Seeking a ‘better than bingo’ solution for combating loneliness in older age

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Editor's Note: Journalist Philip Moeller is here to provide the answers you need on aging and retirement. His weekly column, "Ask Phil," aims to help older Americans and their families by answering their health care and financial questions. Phil is the author of the new book, "Get What's Yours for Medicare," and co-author of "Get What's Yours: The Revised Secrets to Maxing Out Your Social Security." Send your questions to Phil.


Barb: In the workplace, people come in contact with others on a regular basis and have, probably, many interactions daily. Then we go to a situation where your significant other is your only source of interaction, and if you are not married, it is highly possible that your only daily interactions are with the grocery store clerk. Is anyone studying what this does to people? Is anyone making significant inroads in insisting that we not isolate ourselves? Going from a busy workplace to a senior center does not cut it, at least not for me. Can you please watch out for and write about how retired people are getting together to counter boredom and isolation? I'm seeking a "better than bingo" solution.

Phil Moeller: Thanks for raising the issue of loneliness. There is a lot of behavioral research on loneliness. Google Scholar, which tracks research papers, returns more than a half million hits on "loneliness," including more than 15,000 so far in 2017.

A leading behavioral psychologist told me several years ago that the health effects of loneliness are comparable to smoking a pack of cigarettes a day!

There is no doubt that being cut off from others can produce devastating health effects, including shortened lives. Becoming less active in retirement, for example, is widely cited as a serious health issue. And with rising numbers of older Americans, growing life spans and the weakening of family structures, more seniors are living alone and facing the challenges of being isolated. A leading behavioral psychologist told me several years ago that the health effects of loneliness are comparable to smoking a pack of cigarettes a day!

Combating loneliness takes planning and work, and women generally are much better at this than men. While few would question the need for making long-term financial and even health care retirement plans, there is relatively little formal emphasis on making long-term plans for getting and staying involved in multiple social activities. Yet, like Barb, we know that the odds for leading a satisfying later life are higher when we have shared interests with other people and things to do with friends.

The health benefits of social interaction can radiate out in relationship "rings," beginning with tight family and friendship ties and extending out to part-time work, volunteering, religious groups and other group activities, including even interacting with strangers. That Starbucks barista who cheerfully makes your morning coffee can literally be better for your health than the proverbial apple a day.

As seniors age, it becomes increasingly important to develop and have friendships and social interactions with younger people. They can connect you with new ideas and activities, as well as countering the tendency for people to experience a bittersweet and isolating legacy of aging — outliving their friends.

The internet and related communications developments are making it easier than ever to discover other people who share your interests. These connections can range from relatively impersonal community events to much stronger bonding commitments. Affinity retirement communities, for example, are popping up everywhere, drawing groups of like-minded seniors. Whatever you like, there are other people near you who like the same things.

I wrote extensively about longevity and loneliness several years ago, in pieces for U.S. News & World Report. Here is an article about loneliness research. Next Avenue, a great site for seniors, has published several good pieces. Go to the site and search on loneliness to see them.


Erica – New Jersey: How can I determine how much I would save in total annual costs if I buy a Part D drug plan versus paying for medication without Part D insurance? Also, if I sign up for a Part D plan assuming I take certain drugs, and my medical status changes mid-year, can I revise my plan, or will I need to pay retail prices for new medications until the annual enrollment period comes around? This stuff if unbelievably complicated! I have a Ph.D., and am confused and overwhelmed by the daunting task of making these medical insurance coverage decisions.

Phil Moeller: You can use Medicare's plan finder to calculate how much you would pay for drugs on a Medicare Part D drug plan. If any of the drugs are really expensive, this likely will involve calculations involving the Part D donut hole and related Medicare silliness.

Then, I would find out the prices for these same drugs at your preferred pharmacy. This can be complicated, as it may include your use of pharmaceutical company discounts — something that Part D enrollees aren't allowed to use. There are drug pricing websites that can help. (I don't recommend specific sites, but a few minutes with a search engine should get you where you need to go.)

READ MORE: Here's how to find the Medicare Part D drug plan right for you

Prices for frequently prescribed generics are often similar at retail versus Part D plans. But as drugs become more expensive, the leverage of Part D plans kicks in and they should be able to provide you much better pricing than at retail.

When you get a Part D plan, it will cover you for any drug in its formulary. Obviously, you would need to be a psychic to know ahead of time whether a plan's formulary included a drug you did not yet need!

If I thought the odds were good that I'd be expanding my list of prescribed drugs, I'd tend to look for plans with broad formularies. It may be tempting to pick a cheap, low-premium plan. But you do get what you pay for or, in this case, what you don't pay for.


Wayne – North Carolina: Is there any advice on how to judge the potential future rate increases on Medigap plans based on issue type? I am in North Carolina, and most plans are attained-age policies with only one plan being issue-age type and one being community rated.

Phil Moeller: You are asking the right question. I have been asking it as well for years, and I am frustrated that I can't get good answers either. (For those unfamiliar with Medigap issue types, page 18 of Medicare's annual guide to Medigap explains them.)

I tried to get this information from the National Association of Insurance Commissioners (NAIC), the national membership group of state insurance departments. They said I could call each state and ask! I reviewed several state insurance department websites, but could not find historical information on Medigap rate increases.

READ MORE: Do you know how Medigap policies work?

My only suggestion, and it's of limited value, is to check out the claims-paying ratings of individual insurers. These are produced by the likes of Moody's and Standard & Poor's, and they evaluate the financial health of insurance companies. Over time, premium stability should be linked to financial stability. Of course, an insurer could be financially stable, because it had charged the highest premiums!

Sorry I can't be more helpful. If someone had a little money and a lot of time, this issue could be tackled by a crowd-sourced website that asked Medigap consumers what they paid for their policies at different points in time. Such entries would need to identify location and names of insurers.


Lee – Pennsylvania: I turn 65 in September and continue to work. My plan through work costs me $149.29 every two weeks (medical, dental and prescription coverage), and also includes $600 in annual contributions to a flexible spending account. I consider myself to be relatively healthy, and in the last few years, the only time I've gone to the doctor has been for my yearly physical, which is required by my employer as part of its wellness program. How do I decide if I should stay with my current employer plan or switch to Medicare and then select other plans to cover dental and prescriptions?

Phil Moeller: I cover all of this is in detail in my Medicare book, but here's a brief answer:

The premium for just Part B of Medicare will set you back $134 a month plus a $183 annual deductible. Part A has no premium but carries a stiff deductible of $1,316, and this is not for a whole year but just for each episode of coverage (usually, 60 days must separate your hospital stays to mark a new episode of coverage).

The monthly premium for a Part D drug plan is in the $40 range, with a deductible of up to $400 a year. Some plans absorb part of this deductible or, in the case of people who take only commonly prescribed generic drugs, waive it altogether. Here's a Medicare page summarizing these costs.

A Medigap supplement plan can set you back anywhere from about $100 to nearly $200 a month, depending on the type of plan you get. Medigap plans will pay the 20 percent of Part B expenses that basic Medicare doesn't pay. And while I know you said you're healthy, you really should make this comparison using the assumption that this will not be true in the future.

You would also need to add the cost of a dental plan. And what about vision and hearing? Medicare doesn't cover those either, except for operations related to cataracts and the like.

I hope these numbers help inform your efforts.


Karen – Washington: My husband is 66 and lost his job of 40 years after several cancer surgeries left him unable to work. He was forced to apply for Social Security at 62, because we needed the money. I will turn 65 this September and am deciding when and how to file for my benefits. I was the victim of a drunk driver about the same time he lost his job and still suffer with a TBI (traumatic brain injury), which contributes to my inability to sift through all the various information regarding Social Security benefits.

Phil Moeller: I'm sorry you and your husband have had such a rough time.

Because your husband has already filed for his own retirement, you are eligible to file for a spousal benefit based on his earnings record.

If you can wait until your full retirement age of 66 to file for this benefit, you would qualify to file a restricted application for this benefit while permitting your own retirement benefit to rise in value by 8 percent a year for up for four years. It would reach its maximum value when you turn 70.

READ MORE: How does Social Security's cost of living adjustment affect Medicare?

At 66, your spousal benefit would be half of what your husband would have received at his own full retirement age of 66. You should calculate what this benefit would be and then compare it to your own retirement benefit at age 70.

When you turn 70, you would either keep receiving the spousal benefit or, if your retirement benefit would be larger, file for that one. Social Security then should provide you an additional payment that is roughly equal to the amount by which your retirement benefit exceeded your spousal benefit.

If you feel you can't wait until age 66 to file, I understand. However, you should be aware that if you file for a spousal benefit before your full retirement age, it would trigger Social Security's deeming rules. Under these rules, the agency would consider you to be filing for both your spousal and retirement benefit at the same time. Both benefits would be subject to early claiming reductions, and you would get only the higher of the two benefits. In the process, you'd never be able to defer your own retirement benefit as you can if you wait until 66 and file a restricted application for just your spousal benefit.

I'm sorry this is so complicated. That's why we had to write an entire book about Social Security!

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