Medicare Part B Premiums Announced for 2017

Julie CarterNovember 17, 2016

Last week, the Centers for Medicare & Medicaid Services (CMS) announced the Medicare Part B premiums for 2017. Starting January 1, most people with Medicare will see a small increase in their Part B premium, from $104.90 to an average of $109.00 per month. But about 30 percent of people covered by Medicare will see a minimum Part B premium of $134.00, a 10 percent increase from the minimum 2016 premium of $121.80.

This difference in premium amounts is due to a federal law which is commonly called the “hold harmless” provision. This provision prevents about 70 percent of beneficiaries from seeing major increases in Medicare Part B premiums when Social Security cost of living adjustments (COLAs) are nonexistent or very small. The announced COLA for 2017 is very small, 0.3 percent, triggering the hold harmless provision.

Those who are held harmless will not see their Part B premium increase by an amount that is greater than the dollar amount of their COLA increase. Because the COLA is a percentage of a person’s Social Security benefits, the exact dollar amount of the increase, and the premium, will vary. For example, someone who has a premium of 104.90 deducted from their full Social Security benefits of $1,000 in 2016 will see a COLA of $3 and will have $107.90 deducted from their check for the Part B premium in 2017. Someone who gets 2,000 in Social Security benefits, will see a COLA of $6 and will have a Part B premium of $110.90.

Not everyone is protected by the hold harmless provision. Because the protection is tied to Social Security benefits, people with Medicare who do not receive Social Security or do not have premiums deducted from their Social Security checks are not covered. Those people who are new to the Medicare program in 2017, those who pay income-adjusted premiums, and those whose premiums are paid by their states are also not covered.

While announcing the new premiums, CMS vowed that its parent agency, the Department of Health and Human Services (HHS), “will work with Congress as it explores budget-neutral solutions to challenges created by the ‘hold harmless’ provision.” Last year, the Medicare program faced an even larger premium increase for those not held harmless because the COLA for 2016 was zero. In response, Congress acted to reduce the increase in premiums for those not held harmless to the level that premiums would have gone up had the hold harmless provision not gone into effect.

In addition to the updated premium amounts, CMS announced an increase in the Medicare Part B annual deductible, from $166 in 2016 to $183 in 2017.

Read the CMS announcement.

Find the original article here.

6 Ways to Pay Down Your Debt

Older households have more than doubled their debt in a dozen years
by Lynnette Khalfani-Cox, AARP Bulletin, May 2016

The years leading up to retirement used to be the time when people paid off obligations like the mortgage, auto loans or credit card bills. These days, however, an increasing number of Americans in or approaching retirement are saddled by consumer debt that leaves them feeling cash strapped each month.

Cut out the extras
The first step in repaying unwanted debt is to take a realistic look at your spending, separate needs from wants and plug any leaks in your budget. For example, are you paying for premium cable service when basic would suffice? Are you signed up for a gym membership you don’t even use? To help minimize such unwanted spending, try a free service like, which finds and cancels recurring subscriptions you no longer want. “The average person using Truebill saves more than $500 a year just by canceling unwanted subscriptions,” says CEO Yahya Mokhtarzada. Put those savings toward your debts.

Double your payments
One reason many people stay locked in a cycle of debt for years is that they only make minimum payments. Experts say that’s unwise if you want to be debt-free during your golden years. “You always want to aggressively pay down the most expensive debt first,” says Kimberly Foss, a certified financial planner and founder of Empyrion Wealth Management in Roseville, Calif. She recommends initially attacking high-rate credit cards, preferably by at least doubling the minimum payment. “Do more if you can,” she says. But if you can’t, “even $5 extra is better than just making a minimum payment.”

Refinance credit card debt into personal loans
Another option to more quickly eliminate credit card debt or costly payday loans is to refinance those obligations into lower-cost personal loans, known as peer-to-peer loans. “They’re fast and easy to get online, and people typically get the money in two to five days,” explains Todd Albery, CEO of Quizzle, a credit information site. Albery says about 80 percent of personal loans are done to consolidate credit card debt. Consumer financial services company Bankrate has found personal-loan offers as low as 5.5 percent for people with good credit, but the average is 11.3 percent. That’s still better than rates from most credit cards, which now average 15.7 percent, Bankrate reports.

Sell stuff
After a lifetime of raising kids or moving from one household to another, many boomers and retirees have accumulated way more stuff than they currently need. To raise cash for debt elimination, unload unnecessary clothes, jewelry, furniture, electronics and household goods. You can have a garage sale, sell items on eBay or Craigslist, or take items to local consignment shops. If you have two or three cars, consider selling one and save on gas, insurance and maintenance.

Beware of debt-settlement pitfalls
Although TV and radio ads offer to help you settle your debt for pennies on the dollar, financial pros say debt settlement can create other problems. Settlement companies typically require consumers to set aside money each month—sometimes for years—into an account to be used later in negotiations with creditors. But, the Federal Trade Commission (FTC) warns, many consumers can’t keep up with those deposits and drop out. And there’s no guarantee creditors will settle—so your debt woes could remain. The companies also sometimes advise consumers to stop paying creditors directly, which can trigger late payment penalties and ding your credit history, the FTC says.

Consider bankruptcy as a last resort
If you suffer a job loss or serious health issues later in life, research shows that you can easily slip into debt because of medical bills, which is the No. 1 cause of personal bankruptcy in the U.S. If you’re out of work, retired or simply can’t cover your monthly expenses—or if you racked up insurmountable medical bills due to an illness or injury—then bankruptcy may make sense. Just consider all your options first, and recognize the potential damage to your credit rating before you seek bankruptcy protection.

This article originally appeared here.

Older Workers Ask: Where’s My Flexible Retirement?

By Richard Eisenberg, CONTRIBUTOR, JAN 28, 2016 @ 08:28 AM

Riddle me this: World populations are aging, labor forces are shrinking and government-run retirement programs are running short of cash, so why aren’t employers and politicians embracing flexible retirement for older workers?

“Many, if not most workers — especially those nearing retirement — envision retirement as a transition, something that happens over time,” says Catherine Collinson, president of Transamerica Center for Retirement Studies and executive director of the Aegon Center for Longevity and Retirement. “However, employment practices and government retirement benefits are not fully supportive of that. They haven’t kept up with the changing expectations and needs of workers.”

The New Flexible Retirement
For proof of this disconnect, I direct you to Exhibit A: Collinson’s latest report, The New Flexible Retirement, based on surveys of 16,000 workers and retirees in 15 countries.

It found that 56% of workers (61% in the U.S.) envision a “flexible transition” to retirement. But only 27% of workers 55 and older (25% in the U.S.) said their employers offer the opportunity to shift from full-time to part-time working arrangements as they phase into retirement. And just 9% of workers 55 and older say their employer offers retraining opportunities to help them phase into retirement.

Collinson said the Aegon report defined flexible retirement as including people who envision transitioning from full-time work to part-time work, or working in a different capacity, or working as long as they’re able. By contrast, phased retirement — a subset of this — means gradually reducing your work hours over time until you fully retire.

“When and how people retire is a very personal decision,” Collinson said, “and we need to think about tailoring it to their wants, needs and circumstances.”

In some countries, the survey found, the vast majority of older workers want to transition to retirement, but their chances are pretty dim.

For example, 71% of 55+ workers in India said they envision a flexible transition to retirement, while only 41% said their employers offer the opportunity.

The Many Winners From Flexible Retirements
What’s strange is that flexible retirement could be so beneficial for employers, governments and the public — if only more people were allowed to do it.

Carol Graham, a senior fellow at the Brookings Institution and professor of public policy at the University of Maryland, recently wrote a paper saying that “flexible retirement may be one solution to the challenges of unemployment, aging populations and public pension burdens.”

Using Gallup World Poll data on well-being, income, health, employment and other variables in more than 160 countries, Graham concluded that “voluntary part-time workers in Europe and the U.S. are happier, experience less stress and anger and are more satisfied with their jobs than other employees.” Also, she noted, “late-life workers have higher levels of well-being” than retirees and are more satisfied with their health.

Said Graham: “At a time when unemployment, workforce productivity and health problems related to an aging population present multifaceted challenges, exploring the potential contribution of flexible-work arrangements in meeting these challenges is a low-risk and potentially high pay-off proposition.”

So why do so few U.S. employers offer it? “Many employers, especially over the last eight years, have been so focused on recovering from the recession and staying sustainable and competitive, that some of their employment practices haven’t received the level of attention they deserve,” said Collinson.

Countries That Get It
Employers and governments in a few countries, however, do seem to get it.

Germany, Graham said, introduced a number of flexible work arrangements during the recent recession “and there is some evidence that these policies protected the labor market and even added jobs.”

The Aegon report also cited progressive policies in Australia and Japan.

Australia’s “Transition to Retirement” government-sponsored pension, for instance, is favorably taxed. It lets workers move from full-time to part-time work and complement their income with the pension. About 20% of Australian workers over 55 have participated in this program since it was introduced in 2005.

In Japan (which has one of the most rapidly aging populations), the Aegon study said “flexible retirement is more of a reality than an expectation or an aspiration.” One reason: since 2013, employers there have been required to choose one of three options for employees who reach 60 and their preferred one is the “continued employment system.” This lets firms offer flexible working arrangements on a yearly contract basis until the workers turn 65.

“It necessitates conversations between pre-retirees and employers that can be good for both sides,” said Collinson.

By contrast, she noted, one barrier to flexible retirement in the United States is a reluctance to have such talks.

“Employees don’t want to bring it up for fear of being marginalized if they have to change their plans, and employers don’t want to raise the possibility of a flexible retirement for fear of being perceived that they’re engaging in age discrimination,” said Collinson.

A Phased Retirement Letdown
One recent government-backed foray into phased retirement in the United States hasn’t gone very well.

Congress passed a law in 2012 allowing federal workers to arrange phased retirements, and the program has the potential to reach 2.5 million government employees. But the Office of Personnel Management has only received 31 applications. Few government agencies have made the benefit available to their employees.

Jeff Neal, founder of the blog, says phased retirement is looking more and more like “The New Coke” of Civil Service reform — “an idea that seemed great, but never found a market.”

Said Collinson: “That begs for a public dialogue on why it hasn’t taken off, so we can all learn from the experience.”

Why Flexible Retirements May Flourish Here
She’s optimistic that in coming years more U.S. employers will revise their HR policies to make flexible retirement an option — out of necessity.

“Many may be in denial about the aging of the population today,” Collinson said. “But at some point, a critical mass of baby boomers will want to retire.” And without offering flexible retirements, she added, “the alternative will be running the risk that their seasoned employees will retire on two weeks’ notice. That can prove very disruptive.”

If you’d like to arrange a personal flexible retirement plan at a workplace without a formal program in place, first weigh the pros and cons. A few potential drawbacks: Deciding to go the phased retirement route could reduce your pension and Social Security benefits and mean you’ll need to halt your 401(k) contributions.

Should you decide that you want some type of flexible retirement, take the initiative to discuss it with your manager — but be sure this is really the way you want to retire. Your boss likely won’t give you a chance to change your mind.

“Once the genie is out of the bottle, it can be very hard to put it back in,” Collinson noted.

This article originally appeared here.

As Population Ages, Where Are the Geriatricians?

As Population Ages, Where Are the Geriatricians?

By KATIE HAFNER, JAN. 25, 2016

PORTLAND, Ore. — Ruth Miles, 83, sat in a wheelchair in a small exam room, clutching a water bottle, looking frightened and uncomfortable.

She was submitting to the tender scrutiny of Dr. Elizabeth Eckstrom, who scooted her stool so close that she was knee to knee with her patient.

Ms. Miles had broken her pelvis after tripping on an electric cord in her apartment. The weeks since then had been hellish, she told her doctor. At the rehab center, incapacitated and humiliated, she had cried for help from the bathroom. Her hands were covered with bruises from the blood thinners she was on. She winced as Dr. Eckstrom tugged slightly at a bandage that adhered stubbornly to her left elbow. “We’ll have to get that changed,” Dr. Eckstrom said softly.

Dr. Eckstrom, 51, who spends her days focused on the complex medical needs of older patients, is, like the Central African okapi, a species that is revered, rare and endangered. She is a geriatrician.

Geriatrics is one of the few medical specialties in the United States that is contracting even as the need increases, ranking at the bottom of the list of specialties that internal medicine residents choose to pursue.

“One of the greatest stories of the 20th century was that we doubled the life expectancy of adults,” said Terry Fulmer, president of the John A. Hartford Foundation, which funds programs to improve the care of older adults. “Now we need to make sure we have all the supports in place to assure not just a long life but a high quality of that long life.”

Here in Oregon, there is approximately one geriatrician for every 3,000 people over 75. The shortage will grow more acute as the state’s population continues to age.

Oregon’s problem is mirrored across the United States. According to projections based on census data, by the year 2030, roughly 31 million Americans will be older than 75, the largest such population in American history. There are about 7,000 geriatricians in practice today in the United States. The American Geriatrics Society estimates that to meet the demand, medical schools would have to train at least 6,250 additional geriatricians between now and 2030, or about 450 more a year than the current rate.

Yet, the field is becoming even less popular among physicians in training. Oregon Health and Science University, where Dr. Eckstrom practices, had five slots open for geriatrics fellows for 2016 and filled only three.

Last year, Dr. Elizabeth White-Chu, who directs the university’s geriatrics fellowship program, said she had resorted to cold-calling residency programs throughout the Pacific Northwest in search of candidates. This year, there were so many unfilled slots around the country that Dr. White-Chu did not even bother to call. “It would have been a total waste of time.”

A geriatrician is a physician already certified in internal or family medicine who has completed additional training in the care of older adults. In addition to providing clinical care, geriatricians are skilled in navigating the labyrinth of psychological and social problems that often arise in the aging population.

“Part of the reason aging has such a negative connotation is this sense that you can’t cure older people’s problems,” said Dr. Kenneth Brummel-Smith, a professor of geriatrics at Florida State University College of Medicine in Tallahassee, Fla., a state with a particularly severe geriatrician shortage. “And yet a good geriatrician can bring someone back to functional status.”

People avoid the field for understandable reasons. Geriatrics is among the lowest-paying specialties in medicine. According to the Medical Group Management Association, in 2014, the median yearly salary of a geriatrician in private practice was $220,000, less than half a cardiologist’s income. Although geriatrics requires an extra year or two of training beyond that of a general internist, the salary for geriatricians is nearly $20,000 less.

Since the health care of older patients is covered mostly by Medicare, the federal insurance program’s low reimbursement rates make sustaining a geriatric practice difficult, many in the field say.

“Medicare disadvantages geriatricians at every turn, paying whatever is asked for medications and procedures, but a pittance for tough care-planning,” said Dr. Joanne Lynn, a geriatrician and the director of the Center for Elder Care and Advanced Illness at Altarum Institute, a nonprofit health systems research organization based in Ann Arbor, Mich.

Dr. Eckstrom said she knew of several board-certified geriatricians in Oregon who, in order to avoid attracting too many older patients, went into practice as general internists, making certain not to mention their geriatrics training. “With too many Medicare patients in their practice, they wouldn’t be able to make ends meet,” she said.

Marie Hall, 84, who lives in Portland, knows all too well the difficulty of finding a geriatrician. A little over a year ago, several months after Ms. Hall underwent back surgery that left her with nerve damage, her longtime geriatrician retired, and the hospital did not replace her.

Eventually Ms. Hall got in touch with Marcy Cottrell Houle, a Portland author who had just written a book with Dr. Eckstrom. To Ms. Hall’s relief, Ms. Houle helped get her in to see a new colleague of Dr. Eckstrom.

“I knew I needed that kind of specialized care,” Ms. Hall said, “that I needed to think ahead for when the downhill slide really comes.”

A Debate on Necessity

Some primary care physicians argue that geriatricians are unnecessary, that most ailments among older adults are the same as those that hit the middle-aged population, such as diabeteshypertension and heart disease. The difference, they say, is that older patients just have more of them.

“This is simply untrue,” Dr. Eckstrom said. “Just think about dementia, or delirium caused by a medication. Those are just two conditions you seldom see in middle-aged adults.”

Dr. Eckstrom embodies both the frustration and gratification that characterize a geriatrician’s day. She spent most of her 40 minutes with Ms. Miles sweeping up after the caregivers who had preceded her: pressure ulcers, a wound dressed poorly, dehydration, depression.

She gave her patient a pep talk, urging her to be up and walking as much as possible, and to take in more fluids. She commented on her patient’s brightly colored shoes. Throughout the morning, in fact, she made a point of admiring something each patient was wearing: a bright piece of jewelry, a colorful scarf, an all-purple outfit.

Then, as if Ms. Miles were doing her doctor a personal favor, Dr. Eckstrom added, “I very much appreciate that you’re not taking too much of the oxycodone.”

At the end of the appointment, Dr. Eckstrom took Ms. Miles’s hand and said, “You can always call me.”

“You’re too busy,” Ms. Miles said.

“I’ll squeeze you in. I’ll make it work.”

Ms. Miles had arrived at her appointment defeated and anxious. By the end, she was relaxed, even animated.

“I know how lucky I am to have her,” she said as a nurse carefully removed the bandage on her elbow and replaced it with one that would not stick to the wound.

That afternoon, Dr. Eckstrom worked with three residents who were on a rotation that included geriatrics. When the residents went in to see patients, they were engaged enough, but decidedly ho-hum about the specialty, voicing a preference for more vibrant fields like oncology, with its experimental new drugs, and cardiology, which combines good pay with the excitement of new technologies.

Young physicians in training find it difficult to muster interest in the slow grind of caring for older patients, and days filled with discussions about medication management, insomniamemory loss and Meals on Wheels deliveries.

An old family member is often the inspiration for medical students who choose geriatrics. “My grandmother was one of my best friends when I was growing up,” said Dr. Emily Morgan, 37, who recently joined Dr. Eckstrom in her practice. Dr. Morgan said that watching her grandmother’s decline after a car accident, followed by a terribly painful death, instilled in her a deep belief “in the inherent dignity and worth of a life, especially towards the end.”

Chase West, a second-year medical student at Florida State, was present for much of his own grandmother’s decline. “Just seeing how the specialists worked with her in the last two months triggered that light-bulb moment,” he said.

Dr. Eckstrom was a general internist who practiced in primary care for nine years before returning to Oregon Health and Science University to complete a geriatrics fellowship. “I thought I was doing a good job caring for my patients,” she said. “But I wanted to do more geriatrics teaching and research.” The fellowship opened her eyes. “I had no idea what I didn’t know,” she said.

Phyllis Wolfe, 76, has been seeing Dr. Eckstrom for more than 12 years. Two years ago, she had a series of mini-strokes that affected her memory. Then she developed two small-bowel obstructions, and each surgery was followed by significant cognitive decline and delirium. Her gait was unsteady, and she was in danger of falling.

Ms. Wolfe’s health gradually improved not by virtue of drastic interventions, but from careful attention to every possible detail. Dr. Eckstrom stopped Ms. Wolfe’s prescription for Ambien, an insomnia drug that can cause confusion in older patients. Dr. Eckstrom also suggested an exercise program to prevent a fall, and put Ms. Wolfe on a nutrition plan.

In Dr. Eckstrom’s office that day, Ms. Wolfe was transformed — lively and clearheaded. “If you hadn’t seen her six months ago, you’d never know she had all those problems,” Dr. Eckstrom said.

Ms. Wolfe passed a standard memory test with ease, and the appointment turned into a session of helpful hints that seemed almost homespun but were backed by evidence.

“Elevate your legs for 30 minutes before going to sleep and you’ll need to go to the bathroom during the night less often,” Dr. Eckstrom said when Ms. Wolfe asked about needing to stay well hydrated, then having her sleep disrupted by frequent trips to the bathroom.

“Instead of iron pills, buy a cast-iron skillet, one of the best ways for the body to absorb iron,” Dr. Eckstrom advised in response to Ms. Wolfe’s concern about iron pills.

Ms. Wolfe said she had tried to get a few of her friends in with Dr. Eckstrom, with little luck. Her practice is full.

Dr. Eckstrom began taking care of Ms. Wolfe when she was 64. Dr. Eckstrom said she prefers to start with patients when they are still relatively young, so she can follow them into old age.

“The majority of my patients are in their 80s and 90s, but I’ve been seeing many of them for 20 years,” she said, adding that care for these patients is less complex, as they have entered old age in better shape.

‘Sick of the Whining’

While many in geriatrics have resigned themselves to their predicament, some believe the field will soon receive the recognition it deserves. New payment models that hold doctors and health systems accountable for keeping people healthy are on the rise, and geriatricians foresee a day when they are better valued and compensated.

“A lot of us are sick of the whining,” said Dr. Rosanne M. Leipzig, a geriatrician and professor at the Icahn School of Medicine at Mount Sinai, which is experimenting with a two-year program that combines geriatrics and palliative care.

And there is an emerging emphasis on training many different health care professionals — nurses, pharmacists, internal and family medicine physicians, physician assistants, and physical and occupational therapists — to see older patients through a geriatrics lens rather than focusing solely on creating more geriatricians. Mini-fellowships at teaching hospitals to train practicing physicians in geriatrics have sprung up around the country. Cardiology, urology, emergency medicine and other specialties are promoting geriatrics training and research within those disciplines.

Acknowledging an older person’s need for dignity is an important part of Dr. Eckstrom’s practice. When talking with a patient about giving up driving, she refers to it as “retiring from driving,” casting it as an act of liberation, as if driving were a job to be freed of.

It is that kind of perspective that drew the attention of trainees already attracted to the human side of medicine. Dr. Kathleen Drago grew to love geriatrics while training under Dr. Eckstrom. “I got caught in Elizabeth’s web,” she said. “You meet people who have walked these incredible paths, and are starting to reflect on their lives and focus in on what’s important in the time they have left.”

Dr. Drago, 31, left medical school with a debt of around $270,000. “I made a decision that was distinctly against my own financial interests,” she said. “But I come to work every day, and I get to deliver the patient-centered care that I dreamed of as a med student.”

She now works as a geriatrician at Oregon Health and Science University, seeing only hospitalized patients. Recent evidence about care provided by geriatrics teams shows that with the care of such teams, the hospitalization of older adults runs shorter, costs less and results in fewer complications, including falls, pressure ulcers and urinary tract infections.

While making her rounds in the hospital one recent afternoon, Dr. Drago introduced herself to a 79-year-old woman in the intensive care unit. The patient, who has dementia, had been found lying on the ground the previous night a quarter-mile from her home, bruised and bloodied, with three cracked ribs and bleeding in her brain. She had left the house with a Bible in one hand and an American flag in the other.

Dr. Drago sat down and began a frank yet gentle conversation with the patient and her daughter about the next steps. The doctor stayed for two hours.

This article originally appeared here.

Retirement Spots With Affordable Health Care

Out-of-pocket health care costs for retirees vary considerably by state.

By Robert Berger, Jan. 29, 2016, at 9:39 a.m.

When deciding where to retire, a huge variety of factors come into play. There are financial considerations, such as the general cost of living and how many affordable homes are available. There are also lifestyle decisions including the kind of weather you prefer and how close it is to your family and friends. Retirees should, of course, think through all these factors. But here’s one more to add to the list: the places that have the lowest health care costs for retirees.

Retirement health care costs are all over the board. However, costs will certainly rise as you age. Even those in excellent health at age 75 can expect to pay an average of over $5,000 per year in medical expenses, according to a Merrill Lynch report. Your costs may vary, though, depending on your health, age at retirement, retirement health benefits and other factors.

Still, you can actively work to reduce your retirement health care spending by choosing a state with lower average health care costs for retirees. Settling in a state with more affordable medical care, on average, could save you a bundle during retirement.

One new tool from HealthView Services allows financial planners to access cost information for Medicare Parts B, D and supplemental insurance for various states. The tool totals first-year and lifetime costs to give retirees a better idea of which states provide the most and least expensive health care to retirees.

Hawaii, surprisingly, has some of the lowest first-year and overall lifetime costs for Medicare users. For a 65-year-old starting coverage in 2015, first-year costs for Medicare Parts B, D and supplemental premiums in Hawaii would total about $2,818, according to HealthView. That’s over $800 less than the $3,707 a retiree in Michigan would pay for similar coverage in the first year of retirement.

The more expensive premiums add up over a lifetime. HealthView estimates that premiums between ages 65 and 84 will total $112,528 for someone in Hawaii versus $152,175 in Michigan, a difference of nearly $40,000. Most of the cost differential is due to variations in the cost of Medicare supplemental insurance. Medicare Part D premiums also vary by state and the plan you select. Medicare Part B premiums are set by the federal government and do not vary based on where you live.

Of course, Medicare premiums aren’t the only cost you should be concerned with. You will also face deductibles, copays and coinsurance. The cost retirees pay out-of-pocket for hospital and doctor visits, tests, prescription drugs and other medical expenses can vary from state to state. Retirees should look at actual health care costs by state, not just premiums.

The cost of tests and visits can vary dramatically from one hospital to the next, and this can be difficult to compare in advance of a procedure. According to the Kaiser Family Foundation, states where residents spend the least on health care include Wyoming, Vermont and the Dakotas. States where individuals spend the most include Texas, New York and California.

Some states with a relatively high cost of living have a relatively low cost of health care. So a move to Hawaii, which is known for its relatively high housing costs, might not end up saving you money, even if your health insurance premiums will be a little bit lower there. Before making a move, retirees should consider all the financial and lifestyle angles and total up their likely cost of living in any particular state.

Where to retire depends on a number of factors, including how much you have saved, what your retirement lifestyle looks like and the overall costs of living. But when calculating these numbers, don’t forget one big one: the cost of health care.

Rob Berger is the founder of the personal finance blog the Dough Roller.

Rob Berger is an attorney and founder of the popular personal finance and investing blog, He is also the editor of the Dough Roller Weekly Newsletter, a free newsletter covering all aspects of personal finance and investing, and the Dough Roller Money Podcast.

The original article can be found here.

Meet our New Team Member!

There has been a lot of changes going on at Stateline Senior Services over the past few months.  As you know, last year in September, we added Nancy Petronio to our staff as another sales agent. Well, this year we said goodbye to two staff members and hello to one. Wendy McCloskey and Jeanmarie Donovan left us to pursue other interests.  While we are sad to see them go, we wish them all the best with their new endeavors. In April, we welcomed Kate McCloskey to our staff.  She will be doing a combination of what Wendy and Jeanmarie previously did. Kate will be our Scheduling Coordinator and will also help with Customer Service.  You can see her profile on our “About” page on our website. We hope that you, our clients, will join us in welcoming Kate to our team.  As always, we appreciate your business and look forward to serving you in the future.