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My husband turns 65 in March. So I’ll take a cake to the town hall for the monthly meeting of the volunteer fire department, where Bill is assistant chief. I expect there will be good-natured ribbing about needing more personnel to put out so many candles. But they won’t put Bill out to pasture because of this birthday. In fact, they won’t let him hang up his helmet just yet.
Because our neighbors know something that’s rarely mentioned in articles about the poor health status of rural elders. You know, the studies that cite our higher rates of obesity, tobacco use, and reduced access to health-care options. Here’s what you seldom see mentioned: Despite those factors, some studies indicate that rural elders may be more able than their urban counterparts.
Despite negative health behaviors, many aspects of rural social life contribute to positive health outcomes. “Rural areas frequently have strengths including dense social networks, social ties of long duration, shared life experiences, high quality of life, and norms of self-help, and reciprocity”.
At a certain age, things fall apart no matter where you live. But for now, Bill is following in the footsteps of many of our rural neighbors who have already gone over the hill but keep doing what needs to be done for their families and communities.
So instead of retirement, here’s what we’re celebrating on Bill’s 65th birthday:
Medicare. Like a quarter of a million baby boomers who turn 65 each month, Bill goes on Medicare in March. At last. After 40 years of payroll taxes deducted from paychecks. After a lifetime of paying taxes so those with no insurance could get the health care they needed. After 30 years paying out-of-pocket health insurance premiums, shouldering the risk for all those in our insurance pool while we were the healthy ones.
For the past two years, we’ve bought our insurance on the health care exchange and qualified for a tax credit that makes our coverage affordable. Every time I hear someone say how expensive the policies are, how high the deductibles are, I have to bite my tongue. Before the Affordable Care Act went into effect, our health insurance monthly premium was more than $1,300. With a $6,000 deductible on top of that $15,000 a year. Even though we had insurance, we couldn’t afford to seek medical care. Because we had been denied a policy once and had to appeal the decision to even get insurance, we were afraid to give it up. So we gave up other things instead.
Jumping the Seven Year Ditch. Until the Affordable Care Act went into effect, we spent years dreading the day when Bill would go on Medicare. Since I’m seven years younger than he is, we worried about how we would afford both a Medicare Supplement for him and an out-of-pocket premium for me — if I could even get a policy. And with premiums increasing as much as 20% a year — fast outpacing our income — it seemed likely that I would spend my early 60s uninsured, underinsured, or digging us into a deep financial hole we called it the Seven Year Ditch.
So for Bill’s 65th birthday, we’re celebrating Obamacare. It’s not perfect, but we can afford coverage for me until I, too, start Medicare. When we joined the health exchange, we planned ahead: I am the insurance subscriber and Bill is listed as the spouse. Once his Medicare kicks in, he’ll drop off that policy and I’ll still be covered. The premium for just me will go down enough for us to afford both my policy (with the tax credit) and a Medicare supplement for him.
People Who Help People. We’re also celebrating the people who help people like us navigate these changes. Late last year while I was away getting my parents moved into assisted living, Bill saw something in the local newspaper about a half-day class on Medicare benefits. So he went in to the county seat and came home with a big folder stuffed with information and a bunch more questions. Last week we went together to meet with the benefit specialist at our area Aging & Disability Resource Center. She helped us sort out his options: Medicare plus a supplement, or Medicare Advantage? Even better, she explained to us how SeniorCare works in Wisconsin. It’s a state-based prescription drug benefit available to Wisconsin residents who are 65 or older. And it’s just $30 a year. It’s perfect for an active, able 65-year-old like my husband. We might have stumbled across it on our own. But probably we would have spent a lot of time agonizing over which Medicare prescription plan would best fit needs we don’t have right now. (If you need similar help, visit the State and Area Agency on Aging (SAA/AAA) Finder.)
Parents Who Continue to Teach Us. We’ve learned a lot about how we want to meet the challenges of aging from our parents. For example, Bill has softened his stand against technology (“It’s a fad”) because my 83-year-old father was making him look bad. Dad had only used a computer to play Freecell. But in the past couple of years, Dad has learned to use an Android tablet to email me pictures of bills and statements so I can help sort out the charges. He can Skype with my sister, who lives overseas. He can “OK, Google” to learn more about medical lab results, exercises for sciatica, and driving directions to different medical specialists.
Yes, Dad still drives. We’re learning from that, too. For someone who spent most of his life in the country, it’s hard to change the default response to anything besides driving their own car. Bill and I will have to give up our wheels at some point, too. That means we’ll have to develop new skills for managing our transportation needs. We keep telling ourselves we want to make that choice before our neighbors are asking, “Shouldn’t someone do something about them?” Remind me, down the road, that I said that. And send me to Rural Health Information Hub’s Transportation to Support Rural Healthcare page.
A Great Credit Rating. The one lesson from our parents that didn’t seem to take for us was about saving for retirement. Bill and I had a good laugh once when we saw what a household budget was supposed to look like: Housing 25%, transportation 15%, food 12%, savings 10%….). The financial “experts” offering that helpful advice assume your health insurance is paid by an employer, so they don’t even account for it in the equation — let alone make it the single largest budget item for a family.
For years, our out-of-pocket health insurance premiums funded what I’m sure were very nice vacations for insurance company shareholders, but we couldn’t afford to travel. We couldn’t afford a new car. Or make contributions to our IRAs. Still, we managed to pay off the mortgage on our modest home. When we approached the credit union for that loan, they looked at our income and balked. Then they checked our credit rating and loaned us more than we asked for.
Like many people in rural areas, we stretch our dollars. Bill hunts and fishes and we grow our own vegetables, satisfying our needs for both food and recreation. I hang laundry on the clothesline because we couldn’t afford to replace the dryer when it died — and not having one cut our electric bill by $16 a month. We don’t have cell phone plans, or satellite TV. Bill drives a pick-up truck that’s older than two officers on the volunteer fire department.
Our failure to save more for our golden years wasn’t because we haven’t worked hard. But to make the kind of modest investments my parents made which, we hope, will last long enough to pay their assisted living expenses for maybe three years, we would have had to give up our health insurance. OK, maybe we were stupid to funnel so much of our earnings to insurance companies. But I am mightily offended by any implication that our paltry savings are our just desserts for being lazy, ignorant, spendthrift hicks. And I’m gravely worried about how the hard-working young people in our life will ever manage to achieve any level of financial security. They already face greater economic challenges because where they live is rural.
Good Investments. It’s not that we haven’t invested anything for our future. But our best investments are not things you find on the NASDAQ. We buy good tools that will last, because we expect to be working for, well, a lot more years. We pay for regular dental care out of pocket in the belief that good oral health contributes to overall health. Our property taxes support the local 4K-12 school district and the area technical school, which educate the people who one day may be helping us perform activities of daily living, and the EMTs and firefighters who might one day save our lives or our home.
And for the next two years, Bill’s goal is to invest time in helping to train his replacement as our rural volunteer fire department’s assistant chief. He and the chief are eager to step down, and younger members are eager to step up. They’re working to gain the experience to take on those new roles. So at every training and every scene, Bill is thinking about how he can frame assignments to the benefit of the department’s future leaders. He’s even learned to text them when he wants to discuss fire department business, and (grudgingly) admits that texting isn’t a fad.
Next month when Bill blows out the candles on that cake (which, yes, will contribute to rural obesity), I suspect he’ll be wishing for our continued good health and more years of being able. And giving thanks for our rural community, and for loved ones and neighbors who set such great examples about how to keep doing what needs to be done. Because that’s what 65 looks like here and now.
Donna Kallner lives in northern Wisconsin. She says she has been forbidden to mention the age of her husband, Bill, at any birthday since he turned 40. On that occasion, the only person who sent one of those “gee, you’re old” cards was Bill’s mother. “And she was entitled,” Kallner said.