How will the Affordable Care Act healthcare exchange affect you?

Like you, I’m interested in learning as much as possible about new regulations and legislation involving the Affordable Care Act, also known as ‘Obamacare.’

I’ve done some research, and here is what I know, so far. Even though this program has nothing to do with Long-Term Care, I’m sharing it with you to help answer some of your questions and clear up any confusion over what you may have heard.

Background: As of January 1, 2014, every individual and all employers with fewer than 50 employers will have to have federally administered healthcare. This is a part of the Patient Protection and Affordable Care Act.

The intent of Healthcare Exchanges is to provide everyone with affordable health insurance. States that opt out of the federal program can set up their own state run health care.  Indiana has not opted out and will be using the federal program.

So what are these healthcare exchanges you may be hearing about? The government has set up a Health Insurance Exchange Marketplace. The Health Insurance Exchange Marketplace is a new application to use to find health coverage for diverse budgetary and personal needs. Small businesses and individuals can use the Health Insurance Marketplace to fill out an application and find out if you can lower costs on your monthly premiums for private insurance plans.

There will be a web site, a phone number to call, and an email to get information about what health insurance program (there are many to choose from) will serve your needs best. (To learn more on ongoing developments, click HERE for updates.)

When does enrollment begin? Open enrollment starts October 1, 2013. Coverage starts January 1, 2014. 

What about costs?  The Health Insurance Exchange Marketplace will help you determine if you qualify for lower out-of-pocket costs. It will also let individuals know if they qualify for free or low-cost coverage available through Medicaid or the Children’s Health Insurance Program (CHIP).

There are many, many more details to understand – and I’m all about learning as much as possible to help protect my clients. If I can help you answer a question or better understand the new system – even though it doesn’t directly relate to Long-Term Care, please don’t hesitate to give me a call.                  ~ Elise

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A painful lesson on adding (financial) insult to (health) injury

When I read Christine’s story (click HERE to read), my heart ached for her. The co-founder of the business “The Parent Care Solution,” Christine and her husband Dan created their company together after caring for Dan’s father, who suffered from Alzheimer’s disease.

Even though Christine and Dan, both in their 50s, had worked with dozens of couples who were under-insured and struggling to provide healthcare for an ill spouse, they had not yet invested in Long-Term Care Health Insurance for themselves. As many do, they thought they were too young for any devastating health problems.

Unfortunately, they were wrong. Dan was diagnosed with a brain tumor at age 55  and died just 13 months later. After Dan was diagnosed, he could not buy Long-Term or Short-Term Health Insurance. And as the owners of a small business, Christine and Dan were under-insured with their health insurance. Thirteen months of surgeries, chemotherapy, and hospital stays took their toll not only emotionally on the two, but also financially.

As Christine says, I became painfully aware of how important it is to have a plan during such an emotionally trying time… The longer you wait, the fewer choices you will have and the more it will cost you, emotionally as well as monetarily.”

Nothing could have eased the terrible pain and emotional suffering of this couple. But when it came to financial pain, financial health care planning could have made a big difference. The lesson Christine learned the hard way could be acted upon by you early enough to make a difference in your life and that of your spouse.

It’s just too easy to postpone talking about difficult matters. As the owner of YourLTCresources, I consider it is my personal passion to guide the “Christines and Dans” of this world with the information and resources they need to make informed, educated decisions about their future. I hope you’ll contact me to learn about what Long-Term Care Health Insurance, Critical Care and Short-Term Health Care Insurance can do for you.                                                      ~ Elise

Preparing for planning

You’ve probably heard the saying, “proper prior planning prevents a poor plan!” When you’re relatively young and healthy, no one wants to think about Long-Term Care health insurance. But planning ahead is what makes this program so wise.

The Flashlight Story is a great example of this from Patrick Broccolo, owner of Senior1Care in a marketing meeting recently:

With the history of violent thunderstorms and tornados in Indiana, what’s the one thing we should all have ready for outages or damage? A flashlight, of course, but preferably with working batters. Patrick has the flashlight but it needs D batteries. He admits that it would be easy enough even to grab some off the end cap of the grocery or hardware store. But when does he actually buy the batteries? After the crisis – after the electricity is out.

Obviously, you get the message. Here’s few ideas for keeping your “batteries” in place:

  • Get regular checkups to keep yourself healthy as possible for as long as possible.  
  • Consult your accountant and lawyer.
  • Talk to your family about your future plans!
  • Do not assume Medicare covers everything.
  • Consider what could happen if you need Medicaid.
  • Look at Long-Term and Short-Term Health Care insurance and find out what options work best for you.

Your “flashlight” should be charged up and ready when you need it. Be sure you look ahead and are prepared for your future!   ~ Elise

Health costs are skyrocketing. You need additional insurance protection.

AARP keeps telling us this fact, and I keep reminding my clients to pay attention: The U.S. health care system is the most expensive in the world.  AARP’s 2009, 2010, 2011 and 2012 studies all point to just how expensive it can be to have healthcare in our country. What’s more frightening is that medical costs continue to rise each year. Dramatically.

Here are the facts according to reports from both AARP and the American Heart Association:

  • Americans spend an average of $8,200 per person on general health care every year (For comparison, Canadians spend just $4,400 annually).
  • A typical hospital stay costs an average of $236 per day in India, $655 per day in France and a whopping $3,949 per day in the U.S. (2011 Comparative Price Report Medical and Hospital Fees released by the International Federation of Health Plans.)
  • The first day of hospital admission averages $1,246, while the cost of discharging a patient averaged $304.
  • An average hospital stay in the U.S. is about $18,000. In the Netherlands and Japan, the 2nd and 3rd most expensive, comparable costs are $4,000 to $6,000 less.
  • U.S. average hospital charge for coronary artery bypass was $122,743 in 2010.
  • Average U.S. cost of hospitalization for a stroke was $87,600 in the same year.

These prices are averages, and don’t reflect costs paid by health insurance. These prices also only reflect hospital costs. Add your surgeon’s bill, your anesthetist, medications, plus quite often, rehabilitation and home health care, and frequently, nursing home care. Even Medicare or a good general supplemental health plan will only pick up 80% of these costs. (That still leaves a substantial amount on the table to be picked up by YOU!)

Don’t let a health crisis deal a critical blow to your finances. Be ready. Advance care planning is a conversation you need to have with a health insurance professional BEFORE anything happens!

~ Elise

 

 

Indiana health care insurance professional gives ‘boomers’ exactly what they are looking for

We baby boomers are changing the nature of health care planning. With 70 million of us, our dramatic numbers alone are radically altering the world of health care insurance.

As ‘boomers,’ we have high expectations and prefer to leave nothing to chance. We want control of our financial and health planning to ensure we get the type of healthy, dignified, independent, and secure future we have envisioned.

Those of us edging toward retirement plan earlier and plan thoroughly. I enjoy working with pre-retirement clients to plan for all health care contingencies. They are bright, well educated, and expect a long, healthy future with a lot more self-sufficiency and control than their parents had.

If you are a boomer, we should talk. Soon. Because nothing ever goes absolutely according to plan, it’s smart to look ahead, before a health emergency strikes you or your partner.

And, because health care prices continue to go up, health insurance costs continue to rise as well. There’s no better time to lock in rates for Long-Term Care, Short-Term Care and Crisis Care health insurance plans than right now, while you are healthy.

As a health care insurance professional for 26 years and a baby boomer myself, I can help make sure you cover all your health ‘bases’ and get the type of coverage that will leave nothing in your future to chance.

~ Elise

 

What is the difference between Medicaid & Medicare?

As a health insurance professional, I deal with this confusion all the time. Here’s what you need to know:

Although Medicaid and Medicare sound alike and are both government programs, they exist for very different reasons.

  • Medicaid is a federal program, administered by each state. It provides basic health coverage for low-income, financially dependent people. You must qualify for eligibility, which is tied to financial need.
  • Medicare is also a government program. It provides health insurance for people 65 or older, and people under age 65 with certain disabilities. Medicare is not tied to financial need. It is an entitlement program paid for through your Social Security taxes.

Since the U.S. healthcare system is THE MOST EXPENSIVE in the world, it makes sense to find health care insurance that assures you complete health care coverage, even if you have Medicare.

That’s because “having Medicare” will not pay your bills when you:

  • Need financial assistance while you are going through a critical illness. (But having Critical Care Health Insurance will pay you cash.)
  • Require prolonged health care assistance when you are older and in need of assisted living, nursing home care, hospice or home health care (Like Long-Term Care Insurance does.)
  • Need a cash benefit over and above any other medical insurance or disability insurance (As Short-Term Care and Critical CareHealth Insurance will provide).

I am sensitive to the worry I see in my potential clients’ faces when they consider how they want to be cared for, should they face a health crisis. That’s why health insurance advance planning makes good sense.

There is nothing that beats surefooted planning for all possibilities. That helps our clients – and me – rest easier, knowing they are protected.

 

Decisions about Health Care Insurance begin at the kitchen table

The most common misunderstanding about advance care health planning may be that it requires consulting with an attorney and the creation of numerous complex legal documents. In reality, advance planning starts at the kitchen table, with a thoughtful conversation with your spouse and/or family members.

Focus on advance care planning, talking about how you want your health care needs handled, financially as well as physically, and from there, move on to a discussion about a living will, a will and burial decisions. Then you are ready to speak with a Health Care Insurance advisor to set up a health care plan that meets your needs, and an attorney to take care of your will.

Yes, some of the topics may be uncomfortable to talk about. Studies show most people would rather indefinitely postpone these conversations, rather than have them. But all it takes is one cautionary tale from someone like me, a Health Care Insurance advisor, to realize delaying is not the answer.

Claire and Rich, both in their 50s, sat down with me and talked for about an hour and a half about Long-Term (LTC) and Short-Term (STC) Health Care policies. They agreed that having both a LTC and STC policy could help them, but decided to take a few days to think through some of the plans I showed them.

When I checked back with them, Claire had decided to postpone their decision for a couple of months, until after the holidays.

Unfortunately, Rich had a stroke about a month later, and was unable to buy the Short-Term Care policy that would have helped Claire pay for his home health care and nursing home care needs while he was recovering. Like many stroke victims, Rich lived, but will now be ineligible for Long-Term and Short-Term Care policies because of his pre-existing condition.

I was still able to help Claire, but felt very badly not to have been able to help Rich as well.

 Unfortunately, most of us don’t want to think about end of life and critical care health needs – often waiting too long – until after something devastating happens.

This is the reason I’m so passionate about health care insurance! I want to make sure you don’t get caught up in a crisis situation like Claire and Rich did. Both LTC and STC health insurance needs to be decided upon WHILE YOU ARE HEALTHY.

Together, let’s make your future health care decisions a priority, beginning at your kitchen table.

~ Elise

Critical Care Insurance and how it benefits you

People are living much longer lives even after suffering a heart attack, cancer, heart bypass surgery, suffering a stroke, or many other maladies that used to guarantee fatality. No more, thanks to early earlier detection, better prevention and medical advances in serious healthcare treatments.

Unfortunately for many of us, surviving such a catastrophic illness can bring with it serious financial hardships – especially if that illness leads to a prolonged, expensive stay in a nursing home or assisted living facility (or both) while recuperating.

This is where Critical Care Insurance can help. Relatively new to the health care insurance scene, Critical Care Insurance provides monthly cash benefits for at home care, assisted living and nursing home care. The benefits provided progress with the expenses and duration of each level of care.

Here’s how it works. Let’s use Pat as an example:

Before Pat became ill, she purchased a Critical Care Policy with a monthly base benefit of $2,000 with a maximum benefit period of 18 months. Some years later, Pat suffered a stroke. Like many other stroke patients, she required lengthy follow up care.

Here’s how her Critical Care Coverage helped pay Pat’s bills:

  • 3 months in nursing home = $12,000
  • 8 months in assisted living = $24,000
  • 3 months in home care = $6,000

Total Critical Care paid to Pat over the course of 14 months of recovery in various facilities = $42,000.

What’s even better? Twelve months after Pat fully recovered from her stroke, all of her Critical Care Benefits were fully restored. So if Pat suffers from another catastrophic health event, she will be covered again.

If not for her Critical Care policy, that $42 thousand would have had to come from Pat’s retirement savings, the equity in her home –or even from her children. That’s something none of us wants to consider.

As an extended care advisor, I can help you figure out a plan of health insurance that fits you in every way possible. Together, we can choose a plan, a benefit period and a monthly base benefit amount that is right for you. Whether you are 18 or 84, I want to be sure your future health doesn’t cause you a moment’s stress or anxiety.

~ Elise

Long-Term Care insurance = being prepared for the future

Many of us think that if we have life insurance, Living Will, employer health insurance or private health, or Medicare, we’re all set. But unfortunately, that’s just not the case. I’ve seen what unexpected health crises can do when there hasn’t been forethought and planning, and it’s not pretty. In this regard, my insurance CLTC certification and training are important, but just as important is my 25 years of experience.

Because I know what CAN happen, I know how to protect you from as many potential problems as possible. As the co-founder of Your LTC Resource, my job is to assure that singles, couples and families are protected in as many ways as possible when it comes to their future healthcare needs.

That phrase “as many ways as possible” is incredibly important. We can’t know what our future mental or physical health will be. That’s why we need to have Long-Term Care insurance that is flexible as well as responsible.

Being flexible means both Long-Term and Short-Term Care insurance. It means taking a good look at your present health insurance policies, and finding the gaps. The more planning we do, the better prepared you’ll be for every health and financial contingency.

When you do our Long-Term Care planning homework, the payoff in your future is well worth the time.

~ Elise