Entries Tagged 'Health Insurance' ↓

Recent Survey Finds 1/3 of U.S. Seniors Lack Medicare Knowledge

Whether you are turning 65 or have been a Medicare recipient for years, many seniors find Medicare benefits confusing. According to a recent article from the RISE Association network for healthcare professionals, one in three U.S. seniors lacks knowledge of their Medicare benefits. This lack of information may cost you money.

You may hear the words “Medicare Advantage” (MA) and “Medigap” used interchangeably. Both provide supplemental benefits beyond original Medicare, but they are not the same. Each plan can impact which physicians you visit, your copays and other supplemental offerings. Scheduling time with a licensed health insurance agent can inform you of the advantages and disadvantages of both approaches to coverage because the differences are many.

Original Medicare consists of hospital and medical insurance, known as Part A and Part B. Private health insurers offer plans called Part C, also called Medicare Advantage plans. These MA plans offer parts A, B and D for prescription drug charges. In an MA plan, you’ll work within the provider network created by your insurance company. Medigap plans pay after Medicare pays, while MA plans pay instead of Medicare. Medigap is a supplemental plan that covers much of your deductibles and copays. Medigap and MA plan costs vary by state. Since many supplements are “community rated,” states with higher living costs can mean higher Medigap costs.

If you plan to travel internationally, consider this: some supplemental plans cover many of the costs arising from sickness or injury while traveling internationally, while some do not. If you plan to travel overseas, be sure to call us to determine if a travel policy is right for you.

Medicare can be bewildering. Even if you have been on the same plan for years, call us to discuss your plan. We can help you find out which coverage approach is best for you and make sure you are in the know.

Open Enrollment – Contact Us Now about ACA Coverage

Like last year, you will have only 45 days to make changes to your Affordable Healthcare Act (ACA) plan for 2021. Open enrollment, the time the ACA law allows you to change plans or enroll in a new plan, begins November 1, 2020 and ends December 15, 2020. While some states may offer longer enrollment periods, schedule time now with us to discuss your current plan or make changes if you want to make changes to your current plan.

Even if you like your plan, we can help you complete a speedy cost-benefit analysis of changing plans. You may have been in a Health Maintenance Organization (HMO) plan and found it too restrictive. We can quote the cost to switch to an Exclusive Provider Organization (EPO) plan, where you won’t need a referral to visit a specialist. Knowing the cost differences between an HMO and an EPO can help you determine if you can afford to switch.

If you are currently on an ACA plan, you may know the ACA plans are categorized by their names. If you buy a Bronze plan, you will pay less monthly but more out of pocket. A Bronze plan may make sense if you are in great health, but a Platinum plan, with the most expensive monthly premium, means you’ll pay much less out of pocket if you have ongoing medical expenses or expect a major surgery.

Because we are extremely busy as open enrollment nears, call us today to reserve your appointment.

Be Better Prepared for the Unexpected When You Travel

Is travel getting riskier? Whether traveling for business or pleasure, travel is riskier than ever. Take the recent case of the man in Phoenix for the Fiesta Bowl who was carjacked and shot by a group of local teens. A survey cited in Business Travel News by International SOS, a travel risk-management firm, found that over half of travel managers reported increased business travel risk in 2019, and almost half believed travel risk will increase in 2020.

Security threats, civil unrest, and even weather-related risks can cause travel problems at home and abroad. A travel insurance policy can help ensure outside help if you become sick or injured while traveling on vacation or business.

Business travelers face different concerns from those traveling for pleasure; however, the risks are similar. Travel insurance can help protect you against last-minute trip cancellations and lost luggage. Some policies offer kidnap and ransom coverage, repatriation in case of injury or worse, and expert help in medical emergencies.

Consider this. You’re in Cuenca, Ecuador, and fall, suffering a compound leg fracture. Who is the best doctor in Cuenca to repair your injury? Should you have the injury stabilized in Cuenca and then travel elsewhere for further treatment? What if, after a serious injury, you need to return home for treatment? The right policy can offer emergency medical assistance and response. Highly trained medical and security personnel can direct you to the appropriate medical treatment and, if needed, return you to the US for care.

Usually, travel insurance is inexpensive. The rates vary based on the travelers’ ages, the deductible and coverage limits you select, and where you travel. While travel insurance websites offer online quotes, it’s better to work with an experienced agent to determine the broadest coverage for the best rate.

Open Enrollment for Affordable Care Act Coming Soon

Each year, open enrollment allows new enrollment in the  Affordable Care Act (ACA). This period also gives those already enrolled a chance to review their coverage, change deductibles, and fine-tune their ACA plans.

For example, according to CNN, the average deductible for a Bronze plan is about $5,900, with an average out-of-pocket limit of a little under $7,000. Upgrading to a Gold, Silver, or Platinum plan will cost more per month; however, this could allow you to lower your out-of-pocket costs. How? A Bronze plan covers about 70 percent of your medical costs per year while a Platinum plan covers about 90 percent of your yearly health care costs.

Our no-obligation consultation about your 2020 ACA coverage can help you determine if you should stick with your current plan or consider upgrading to save on annual health care costs.

We do get busy during open enrollment, so do not hesitate to call us now. We can discuss your options and help you determine if you want to make the switch when open enrollment begins November 1, 2019. If you miss the last day of open enrollment (December 15, 2019), you will not be able to enroll for 2020 unless you qualify for coverage due to a special life event, like losing your group insurance.

Do not wait until the last minute to discuss your ACA options with us. Plans sold during the 2019 open enrollment period go into effect on January 1, 2020. If you had coverage under the ACA in 2019, your re-enrollment is automatic. However, your plan’s cost may increase, or you may find that you have different medical needs and would like to switch plans.

Don’t struggle alone with the online options when professional help is available. Contact us today.

Travel Insurance Is Crucial for Those 50+

In today’s uncertain world, a health travel insurance policy makes more sense than ever. But if you’re over 50, you definitely need to consider purchasing it before setting out abroad or on a cruise. Injuries and illnesses arise during travel, and ensuring you have the proper medical coverage to meet your needs is crucial.

New situations, different terrain, and riskier activities, such as parasailing or hiking excursions, can contribute to injuries, particular for older travelers. Even driving in a strange country can be a problem for many.

According to the Centers for Disease Control and Prevention, motor vehicle crashes are the top cause of death of U.S. citizens abroad.

Medicare and Medigap

If you have Medicare, your coverage applies in the U.S. wherever practitioners accept it. But if you have a Medicare or Medigap supplement, check with your supplemental insurer on overseas coverage. The Medicare.gov website offers travel coverage advice, and warns that Medigap policies have a lifetime travel emergency coverage limit of $50,000.

Evacuation and repatriation coverage

The best way to ensure you have the broadest coverage overseas is with a travel insurance policy. For example, travel insurance provides emergency evacuation and repatriation. If injured overseas, you (and your spouse) may want to return home for treatment and recuperation. This coverage goes beyond transporting you after an injury or illness. It includes advice, coordination of admission to a local facility, medical air transport and escort when needed, and ground transportation coordination at both ends of an evacuation; it also smooths immigration and flight clearances and assists with travel arrangements.

While some travel policies cover both medical and repatriation, you still may require two policies. Also, although some insurers offer coverage for a single trip, if you make frequent trips in the same year, an annual plan may be the best choice for you. Snowbirds in particular may benefit from this type of plan.

The Differences Between Medicare and Medicaid

Many people know of “Medicare” and “Medicaid,” but they may not know the difference between them. The confusion is understandable: Both Medicare and Medicaid are government-sponsored programs providing health care to US citizens. Taxes pay for both programs, and Congress instituted both in the mid-1960s. However, the programs are very different from each other.

Medicare offers dependable coverage for a small monthly premium for US citizens aged 65 and older and for those with a disability, whatever their income. Medicaid is a joint state and federal program designed to provide medical care to those who either don’t have health insurance or have insufficient health insurance and lack the financial resources to buy it. Basically, to qualify for Medicaid, a person must have a low income and few assets.

Currently, the federal government funds up to 50% of Medicaid’s costs, and wealthier states receive less funding than those states that are cash-strapped. One key difference: Medicaid consists of 50 state-run programs, while Medicare is one federal program covering all citizens who meet the age criteria, regardless of their income.

Eligibility and core benefits

Medicaid has specific federal guidelines for eligibility that must be met first, and then each state adds its own guidelines. The federal government mandates certain “medically necessary” treatment, such as lab services, X-rays, and pediatrician visits. States can then add additional benefits, such as vision and dental care, and prescription drug coverage.

Long-term care

For those unable to care for themselves, Medicaid may fund long-term care. Because Medicare does not cover these costs, and eligibility rules are complex, most people seek assistance from attorneys who specialize in Medicaid eligibility.

Medicaid usually doesn’t cover day care for those who can’t be alone during the day but have family present at night. Additionally, not all facilities accept Medicaid. If you’re concerned about your long-term care needs, discussing them with an insurance professional is always your best bet.

Supplemental Insurance: Is It Really Worth It?

Each year, thousands of Americans transition from group health, no insurance, or a personal health insurance policy to Medicare; in 2015, more than fifty-five million Americans took advantage of Medicare coverage. And that’s good.

However, many people don’t realize that Medicare only covers part of their health care costs. The individual must cover the remainder, which includes copays, deductibles, and dental, hearing, and vision care.

Generally, when US citizens turn sixty-five, Medicare enrollment is automatic. However, the significant coverage gaps above can cause financial hardships if you don’t understand the choices Medicare offers. For example, “original” Medicare provides Part A (Hospital) insurance and Part B (Medical) insurance. However, Part A and Part B have different costs: Part A is automatic for most people; Part B is $104.90 per month in 2016. Both have copays and deductibles, which can be steep.

By sixty-five, most of us take at least one prescription medication. For prescription coverage under Medicare, you must have a Medicare prescription drug plan. Therefore, you should consider Medicare’s Part D; be aware, however, that it will cost extra.

For help with copays and deductibles for lab tests, doctor visits, and hospitalizations, you’ll need to shop for supplemental coverage. Medicare pays private insurers a fixed amount each month to manage your health care. You may hear it called “Medigap,” “Part C,” or “Medicare Advantage,” and it requires an additional monthly premium payment.

Each supplemental plan covers different doctors, hospitals, and lab facilities, so it’s important to work with an experienced health insurance agent to choose a plan that will cover the medical providers you want to work with.

If this all sounds confusing, it is. While you can navigate the Medicare website, gather information about the various plans, and even choose a policy online, you run the risk of making a costly mistake. Call my office before you make that important transition to Medicare.

Happy New Year! It’s Time to Review Your Insurance Coverage

Exercise more. Eat better. Learn something new. It must be New Year’s resolution time again. As 2016 approaches, it’s a good opportunity to make New Year’s insurance resolutions by reviewing your coverage and deciding if changes are needed. As you examine your policies, consider making these resolutions for next year:

Update home inventory: Is your home inventory up to date? What have you sold, donated, or pitched in the past year? What devices will the family splurge on this Christmas? An up-to-date home inventory is essential to make the most of your coverage in case of theft or disaster. Include all items and their cost. Store this list off-site or in the cloud.

Assess car policies: Does your vehicle coverage accurately reflect your car’s value? As autos age, you may want to reduce coverage. Who drives the car? Are primary and occasional drivers designated properly?

Check for savings: Are you currently taking advantage of every savings opportunity? A call to my office will be worthwhile. Check for new programs, multiline discounts, and changes in policy requirements; they may save you a few bucks in the coming year.

Life changes: Be sure to discuss with my office any life changes, such as marriage, divorce, death, or births as well as home purchases, renovations, job changes, and health concerns. These can impact your insurance needs and may affect everything from your homeowner and life insurance policies to health insurance. You may even need commercial insurance if you’re starting your own company in the New Year.

Health Insurance Options for People With Pre-Existing Conditions

Numerous adjustments are already being made to the new health care reforms, and with these come questions about how and when all the changes will go into effect. One of the most hotly debated topics having to do with the new laws is how pre-existing health conditions will be handled.

While many feel the ideas behind President Barack Obama’s plan are good, the number of Americans locked out of obtaining health insurance due to pre-existing conditions may not be as bad as originally indicated. Only about 8,000 people have taken advantage of health insurance options offered to high-risk individuals. Because of that low number, the government has now cut premiums for these high-risk pools and expanded some of the benefit options to entice new applicants.

The truth is, though, that many people with pre-existing health conditions may not even need to rely on the government’s program.

In fact, although there may be some restrictions in coverage, a number of insurance companies will provide health insurance to people with pre-existing conditions.

Oftentimes, applicants will be required to pay higher premiums for coverage, or they may need to undergo waiting periods – sometimes between 12 and 24 months – before having their pre-existing conditions covered. But, before assuming that the options in the health care reforms are the only choice, it is a good idea to check with a good health insurance broker regarding insurance for those with a pre-existing condition.

Health Care Reform To Increase Insurance Premiums October 1, 2010