 Medicare’s annual open enrollment period begins October 15 and, given the COVID-19 pandemic, financial planners are urging beneficiaries to review and choose the plan that best suits their health care needs.
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Medicare open enrollment for Medicare Advantage plans and Part D Drug coverage starts October 15, 2021 and ends on December 7, 2021.
We all know cancer is a catastrophic life event. The simple words “you have cancer” is devastating. Its not just emotional and mentally devastating but it can also be financially devastating. Just last year, I had a healthy 50 something client go for her annual mammogram. She was in shock when she learned she had stage 4 breast cancer that would require not only chemotherapy but also a double mastectomy. One of her first calls was to me as her agent to see how we would navigate this with her insurance and her finances. According to the American Cancer Society, there were over 1.7 million new cases of cancer in 2019. 140,000 of those cases were under 45 and the remainder for over 45 years. The cases were virtually 50/50 male vs female. So, no matter of your age or gender you are. The good news for cancer is increasing survivability rates. Over 5 years, the survivability for whites went from 39% to 70% and for African Americans it with from 27% to 64%. Obviously, we have gotten better at detecting cancer early and treating. So what does cancer cost? In 2015 cancer was estimated to cost $80.2 Billion dollars. 52% of that costs was hospital outpatient/doctor costs. 38% of that total was from inpatient hospital costs. It is also estimated that cancer costs $94 Billion in lost income earnings due to cancer. Cancer not only affects the person diagnosed but also affects the whole family and even friends. Cancer diagnosis will often require over night stays in hotels while the patient gets treated. Lost wages affect the whole family. So why a cancer plan? Some will say I have great insurance, I don’t need it. As I said how do you replace wages? How do you pay for the out of town trips for treatment? This can mean $1000s in money. A simple cancer plan help you replace this lost income and pay for out of town expenses as well as even pay your deductible on your health plan. Many companies offer plans for cancer. Cigna, United, BCBS, and many smaller companies all offer competing plans. These plans work very simply. They pay a preset amount upon diagnosis of cancer. Most of these plans pay anywhere from $5,000 too as mush as $100,000. The premiums are very affordable. Most plans are just a few dollars a day. As you can imagine, a $25,000 policy would help pay for months of lost wages and travel as well as help cover the plan deductible. Here is the link to the pdf from the American cancer society I used. https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2020/cancer-facts-and-figures-2020.pdf I often get asked what are my options with health insurance. Despite what many people think there are many options.
Option 1- Group insurance. This is the kind of insurance you get from an employer. This is traditionally offered as a PPO (Preferred Provider Organization). Typically these plans offer benefits like Co-Pays for both doctors and prescriptions. They also have a smaller deductible for hospital based procedures. I do offer these services. I work with United, BCBS, Cigna, Aetna, Humana, Concordia and National General. Even if you are just a group of two, I can help! Option 2- Affordable Care Act (Obamacare or Marketplace). This insurance often has a bad name. People have heard so many bad things about this option that they mere mention of it sends them off the edge. The ACA is (In Texas) either an HMO (Health Maintenance Organization) or EPO (Exclusive Provider Organization). As many people know these both offer smaller networks than a PPO. However, for those with pre-existing conditions ACA plans are often your best option if you do not work for a company with health insurance. These plans also have specific times to enroll and qualifiers if your are outside of this period. Option 3- Short Term Insurance. This insurance is a great option for those that need insurance for a few months. They are deductible driven plans meaning that there are not a lot of benefits before you meet your deductible. These plans also work for those that are ok with a catastrophic style plan. These plans will allow enrollment year around. There are also options for 1 month to 36 months of continual coverage. So the term short term is a misnomer in those cases. Option 4- Private health insurance. This insurance type is often an indemnity style plan. This simply means there is a fixed benefits paid for a particular service. These plans often work on either the Multi-plan or PHCS (Private health care systems) networks. While these are large national groups, there are many small groups under the bigger umbrella. These plans do not offer (usually) a out of pocket cap. Option 5- Medical sharing. While this is not insurance, many Americans have these plans. This is simply of group of people (often faith based) who work together to share bills. This is often a cash pay system at the point of service and then a submission to the group for payment back to you. Option 6- Medicare. This is only for those on disability or 65 years of age or older. While there are many different aspects of life insurance policy design that you’ll want to understand before you take out a policy, the most fundamental thing to know is the difference between term insurance, universal insurance and whole life insurance.
Term Insurance Term life insurance provides a death benefit if the insured passes away during a certain time frame specified within the policy. While the policy may have some added benefits attached (such as spouse or child coverage riders) there is no cash value associated with the policy, so there is no surrender value if it is terminated. Because term life insurance covers a specified time period and has no cash value accumulation, it’s less expensive than other types of life insurance. Most people use this type of life insurance to cover a specific period of time such as to cover the 30-year term on their mortgage or to cover the period of time while their children are still dependents. Whole Life Insurance While a term policy only pays a death benefit if death occurs in a specified time period, a whole life policy will provide a death benefit for life—as long as premium payments are made on time. Additionally, the policy has level premiums and will accrue cash values, which grow tax-deferred at a guaranteed rate. Once the cash values reach the same value as the death benefit (usually around age 100) the policy will mature (or endow) and the value will be paid out to the owner. Universal Life Much like a whole life policy, a universal life policy is meant to provide death benefit protection for the insured’s entire life. The major difference between the two is that universal life policies offer some flexibility in death benefit and premium. Cash values for universal policies grow tax-deferred based either on prevailing interest rates or their growth may be tied to the performance of a chosen index. With underwriter approval, you can increase the death benefit of the policy so that it includes the cash value portion. You can also reduce your premiums over time—even stop paying them altogether—if your cash values grow sufficiently. Because interest rates can rise and fall, it’s important to continually monitor the cash value performance to ensure that future plans to stop paying premiums can be supported. There are now many other types of life insurance policies as well such as those linked to investments, those that provide long term care benefits, UL policies with no-lapse guarantee riders, or other hybrid products. Contact me today to make an appointment. It’s quite similar to employer coverage you’ve had in the past. You paid your share of the monthly premium via paycheck deductions. That purchased the insurance coverage. Then when you used that insurance, you also paid your share of each medical service, right? You had co-pays at the doctor’s office. You probably also incurred a deductible if had surgery or hospital stay. It works the same with Medicare
What Medicare Pays For: Part A pays for your first 60 days in the hospital. Your share of that cost is a hospital deductible, which will be $1364 in 2019. After 60 days consecutive days in the hospital, Medicare pays a diminishing share of your benefits. You begin paying a larger share in the form of a daily hospital copay. This can be hundreds of dollars per day, so you need supplemental coverage to protect you from those expenses on Part A services. This can be hundreds of dollars per day, so you need supplemental coverage to protect you from those expenses on Part A services. Part B pays for your outpatient care. This includes things like doctor visits, lab-work, imaging tests, surgeries, durable medical equipment, and even things like chemotherapy, radiation, and dialysis. After a small deductible that you pay once per year ($185 in 2019), Part B will cover 80% of all of these services for you. Your share is the other 20% of all of these services, with no cap. That can be quite a bit of money for some of the bigger ticket items like surgeries or cancer treatments. You’ll need supplemental coverage to protect you from high Part B expenses. Part D helps to pay for retail prescription medications. By that, we mean medications that you yourself pick up at a local pharmacy or via the plan’s mail order. You do NOT need any supplemental insurance for Part D. It has built-in co-pays for medications so that you don’t get smacked with paying 100% for necessary medications. When the time comes, it’s easy to find the right Part D plan by using Medicare’s Plan Finder Tool. |
AuthorJust my thoughts on the industry! I have been in the industry for over 4 years. I am here for you. Ask questions! Archives
September 2020
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