Low deductible health insurance plans were once very popular, offering low out-of-pocket expenses in the event of a major medical claim or an emergency. Low deductible health insurance plans still exist, but the trend now is to buy high deductible plans instead.
There are a number of ways to buy a high deductible health insurance plan, with the most common way being to buy a Health Savings Account (HAS). Customers with families are able to save several hundred dollars per month by opting to buy a Health Savings Account plan. HSAs offer one deductible for the family with no co-insurance and once the deductible is met, those on the plan are 100 percent covered.
Many people have difficulty with HSAs and are not able to utilize the full benefits offered. Often, many people do not invest their savings into the account. Regularly adding money the account means the funds in it are tax deductible and any interest earned is tax deferred. HASs are a good investment in you and your health. Perhaps the biggest benefits for account holders is their account can pay for any medical bills. Additionally any funds left over will roll over each year.
When buying a high deductible health insurance plan it is best to add supplemental benefits. In fact the two most often bought plans are the Accidental and Critical Illness plans. Having extra coverage is a smart thing to do as roughly 59 percent of all medical claims filed are for critical illnesses and approximately 19 percent are filed as a result of an accident. It is also important to remember that a health savings account plan covers all wellness exams 100 percent. Wellness exams include immunizations, pap smears, PSA exams, mammograms and colonoscopies.
With the current administration the health insurance marketplace is in flux, if you take the time to research your options, you will find plans that suit your lifestyle and budget.
When making choices on Medicare and Medigap policies keep in mind that your decisions will have various effects on your finances. Often, Medicare and Medigap will cost you more than expected. To ensure that your premiums cost less, do your research on the numerous plans and their costs.
For instance, if you are looking to save money on a Medigap policy, then you want to stay alert for value added benefits. Value added benefits, in a Medigap policy, could include free access to various fitness facilities, hearing aids, eye exams and eye wear. Free services, like these, could save thousands of dollars a year. Such savings are important for seniors often struggling to get by on a limited income.
Many seniors miss out on these extra benefits. However, to find out about value added benefits ask what benefits are included with your policy. Do not assume that all Medigap policies have the same benefits or have any extra benefits at all, because they may not.
Remember to make it a point to find out what your Medigap policy covers. Additionally, find out what other benefits may be included that can save you money.
Medicare does not offer coverage for younger spouses or dependent children when the other spouse qualifies for Medicare. No one may receive Medicare benefits prior to the age of 65, unless eligible at a younger age due to a disability. What can be done to cover the younger spouse?
There are some options that may be considered for the younger spouse who is not ready to retire. Those options include planning on working past the retirement age of 65, if that is at all possible, which would permit the younger spouse to continue to be covered under an employer health insurance plan until they are eligible for Medicare.
Failing that option as a possibility, there may be employer options open, such as the employer providing retiree health benefits. This is something that would need to be checked with the benefits administrator along with asking whether or not your spouse may continue under their plan as well. In addition, if your spouse is employed, they may switch to their employer’s provided health care plan.
Individual health insurance through the Health Insurance Marketplace, or Obamacare, may be worth considering as well, especially since the proposed health care plan by the current White House administration did not pass, keeping the health care plan in place. Thus, insurance pricing is currently very competitive. The policies offer comprehensive health coverage, insurers cannot deny coverage or charge extra for pre-existing conditions.
An option to consider is COBRA. If you work for a firm that has 20 or more workers, once you make the change to Medicare, your younger spouse could stay with the company insurance for 18 to 36 months. While this is an expensive option, it may work for you depending on your circumstances. If the company has fewer than 20 workers, continued coverage may be available provided your particular state has what is referred to as “mini-COBRA.”
If your income is below the 400 percent poverty level ($64,080 for couples, $27,520 for individuals) then you may be able to receive a tax credit to reduce the amount you will have to pay for a health insurance policy.
For information on insurance plans in your state visit https://www.healthcare.gov/ or call the toll-free helpline at 800-318-2596.
Some Medicare beneficiaries, those that are fairly new to the program, are not aware that if they do not agree with a payment decision or coverage decision made by a Medicare health plan or by Medicare, that they might file an appeal.
There are five levels involved in the appeals process and a beneficiary can proceed up a level if the appeal is denied at a lower level. In order to prepare for an appeal, make sure to gather any and all information from your physician or healthcare practitioner.
If you need a quick decision because your health is in jeopardy, you may request a quicker decision. If your doctor or your Medicare plan agrees, a decision must be delivered within 72 hours.
Always be aware of what Medicare covers and does not cover and what options are available to you if you disagree with decisions made that may affect your health.
Many Medicare beneficiaries do not realize that once they sign up for Medicare they are eligible to get a number of free preventive services. Additionally, for new beneficiaries, Medicare Part B offers a “Welcome to Medicare” preventive visit during the first 12 months of enrollment. During this visit, your doctor will review your medical history and provide you with information regarding any services you may need. Beneficiaries who have had Medicare Part B coverage for over 12 months qualify for an annual wellness visit to update or get a personal health care plan from your doctor.
Medicare also provides its beneficiaries with other free preventive services. Some of these services are listed below:
A cardio-vascular screening every five years
Annual mammograms
Annual flu shots
Annual screenings for prostate cancer
Annual screenings for cervical cancer
Annual screenings for colorectal cancer
When you sign up for Medicare, take the time to find out what it offers. Preventive services are important for all beneficiaries to take advantage of as theses benefits lead healthier lives. Always read your health care insurance policies and if you have questions, speak to a health care insurance expert agent.
While Medicare costs seem to always be increasing, the good news is that the coverage gap, part of Part D, is going down.
The coverage gap, also known as the “doughnut hole” is a temporary limit on what Part D, the drug plan, will cover for prescription drugs. In other words, the doughnut hole is defined as the period where you pay for your drugs out of pocket.
Not everyone will enter the doughnut hole. The doughnut hole begins only after you and your plan have spent a certain amount on covered drugs. In 2017, that doughnut hole or gap starts when total drug costs reach $3,700. If a beneficiary is in that hole, they get a 60 percent discount on brand-name drugs and a 49 percent federal government subsidy for generic medications.
In addition, there also is catastrophic coverage where the government starts picking up most drug costs when out-of-pocket expenses for a patient are over $4,950.
It is always a good idea to check into your health insurance options periodically. It is important for you to understand your coverage and how it changes.
There are a number of opportunities to enroll in Medicare. Being aware of all the possible enrollment periods can help you avoid penalties.
There are multiple enrollment windows in addition to the initial seven-month initial enrollment period. If you missed signing up for Part B during the initial enrollment window, you are not working or are not covered by a spouse’s health insurance through work, you may sign on for Part B during the general enrollment period from January 1 to March 31. If you sign up during that period, you coverage begins July 1. However, you will pay a life-penalty of 10 percent for each 12-month period you did not sign up for Part B.
If you are currently working and are covered by an employer’s plan, you may sign up later without penalty during a special eight month enrollment period applicable if you lose employer health care coverage. If this special enrollment period is missed, you need to enroll in the general enrollment phase.
The open enrollment period, from October 15 to December 7 every year, permits you to change Part D plans or Medicare Advantage for the next year. Note that you may now change Medicare Advantage plans outside of the open enrollment period if you choose a plan with a government awarded five-star quality rating.
Ideally, it is best to sign up for Medicare early, but you can certainly wait until your 65 birthday. It is important to remember though that signing up late may incur penalties that increase your monthly payments permanently.
If you already receive Social Security benefits, you are automatically enrolled in Parts A and B. You can opt out of Part B, since is has a monthly cost. However, if you choose to keep it, the premium cost will be deducted from your Social Security benefits.
If you are not on Social Security, you have to sign up for Parts A and B yourself. Starting three months before your 65 birthday, there is a seven-month period referred to as an initial enrollment window that begins. This window closes three months after your birth month. To make certain you get coverage for when you turn 65, you need to sign up in the first three months.
You may be able to delay signing up for Medicare is you are still working and your employer is providing health insurance or if you happen to be on a working spouse’s health insurance plan. If you lose coverage provided by an employer, you must sign up for Medicare within eight months to avoid serious penalties when you enroll.
Each year the government releases the costs for Medicare premiums for the coming year. While Part A, hospital insurance, is free for most people, the premiums for Part B — doctor visits, tests and procedures — and Part D, drug coverage, are paid for by the beneficiaries.
The amount payed in premiums is based on your income tax return from two years prior to the current fiscal year. There are five income thresholds on which premiums are calculated from. If your income is above a certain threshold then your Medicare premiums may also be higher. It is best to check annually, with a knowledgeable insurance agent, for any changes in the income thresholds. This is important to remember because if your increases you will likely pay more in premium for Parts B and D.
For example if your adjusted gross income as a single taxpayer, plus tax exempt interest, is over $85,000 or your income as a married couple and filing jointly is $170,000, Medicare premiums for Parts B and D can come with a surcharge.
In 2017, higher wage earners’ premiums range from $187.50 a month to $428.60 a month for Part B. For Part D coverage, high earners pay an extra charge from $13.30 to $76.20 in addition to regular premiums.
Since these numbers change based on the wages you earn and any changes in the health insurance coverage requirements, it is best to speak to a health insurance carrier to determine what you may be paying for premiums each year.
Right before the House vote on the new health care legislation, the Senate approved a $1.1 trillion spending bill that will finance the government until September and prevent a government shutdown. The approval of the spending bill allowed the House to safely pass the American Health Care Act (AHCA).
While House Speaker Paul Ryan is hopeful that the Senate can pass a bill meant to replace the Affordable Care Act (ACA) in a couple months, this is highly unlikely. The Senate, which moves more slowly than the House, will now begin work on creating a health care plan that will be acceptable by all the factions of the Republican party. This could mean that the Senate will need to write a new bill all together.
Because the members of the GOP are divided on the issue of a new health care bill it may prove to be a challenging task to pass it. Furthermore, the Senate needs a 51-vote majority to pass the bill, which allows them only two defections. The Senate is expected to take until August to push a bill through with the needed support. When the Senate produces a new or updated bill it will return to the House for a vote.
Until the Senate and House agree on a new health care bill, the ACA remains in place. Thus, those selling and buying health insurance will be adhering to the rules and regulations already in place.
