By Betty Berry, Tuesday, Nov. 16, 2010 Q: I am hearing more and more about elder abuse. What is considered elder abuse and if I suspect it who can help?
A: Elder abuse is a growing concern for the many agencies and individuals serving the senior population. Abuse can be inflicted in numerous ways. It can be actual physical, emotional or financial abuse or it can be a result of neglect or abandonment. It can also be self-neglect.
Physical abuse is any pain or injury inflicted by a person in charge of care or in a position of trust. It is probably the easiest type of abuse to recognize.
Emotional abuse is willful infliction of mental suffering. Examples are verbal assaults, threats, harassment and even isolation. It is more difficult to detect and usually exists for quite some time before discovery.
Financial abuse is defined as any theft or misuse of an elder’s assets by a person in a position of trust. Its detection is sometimes made difficult by the way an elder has elected to hold title to their assets.
Neglect can result from failure of a caregiver to provide reasonable personal hygiene care, medical care or protection from health and safety hazards. Abuse also occurs from self-neglect when elders fail to provide for themselves through inattention or inability to manage.
Abandonment is considered the desertion of an elder by someone who is responsible for the care and custody of a senior when the person cannot manage for himself or herself.
Suspicion of any type of elder abuse should be reported. Adult Protective Services can be reached at 654-3200. If the elder is in a long-term care facility, contact the Long Term Care Ombudsman at 656-1986.
Q: I retired before age 65 and have healthcare benefits from my employer. Will this be considered a Medicaresupplement when I enroll in Medicare?
A: Since you are not yet age 65 your employer-provided healthcare benefit is your primary coverage. When you turn 65 and go on Medicare those benefits become your secondary coverage and may change. They may or may not provide the same benefits as a Medicare Medigap plan.
Employer retirement plans are not the same as the state-regulated Medicare supplemental plans known as Medigap policies. They do not necessarily provide the same services since coverage depends on the contract between the employer and the insurer. They are known as carved-out policies and could provide less coverage, equal coverage or better coverage then the Medigap policies.
Coverage will also vary depending upon whether the employer’s plan is a fee-for-service, managed care HMO or a PPO preferred provider network plan.
To determine the adequacy of the coverage, ask the following questions of your employer: What will the plan pay after Medicare has paid? Does the plan pay for services Medicare does not cover? Will the plan cover you if you move out of the area? Is the plan guaranteed renewable? Are there annual or lifetime limits on benefits? Do you have a choice of plans? What is the ongoing cost to you?
If your spouse is under 65 and covered by your retirement plan you will need to determine if that coverage continues after you reach 65 and your coverage becomes secondary.
Read your benefits booklet or healthcare policy very carefully because these type of plans are changing rapidly. For all unresolved questions call your employer’s human resources department.
After you have determined how your employer plan works I suggest strongly that you contact HICAP (Health Insurance Counseling Advocacy Program) at 477-4710 to make an appointment with a HICAP counselor before making any final decisions. The hour you spend with them will make all the difference in the way you understand senior healthcare coverage.
— Betty Berry is a senior advocate for Senior Concerns. The advocates are at the Goebel Senior Adult Center, 1385 E. Janss Road, Thousand Oaks, CA 91362; or call 495-6250 or e-mail firstname.lastname@example.org (please include your telephone number). You are invited to submit questions on senior issues.