Ask Liz Weston

Get smart with your money

Q&A

Q&A: A health crisis brings high medical bills. Here are tips for dealing with the costs

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Dear Liz: I have been diagnosed with Stage 4 cancer which has metastasized into at least two areas. Surgery, chemo, perhaps a stay in rehab and possibly radiation therapy will be prescribed by my oncologist. In order not to deplete my retirement savings (the oncologist estimates that I will live longer — years — if the treatment goes well), what resources can be identified to help financially with co-pay, medical and prescription costs? I already know about hospital benevolence programs. I am going to revert to my monthly “austerity” budget, watching every penny of my expenditures and trying to avoid or reduce them. I will be unable to work part time, as I have been doing, for at least this year. I am 70. I have Medicare and a Medicare supplement plan as well as a Part D prescription plan. Thank you for any suggestions.

Answer: You’ve just received a shocking diagnosis and it’s understandable that you’re worried about the costs you’ll face.

Your Medicare supplement plan — also known as a Medigap plan — is designed to cover some or all of the costs not paid by traditional Medicare, including co-payments, co-insurance and deductibles. The plans with lower premiums typically have skimpier coverage. You’ll want to carefully review your plan to see what coverage you have.

You probably will have questions, so consider connecting with your State Health Insurance Assistance Program. This program can refer you to a government-funded counselor who can provide free Medicare counseling. You can find your regional SHIP using the online locator or by calling (877) 839-2675 and say “Medicare” when prompted.

Ask your oncologist about lower-cost treatment options and any charitable programs they have or are aware of. Benefits.gov can show you what government programs might be available to help with costs, while 211.org can help you check if there are any local programs. You may be able to seek out cheaper prescriptions through online pharmacies, GoodRx, NeedyMeds, manufacturer discount programs or Medicare’s Extra Help program, which helps Medicare recipients with limited means to afford their medications.

Another option for people with catastrophic medical bills is to file for bankruptcy. Your retirement accounts would be protected, but you’d want to discuss your options with a bankruptcy attorney long before you file.

While you’re researching, keep in mind that the U.S. medical system is set up to push treatment, often regardless of the cost, efficacy or toll on quality of life. Physician and certified financial planner Carolyn McClanahan warns that people can find themselves on a “medical treadmill” that continues pushing painful, debilitating and costly treatments with little or no real benefit to the patient.

Consider having a frank talk with your oncologist about how much more time each treatment will likely get you — not just in a best-case scenario, but in an average-case scenario — and how you are likely to feel during the treatment. A second opinion may also be a good idea. These discussions can help you decide if you want to pour all your available resources into paying for treatment or if there are other options that would allow you to better enjoy whatever time remains.

McClanahan recommends picking up a copy of Katy Butler’s excellent book, “The Art of Dying Well: A Practical Guide to a Good End of Life.” Despite its title, the book doesn’t just focus on the very end of life, but also provides essential information about how to best navigate the healthcare system as an older person.

Q&A: IRAs, pensions and taxes

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Dear Liz: I contributed to an IRA during my working years. I’m now retired. Both my and my spouse’s IRAs are Roths, so we have no required minimum distributions. I’d like to continue contributing to an IRA, but neither I nor my spouse have W-2 or self-employment income anymore. We do, however, both collect pensions, which are taxed as ordinary income. Shouldn’t we be able to make IRA contributions, as we earned these pensions by working, and they are taxed exactly the same as our paychecks were taxed?

Answer: Nice try! There’s no longer an age limit for contributing to an IRA or a Roth IRA, but the IRS insists that those who contribute have earned income — which means wages, salary, tips, bonuses, commissions or net self-employment income. Payments from pensions and retirement funds don’t count as earned income.

Q&A: Wondering why your credit score is bad? Here’s how to make it better

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Dear Liz: I am trying to get my credit score figured out and was wondering if you have any recommendations for a credit report guru in my area? I need someone to walk me through why my score isn’t higher and to help me resolve that issue.

Answer: Unfortunately, many credit repair companies are scams. Even those that are legitimate are essentially selling you something you can do on your own, for free.

Understand first that you don’t have just one credit score: You have many, and they change all the time based on the information in your credit reports. Consider signing up for a service that provides you a free score that you can monitor over time. That can help you understand what behaviors help and hurt your credit. These services also typically give you reasons why your score isn’t higher. (You may be able to get a free credit score from your bank or a credit card issuer. If not, many sites online provide free scores.)

Next, get all three of your credit reports for free from AnnualCreditReport.com. (Type the address into your browser rather than using a search engine, since there are many look-alike sites. If you’re asked for a credit card, you’re on the wrong site.)

Look for obvious problems, such as accounts you don’t recognize or late payments being reported when you paid on time. Dispute incorrect information, using the links provided. Negative information that is correct can typically stay on your credit reports for seven years, although the impact on your scores should diminish over time.

In general, you can improve your scores by paying bills on time, using 10% or less of your available credit limits and having a mix of credit types (credit cards and installment loans). If you’re starting from scratch or trying to improve bad scores, consider a credit-builder loan from a local credit union or an online lender.

Q&A: Care planning for ‘solo agers’

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Dear Liz: My wife and I don’t have children or any relatives nearby. So far, we’re healthy and completely independent, but that won’t always be the case. Do you know of any fee-based agencies or organizations that might provide assistance with such things as arranging a caregiver if needed, or helping our executor clean out our home?

Answer: A geriatric care manager can help assess your needs as you age and come up with a plan to meet them, including arranging for caregivers or finding an assisted living facility. You can get referrals from the Aging Life Care Assn.

An estate liquidator or a professional organizer can help with clearing your home. You (or your executor) can get referrals from the American Society of Estate Liquidators and from the National Assn. of Productivity & Organizing Professionals.

Also consider building a community of friends and neighbors who can help you as you age, and vice versa. You might be able to get some help from the nonprofit Village to Village Network, which is a group of community-based membership organizations helping people to age in place. The books “Who Will Take Care of Me When I’m Old?” by Joy Loverde and “Essential Retirement Planning for Solo Agers” by Sara Zeff Geber would be helpful reading.

Q&A: Taxes and inherited IRAs

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Dear Liz: Thanks for the recent column concerning children getting an inherited IRA, because I’m in that situation. Is the attorney for the estate required to include tax information with the distribution, or is it up to my accountant to sort things out? And since I don’t really need the money right now, would I have options as to how I receive the funds to avoid a tax hit?

Answer: You can’t avoid a tax hit with an inherited traditional IRA. The money has to come out and the withdrawals are taxable. For beneficiaries who aren’t the surviving spouse, the account typically must be drained within 10 years. (There are exceptions for beneficiaries who are minors, disabled or chronically ill.)

You have some flexibility about how rapidly you take the money out, however. If the account owner hadn’t started required minimum distributions before dying, you can withdraw money at any rate you want, provided you empty the account by Dec. 31 of the 10th year following the year of the owner’s death.

If the account owner had started required minimum distributions, you must take a minimum distribution each year. These are typically based on your own life expectancy. In addition to those annual withdrawals, you’ll need to take out the remaining money by the end of the 10th year following the year of death.

There was initially some confusion about whether beneficiaries had to take yearly required minimum distributions or could wait until the 10th year to withdraw the funds, said Mark Luscombe, principal analyst for Wolters Kluwer Tax & Accounting. Because of that confusion, the IRS has waived the penalties for failing to take required minimum distributions when the IRA owner died in 2020, 2021 or 2022. The waiver of penalties would not be available if the IRA owner died in 2023, Luscombe said.

Leaving money in the account as long as possible means the balance has longer to grow tax deferred. But you also could face a whopping tax bill in that 10th year. Definitely discuss your options with your tax pro. While the attorney for the estate may help with some details — such as arranging to get the money transferred from the deceased owner’s account — it will be up to you to set up your own inherited IRA and to arrange for distributions.

Q&A: Where should you put your extra cash? Here are some ideas

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Dear Liz: At 82, I am selling my house and moving to a senior community. For the first time in my life, I will have a substantial amount of cash. Given my age and the fact that certificates of deposit and savings accounts are currently paying more than 5% interest, does it pay for me to start investing in other ways?

Answer: How you figure out what to do with your money is mostly the same whether you’re 28 or 82.

You start with your goal and your time horizon, or how long you have until you need the money.

For example, you may have to put aside some of the home sale proceeds to pay capital gains taxes if your home has appreciated more than the $250,000 that’s normally exempted from tax. Since the tax bill will be due within months of the sale, you shouldn’t take unnecessary risks with this cash. A high-yield savings account would be a good solution for any money you need to keep safe and liquid.

You also may want to earmark some money for long-term care. This goal is much more ambiguous, because it’s impossible to predict how much you’ll need or when. You may want to consult an elder law attorney, who can discuss your options.

Once you settle on a figure, you’ll want that money to be somewhere safe and readily accessible. Certificates of deposit that mature at different times could be an option, as could the high-yield savings account mentioned above.

If you have a goal that’s many years in the future, you could consider a mix of stocks and bonds. Stocks in particular offer long-term returns that historically beat inflation.

Most working people who want to retire will need to invest in stocks to accumulate and maintain a sufficient nest egg. They can take the risk of losing money in the short term because they have many years ahead for their investments to recover.

And that’s where your situation differs from that of a 28-year-old. The average life expectancy for an 82-year-old male is about eight more years, while the average life expectancy for an 82-year-old female is around nine more years, according to the Social Security Administration.

You may have enough time left to ride out a bad market. But if you don’t have to take such risks to achieve your goals, consider playing it a bit safer.