Squared Away Blog

Here’s something you should know about Medicare Advantage plans: the vast majority of these insurance policies require prior approval before a person can receive some medical treatments and services. Historically, that was not the case, and prior authorizations are still very unusual for people who are enrolled in original Medicare and a Medigap supplement. But in the case of Medicare Advantage plans, physicians submitted more than 35 million requests for prior authorization to insurers in 2021, and more than 2 million of them – or about 6 percent – were fully or partially denied, according to the Kaiser Family Foundation’s new report on more than 500 Advantage plans. Only about 11 percent of the denials were appealed, but the vast majority of…

Nearly half of the people receiving federal disability benefits have a psychiatric impairment that interferes with working. And they tend to be younger and more willing to work than other disability beneficiaries. This makes them good candidates for employment support programs that encourage working at least part-time and might even prevent them from applying for benefits at all. According to a Mathematica review of research on three government jobs programs, the programs had some success in boosting participants’ employment and earnings. However, they didn’t prove effective over the long term in reducing their reliance on federal disability benefits. One federal program in Texas was geared to people with disabilities who had not applied for benefits when they entered the program. The program…

The Internet has become a necessity in our modern society. Yet 42 million Americans live in areas of the country where the connections to technology are subpar or, in extreme cases, nonexistent. At the same time, federal and state governments are increasingly relying on people to interact with them online. This mismatch between a growing reliance on the Internet and a lack of easy access is a problem for one especially vulnerable population: people with disabilities. Without access to a fast reliable Internet connection, it can be very difficult to apply online to Social Security for disability benefits or to file the periodic reports the agency requires of people who are receiving them. In a recent report, the Urban Institute found that counties…

As the bad first two years of the pandemic recede in the rear-view mirror, a new report reminds us how tough things got for renters. In 2021, a record 21.6 million U.S. families were paying more than 30 percent of their income on rent, which is the real estate industry’s benchmark for people whose housing costs have become a financial burden. That amounts to just under half of all renter households who were struggling during COVID – very close to the high reached during the Great Recession. And the vast majority of the 1.2 million increase from 2020’s level was in the group that struggles the most: families who pay more than 50 percent of their income to rent a…

The best reason to set up a power of attorney for yourself or an elderly family member is to avoid a far more contentious and expensive alternative later: guardianship. A power of attorney becomes urgent if an elderly family member is showing early signs of dementia. “You want to run, not walk, to get that done because capacity tends not to get better,” said Jonathan Williams, an attorney with the Clarity Legal Group in the Raleigh-Durham, N.C., area. “Having good legal documents in place, if the person has the ability to execute them, can be helpful later on,” he said. In a power of attorney, the person signing the document agrees to name an agent, usually a trusted family member…

During the pandemic, calls to mental health hotlines soared. People in emotional distress learned that psychologists were booked months in advance or were completely unavailable. While COVID dramatized the need for mental health treatment generally, new research reveals how important being treated is to people with disabilities. Isaac Swensen and Carly Urban at Montana State University found that ready access to outpatient care slightly increases applications for disability benefits by working-age people under Social Security’s insurance program and by poor and marginally employed workers under the companion program, Supplemental Security Income (SSI). Mental illness in its severest forms can interfere with the ability to work, making some individuals eligible for federal disability assistance.  But to qualify, the Social Security Administration requires…

About one out of every five Latinx workers in this country lacks health insurance. The uninsured ratio rises to one in four in the states that have chosen not to expand their Medicaid programs to more low-income workers under the Affordable Care Act. The motivation for Josefina Flores Morales’ new research is that there’s more to health insurance than just medical care. It is also critical to individuals’ financial health, she argues, and broader insurance coverage in the Latinx community is an underappreciated way that the vast wealth gap between them and non-Latinx White workers could be reduced. Having insurance keeps people healthy so they can continue to work and is important for other financial reasons. Insurance reduces the size of medica…

A popularized image of parents who struggle when adult children move back home is not shaping up as an accurate picture of the arrangements. Unemployment, divorce, college graduation – adult children in their 20s and 30s move back into a parent’s home for many reasons. And the parents can have all sorts of reactions, good and bad, to their boomeranging kids. Some parents get stressed out by young adults who return home because they need financial support. Others welcome having the kids back to pad the empty nest, help with household chores, or help pay the bills. The return home isn’t necessarily a one-time thing either. “As they attempt to gain financial independence, adult children may alternate between living on…

For the sliver of retirees who are far behind in paying their own or their children’s student loans, Social Security can withhold part of their benefits to pay the loans back. But college has gotten much more expensive since the baby boomers attended, and loan delinquencies are higher among working people and especially Black Americans. When today’s Black workers retire, their estimated household delinquency rate will be 5.4 percent – well more than double the rate for White and Hispanic retirees. The question is how withholding Social Security benefits will impact the financial security of these future retirees. In cases where the federal government withholds some benefits, it garnishees the lesser of 15 percent of a delinquent borrower’s monthly retirement…

Walk into a restaurant, retail store or hotel, and you might encounter a manager who seems to be doing the same tasks as the people he’s managing. Maybe you’re in one of those jobs. A lawsuit by employees against a retail store revealed how meaningless the title of manager can be: the store managers were “stocking shelves, running cash registers, unloading trucks and cleaning parking lots, floors and bathrooms.” Hardly the types of responsibilities that go with overseeing one’s coworkers. The employees were suing for overtime pay under a Depression-era federal law to receive back pay for overtime when they worked more than 40 hours per week. Employers are exempt from paying overtime under this rule, however, if the employ…

This is a fact of retirement life: older Americans haven’t paid as much into Medicare and Medicaid as government spends on their healthcare and nursing home stays. But it is middle-class retirees who get the most out of the system, according to a new study. Middle-income households receive about $230,000 to $260,000 more in Medicare and Medicaid benefits, on average, during their retirement years than the total amount they’ve paid in. Their contributions consist of the Medicare payroll and income taxes deducted from workers’ paychecks, the portion of their federal and state income taxes devoted to Medicare and Medicaid, and the Medicare Part B and D premiums they are paying in retirement. The net benefit of the programs to the midd…

“Is it medically necessary for a person to be able to chew?” Dr. Lisa Simon, a physician and dentist at the Harvard School of Dental Medicine, asks. This is a serious question for older Americans in fragile health. I know a 93-year-old man whose teeth problems make it extremely difficult for him to eat meat and many other foods on the dinner table. Two-thirds of retirees do not have dental insurance, which means they may decide to forgo getting expensive dental care. The importance of dental care to nutrition and health is also an equity issue for older Blacks and low-income retirees, who are more likely to be missing all of their teeth. Medicare has historically paid for very few dental procedures…