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It takes a number of strategies to stay healthy and vibrant late into life. Get plenty of sleep, exercise regularly and challenge your brain.

Numbers are importantto Jan Sirota, a retired investment banker who lives in Sarasota, Florida. Sirota just celebrated 11 years of marriage, he cycles 40 miles per day, mentors four high school students and races cars 150 miles per hour in High Performance Driver Education events. The number that doesn’t seem to matter?  His age.

“I’m 75, and it’s irrelevant to me,” Sirota says. “There’s no reason to say that I’ll slow down because I’m getting older.”

Many older adults do slow down, however, when faced with chronic disease, disability or isolation. So why is it that some people, like Sirota, can escape that fate and live vibrantly later in life? “Certainly genetics play a big part in this, and then of course luck. However, I don’t want anyone to think we can’t fight destiny a little bit,” says Dr. Patricia Harris, a geriatrician and professor at the David Geffen School of Medicine at UCLA.

Age-Related Changes

Some change is inevitable. We lose muscle and bone mass as we get older, and we experience a decline in sex hormones, kidney function, mental sharpness and reaction time. Cartilage in the joints often wears away and causes pain, digestion slows, balance becomes impaired and vision and hearing may decline. Chronic disease may also develop, such as cardiovascular disease or Type 2 diabetes.

A shift in social connections can also affect us in older age. Our children grow up and move away. We no longer see co-workers when we retire. People close to us – friends, siblings, a spouse – succumb to illness or dementia. This can lead to loneliness, isolation or depression, and a downward spiral.

“Loneliness is one of the biggest problems I see,” Harris says. “It leads to depression and a loss of motivation to manage health. People become sicker and frailer, which keeps them from getting out and socializing. It increases the risk for an early death.”

Early Action Steps to Age Well

Research is increasingly demonstrating that the way you take care of yourself today may have a big effect on your health later in life. For example:

Exercise: Studies have linked midlife fitness with reduced odds for developing chronic disease (such as Alzheimer’s disease, stroke and diabetes) later in life. “Exercise has been shown to reduce the risk for cardiovascular disease, muscle loss, obesity, depression, cancer and many other chronic diseases. It has a direct effect at the cellular level. It decreases systemic inflammation, fat in the body and LDL ‘bad’ cholesterol, and it increases HDL ‘good’ cholesterol, bone density and muscle mass,” says Dr. Saket Saxena, a geriatrician at Cleveland Clinic and clinical assistant professor of medicine at Case Western Reserve University School of Medicine.

Healthy Eating:Studies have shown that eating a healthy diet in midlife is associated with better health in our older years. “A Mediterranean-style diet is associated with longevity around the globe,” Saxena says. The diet includes a fair amount of fruits, vegetables, legumes, seeds, nuts, olive oil and whole grains, plus moderate amounts of fish, poultry and wine and low amounts of red meat and meat products.

Avoid Sunlight:Something else you can do now that may help later is avoid sunlight, according to Dr. Manjula Jegasothy, an aesthetic dermatologist and clinical associate professor of dermatology at the University of Miami’s Miller School of Medicine. “Extended UV radiation exposure over a lifetime can cause so much DNA damage that it hastens cell aging throughout the body,” Jegasothy says. “UV exposure also increases the risk of skin cancer. And from an appearance standpoint, UV exposure ages the skin.”

What if You’re Already Older?

If you haven’t taken great care of yourself over the decades, there are still lots of things you can do to make the most of the years ahead.

Follow the basics. “Time and again studies show true benefits of not smoking, keeping weight down and keeping major health conditions like high blood pressure, heart disease or diabetes well controlled,” Harris says. Aim for seven to eight hours of sleep each night to avoid fuzzy thinking and reduce the risk of falls.

Start exercising:“Exercise reduces stress levels in our bodies. It circulates oxygen to all tissues, which is good for the brain. It builds up strength, so you’re at less risk for falling and frailty.  And strong muscles make our bones hurt less,” Harris says. How much exercise do you need? The standard recommendation is 150 minutes per week of moderate intensity exercise, such as a game of tennis or brisk walking. “That’s daunting,” Harris says. “Consider that a goal, not an absolute. If you get out and walk regularly for three minutes when you hadn’t been walking at all, that’s a real accomplishment.”

Be Resilient:Learn to be resilient. Being able to bounce back from adversity, such as the loss of a loved one or a job, can help you cope with life’s ups and downs, stay active and avoid depression.

Socialize More: It helps fight loneliness, depression and isolation. If you’re far from loved ones, make new friends.  Join a club, volunteer or meet your neighbors. “The number of social interactions in a day or week improves life expectancy, even in people with heart disease and colon cancer,” Harris says. “It doesn’t have to be a best friend.  It can be someone in a coffee shop or the person at the cash register in the grocery store.”

Challenge Your Brain:We all can’t race cars like Sirota, but we can try a new a hobby, learn another language or take a class at a local college (many universities, including Harvard and Yale, allow you to take free classes online, although you won’t receive credit. “Staying mentally active in some way staves off dementia,” Harris says. “It has to be something that continues to engage your brain as you get older.”

Get Your Hearing Checked:“Hearing impairment can lead to a decline in socialization and mental stimulation, which can have an impact on activity, which can lead to depression and isolation, which can lead to functional decline and can reduce longevity,” Saxena says.

Reduce Stress:Chronic stress raises inflammation in the body. “People with higher levels of inflammation in the body, like C-reactive protein, have a more limited life expectancy,” Harris says. Try meditating, yoga or tai chi.

Live With Purpose:It’s associated with a reduced risk of cognitive decline and Alzheimer’s disease. Sirota says it just makes him feel good. He’s passing on his business experience to enterprising high schoolers. “It gives me incredible joy to help kids,” he says. You can live with purpose by volunteering, helping a family member or doing anything that gives you meaning.

The Bottom Line

Many aspects of health are related, such as isolation, depression and functional decline. It makes sense, then, that we need a combination of strategies to stay vibrant. “It really takes a lot of things to live longer and healthier,” Harris says.

For Sirota, that means doing as many activities as possible to enrich life. “Never step down your game,” he says. “There’s no reason to not keep doing something until something stops you.”

by Heidi Godman, Contributor – U.S. News & World Report

Feb. 23, 2018

 

If you have health insurance, you may think that all potential healthcare expenses are covered – or at least that you’ve done all you can to be covered.  However, you might want to look into critical-illness insurance.

First, a question for you.  What’s the No. 1 cause of personal bankruptcy?  Credit card debt?  Unmanageable mortgages after a job loss?  Gambling excesses?  Nope, nope, and nope.  The answer is unpaid medical bills.  The folks at NerdWallet.com have estimated that households containing about 1.4 million people filed for bankruptcy protection in 2017 because of steep medical costs – often associated with a serious illness.  And there are many other people with massive medical bills who avoid bankruptcy, but only by wiping out their savings and/or retirement funds.

What Is Critical-Illness Insurance and What Does It Do?

This kind of insurance exists simply to cover the major costs that result from a serious illness such as cancer, stroke, and heart attack.  If you are diagnosed with an illness that’s covered by the policy, you will receive all or a portion of the policy’s face value in a lump sum tax free.  The money can be used for anything you wish.  Yes, your health insurance will assist with the medical bills but there are deductibles, copays, and coinsurance to be accounted for, not to mention the costs associated with lost income, travel to distant treatment centers, and super-expensive medications.  What if the best place for your cancer treatment is out-of-state and/or your health insurance isn’t accepted there?

What Does Critical-Illness Insurance Cost?

Compared to long-term care insurance and disability insurance, critical-illness insurance is quite reasonably priced.  You can get coverage that will pay out a lump sum that ranges from $10,000 to $1 million.  For example, a 55-year-old can have a $30,000 critical-illness policy covering cancer, heart-attack and stroke for about $110.00 per month.  Of course there are some health questions to answer in order to qualify for the coverage, but for amounts under $100,000, the underwriting process is simple and quick.

So for a relatively small amount of cost, you can have a relatively large amount of peace of mind.

People with religious beliefs live around four years longer on average than those who don’t, according to recent research.

Scientists at Ohio State University arrived at the figure after studying over 1,000 obituaries from across the U.S. The team also factored in whether the person was married and their sex, which both can affect how long a person will live.

Laura Wallace, lead author of the study and a doctoral student in psychology at Ohio State University, said in a statement: “religious affiliation had nearly as strong an effect on longevity as gender does, which is a matter of years of life.”

To investigate whether religious beliefs could affect the age a person dies, the team first assessed over 500 obituaries in theDes Moines Register,a newspaper in Iowa, from between January and February 2012. They documented the age, sex, marital status, social and volunteer activities listed in the piece, as well as the religious affiliation of the deceased.

The data revealed that those whose obituaries included a religious affiliation lived 9.45 years longer than those who did not – which dropped to 6.48 when gender and marital status were factored in.

A second study involved over 1,000 obituaries from 42 major U.S. cities, published on newspaper websites in the year following August 2010. That analysis showed people whose obituaries included their religious affiliation lived an average of 5.64 years longer than those who didn’t. The average dropped to 3.82 years when gender and marital status were taken into account.

Building on previous studies which suggest that volunteering and social events can extend lifespan – both activities which are integral to many religious groups – the researchers combined their new data to unpick whether these explained the spike in longevity.

While they did play a part, the researchers behind the study published in the journalSocial Psychological and Personality Sciencebelieve they weren’t the only factors.

Lifestyle guidelines, such as abstaining from drinking alcohol or taking drugs, could explain the boost, as well as practices which ease stress, such as praying or meditating.

“There’s still a lot of the benefit of religious affiliation that this can’t explain,” said Wallace.

Furthermore, the relationship between religion and a person’s lifespan might also depend on the average religiosity of the city in which they live.

“The positive health effects of religion spill over to the non-religious in some specific situations,” Wallace said. “”The spillover effect only occurs in highly religious cities that aren’t too concerned about everyone conforming to the same norms. In those areas, non-religious people tend to live as long as do religious people.”

The researchers acknowledged their study was limited by the fact it could not control race and lifestyle choices, which are important factors for longevity.

This is the latest research to point to religion having life-boosting effects. In 2016, a study published in the journal JAMA Internal Medicinesuggested that regularly attending religious services can increase lifespan.

The team at the Harvard T.H. Chan School of Public Health analyzed data on around 75,000 middle-aged female nurses in the U.S., who were asked every four years between 1992 and 2012 about their lifestyle choices, including whether they attended a religious service regularly.

Those visiting church at least once a week were found to have 33% lower risk of death than those who never went.

by Kashmira Gander – Newsweek

June 14, 2018

Question:

What kind of discount can we expect in the Medicare Part D Donut Hole or Coverage Gap?

Answer:

Starting back in the 2011 Medicare Part D plan year, a discount or co-insurance (cost-sharing) was introduced to reduce the cost of generic and brand-name prescription drugs purchased by non-LIS Medicare beneficiaries once they entered the Coverage Gap (or Donut Hole / Doughnut Hole) portion of their Medicare Part D prescription drug plan (or Medicare Advantage plan that included prescription drug coverage).

If you reach the Donut Hole phase of your Medicare prescription drug plan andyour medication is on your plan’s formulary andyou are not receiving financial Extra Help (Low Income Subsidy):

• In 2019, you will receive a 70% discount on brand-name drugs and a 63% discount on generic drugs. (You will pay 25% of your plan’s negotiated retail cost for brand-name prescriptions and 37% of the retail cost for generics.)
• As a reminder, in 2018, you received a 65% discount on brand-name drugs and a 56% discount on generic drugs. (You paid 35% of your plan’s negotiated retail cost for brand-name prescriptions and 44% of the retail cost for generics.)

See the charts below for Donut Hole discounts 2011 to 2020.

Please note:The Donut Hole discount is not available to anyone receiving financial Extra Help (the Low-Income Subsidy).   Also, the Donut Hole discount is only for Medicare Part D drugs included on your Medicare prescription drug plan’s formulary or drug list.

The generic drug discountwill increase each year until the plan year 2020 when the co-insurance for generics in the Coverage Gap will be 25%.  The following table shows how the annual generic drug discount increases:

 

Generic Drug Discount
Plan Year	Beneficiary Cost-Sharing	Plan Cost-Sharing
2011	93%	7%
2012	86%	14%
2013	79%	21%
2014	72%	28%
2015	65%	35%
2016	58%	42%
2017	51%	49%
2018	44%	56%
2019	37%	63%
2020 and beyond	25%	75%

 

The brand-name drug discountoperates differently from the generic drug discount – but the brand-name drug discount will also be reduced to co-insurance of 25% in 2019.

 

Brand-Name Drug Discount
Plan Year	Beneficiary Cost-Sharing	Plan Cost-Sharing	Manufacturer Cost-Sharing
2011	50%	0%	50%
2012	50%	0%	50%
2013	47.5%	2.5%	50%
2014	47.5%	2.5%	50%
2015	45%	5%	50%
2016	45%	5%	50%
2017	40%	10%	50%
2018	35%	15%	50%
2019	25%*	5%	70%
2020 and beyond	25%	5%	70%

 

* President Trump signed the Bipartisan Budget Act of 2018 on Friday, Feb. 9, 2018 that effectively “closes” the Coverage Gap for brand-name drugs, with the brand-name Donut Hole discount increasing to 75% in 2019.

A key feature to the new law is that the pharmaceutical industry will be responsible for 70% of the cost of medications in the Coverage Gap, therefore you will receive credit for 95% of the retail drug cost toward meeting your 2019 total out-of-pocket maximum or Donut Hole exit point (the 25% of retail costs you pay plusthe 70% drug manufacturer discount.  As a note, since the brand-name drug manufacturer will take on an additional 20% of the retail cost, the Medicare Part D plan’s responsibility will decrease to 5% (from the originally planned 20% in 2019 and 25% in 2020 and beyond), the Medicare beneficiaries portion will decrease to 25% (from the original planned 30% in 2019).

Looking for more?  Related questions can be found here:

• If I reach the Coverage Gap and get a Donut Hole Discount on my brand-name drugs purchases, do I still get full retail credit toward meeting my Donut Hole exit point?
  
  
• What do I pay when the purchase of my medications moves me from my regular coverage into the Donut Hole? Do I get coverage from my plan or do I receive the Donut Hole Discount?

Humans have been living longer for decades, and a new study shows there is no ceiling in sight for lifespan.

A study published recently in the Journal of Science found that the death rate of seniors abruptly slows around 80 years old and then plateaus at 105 years old, which they interpreted to mean that humans are not close to a biological limit on how long they can live. The researchers examined records of Italians who had reached 105 years old between 2009 and 2015 (born between 1896 and 1910). Their search resulted in 3,836 people. After verifying their age with their birth certificates, the researchers examined which of those Italians had died during the study period to determine the rate at which different age groups died.  This study comes after a 2016 study by scientists at Albert Einstein College of Medicine which put the maximum human lifespan at about 115 years.

The new study focused on mortality rates, which are relatively high in infancy and decrease during a person’s early years. They then go up in a person’s thirties and drastically increase when people reach their seventies and eighties, according to the Centers for Disease Control and Prevention.

However, Elisabetta Barbi, a demographer at the University of Rome, and her team discovered that among very old Italians, the death rate stops rising around age 80, begins to decelerate and then plateaus after age 105.  “If there’s a fixed biological limit, we aren’t close to it,” Barbi told The New York Times.  Co-author of the study, Kenneth Wachter, a demographer at the University of California, Berkeley echoed Barbi.  “The plateau is sinking over time. We’re not approaching any maximum lifespan for humans yet,” he told the Times.

Although the study doesn’t explain why death rates plateau at 105, one possibility is that some people have genes that make them stronger than others, while some have genes that make them more frail. Weaker people will die off sooner, leaving only the more resilient people behind.

Written by: Alexa Lardieri – US News and World Report – June 29, 2018