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How to Maximize 2017 Income Tax Medical Deductions

One of the deductions that may disappear with the proposed federal tax reform bill is the one for medical expenses.

Currently if you itemize your expenses, you can deduct qualified medical expenses that exceed 10% of your adjusted gross income (AGI). For those age 65 and older, the available deduction is 7.5%.

According to the IRS, the following may be included as qualified expenses for most medical and dental expenses you paid for yourself, your spouse and your dependents for:

    • Diagnosing, treating, easing or preventing disease
    • Prescription drugs and insulin
    • insurance premiums for policies that cover medical and dental care
    • Some long-term care insurance costs

The cost of nutritional and herbal supplements and other natural medicines can only be deducted when they are recommended by a medical practitioner as treatment for a specific medical condition diagnosed by a physician.

Given the uncertainty about whether medical expense deductions will be available in 2018, it is wise to avoid delaying any qualified medical expenses you can if you itemize expenses on your tax return.

For more information, visit


Save Money on Organic Produce: Dirty 12 and Clean 15

Most people pursuing a healthy lifestyle will choose organic produce whenever possible to avoid pesticides, shown by U.S. and international agencies to be associated with brain and nervous system toxicity, hormone disruption and cancer, as well as skin, eye and lung irritation.

Although availability has increased dramatically in the last few years, organic continues to cost more than produce grown by conventional means. However, because some produce has protective peels or husks, you don’t need to buy expensive all organic to avoid toxic pesticides.

Every year the Environmental Working Group (EWG) releases its Dirty 12 and Clean 15 lists, documenting which fruits and vegetables have the highest and lowest amounts of pesticide residue. The lists are based on scientific data from the USDA (United States Department of Agriculture).

Here’s how to save money when buying organic produce.

The Dirty 12

Here are the 2017 Dirty 12, in descending order of contamination: strawberries, spinach, nectarines, apples, peaches, peas, cherries, grapes, celery, tomatoes, sweet bell peppers, potatoes. Plus: hot peppers

The list changes each year. For example, spinach was number eight last year, but has moved up to number two this year due to the finding of contamination with new fungicides and an insecticide. In 2016 and 2017, the EWG has made a special note of hot peppers. Although, they don’t meet the EWG’s traditional ranking criteria, they were found to contain insecticides toxic to the human nervous system.
According to the EWG, cleaning conventional produce with vegetable/fruit washes is not enough to remove all toxic contaminants.

As a result of their studies, the EWG recommends buying only organic produce of the items on the Dirty 12 list.

However, you can save money and still be protected from toxic pesticides by buying conventional produce instead of organic foods that appear on the Clean 15 list.

The Clean 15

The Clean 15 list includes: sweet corn, avocados, pineapples, cabbage, onions, sweet peas, papayas, asparagus, mangoes, eggplant, honeydew melon, kiwi, cantaloupe, cauliflower, grapefruit.

Click here to obtain the free EWG pocket-size Shoppers Guide with the Dirty 12 and Clean 15 Lists.

Unaffordable Rx: 9 Ways to Save

In the U.S., prescription drug prices continue their meteoric rise. The truly outrageous increases hit the national news outlets and some result in congressional hearingsFor example, Mylan, the maker of the life-saving EpiPen allergy-reaction injector, increased the price of its two-pack from $100 in 2009 to $608 in 2016.Nitropress, a common blood pressure drug, rose more than 300%, soaring from $214 to $881 last year. On average, drug prices have doubled in the last decade, according to AARP.

Simultaneously, insurance company formularies of covered drugs have narrowed, while co-pays have increased. This double-whammy has hit older Americans the hardest, as they use more medications than any other age group. Many retirees with limited income are faced with deciding whether to spend their limited funds on needed medications or on food.

As this situation will continue to worsen in the future, it’s getting more important to find ways to obtain the medications you need at better prices. Continue reading Unaffordable Rx: 9 Ways to Save

Dietary Supplement Expiration Dates

In contrast to prescription and over-the-counter medications, manufacturers of nutritional supplements are not required by the FDA to print expiration dates on their products. However, many do some voluntarily. If there is a labeled expiration date, the company is required to have stability data demonstrating that the product will still have 100% viability of all the listed ingredients until that date.

Over time, most of the ingredients in nutritional supplements gradually decompose. This makes the product less potent, although typically not dangerous. To address his phenomenon, many companies add higher amounts of the ingredients listed on the label, especially those like vitamins C and B12 that decompose rapidly.

Most supplements retain their full potency until 2 years after the label date. Probiotics, liquids and oils, which are less stable, typically retain full potency for about a year. Be sure to store your supplements in a dark, dry place, except those that have direction labels requiring refrigeration.

When deciding on supplement brands, check out, an independent testing company, which routinely analyzes competitive brands and reports on the veracity of their ingredients as well as cost.

Increase Your Bone Density with 12 Minutes of Daily Yoga

A Common Disease in Older People

Each decade after about age 30, the mineral density of our bones declines. The decrease in bone mineral density (BMD) that occurs with aging is called osteopenia when it is mild and osteoporosis when it is more severe. Both men and women suffer from osteoporosis. Worldwide, osteoporotic fractures occur in 33% of women and 20% of men over age 50.  ( Reports/osteoporosis_in_men_2004_english.pdf). In the U.S., an estimated 44 million women and men aged 50 and older suffer from low bone mass or osteoporosis.

The most common bone fractures occur in the spine, hip, thigh bone (femur) and forearm. Bone fractures, especially of the hip, often triggers a downward spiral in health. Researchers have shown that in comparison to fracture-free individuals of the same age, those with hip fractures face a 3-4 times greater risk of dying. ( Continue reading Increase Your Bone Density with 12 Minutes of Daily Yoga

Obamacare 2017 Open Enrollment

The Open Enrollment Period for obtaining healthcare coverage through the ACA Health Insurance Marketplace is November 1, 2016 through January 31, 2017. However, to begin coverage January 1, 2017, you need to complete your enrollment by December 15, 2016.

As in previous years, depending on your income, you may be eligible for subsidies for monthly premiums. About 85% of ACA enrollees do qualify for federal tax credit subsidies.

The Kaiser Family Foundation (KFF)  provides an easy-to-use, free tool   for calculating your monthly premiums and subsidies:

More Difficult to Find Affordable, Comprehensive Plans

Unfortunately, there are several unfavorable factors impacting Obamacare coverage for 2017, including the withdrawal of some large insurers from offering plans in selected states.

In general, 2017 premium increases will be larger than they were in 2016. Rates will vary by geographical area and the type of plan selected. This trend is not limited to Obamacare plans, but is also impacting individuals who have coverage through their employers. Deductibles and copayments are continuing to rise.

The other trend that is continuing is the narrowing of networks. There are both fewer doctors available in general and contraction of choice in specialists. Again, this is the situation for both Obamacare and employer plans.

A newer trend for Obamacare is the limited availability of independent insurance brokers to assist with making plan choices. These agents work on a commission basis, and now insurers are either reducing or no longer paying commissions to agents for helping people obtain ACA coverage. For example, Cigna, Aetna and UnitedHealthcare have dropped commissions in many states. As a result, a growing number of brokers are declining to offer their services to new enrollees, although some will continue to assist established clients.

For 2017 coverage, it may take a bit more time to evaluate your options and find a plan that is best suited to your needs. Remember, there is still help available from and from individual insurers.



Medicare Open Enrollment

It’s that time again—October 15 – December 7—when you can make changes in your Medicare health plan (Parts A & B or C) and prescription drug plan (Part D) for 2017. If you’re happy with your current plan, you don’t need to do anything. However, if you want to switch between Original Medicare and Medicare Advantage, pick a different Medicare Advantage plan or change your Part D plan, you can only do so during the Open Enrollment Period.

2017 Medicare Changes

Premiums and Deductibles

The  Medicare Part B premium for new enrollees who have income of $85,000 or less is $121.80. For current enrollees the premium remains the same because there was no cost of living increase for 2016. The Part B deductible is $166 for 2017.


Find coverage information at or in Medicare &You 2017, the official U.S. government Medicare handbook.

Medicare Advantage Provider Networks

Medicare Advantage Plan HMO and PPO networks change each year and sometimes during the year. If you want to keep particular doctors, make sure to check that they are still in your plan. There is a continuing trend to narrow networks, which means there is less provider choice.

Part D Pharmacies and Formularies

Which pharmacies are included in a Part D plan and which are preferred can change each year. Formularies typically change each year and sometimes during the year. Part D plans usually send out their next year’s information a month or more before Open Enrollment. Take the time to review these materials carefully for changes that effect you.

During the year, your plan may substitute one generic for another for treating the same condition. Be aware that all generics are not created equal. If a substitution occurs with a drug you take, contact the doctor who prescribed it as the new one may have different side effects than the original.

If you need an expensive drug that’s not in your formulary, visit This organization has a rigorous verification and certification process for finding and comparing prices of reputable, online licensed pharmacies. These foreign pharmacies, many in Canada, can legally provide a 3-month supply of branded drugs with your doctor’s prescription. The savings can be substantial. All large pharmaceutical companies have manufacturing plants in foreign locales that must meet the same FDA standards as U.S. plants. As overhead costs are much lower, the prices are also significantly lower. However, generic drugs are cheaper in the U.S. due to increased competition.



Dehydration Dangers

Recently, I traveled from my home in Santa Monica to my favorite desert spa in record 121° heat. At 10 pm, it was still 106°. During my three days there, I drank liquid continuously. I estimate 16-20, 8-ounce cups daily. During such severe heat, people become very sensitive to dehydration. But it’s important to stay adequately hydrated year-round.

Dehydration Causes

Dehydration can happen for many reasons besides heat exposure, including as a side effect of prescribed medications; diarrhea; excessive sweating; loss of blood; diseases, such as diabetes; as well as the effects of aging

Dehydration Symptoms

If you notice your mouth is dry and you’re tired, see what happens once you drink some purified water. If you immediately perk up, that’s feedback that you were dehydrated. Dehydration can range from mild to severe. Severe dehydration can be life-threatening. If you develop severe diarrhea with or without vomiting, fever, moderate diarrhea for 24 hours, bloody stool, or you can’t drink any liquids, get professional treatment as soon as possible. Chronic dehydration may affect your organs and lead to kidney stones; increased cholesterol; constipation; liver, joint, and muscle damage, as well as impaired balance. Continue reading Dehydration Dangers

Employers Continue Their Cost-Shifting to Workers

With the news focused on Affordable Care Act (ACA) health insurance plans, it is often forgotten that nearly half (49%)  of  people under 65 receive their health insurance coverage from their employers or are covered by their spouse’s plan.

Patients, even those with employer-sponsored health plans, may face another condition after they are discharged from a hospital stay: acute sticker shock.

Out-of-pocket hospitalization costs rose 37% from 2009 to 2013, with the average patient paying more than $1,000 per hospital visit, according to a study conducted by the University of Michigan and published in JAMA Internal Medicine.

The survey, which was conducted before many of the Obamacare provisions were in place, including the 2014 health insurance marketplaces, examined 7.3 million hospital stays from 2009 to 2013, using data from three of the largest insurers: Aetna, United Healthcare and Humana.

Driven by an 86% rise in deductibles and a 33% increase in coinsurance — the part of the hospital bill that patients are expected to pay —out-of-pocket (OOP) costs rose faster than health insurance premiums. Annually, OOP spending increased 6.5%. In contrast, health insurance premiums increased 5.1%.

The data demonstrate that employers were shifting more costs to patients, according to Emily Adrion, lead author of the study. About 85% of health insurance benefit packages required coinsurance for inpatient hospitalizations, in addition to meeting an annual deductible. Patients with individual plans paid more than $1,800 on average, the researchers found. In contrast, those with consumer-directed plans — high deductible policies paired with health savings accounts (HSA) —OOP hospital costs topped $1,200.

AMA Updates Ethics Code

For the first time in more than 50 years the American Medical Association (AMA) has updated its code of ethics.

The AMA Principles are standards of coduct that define the ethical behavior of physicians in all specialties.

AMA Principles of Medical Ethics

A physician shall:

  1. Be dedicated to providing competent medical care, with compassion and respect for human dignity and rights.
  2. Uphold the standards of professionalism, be honest in all professional interactions, and strive to report physicians deficient in character or competence, or engaging in fraud or deception, to appropriate entities.
  3. Respect the law and also recognize a responsibility to seek changes in those requirements which are contrary to the best interests of the patient.
  4. Respect the rights of  patients, colleagues, and other health professionals, and  safeguard patient confidences and privacy within the constraints of the law.
  5. Ccntinue to study, apply, and advance scientific knowledge, maintain a commitment to medical education, make relevant information available to patients, colleagues, and the public, obtain consultation, and use the talents of other health professionals when indicated.
  6. In the provision of appropriate patient care, except in emergencies, be free to choose whom to serve, with whom to associate, and the environment in which to provide medical care.
  7. Recognize a responsibility to participate in activities contributing to the improvement of the community and the betterment of public health.
  8. While caring for a patient, regard responsibility to the patient as paramount.
  9. Support access to medical care for all people.