Senior Health Care Insurance

Health Insurance For Seniors On The Net

When a good friend of mine inquired where he could obtain information about medical insurance for his out-of-state, elderly mother, I told him to try the Internet.

He reported back to me about a week later, in desperation: “I am giving up, I am too confused.” He had taken on an overwhelming project with his widowed mother, living in another state. As the only child, and following the sudden death of his father, it was his responsibility to care for his mother.

In this world of technology, the family unit is often living in different geographical areas and the family members are usually quite involved with their own lives, careers, and families. In addition, when both parents are alive, often one or both parents are quite independent and do not require a lot of assistance. As time goes on things, of course, change, and sometimes change very suddenly. There can be a crisis, with regard to the health care needs of one or both aging parents.

With our baby boomers facing this problem in ever increasing numbers, and with the information highway in full bloom, there is a definite need for planning.

Protecting your parent’s assets and health is a huge and daunting undertaking, which requires a tremendous amount of education and practical application. Our seniors face many diverse responsibilities upon reaching age 65. To name just a few: Estate planning, taxation, Medicare, social security, wills, insurance, and various other legal and financial matters. All of these different areas require expertise from accountants, lawyers, estate planners, insurance agents, home brokers, financial advisors, and others.

The Internet is a good starting point for most people to find resources for questions and solutions for your problems. There is, however, no replacement for good solid intelligent advice from an expert.

Twenty years ago, insurance for elders was sold by “senior insurance specialists”, with just a handful of companies in each state. The programs were most often Medi-gap or Medicare supplemental policies, which covered the expenses not covered by Medicare, including hospital and doctor deductibles, durable medical devices, and non-approved Medicare costs. Ironically these specialists did not sell a lot of nursing care policies, even though Medicare paid a national average of less than 2% of these expenses. With the advent of “financial and estate planning” and more insurance companies entering this market, a more broad and diversified product line became available to agents, brokers, planners, and seniors.

Part of this new diversification was the “home health care plan”, sold by itself, and in conjunction with senior health insurance products. The appeal of the “home health care policy” was that a senior could stay at home and still receive medical and custodial benefits, allowing a person to recuperate in the comfort of their own home.

This was the answer to a huge problem. The last place an older person wanted to go was a “retirement home”, or “rest home”, or, God forbid, the “nursing home.” It appeared that seniors could now rely on this new innovation without worry of having to move out of their home environment in the event of a health problem.

As with most things,” if it is too good to be true”…. The home health care policy is no exception. The problem is, there is not enough coverage for a lengthy illness or recuperation time. The fact is, the new trend is toward an “all in one” type facility, allowing for a variety of levels of care all in one location. In other words a senior could start off with little or no health care concerns in an independent, less expensive area, and then go to an assisted living, or nursing care facility, all within the same compound.

A “nursing home” requires a nurse on the premises 24 hours per day, assisted living is just eight hours. The advantages to this are financial. The patient or senior is only charged according to the care level required during the time he or she is admitted to that facility. Another benefit is it alleviates a lot of planning because the care is delivered, as it is needed. The medical attention is available to all residents regardless of their current health.

Some people are offered a lifetime package, which covers their care for the rest of their life, regardless of their current age. It also allows for social outlets to an otherwise somewhat isolated group. On-line shopping services have become a huge business. It is definitely here to stay and many insurance policies are purchased from Internet quotes and on-line applications.

There are literally hundreds of thousands of insurance agents and brokers advertising on the Internet. Most of them will provide instant on-line quotes and even applications for the potential insured. I highly discourage a layperson to purchase insurance in this fashion. A little knowledge can be dangerous.

The federal government has mandated to all states through legislation, the standardized senior health insurance policy guidelines, which are governed and regulated by each state insurance department.

There are plans for almost every level of health. Some are designed and priced for a less than healthy individual. Others are for a person with minimal health concerns. . The whole concept of insurance is to provide protection for “unanticipated” sickness or injury, especially catastrophic expenses, which would devastate a person’s net worth. The more small expenses a person is willing or able to pay (self-insure), the lower the rate. I recommend this strategy when evaluating your insurance options.

Another consideration when reviewing various insurance plans is to look at the company itself. How long has the company been selling this type of insurance? Do they have a lot of complaints filed with the local department of insurance? Are the rates stable? Does it pay claims on time? Service? Most agents talk about the rating. These ratings are as follows: A+, A, A-, B+, B, B-, C+, C, C-, or “not rated”.

Do not be fooled by rating alone. It is good to have a high rating, but it is far better to have a company that has longevity, stability, innovation, service, and expertise. The problem is that some companies enter into a market and quickly leave without explanation. This does not give security to the policyholder.

The most important consideration should be a review of the profit/loss ratio for that product. This will establish stability, and longevity in the market. An insurance company with a moderate profit in a particular line of business will remain in that market. On the other hand, a company with losses will make changes and possibly even withdraw. This is information not normally available to Internet users.

Before entering into an insurance contract, the senior person, the family, and other advisors must be realistic, and a careful evaluation of the entire picture must be examined. The age, the health of the senior, the financial resources, the personality and attitude of the senior, and most importantly the desires of the senior, should all be considered.

Early planning is important, as qualification becomes increasingly more difficult as the applicant’s health declines. The senior health care market is complex. I will offer some words of advice to attempt to alleviate potential pitfalls.

*Choose a well-informed, seasoned, and service oriented agent or broker to assist your decision making process. The professional can offer invaluable information, but do not be afraid to ask a lot of questions and even get a second opinion.

*Do not wait until your parent or loved one is sick, or injured. Plan ahead and take the time needed to cover all the options.

*Choose an experienced insurance company. A Company that has been in the marketplace for a significant time and has maintained a balance of rates and benefits and sound risk selection with moderate rate increases over time is your best bet.

*The plan should be flexible, with a broad range of options and benefit selections to the insured. There should be no tricks, or complicated language for the coverage. An incredibly low rate is a red flag for trouble in the future.

*Do not rush or be rushed by an over aggressive sales person.

This policy will not be inexpensive and will need to be read and reviewed for a clear understanding of the contents. This is one advantage to the Internet. You are allowed to read indefinitely before you act.

A long-term care program, with or without insurance coverage, will only work if the senior has input into the care selection process. If there are any questions about the accreditation of a facility please call the “Continuing Care Accreditation Commission at 202-783-7286.

Is Diet, Exercise, and a Proper Lifestyle Enough to Help You Manage Your Health?

Once a year, one of my favorite aerobics leaders asked her participants to look at their bodies in the mirrors that lined the room. She would then tell us there were two very important things we should understand about our bodies.

The first was that a body was not like an automobile or other consumer good. What she meant was that we can’t trade it in or buy a new one when it breaks down. It is the only one we are ever going to have.

The second is that we have no right to expect or assume that someone else will take responsibility for it if and when it did break down. What she meant is that we have to take on that responsibility ourselves. Yes, medical practitioners can advise, patch and prescribe, but the responsibility is really ours and not one that can be handed off.

How right she was. It has been years since I have been to one of her classes – I haven’t stopped exercising, she retired – yet to this day I often think about her words.

It is difficult to argue against an exercise regimen, healthy diet and good lifestyle habits as the best means to a healthy body. But is there more you can or should do? No doubt there is. There are probably a lot of other things you can and should do, but I would like to share one additional thing that I do, and which I believe to have significant value.

I keep meticulous records of things related to my health. I keep the data current and I keep it formally. I use a computer program to manage the data because there is quite a bit of it even though I am in good health.

You may wonder what kind of information I keep, what I do with it, why I do it, and how I do it. Well, let me try to explain.

What Do I Keep Track Of?

I gather five categories of information and they are:

1. medication and supplemental regimens, prescribed or not
2. past, present, emerging and potential medical conditions
3. surgeries, exams, tests and other medical procedures
4. past and scheduled visits with health professionals, and
5. important health measures

The first 4 categories are fairly static in nature – that is, the information does not change once captured and does not require much time or effort keeping it current.

1. In the first category, I keep track of the common name of a medicine, its technical name, the prescribing physician, the dosage and the date I started and/or stopped taking it.

2. In the second category, I record childhood diseases, phobias, allergies, accidents and potential hereditary conditions incurred by my family, such as cancers, heart and other conditions.

3. Next I keep a record of all of the tests I have undergone – ultrasounds, colonoscopies, allergic, etc. – the dates, referring physicians and results if available.

4. And of course a record of my visits with all the doctors and related practitioners I see – when I visited, when I next visit, what I want to discuss so I don’t forget, questions I have, what was discussed, the outcomes, and so on.

The last category can be much more dynamic in nature – that is, the information may change quite frequently, depending on what I am keeping track of. I refer to this type of information as time-series data because there are many records of the same measure taken at different points in time – daily, monthly, annually or whenever. This data is repetitious so I use it to generate graphs and charts that allow me to see trends and correlations to other data.

5. In this category, there is always a date, then the specific measure taken, and sometimes a target and an upper and lower limit. Examples include the results of blood work (HDL and LDL cholesterol and triglycerides), pulse, blood pressure, PSA for men, blood sugar levels, body mass index, and any other meaningful health measures. One can also track physical activities such as miles run or pedaled, laps swum, hours of exercise and so on – anything one can measure. If one suffered irritable bowel syndrome, for example, tracking the number and severity of daily bowel movements and medication dosages taken for the condition may help to evaluate the effect of various treatments.

What Do I Do With All This Information And Why Do I Keep Track Of It All?

First and foremost, I use the time-series data to help me better manage my health. I believe that one can better manage something if one can measure it. For years, I asked my family doctor for a copy of my blood tests results for HDL and LDL cholesterol, triglycerides and my PSA, among others. I make a note of my blood pressure, weight and height when they are taken. So right off the bat, I have 6 measures that I track. I also track the hours of cardiac intensive exercise I take part in each week and regularly record my weight.

Where I live, medical associations publish recommended targets and limits for health measures based on sex, age and so on. I enter this data so that I can compare my own measures to what is normal or expected. I also look for trends to see which direction my measures are heading in, if any.

I do two things with the results: I find myself changing my diet, exercise pattern or whatever when I see a trend that I do not like. Quite often, this is enough to bring the measure back to where I think it should be. I also bring the charts when visiting my doctors so we can discuss the implications of a specific measure or a trend in a measure, as there may be a need for medication or other options to help me bring the measure back into line.

I bring all of the information with me to every appointment I have with a medical practitioner. When asked about medication or supplements I am taking, for information about past conditions or family history, or for past procedures and surgery, I simply hand the relevant report over, or use them to help me fill in any required forms. I bring a copy of all of this data whenever I am traveling. I believe that well organized medical records like these could be life-saving should I find myself in a foreign hospital or having to see a physician as the result of an accident or illness while away from home. I am convinced it will also help should the time come when I have to deal with insurance companies.

How Do I Do It?

As I mentioned earlier, I use a computer application to help me. You can use paper, note pads and graphing paper, but a computer system makes it so much easier. I use one called ‘the Recordskeeper’. It stores all the information I talked about. It is relatively easy to use and provides me with all the reports I need. I use it for other things also, but that is another story.

So! Is diet, exercise and a proper lifestyle enough to help you manage your health? It may be, but I feel that this additional effort keeps me one extra step ahead in managing my own health. It is my responsibility. I accept that and I feel a lot better and healthier for taking on that responsibility and doing what I do. Perhaps you can and should too.

Health Savings Accounts and High Deductible Savings Accounts Put You in Control of Health Costs

Health Savings Accounts (HSA’s) are tax-exempt accounts where funds grow to pay for medical expenses. They usually earn interest on the funds that are deposited. Funds roll over every year, so an individual does not have to use up their money by the end of the year. The maximum amount that can be contributed on a tax exempt basis is determined by the IRS. This year, an individual could contribute up to $2,850, and a family could deposit $5,650.

Health savings accounts were created to help give control back to consumers and lower health care costs. HSAs provide a financial incentive for consumers to select a High Deductible health plan that is compatible with an HSA. High Deductible health plans will have lower premiums that other types of health insurance, and the combination of a tax-exempt health savings account and a higher deductible health plan should encourage consumers to do some shopping for their health services.

The IRS determines the minimum deductible amount for a high deductible health plan. Right now, the minimum individual deductible is $1,100, which is not really all that high. The minimum deductible for a family is twice that, or $2,200. However, actual out of pocket expenses may be higher than the specified deductible. An insurance policy may require some coinsurance, even after the deductible is met, and not all medical services may be covered. Again, HSAs can help provide funds for extra medical expenses!

Important Facts About HSA’s

  • You can use your money tax-free at any time for eligible medical expenses. You can even use your money to pay for expenses like acupuncture and dental care that may not be covered by your major medical insurance policy!
  • When you turn 65, you can use the money for non-eligible medical expenses. The money is subject to income tax, and there are no IRS penalties. In other words, you can consider your account health savings, plus retirement savings!
  • If you are under age 65 and use your money for non-eligible medical expenses, you will be subject to income tax and a 10% tax penalty.

Learn More About High Deductible Health Plans and HSAs

In order to determine if a high deductible health insurance plan, combined with a health savings account, will benefit your family, you need to compare various plans on the market. It is simple to search on line for various options. I would always look for an on line quoting system that participates in a third party quality assurance system like the BBB On Line Reliability Program.