Switching Medicare Supplement (Medigap) policies

Reasons Why New Yorkers Switch Their Medigap Policies:

As a reminder, Medicare Supplement, also known as Medigap, are policies designed primarily to supplement (or fill the gap) Medicare benefits. You simply present your red, white and blue Medicare card to the provider or facility along with the Supplement / Medigap card to help with out-of-pocket costs; such as deductible and co-insurance amounts with Original Medicare Part A  and Part B.

Currently, there are 10 standardized Medigap plans, each represented by a letter (A, B, C, D, F, G, K, L, M, N; there’s also a high-deductible version of Plan F). These plans are available in most states.  While premiums will vary from state to state the standardized benefits of each lettered plan remain the same despite the insurance company or location. For example, Plan F benefits are the same in Florida as they are in New York.

Q: Is there an Annual / Open Enrollment Period?

Most people buy their Medicare Supplement / Medigap policy during the six month period after they first enroll in Medicare.   After that, in many states,  Medigap insurance companies are generally allowed to use medical underwriting to decide whether to accept your application and how much to charge you for the Medigap policy.

Q: So How Do New York State Residents Have More Protection?

New York State laws and regulations continue this open enrollment period. A person enrolled in Medicare Parts A and B may purchase a Medigap policy at any time. Insurers may not consider an applicant’s health status, claims experience, or age.  Laws in New York also prohibit insurers from basing Medigap premiums on age and charging a higher premium as they grow older.  Also,

Q: But What About Pre-Existing Conditions; Are They Covered?

Medigap insurers may impose up to a six-month waiting period to be covered for any preexisting conditions a person may have. Federal law and New York State regulation define a preexisting condition as any condition for which medical advice was given or treatment was recommended by or received from a physician within six months before the effective date of coverage.

Under New York State regulation, the waiting period may be either reduced or waived entirely, depending upon whether an individual has had previous health insurance coverage. Medigap insurers are required to reduce the preexisting condition waiting period by the number of days an individual was covered under some form of “creditable” coverage so long as there were no breaks in coverage of more than 63 calendar days.   Translation: If you are switching from a “creditable” plan that you have held consecutively for six months, New York regulation requires the new Medicare Supplement / Medigap plan to reduce or waive the six month pre-existing condition waiting period.

Questions about Switching a MediGap Policy?

Please call me at (518) 346-2115 or send a quick note with your contact information and question.

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

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

Family Caregivers Kit: 9 Free Publications

helpManage a loved one’s finances and health care with knowledge and confidence.

The Family Caregivers Kit is a collection of publications that help you understand your duties as an agent under a power of attorney, keep track of medications, protect your loved ones from scams, and more.

 

PUBLICATIONS FEATURED IN THE FREE FAMILY CAREGIVERS KIT

( Download Adobe Reader to view these publications.)
  1. Consumer Action Handbook  Family Caregivers Kit -1
  2. Health Scams Family Caregivers Kit -2
  3. Money Smart for Older Adults: Financial Exploitation  Family Caregivers Kit -3
  4. Managing Someone Else’s Money: Fiduciary   Family Caregivers Kit -4
  5. Managing Someone Else’s Money: Court Appointed Guardians Family Caregivers Kit -5
  6. Managing Someone Else’s Money: Representative / VA Fiduciary Family Caregivers Kit -6
  7. Managing Someone Else’s Money: Trustees / Revocable Living Trust Family Caregivers Kit -7
  8. My Medicines  Family Caregivers Kit -8
  9. Use Medicines Wisely  Family Caregivers Kit -9

 As an independent licensed Life, Accident and Health Insurance professional, I represent several insurance companies authorized to conduct business in New York.  For more information about how affordable insurance can protect your assets and provide you greater control over your financial planning, please contact me at (518) 346-2115 for a confidential and complimentary consultation.

"This service is provided by the Consumer Financial Protection Bureau, 
Food and Drug Administration's Office of Women's Health and the 
Federal Citizen Information Center at the General Services Administration."

The value of voluntary long-term care insurance.

Recently I was involved on a case where adult children, as part of their financial planning, explored the purchase of long term care protection on their parents. (Of course, the parents had to consent, and qualify medically.)

The rationale was this:  the adult children and spouses understand that 40% of women, and 37% of men, at some point will assist an individual requiring long term care.  (And 70% of people 65 or older can expect to use some form of long term care. Source)

Statistics also that report nearly 2/3 of those caregivers end up making work accommodations to provide care for a family member – usually a parent or in-law that most often is still living at home.

As the parents do not have long term care insurance, the adult children are exploring purchasing the policies as a way to extend their parents’ limited resources and protect their own respective incomes in the event long term care become necessary.   Yes, this seems like a generous gift to their parents but this is also smart balance sheet planning on their part.

(The adult children know that AARP has found data showing that a 50-year-old or older family caregiver who leaves the workforce to care for a parent forgoes, on average, $304,000 in lost salary and benefits over their lifetime. These estimates range from $283,716 for men to $324,044 for women.)

Here is a helpful link to a page where you confirm today’s cost of care  and what it may cost in the future.

As today there are more options available for long-term care protection solutions, let’s talk.

Dan

New York State residents: for a complimentary consultation and review of available options, please call me at (518) 346-2115 or schedule a telephone appointment at a time most convenient for you.

caregivers-profile

Source:
http://www.pbs.org/newshour/rundown/what-working-a-part-time-job-for-five-years-for-free-looks-like/

NY State EPIC Drug Plan for Seniors

drug-costsEPIC, (Elderly Pharmaceutical Insurance Coverage) is a New York State program for seniors administered by the Department of Health. It helps eligible seniors supplement their out-of-pocket Medicare Part D drug plan costs.  Eligibility requirements are:

  • Resident of New York State
  • Age 65 or older
  • Income up to $75,000 (single) or $100,000 if married.

EPIC offers two plans, based on your income:

  • Fee Plan for members with income up to $20,000 if single or $26,000 if married.
  • Deductible Plan members with incomes ranging from $20,001 to $75,000 (single) or $26,001 to 100,000 (married.)   Download EPIC Application Here

EPIC members are required to be enrolled in a Medicare Part D drug plan or a Medicare Advantage health plan which includes Part D. Enrolling in EPIC will give a member a Special Enrollment Period (SEP) to join a Medicare Part D drug plan. Medicare Part D provides primary drug coverage for EPIC members. After a Part D deductible is met, if applicable, EPIC provides secondary coverage for approved Part D and EPIC covered drugs. EPIC also covers approved Part D-excluded drugs such as prescription vitamins as well as cough and cold preparations after enrolling in a Part D drug plan.

help

You or someone you know may now be eligible for EPIC help.  Download the EPIC Application and call me at (518) 346-2115 for assistance with submitting your request.

 

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.