Questions to ask your doctor.

My thoughts on some of the six excellent questions Elizabeth Rosenthal, author of “An American Sickness,” suggests you should ask at every doctor’s appointment to make sure your medical bills are what you expect.

Question #1. How much will this cost?  Your provider’s office staff will know the fee a procedure, or series of procedures are billed at. And they will be able to tell you if your health plan has negotiated a different fee schedule including your flat copay or co-insurance percentage. To be forewarned is forearmed.

Question #4: Are there cheaper alternatives that are equally good, or nearly so? One example I see is a medication that is a combination of two, or more, off-patent generics. Check your health plan’s drug formulary and compare the co-pays. If the new combination pill is high priced ask your prescribing doctor why the one pill is recommended over taking two; sometimes the only benefit is convenience.

Question #5. Where will this procedure take place and how does that selection affect my cost?  Your health plan may have a preferred pricing arrangement (called “in network”, “participating” or “contracted”) with other facilities. Ask your doctor about performing the procedure at one of those.

One more suggestion. Contact your health plan agent or member services representative when planning an appointment with a new provider or facility.  Your plan may have preferred providers, usage limitations and pre authorization requirements. 

http://www.pbs.org/newshour/making-sense/column-6-questions-to-ask-at-every-doctors-appointment/?utm_source=facebook&utm_medium=pbsofficial&utm_campaign=newshour

Comparing Short Term Care to Long Term Care Insurance.

Long-term-care

What is Long Term Care? Almost 70% of people turning 65 will need long term care at some point in their lives. Long term care is when we need help with two or more daily activities such as bathing, dressing, eating or using the bathroom. (i)  Care can be provided in a nursing home, assisted care facility or at home.

Costs vary depending on whether the care is provided in our home, in an assisted living facility or nursing home.  (Here is a helpful link to look up the cost of care in your area.) You’ll see nursing home costs are about double that of home care.

Doesn’t Medicare Pay These Costs?  Don’t count on it. Part A covers skilled nursing care in a skilled nursing facility (not home care) under certain conditions for a limited time; and even then it’s usually related to a hospital stay and discharge.  (ii)  And, no, Medicare does not cover long term or custodial care. (iii)

So, How Would I Pay for This?

In the U.S., 10,000 people turn 65 daily. Most do not have the financial reserves or long term care insurance    protection against what could wipe out your lifetime of savings and accumulated assets.   Why not? Well,the three reasons why people defer obtaining a long term care policy are:

  1. The cost. Let’s face it, traditional long term care premiums can be pricey. Not as expensive as one year of care but beyond what many middle age household budgets can afford.  (Paying off mortgage, college education(s), retirement funds, etc.)
  2. Denial. “I am not part of the 70% that will need care.”  “My children will take care of me.” “I have good genes.”
  3. Complexity.   Underwriting for eligibility can involve extensive medical forms, physician statements, lab results and pharmacy screens to confirm eligibility.  (Download FREE Shopper’s Guide to Long Term Care Insurance target=”_blank” )

And So How Does Short Term Compare to Long Term Care Protection?

 Short Term Care

  • Benefits paid for up to one year
  • A 20 to 60 day waiting period
  • No Plan of Care Required
  • Simple Application
  • More Affordable
 Long Term Care

  • Benefits paid for up to ten years
  • A 90 to 365 waiting period
  • Yes, a Plan of Care Is Required
  • Extensive Application
  • More Expensive

Next Step

Call me at (518) 346-2115 and we can review the 10 Yes /No eligibility questions and create your customized premium quote.

Please visit and follow our Facebook Page. Daniel G. Alcorn, a licensed and independent agent, represents licensed insurance companies in Massachusetts and New York.  Dan may receive compensation for individual enrollments in Medicare Advantage, Medicare Supplemental Insurance , Medicare Prescription Drug or Long Term Care /Short Term Care plans.
Sources:

(i) http://longtermcare.gov/the-basics/what-is-long-term-care/

(ii) http://www.medicare.gov/coverage/skilled-nursing-facility-care.html

(iii) http://www.medicare.gov/what-medicare-covers/not-covered/item-and-services-not-covered-by-part-a-and-b.html

NY State Tax CREDIT for Long-Term Care Insurance

NY State Tax Credit

Did you know?
New York State residents are entitled to a nonrefundable tax CREDIT if you or your business pay premiums for qualifying long-term care insurance policies.

How much is the credit?
“The allowable credit is 20% of the premiums paid during the tax year for the purchase of, or for continuing coverage under a qualifying long-term care insurance policy.”

Click here for New York State 2013 Filing Forms

As a licensed Life Accident and Health Insurance professional, I provide information about how affordable long-term care insurance can protect your assets and provide you greater control over your care. Please contact me at (518) 346-2115 for a confidential and complimentary consultation.

Top 10 Considerations when Buying Long Term Care Insurance (LTCi)

Your personalized Plan Design will reflect four important selections:

  • Amount. The maximum daily or monthly benefit.  (Choose monthly. )
  • Period.  The number of days or months the benefit will apply.  (Maximum ten years.)
  • Inflation Protection.
  • Elimination Period.  The amount of time you will wait after eligibility and before benefits are paid.

Listed below are the ten most essential considerations that to consider before going ahead with a long term care insurance purchase:

1.    Carrier rating – How stable is the insurance company? Do their customers report trouble in claiming benefits?

2.    Type of policy – Is this the right type of policy that can best answer my needs?

3.    Affordability – Are the premiums well within my budget? Can I still afford to pay premiums if my situation changes in the future?

4.    Insurance agent – Can I depend on and trust my insurance agent to help me make these important decisions?

5.    Coverage for types of care – Will the policy pay for any care services that I may likely need in the future?

6.    Inflation protection options – Does the policy have an inflation protection feature to cover the rising costs of care?

7.    Insurance riders – What insurance riders or additional options do I need to add to my policy so I can maximize my coverage?

8.    Care coordination option – Does the policy come with care coordination services?

9.    Benefits – What is the optimal total benefit amount I should get to cover all my care needs but still keep the policy affordable?

10.    Partnership Program certified – Does the policy come with the advantages of being certified for the state’s Partnership Program?

New York State residents: for a complimentary consultation and review of available options, please call me at (518) 346-2115