Prime Timer News Briefs

Being prepared for a natural disaster is crucial to protecting your safety and well-being.

Below are a series of links in BLUE to learn how to get the care you may need if an emergency is declared and you have to evacuate to a safe area.

Get Care in an Emergency

💊   Getting your prescription drugs during a disaster or emergency: You can move most prescriptions to another nearby in-network pharmacy, and back to your regular pharmacy when the emergency or disaster ends. Contact your Medicare drug plan if you need to use an out-of-network pharmacy.

   Seeing a doctor during a disaster or emergency: If you have Original Medicare, you can always see any doctor who accepts Medicare. If you have a Medicare Advantage Plan or other Medicare health plan, contact your health plan about making temporary changes, like using an out-of-network doctor during an emergency or disaster.

   Learn more about accessing critical care (like cancer treatments or dialysis) or repairing or replacing equipment (like wheelchairs or walkers that were damaged or lost during a disaster or emergency).

What do you need help with?

Visiting doctors or other providers

Getting your prescription drugs

Getting dialysis treatments

Getting chemotherapy or other cancer treatments

Replacing lost or damaged durable medical equipment or supplies

Paying your premium

Replacing a lost or damaged card

Qualifying for a special enrollment period

For more help:

• Find out how to change your address with Medicare.
• If you need other resources or help after an emergency, visit disasterassistance.gov.

In Seattle, the number of renters aged 65+ increased by more than 20% over the past decade. Moreover, the metro also had a 14% jump in seniors renting single-family homes in 2023 compared to 2013. 

Alexandra Ciuntu, the author of the study explains: 

“Compared to 10 years ago, more seniors are stepping away from the burdens of homeownership (such as property taxes, repairs, and the complexities of downsizing) and, instead, using home equity or retirement savings to support alternative living arrangements. Some are moving closer to family, others are downsizing to cut costs, or renting simply to live on their own terms [such as renting at a 55+ community]. Renting also provides flexibility for a growing number of older adults who remain in the workforce well into their 60s, allowing for job-related moves, seasonal living, or part-time relocation.” 

You can read the full study here: https://www.point2homes.com/news/research/senior-age-group-up-over-2-million-renters-in-a-decade.html  

Yes, Medicare does cover emergency ambulance services and, in limited cases, nonemergency ambulance services too, but only when they’re deemed medically necessary and reasonable.

So, what does that means?

First, it means that your medical condition must be serious enough that you need an ambulance to transport you safely to a hospital or other facility where you can receive care that Medicare covers.

If a car or taxi could transport you without endangering your health, Medicare won’t pay. For example, Medicare probably won’t pay for an ambulance to take someone with an arm fracture to a hospital. But if the patient goes into shock, or is prone to internal bleeding, ambulance transport may be medically necessary to ensure their safety on the way. The details make a difference.

Second, the ambulance must take you to the nearest appropriate medical facility. If you choose to be transported to a facility farther away because the doctor you prefer has staff privileges there, expect to pay a greater share of the bill. Medicare will only cover the cost of ambulance transport to the nearest appropriate facility and no more.

Medicare may also pay for an emergency flight by plane or helicopter to the nearest appropriate medical center if the trip would take too long on the ground and endanger your health.

Nonemergency Situations

Medicare may also cover ambulance transportation in some cases when you’re not facing a medical emergency. But to receive this coverage, your doctor needs to write an order stating that an ambulance is medically necessary because other ways to get you to an appointment could endanger your health.

For example, if you’ve been diagnosed with end-stage renal disease, Medicare may pay if you have a doctor’s order stating that it is medically necessary for you to use an ambulance to take you to and from a dialysis center.

You also need to know that in nonemergency situations, ambulance companies are required to give you an Advance Beneficiary Notice of Noncoverage or ABN if they believe Medicare may not pay. This lets you know that you will be responsible for paying if Medicare doesn’t.

Ambulance Costs

Ambulance rides can vary from several hundred to several thousand dollars depending on where you live and how far you’re transported.

Medicare Part B pays 80 percent of the Medicare-approved ambulance rides after you’ve met your annual Part B deductible ($257 in 2025). You, or your Medicare supplemental policy (if you have one), are responsible for the remaining 20 percent.

If you have a Medicare Advantage Plan, it must cover the same services as original Medicare, and may offer some additional transportation services. You’ll need to check with your plan for details.

How to Appeal

If an ambulance company bills you for services after Medicare denies payment, but you think the ride was medically necessary, you can appeal – see Medicare.gov, click on “Providers & Services” followed by “Claims, Appeals, and Complaints.” To help your case, ask the doctor who treated you for documentation that you needed an ambulance.

If you need some help, contact your State Health Insurance Assistance Program (SHIP), who can help you file an appeal. Go to ShipHelp.org or call 877-839-2675 for contact information.

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Send your questions or comments to questions@savvysenior.org, or to Savvy Senior, P.O. Box 5443, Norman, OK 73070.

The Funeral Rule was introduced in 1984 and enforced by the Federal Trade Commission (FTC) to protect consumers. It guarantees several key rights, including:

• The right to an itemized price list before discussing arrangements.
• The right to refuse package deals that include unwanted products or services.
• The right to buy a casket or urn from a third party, without penalty.
• The right to receive a written cost breakdown before making any payments.

However, in 2022, a joint study by the Funeral Consumers Alliance (FCA) and the Consumer Federation of America (CFA) surveyed 1,046 funeral homes across 35 U.S. state capitals. Only 18% had full price lists posted online – but even this is only a marginal improvement from 16% in 2017, despite long-standing FTC guidelines.

The FTC is now reviewing whether to obligate funeral homes to publish all their prices online.

Anthony Martin, founder of the insurance company Choice Mutual, provides these guidelines:

Red Flags to Watch For:

• No itemized price list provided before discussing services.
• Pressure to “do the right thing” by choosing more expensive options.
• Being told a casket is required for cremation (it’s not).
• Vagueness around what’s included in prepaid funeral contracts.
• Any suggestion that embalming is mandatory (it usually isn’t).

How to Protect Yourself (and Your Budget):
Planning ahead – or even just knowing your rights – can save families thousands of dollars and significant stress. Martin recommends the following steps:

• Shop Around and Ask Questions – always ask for prices up front. Funeral homes must provide these over the phone or email you a price list. Don’t agree to anything without knowing how much everything costs first.
• Don’t Blindly Accept Pre-Packaged Deals – legally, you are entitled to only select the services you want; packages can often include things you don’t want or need, inflating the cost.
• You Have the Right to Buy the Casket or Urn Elsewhere – shop around: retailers and online sellers often offer better deals. Funeral homes are not allowed to charge extra for accepting an outside purchase.
• Get Written Confirmation – always request a detailed statement that outlines every single item and cost before you pay.
• Understand the Details of Any Prepaid Plan – Martin also recommends asking whether it covers just the merchandise, or services as well. Understanding the terms of cancellation is imperative, as is understanding your state’s protections.
• Don’t Reveal Your Budget – keeping your maximum spend to yourself reduces the risk of being “upsold” to match it.
• Take Your Time – if the body is at a hospital or with a coroner, you usually have at least two days – sometimes longer – to make decisions. Don’t feel rushed into anything; take some time away in a peaceful place with other family members to debate matters.
• Decline Embalming Unless Absolutely Necessary – Washington state law does not require embalming, except under special circumstances. You have the right to say no to this if the funeral provider is trying to persuade you to do it.

Burial should be all about honoring a life, not making things financially difficult or devastating for those left behind. “With the right information, families can avoid being taken advantage of and make choices that are respectful, affordable, and meaningful,” says Martin.

As the FTC moves toward greater transparency requirements, it’s a good time for Washingtonians to educate themselves about the funeral industry and ask tough questions.

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The information in this article is courtesy of ChoiceMutual.com.

Expedites Decisions for People with Severe Disabilities

The Social Security Administration recently announced the addition of 13 new conditions to the agency’s Compassionate Allowances (CAL) list. The CAL initiative accelerates the disability application process for individuals with the most serious diseases and medical conditions that, by definition, meet Social Security’s standard for disability benefits.

The newly added conditions are:

• Au-Kline Syndrome
• Bilateral Anophthalmia
• Carey-Fineman-Ziter Syndrome
• Harlequin Ichthyosis – Child
• Hematopoietic Stem Cell Transplantation
• LMNA-related Congenital Muscular Dystrophy
• Progressive Muscular Atrophy
• Pulmonary Amyloidosis – AL Type
• Rasmussen Encephalitis
• Thymic Carcinoma
• Turnpenny-Fry Syndrome
• WHO Grade III Meningiomas
• Zhu-Tokita-Takenouchi-Kim Syndrome

With the inclusion of these 13 conditions, the CAL list now includes 300 conditions in total. Since the CAL initiative began, over 1.1 million people with severe disabilities have been approved through this accelerated disability process.

“By adding these 13 conditions to the Compassionate Allowances list, we are helping more people with devastating diagnoses to quickly receive the support they need,” said SSA Commissioner Frank J. Bisignano.

When a person applies for disability benefits, Social Security must obtain medical records to make an accurate determination. Although not available in every claim, through the Health IT program, Social Security securely receives electronic medical records, allowing for adjudicators to make faster and more accurate decisions.

For more information about the initiative, including a list of all CAL conditions, please visit http://www.ssa.gov/compassionateallowances.

To learn more about Social Security’s Health IT program, please visit http://www.ssa.gov/hit.

People may apply online for disability benefits by visiting http://www.ssa.gov.