addiction treatment, laboratory services, prescription drugs, and preventative services and chronic care treatment.

However, the loosening of these regulations could allow association health plans to become big enough that they may be considered “large group” insurance plans, which cover more than 50 individuals. These large group insurance plans are subject to far less state regulation and fewer ACA requirements than small-group or individual plans. In particular, large group insurance plans do not have to offer coverage for mental health services and other vital care mandated by the ACA.