Moeller: 5 things you should know about Medicare’s new end-of-life discussions

Journalist Philip Moeller, who writes widely on health and retirement, is here to provide the Medicare answers you need in “Ask Phil, the Medicare Maven.” Send your questions to Phil.

End-of-life discussions with your physician or other licensed caregiver are now being paid for by Medicare — one of the program’s major consumer changes taking effect this year. Thinking and talking about your wishes and the kind of health care you want to receive at the end of your life are probably not at the top of your bucket list, or anywhere close, but such discussions could be very important.

A big chunk of health care spending occurs in the final months of a person’s life, and it often brings very little benefit. While Medicare covers a lot of these expenses, particularly through its extensive coverage of hospice services, families are also on the hook for a lot of this end-of-life spending. Beyond dollars, the emotional burden of helping a loved one in their final days often is enormous.
Jim: How can Medicare penalize me for paying for my own prescriptions? I lost my job and my insurance in 2008 and have been paying for my prescriptions since then — all of which were affordable. Now, I have signed up for Part D (drug coverage), and I understand I will have “x” amount taken from my Social Security each month for the rest of my life. This is ridiculous and just another way for the government to get their hands in my pockets. I thought I was saving the taxpayers some money. I love my country, but I hate the politicians. How can regular people catch a break? I lost my job, my house and my retirement. I have nothing left to give them.

Adding to both burdens, your grown children and other friends and loved ones may not have a clue about the kind of care you would want should you no longer be able to make your own health care decisions. There is, unfortunately, a good chance this will be the case. So creating advance directives and other binding end-of-life health care documents is essential.
There is no guarantee that having end-of-life appointments with your doctor will achieve all these hoped-for outcomes. Doctors may not have such discussions on their professional bucket lists either. You and any caregivers you now have need to invest in this opportunity if it is to succeed.

Read more: PBS

Philip Moeller

Philip Moeller is a research fellow at the Center on Aging & Work at Boston College and co-author of “How to Live to 100.”

He wrote his latest book, “How to Get What’s Yours: The Secrets to Maxing Out Your Social Security,” with Making Sen$e’s Paul Solman and Larry Kotlikoff. He is now working on a companion book about Medicare.

Follow him on Twitter @PhilMoeller or e-mail him at


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