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News From MOAA National for July 2017

Dateline: 7/21/2017

Beware When Trading and Selling Online
If you've been around the digital block a few times, you know to be careful when buying online. But you also need to be careful when selling or trading in items. And it's not only the small percentage of unscrupulous buyers you need to watch out for. Sometimes it's the particular online marketplace itself.

Among the options are Craigslist and Facebook Marketplace. Both can hook you up with local buyers, preventing you from having to ship items. Another option is eBay.  Still another option is Amazon Trade-In, which specializes in letting people trade in used smartphones, tablet computers, notebook computers, and other electronics.  You might think Amazon would be a great choice here, with its stellar overall reputation for reliability. Amazon has been around for more than 20 years, and it's by far the largest online marketplace in the U.S.  Amazon always has done of a good job of providing feedback to shoppers about the reliability of sellers, which can be businesses or individuals. About 40 percent of the merchandise sold is from third-party sellers, with the remainder from Amazon itself.

Amazon's overall reliability, however, hasn't prevented unscrupulous people from writing bogus positive reviews about their own items or bogus sabotage reviews about others' items, though Amazon devotes considerable resources to cracking down on this.

Most who use Amazon all the time to buy products and consistently have had positive experiences, from the quality of the items to the fast shipping times. Customers also like Amazon Smile, which lets you designate a nonprofit organization that Amazon will donate a percentage of revenue to. ( Learn how to use Amazon Smile to contribute to participating charities, including the MOAA Scholarship Fund.)

Amazon Trade-In, however, has its problems. Announced in 2009, it initially received positive reviews. When you send in an item, Amazon has you rate its condition and check a box to choose whether to reject the trade if Amazon thinks it's in worse condition or accept the trade at a lower condition if Amazon determines this and a subsequently lower amount of credit. In return for the item, you receive an Amazon gift card, good for buying anything on the huge marketplace that's Amazon.

After a few years, however, stories began to surface about Amazon unfairly downgrading the condition of items people trade in. ZDNet reported this in October 2015 in an article titled Amazon Trade-In: Fair Value for Your iPhone or Scam? According to the article, "It is more or less standard practice for [Amazon] to automatically downgrade the condition of the device no matter what condition it is in."

Lifewire reported the same in an article The Precipitous Fall of Amazon's Trade-In Service and several updates of it, the latest in October 2016. According to the article, if you complain too much about this practice with your own trade-ins, "Amazon can and will just outright ban you. Not just from trading, but from using the site at all."

A new investigation by freelance tech journalist Andrea Smith just found the same thing still is happening.

After repeatedly having items downgraded by Amazon, out of frustration, Smith tested Amazon. She sent Amazon Trade-In an unopened Roku 4 streaming device, sealed with the plastic wrap still around it, as she told me in email. She rated it as being in excellent condition, and she chose "reject the trade" if Amazon didn't agree with the condition. Amazon didn't agree and sent it back.

She phoned to ask what the issue was and was told the device had scratches on it. She looked for the scratches but couldn't find any.Amazon wanted to offer her 45 percent of what it would have if it determined the item was in excellent condition as she said.

Smith says, "Trader beware!" She recommends going with another trade-in site. Other sites include GazelleSwappaSecondSpin, and GameStop.

 Care is Key to Veterans Choice
Just a little beyond his first 100 days in office, VA Secretary Dr. David Shulkin presented more details on his plan to overhaul the current Veterans Choice Program and improve health care delivery in testimony June 7 before the Senate Committee on Veterans Affairs.  

While the VA has yet to officially submit its plan to modernize and consolidate community care programs, MOAA has been able to obtain some details in addition to what we learned during the hearing. The new proposal would consolidate all purchased care programs into a single community care program called Veterans Coordinated Access and Rewarding Experiences (CARE).  

The current Choice program has been cumbersome and difficult to navigate and understand since its inception. In some locations, the program has actually made it more difficult for veterans to access care because of administrative hurdles, contracting rules, and inconsistencies in implementing policies, with prime examples being the arbitrary eligibility standards of 30-day wait time and 40-mile distance criteria established under Choice in order to access care in the community.  

According to the secretary, the Veterans CARE proposal would “clarify and simplify eligibility requirements, build high performing networks, streamline clinical and administrative processes, and implement new care coordination support for veterans.”  

So what will this new proposal mean to veterans?  

The secretary told lawmakers, “We believe that a redesigned community care program will not only improve access and provider greater convenience for veterans, but will also transform how VA delivers care within our facilities.”   “We first need to move from a system where eligibility for community care is based on wait times and geography to one focused on clinical need and quality care. … This gives veterans real choice in getting the care they need and ensures it is of the highest quality.”  

The fix for community care is moving to a program based on clinical criteria where the provider or health care team and veteran mutually determine the best care options, whether within the VA or in the community. The process is expected to empower veterans to work more closely and collaboratively with providers. A simple clinical appeals process would be available when a veteran does not agree with a provider's clinical referral recommendation.  

The decision to use VA or community care will depend on who can provide the best clinical care based on availability of services, access to services, and the feasibility of the veteran getting those services.  

For instance, if the VA does not offer a service or specialized care, or VA is unable to provide care within the clinically appropriate time, or the quality of care at the VA does not meet performance standards, then community care would be an option for a veteran.  

Veterans also would have access to community walk-in clinics in the network to treat minor illnesses or injuries, with no referral required. Additionally, veterans would have a single contact for care coordination and new tools to easily schedule appoints with VA and community providers.  

While committee members praised Shulkin for his fortitude and decisive leadership in fixing Choice, addressing system accountability, and announcing his plan to join with DoD in adopting the Cerner electronic health record (EHR) platform, some lawmakers voiced concerns and skepticism over these system changes.  

Ranking Member Jon Tester (D-Mo.) and Sen. Patty Murray (D-Wash.) worried the community care and associated pilot program proposals would eventually hollow out the VA health system and lead the department down the path of privatization.  

Shulkin assured the committee CARE would make the health system sustainable and stronger in the long run by giving veterans more choice, and reiterated throughout the hearing he had no intention to privatize the VA.  

“But when you have 33 percent of your health care budget going to fund community care, yet only increasing VA direct care spending by 1.2 percent, then you are moving toward privatization, driving veterans to follow the money into the community,” Tester stated.  

Lawmakers also questioned the secretary on his plans to fill the 45,000 existing vacancies and the administration's budget proposal to cut Individual Unemployability (IU) benefits for veterans at age 62 when becoming eligible for Social Security benefits. Shulkin also was asked how he planned to finally achieve full interoperability when the VA and DoD have been unable to do so over at least the last 17 years.  

Shulkin told members he expects to address the vacancy gap within the next year. While sensitive to the issue of cutting IU benefits, VA benefits have increased by $12 billion in just the last two years, and he insisted a current review is warranted.   

In terms of the EHR, Shulkin tried to allay concerns by saying, “The president is fully committed to creating a single system, but I don't think it is fair to Congress or the president until VA provides a plan we can stand behind.” Shulkin is expected to come up with a plan in the next three to six months.  

While there was universal support and commitment to fixing Choice permanently with the end goal of ensuring veterans get the highest quality of care they need, there remains much uncertainty around the actual details of the CARE and EHR plans and how to pay for these reforms.  

Like many veteran service organizations, MOAA supports much of Shulkin's community care plan but opposes cutting IU benefits to pay for veterans health care or making veterans with service-connected conditions pay for health care they earned.  

In closing, Committee Chair Johnny Isakson (R-Ga.) urged lawmakers and veteran organizations to not let pilot programs or other issues be the stopping point to finding a solution.  “No problem is too big when people who want to solve them come together.”  

MOAA couldn't agree more. Stay tuned as we continue to engage and report on these important issues. 

Individual Unemployability Is Safe
The program that allows veterans facing long wait times to seek care outside the VA is rapidly running out of funds - but older disabled vets won't lose their benefits in order to pay for it. 

VA Secretary David Shulkin said his department “walked back” plans in the Trump administration's 2018 budget proposal to cut disabled veterans' individual unemployability benefits once they're eligible for Social Security payments at age 62.

“We're not going to do something that hurts veterans,” Shulkin said at a roundtable with veterans service organizations at the VA's headquarters in Washington, D.C. “But that doesn't mean that we're not going to look for alternative ways … to make these programs work better or work more efficiently.” 

Shulkin's department is under pressure from lawmakers to fill an unexpected shortfall for VA Choice, the $10 billion program Congress created in 2014 that allows veterans facing long wait times who live more than 40 miles from a VA facility to find care closer to home. VA officials thought there was enough money to keep the program running through December. But demand for the program has been high in recent months, reaching nearly 18,000 care-seekers per day, and funding has plunged from about $2 billion to $821 million since March. 

Choice could be out of money within a month, Shulkin said, so the VA has to find ways to make up the shortfall. The secretary is working with members of Congress along with the Office of Management and Budget to come up with offsets to help foot that bill. 

“We're looking at potentially extending some of the administrative fees that were in the original Choice authorization that are expiring in August,” he said. “We are still looking and going back into our mandatory funding and seeing whether there are other programs that can work or that will actually benefit veterans and save money.” 

One solution, Shulkin said, could include focusing on the VA's vocational rehabilitation programs. If veterans can get back to work quicker, they won't need to draw IU benefits in the first place, he said. The secretary is also instructing leaders across the VA to look for programs that can run more efficiently. 

Even though Shulkin said veterans drawing IU benefits are protected for now, members of his department still contend that the IU system needs to be overhauled. During the roundtable, Shulkin acknowledged that he wouldn't have written the rules for IU as they stand today. 

“The way the program was implemented was the unemployment payments never stopped, so you could be 95 years old sitting in a nursing home and you are still going to get unemployment benefits,” he said. “Frankly, if I were designing a new program, I wouldn't design it that way.” 

MOAA has spoken out against the administration's proposal to end IU benefits once veterans reach the age of 62. 

“[IU] is not merely a form of unemployment insurance that should end when someone ages out of the work force,” said Lt. Col. Aniela Szymanski, USMCR and MOAA's director of Government Relations for Veterans Benefits.  “…Veterans don't suddenly stop suffering from a service-connected disability once they're old enough to retire.” 

New Income Tiers for Medicare Part B Premiums in 2018
You may remember some years ago, Medicare had to fix the payment system used to pay doctors. A permanent fix was passed in 2015. The permanent fix established new income tiers for Part B premiums to pay for the doctor payment fix. The new income tiers start in 2018.

Below you can compare the current tiers against the 2018 income tiers. You will see how the higher income tiers have smaller amounts thereby making more people pay higher premiums in the future. The 2018 Part B premiums are not known at this time.

Tax                              2017                             Part B  

Filing                                                                Premiums        




Single               Less than $85,001                     $134/mon

Married             Less than $170,001


Single               85,001-$107,000                       $187.50

Married             $170,001-$214,000


Single               $170,001-$160,000                    $267.90

Married             $214,000-$320,000


Single               $160,000-$214,000                    $348.30

Married             $320,001-$428,000


Single               More than $241,000                  $428.60

Married             More than $428,000

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