Enrolling in Medicare Advantage and Prescription Drug Plans
Are you turning 65 in the next year? It’s time to consider your Medicaid options. Here are the facts: At age 65, you are automatically enrolled in Medicare Part A, hospitalization coverage, which is free, and Part B, which covers lab fees, physician’s fees and medical equipment. There’s a premium for Part B. If you want additional benefits, though, you will need to specifically opt into a Medicare Advantage plan (part C), and or a prescription drug plan (Part D). Medicare Advantage In addition to the basic Medicare benefits, Medicare Advantage plans may also provide additional benefits, such as dental, vision, expanded hospitalization benefits, or more focused care for those with special medical needs, such as diabetics. Premiums vary, depending on your plan and location. You can’t be turned down for Medicare Advantage, but you may have to pay extra if you don’t sign up when you’re first eligible. Note: Don’t get Medicare supplemental coverage if you already have a Part C plan. You don’t need both kinds of coverage – just one or the other. Some things to keep in mind: You can only enroll during your open enrollment period, during certain times of the year. Once you enroll, you stay in the plan for a year. Different plans cover different procedures and treatments. Look at their list of exclusions, or check with the plan before getting a treatment or service. Managed care plans typically come with a list of authorized providers. If you have a preferred physician or other care provider, consult your plan network to ensure your preferred provider is a member of the network. You... read more
Retirement Planning
Many employers are implementing 401(k) matching programs again. In recent years, matching was greatly reduced or eliminated in most businesses. While many are reinstating their matching programs, there are many who still have not started yet. In addition to this, some employers are matching at a lower percentage rate. Research shows that about 75 percent of employers that stopped matching have restored their plans. From this group, about 75 percent have implemented matching plans at the same rate they used before. Less than 5 percent increased their rate. Almost 25 percent lowered their percentage rate. It’s apparent that many employers want to reinstate their plans only when they can afford to do so. Since their ability to reinstate is dependent upon the economy, it’s difficult to predict when that will happen for each individual company. It’s no surprise that defined contribution plans that lack matching offers have a considerably lower rate of participation than plans that offer matching. This is likely the root of the many problems employers will face in the future when their older employees retire without saving enough money in an efficient and timely manner. Research shows recent workforce statistics suggesting that approximately 40 percent of working Americans are 55 or older. This is a significant increase from the statistics gathered 20 years ago. When this recent statistic is considered from a financial point of view, it shows that older workers are likely to be less engaged in their work and are more expensive in general. Many of them may be staying at their jobs because they have to do so in order to collect retirement... read more
4 Good Reasons to Write an Ethical Will
In today’s world, most people are aware of the importance of a will. This document expresses a person’s wishes regarding personal property and money. Living wills have also gained popularity. They are used for expressing a person’s wishes if he or she becomes unable to make decisions for medical treatment and life-sustaining measures. However, there is another important type of will to add to the priority list: An ethical will. This type of will is not a legal document. It is a letter or informal document expressing personal values, hopes, future dreams, life experiences and blessings. The letter is shared with family members or friends while the creator is still alive. Although this idea may not sound as important at first thought, consider the following reasons to create one: It provides a way to impart wisdom. Most people find the task of writing a memoir too extensive. Editing, publishing and paying all the necessary bills associated with such a project requires plenty of time and money. An ethical will is a simple and inexpensive way to convey such important ideas. To reach a larger audience, the will can be shared at a special party, a family gathering or any other occasion. It is a very healthy exercise. Writing about life may have a positive health impact for some people. When individuals have the chance to explore their capabilities, desires and memories, they have a way to relieve stress or cope with life’s problems. Some people may even find that this positive task helps them sleep better. It draws a moral road map. Past reflections are not the only element... read more
The Advantages and Disadvantages of Private Health Insurance
Most Americans have private health insurance. This is a big monthly expense and one that many would prefer to do without. But what are the advantages and disadvantages of a country using this type of health care system? Read below to find out. Advantages: 1. You Choose Your Doctor In the private healthcare system you often have more flexibility in choosing a doctor as well as medical facility. For patients that want the same doctor all the time, this can be a very important advantage of this type of system. 2. Shorter Wait Times If you are having a surgery that is necessary but not life threatening, there are often long wait times. In a private health insurance system the patient will often have shorter wait times because the medical facility is less busy. And even if there are a lot of people waiting, you can often by pass the line by paying a little bit extra for faster medical attention. 3. Improved Facilities Unfortunately, because the public system is funded with government money it does not have access to as much funds as the private sector one do. This means that public hospitals and health care facilities are often overcrowded, and lacking certain comfort amenities. Private health care facilities, on the other hand, are usually well maintained, with private wards, private bathrooms, phones, TVs, and better tasting food. Disadvantages: 1. Private Health Insurance Costs More than Public Health Insurance While the US government might be saving a marginal amount of money by having a private healthcare system instead of a public one; there is no doubt that American... read more
AARP Medicare Rx Plan
The American Association of Retired Persons (AARP) is an organization that provides prescription drugs to the beneficiaries of Medicare at low costs. This Medicare approved organization has designed three drug plans that cover almost all brand name prescription drugs or its generic brand included in Medicare Part D. Around 60,000 pharmacies participate in the AARP Medicare Rx Plan to provide expensive prescription drugs at a reduced rate. The 3 prescription drug plans provided by AARP are AARP Medicare Rx Plus a Enhanced Plan and a Saver plan. Each of these plans includes one or more of co-payment tiers. Tier 1 includes generic drugs and has the lowest co-pay; Tier 2 has preferred brand name prescription drugs with medium co-pay; the higher co-pay Tier 3 includes non-preferred drugs; and the highest co-pay comes in the Specialty Tier. The three AARP drug plans cover the drugs that are also covered by Medicare Part D. AARP Medicare Rx Plan has mid-priced premiums, flat and simple co-pays with no deductibles. AARP Medicare Rx Plan – Enhanced has an additional bonus drug list that includes drugs not covered by Medicare Part D. This plan offers Tier 1 generic drug coverage with flat and simple co-pays and no deductibles. The only plan that has annual deductible is AARP Medicare Rx Plan – Saver. However, this plan includes the lower monthly premiums and co-pays. Other benefits of the AARP plans include discount mail order prescription services, additional assistance for low income beneficiaries, discounts on prescriptions approved by FDA, etc. The organization also offers other discount programs like discounts on vision programs, fitness programs, dental insurance and... read more
What is Hospice?
Hospice care is provided to persons suffering from terminal diseases. It could be the last stages of cancer, kidney disease or other fatal illness. Such patients require constant care administered by medical professionals. This could be the cause of great financial burden for most families. Medicare Part A services include hospice care to provide relief to the patients and their family members. Inpatient and at-home hospice care is provided by the Medicare-approved hospice. Hospice care requires the individual to possess certain qualifying criteria. Medicare Part A eligibility is a must for the seniors who require hospice care. Certification from a physician stating that the individual is terminally ill and has a life expectancy of six months or less is also needed to avail this service. The patient must sign an acknowledgment stating that what he/she wants is hospice care and not the regular Medicare services; they will not be getting any treatment coverage in such cases; for example, a cancer patient cannot get chemotherapy and hospice care covered simultaneously. Medicare Part A hospice care covers equipment and supplies required for hospice care, doctor and nurses, hospice professionals in hospitals and in home, physical and occupational therapies, speech-language pathology, medical social services, counseling services, pain and symptom management outpatient drugs, inpatient care, and other services approved by Medicare. There is also the acute short-term and respite care, and homemaker and home health aide services. You can discontinue hospice care and go back to the standard Medicare services at any time. If you want to return to hospice care after a while, you will need re-certification from the doctor. However, if... read more
Medicare Out of Pocket Expenses
Prescription drugs are the most expensive items in a senior citizen’s medical needs. Even though Medicare Part D offers coverage for prescription medicines, it is not a hundred percent payment for costly medicines. Several out-of-pocket expenses are part of the Medicare Part D plan. Since Part D does not cover all the prescription drugs, these expenses have to borne by the policy holders. Other Medicare expenses relating to Part D include annual deductibles and drug cost co-payments. Most of the Part D plans have an annual deductible of $250 and a 25% co-payment. This 25% co-payment is applicable until the enrollees have reached $2250 limit in drug expenditure. Up to this limit, the out-of-pocket expenses are $750. But, once the beneficiaries cross the $2250 limit, the enrollees will be paying hundred percent of the drug cost which can be very expensive for people with limited income or resources. This coverage gap that defines the range of drug expenditure is often called the Doughnut hole. Because of this factor, it is observed that a number of senior citizens have not enrolled in the Part D plan. This will eventually lead to a rise in the premiums of the existing policy holders. However, not all purchases are considered as out-of-pocket expenses. The following instances do not come under the out-of-pocket expenses criteria: purchase of drugs that are not covered by the chosen plan, purchase of prescription drugs during travels from a pharmacy outside the plan area or network, using other medical insurance plans that the individual holds to buy prescription drugs, and purchase of medicines from other countries. In all these... read more
Medicare Lacks Long Term Coverage
Medicare is touted as the best option for medical care in old age. Unfortunately, it does nothing in terms of long term care. Medicare long term coverage is not realized as this is a very costly affair for the federal government. The maximum number of days that Medicare can take care of medical care is 100 days’ stay in hospitals or nursing homes as inpatients under the Medicare Part A plan. Even in this case, only the first twenty days are fully covered by Medicare; the remaining eighty days’ payments are made on a co-payment basis. All expenses beyond this limit are borne by the individual. Long term care insurance becomes a necessity for majority of people aged 65 or over. It is estimated that the average visit in a long term care facility is about 2 ½ years or 900 days. And, Medicare cannot pay for such a long term with the limited premiums. Individuals are encouraged to find alternative insurance plans that cover long term care in medical facilities or at home. The eligibility criteria for long term care insurance state that the person must be unable to complete any two of the six “activities of daily living”: eating, bathing, continence, dressing, toileting, and transferring (such as from a bed). Other categories of people eligible for long term care insurance include those with Alzheimer’s disease or cognitive impairment. People with a doctor’s approval that they need additional care for at least ninety days are also eligible for this insurance. Long term care insurance provides you the flexibility to choose the type of medical care you prefer to... read more
Medicaid Eligibility Requirements
Poverty alone cannot ensure you that you are eligible for receiving Medicaid benefits. About 60% of poor Americans are not covered by Medicaid just because they do not qualify the criteria for eligibility to get Medicaid services. Therefore, it is essential to know what the different aspects of Medicaid eligibility are and who can apply for Medicaid benefits. Medicaid is a federal and state government joint venture to provide medical insurance coverage to the people belonging to the low income and resources group. Even though Medicaid is a federal and state government funded initiative, the rule regarding eligibility and the range of coverage differ considerably for each state. However, some common criteria are applicable in all cases. The most important factor in deciding the eligibility for Medicaid is income and resources. The income threshold may be different for the various states of the country. The calculation of one’s resources also has slight variations from state to state. Usually, the factors that are considered while assessing the resources are bank accounts, real estate property like land and house, and other assets and items which will make cash if sold. The State Medical Assistance office may help you to assess your eligibility for Medicaid plan. If you receive Supplemental Security Income from the Social Security Administration, you could be eligible for Medicaid depending on your state’s rule. Other factors that affect the eligibility for Medicaid are age, residency, citizenship or legal status, pregnancy, and family size. Low-income families with children, children under 19 (in some states 21), pregnant women and the child born when the mother is on Medicaid, single parents,... read more