By Katie Banks+ | Friday May 30, 2014

Have you heard the expression “Being a woman is not a Preexisting Condition”? If you haven’t, or haven’t completely understood what this meant I’ll break it down for, as well as show how the Healthcare Exchange has addressed these issues when addressing the new metal plans: Bronze Plan, Silver Plan, Gold Plan, and Platinum Plan.

Women Healthcare Facts

Once ObamaCare fully kicks in on January 2014 there are some major changes that affect women. Women are usually charged more for men because their bodies are genetically different from men. With the population being 50/50 the Healthcare Exchange deemed this wasn’t fair. Here are a few facts about women and healthcare to highlight some important issues that women deal with:

• Women use healthcare services more often than men
• Women usually take the lead role when making decisions for their families health services
• Women are more likely to use prescription medication, suffer from chronic disease, and anxiety and depression than men.
• Women have dependent coverage more often than men, therefore put them in vulnerable positions regarding divorce or losing a job.
• Women tend to have higher out-of-pocket medical expenses than men.

Healthcare Exchange Changes Important for Women

With the new Exchange below are some of the important gains women will receive in the health industry:

For more info:
If you have specific questions about your state and how the Healthcare Exchange works for you call 800-930-7956 or contact FinancialRx.

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By Amy De Vore+ | Monday June 27, 2013

So your parent is turning 65 and you don’t know what you need to do? Well, plan a party, hug your father a lot, and help him find out about senior health insurance. It is actually pretty easy to understand, it just seems complicated. Since I’ve been helping my parents I figured I would make a list about what can help with yours out. Here is the list of the three things your parents should get:

1) Medicare
2) Medigap
3) Rx Coverage

This is the third installment of a 3-part article and we are going to focus on Prescription Drug Plans.

If Your Parent Has Medicare Does He Need Rx Coverage?

Yes. Medicare does not cover prescriptions. As you know from getting your own medicines at the local drug store how much they cost without a copay, imagine how much it would cost without even a negotiated rate. It is pretty important that your parents have Medicare Part D, better known as a Prescription Drug Plan.

What Drugs are Covered with a PDP?

Whatever plan you help your parent choose will have its own list of covered drugs (called a formulary). Most drug plans “tier” their drugs from low to high cost. But all Medicare Part D must also cover all vaccines like the Shingles vaccine.

Make sure to look over your parents current prescriptions and ask their doctor if there are any drugs that your parent might take in the future in order to decide which drug plan is the best for your parent.

When to Enroll in a Rx Plan

During the 7-month period that starts 3 months before the month your parent turns 65, the birth month, and ends 3 full months after their 65th birthday month. If your parent were to miss the initial period he may enroll between April 1–June 30.

Rx Plan Tips

Next Steps
Read the previous installments of this article so that you are well versed on how to help your parent out: Medigap and Your Parents and Original Medicare and Your Parents.

Now that you’ve learned how to get prescription drug coverage,  learn if Medigap covers dental. If you would like to speak to an agent about specific questions in regards to Medicare Part D for your parents contact Medicoverage at 800-930-7956.

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By Amy De Vore+ | Monday June 20, 2013

Now that our parents are becoming seniors we want to make sure that they are financially secure -we don’t want them spending our inheritance on medical expenses (kidding, sort of). The 3-part series that I have written about our parents turning 65 deals with:

1) Medicare
2) Medigap
3) Rx Coverage

This is the second installment and it’s all about Medigap. My goal is to dispel any confusion about what Medigap is, and how it works for your parents.

What is Medigap Insurance?

Medigap, also known as a Medicare Supplement Plan, is purchased through a private insurance company, but it works in conjunction with Original Medicare. This all seems like a lot of info, so what does this mean for your parent? All that it means is: Medicare covers the basics, but if your parent were to have a major medical issue, Medicare leaves a lot of gaps open.

This is where Medigap (hence the name, get it now?) kicks in. For instance with Original Medicare if your mother were in the hospital she would pay a deductible for the first 60 days and coinsurance for up to 90 more days, BUT after that Medicare pays nothing. Many people don’t realize that those additional days in the hospital have a lifetime limit of 60 extra days -meaning if she was in the hospital five years apart, she would pay the full amount after 90 days for the second stay.

Now, if your mother has Medigap while hospitalized, not only does Medigap cover the coinsurance, it extends her hospital stay for up to 365, as well as with some Medigap plans the deductible would be covered.

Other Benefits of Medigap Plan F: Most Comprehensive Plan

Basically, if your parent had Medigap Plan F, she would have the greatest financial security if an accident or serious illness were to occur.

Sign Up for Medigap When Eligible

There are two reasons for this: 1) Your parent may become ineligible to sign up after the fact; 2) There may be penalties for signing up late. Click here if you’re ready to sign up on the Medigap Overview Page.

Medicare Supplemental Premiums

Depends on the plan, provider, and zip code how much your parent will pay. Although, and this is important to note, all, yes all, Medigap plans must offer the same coverage as its letter counterpart (i.e. All Medigap Plan A’s must match each other). Plan A, being the most basic, should have the lowest monthly premium, Plan F, because it the most comprehensive, should have the highest premium.

There is a sort of secret loophole out there called Medigap Plan F High-Deductible. This secret means your parent would pay less out of pocket each month, have a deductible of a little over 2k, but you have all the coverage that traditional Plan F includes. And that deductible isn’t really all that high when considering what people pay for traditional health insurance deductibles.

Tips About Medigap

To learn more about Medicare Part A and Part B read the first installment of this series Medicare and Your Parents: Part A & B. And the third installment Medicare Part D, AKA Rx Plans, and Your Parents.

Next Steps
Read the other two installments of this article so that you are in the know to help your parents out. Also find out if Medigap covers dental. If you would like to speak to an agent about specific questions in regards to Medigap for your parents, contact Medicoverage at 800-930-7956.

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By Amy De Vore+ | Monday June 13, 2013

Now that our parents are seniors it’s important that we know about Medicare and its benefits. There is a lot of information that can seem confusing at first -at least that’s how I saw it. So what I did was compile a list of the important things our parents need and I realized it was actually pretty simple. There are basically three things everyone (including us!) must take care of when turning 65:

1) Medicare Part A and Part B,
2) Medigap
3) Prescription Drug Coverage

I have decided to dedicate an article to each item above. This article will talk about Medicare Part A and B and the importance of having both.

Medicare Part A: What is it?

Part A is basically hospitalization coverage. This covers surgery, hospital stays, the in-case-of-emergency stuff.

Part A Covers:

See how I’ve written “some” for each item? I will explain this below.

Medicare Part A: How do you sign up for it?

Many people will automatically be enrolled in Medicare Part A as soon as their Social Security Benefits kick in at 65. However, there are some people who will need to sign up and I have compiled the list of those that need to do so:

Parents Who Need to Sign up for Medicare Part A:

If they fall under any of the categories above or they aren’t sure they are signed up for part A,  visit The Medicare Overview Page at Senior65 to get started. Remember that there is no cost for Medicare Part A if your parent qualifies.

Medicare Part B: What is it?

Part B is non-hospital medical insurance. You know, doctor’s visits, the day to day things our parents need.

Part B Covers:

*Once again with the “somes.”  I promise I’ll get to that below.

Medicare Part B: When to Enroll Your Parents

Unlike Part A, NO ONE IS AUTOMATICALLY SIGNED UP FOR PART B. There is an additional fee of about $100 a month for this coverage but it is totally worth it. There is a 7 month window to enroll without penalties in Medicare. This period begins three full months prior to the birth month when turning 65, the month of their 65th birthday, and the three months that follow. The sooner your parent applies the sooner get coverage. For example, if your parent signs up in the first 3 months they are eligible, their Medicare coverage will begin the 1st day of their birth month

Do not have your parent delay on this because the penalties for signing up late may last a few years. Costing your parents quite a bit more for their monthly premium.

Medicare Part A and B is Only Basic Coverage

What I mean by “basic” is Medicare Parts A &B still leave uncovered gaps for major medical expenses such as extended hospital stays, foreign travel medical emergencies, and prescription coverage. This is why I have put the word some in front of each benefit above. Medicare parts A and B is a good start (a way better than nothing) but it will not protect your parents if they have major medical issues. Also Medicare Part A and B DO NOT COVER MOST PRESCRIPTION DRUGS

If you want to fill in the gaps of your parents health insurance you would want to consider a Medigap policy.  Which is convenient because that is my next article! If you cannot wait for it then visit Senior 65 to learn about Medigap.

Also if you want to make sure that they have prescription coverage you would want to add Medicare Part D. That’s going to be my third article so hold tight and let me finish it before hitting me up with lots of questions :) To learn more read the 2nd and 3rd installments: All about Medigap and Your Parents and Medicare Part D and Your Parents

Next Steps
Follow the installments of this 3-part article to learn more on how to help your parents achieve medical financial security. Also, check out the article, Does Medigap Cover Dental? If you need to talk to an agent about specific questions regarding your parents and Medicare you call Medicoverage at 800-930-7956.

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By Katie Banks+ | Monday May 20, 2013

HSA Definition

Maybe you’ve heard someone in your HR department talk about HSAs or you saw them mentioned in a magazine article. But somehow the actual meaning of the term HSA still escapes you. Well first, let’s clarify the definition of the acronym. HSA stands for Health Savings Account. And I’ll be blunt:  the HSA has a bit of an image problem. You see, many people think the HSA is just for rich people. But let me clarify why that may not actually be the case.

But before we do that, let’s provide a little more detail on the definition. The HSA is a special kind of account that lets the owner keep money in that account, tax free, and then use that money to pay for health related expenses.



Origin of the HSA

The United States Congress created the Health Savings Account to help make health insurance more affordable by giving consumers more visibility into their health care costs, and direct control over and how their health care dollars are spent.  Congress figured that, if consumers put their own money into a savings account specifically designed for health services, they might keep a more careful watch over it. Congress also made the account tax free, as long as the funds in that account were spent on approved health related expenses. This is a great additional benefit, which leads us to our next point.

The HSA as a Savings Account

The HSA, as explained above, is established as a type of tax-free savings account, and this feature sets it apart from any other type of health insurance plan. What is important to note, is that if you have a healthy year, meaning that you don’t spend much or all of the money in your HSA, that money is yours to keep.  You can roll your money over to the next year.  And the next year, and the next. Healthy year after healthy year can add up, and these accounts can even earn a little bit of interest to boot. 

Now remember, you must load up your HSA account at the beginning of the year with a sum of your own money to cover your health expenses for the year. Then, as you visit the doctor, you must pay for your own health care costs as you go, until you meet your deductible (more on that later). This is probably where the HSA gets its bad reputation as being “for rich people only.”  But consider the following before you judge.

Let’s think for a minute about what you learned above about HSAs, in comparison to a regular health insurance plan. For a regular health insurance plan, you must pay a monthly insurance premium, which is often quite expensive. Then on top of that, you are often required to pay coinsurance and/or copays each time you visit the doctor.  But if you have a healthy year and do not use your insurance plan much, you are not able to take back your premiums!  Even if you visited the doctor only once for an annual checkup in a given year, you will have already spent hundreds or, more likely, thousands of dollars on health care for that year. If you had an HSA that year, you would only have paid for that office visit. The rest of your money would still be sitting in your HSA.

Now, that is an example of a very healthy year and is for illustrative purposes only. Remember, most years will not be that way, especially if you have children who are always in the pediatrician’s office for pink eye, ear infections, you name it. But it is something to consider.

How Do HSAs Work?

The overall HSA package has two parts. The first is the health saving account, which we talked about above.

The second part is the “High Deductible Health Plan” or HDHP for short. If you decide to you want to go with the HSA, you must first enroll an HDHP.  By definition, a HDHP has a high deductible. The deductible is the dollar amount worth of medical expenses that you will be responsible for paying out of your HSA for any given calendar year, after which point your insurance carrier will kick in. The HDHP minimum deductible for 2011 is $1,200 for individual coverage or $2,400 for family coverage (it stayed the same in 2011 as it was in 2010.) 

 Those are the minimum deductible amounts. Some plans have higher deductibles. One of the most popular of these type of plans is Anthem Lumenos HSA.

HSA Qualified Expenses

When you set up your health savings account, you will get a debit card that looks just like any other bank card.  But if you try to use this card for anything not medically related, one of two things will happen:  either your card will be rejected or, you will pay a penalty to the IRS. If you somehow use the funds for something not medically related, you’ll pay a penalty to the IRS. So do the right thing and use your HSA card for health related expenses only. Duh.

HSA Contribution Limits

Once you have your health savings account set up, there are annual limits to the amount you can load into the account each year. Here are the 2011 contribution limits (they are the same as the 2010 contribution limits):
• $3,050 for individuals
• $6,150 for families
• $1,000 additional catch-up contributions for anyone age 55 or older

Additional HSA Benefits

There are other benefits in addition to tax planning and the potential for lower payments for insurance. One of them is how you use the money in the HSA account. Some traditional insurance policies have limited coverage for prescription drugs, or no coverage at all for dental or vision care. Since these are all medically related expenses, you can use your HSA card to pay for these, tax-free.

Now you Know What an HSA is!

Now if you hear someone say “What is an HSA, anyway?” you can casually drop in an informed remark, such “Oh, it’s a cost effective method of securing quality health insurance, building assets and directing the money for health care the way the HSA account holder thinks it needs to be spent.”  And then go back to smugly sipping your latte and skimming the paper.

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By Wendy Mihm | Monday November 29, 2010

Some of us may get a little bent out of shape when we shop for health insurance because they use freaky terms like “deductible” and “co-insurance.”  Ok maybe that’s just me. This overview is for individuals.  If you are looking for coverage in CA for your parents, check out Blue Shield California Medigap.

Anyway, I’m here to take the pain out of this often-dreaded task. It’s really not that hard, I swear.  Here’s what you do.

1. Decide if you’re going for a high-end or a basic plan and understand that you will pay more for the high-end plan.  (Duh.)  A high-end plan will cover some or all of your routine doctor visits and prescription drugs, but will charge a higher monthly fee, called a premium.  A more basic plan will not cover these routine medical costs, but will charge a lower monthly premium.  My view is that the primary purpose of insurance is to protect you and your family from financial ruin, should something truly terrible happen.  For that reason, I tend to recommend the more basic plans in order to keep monthly premiums more manageable.  But you should choose what is most comfortable for you.

2. Learn these terms (or just print this out as a cheat sheet for when you shop for insurance online):

Deductible

The dollar amount that you are expected to contribute toward your medical expenses before the insurance company starts kicking in.  For example, if your insurance policy has a $1,000 deductible, you must pay all of your medical fees for that year until you reach the $1,000 mark, after which point the insurance company will start paying the bills.

Co-Pay

The dollar amount that some insurance plans require you to pay for some medical services.  For example a visit to the pediatrician’s office may require a $40 co-pay under certain insurance plans.

Co-Insurance

This is the percentage of fees that you share with the insurance company.  It works like this:  if you have 20% co-insurance, it means that you’ll pay 20% and the insurance company will pay 80% of the costs of medical expenses.  This term applies to medical expenses after the deductible has been met. Not all insurance plans use co-insurance.

Out-of-Pocket-Maximum

This is the most amount of money that you can be expected to pay for all covered medical services in a given year (in addition to your insurance premiums).

Maximum Payout

This is the total dollar amount that the insurance company is legally required to pay toward your medical expenses throughout the lifetime of the policy.  This dollar amount is in flux right now because of the Federal health care legislation that was recently passed by Congress.  That legislation made it illegal for insurance companies to cap the dollar amount that they would pay toward any one individual’s medical costs.  As insurance plans come up-to-speed with the new legislation, this term will become irrelevant.

3. Understand the concept of the trade-off.  If you elect a plan with a high premium, you’ll probably get lower deductibles and other fees.  The reverse is also true:  if you elect a plan with a low premium, you can expect to have a higher deductible and higher fees for medical services.

4. Use your cheat sheet from above to compare insurance plans online – find the plan that has the combination of benefits that you value the most for a monthly premium that you can afford.  I recommend using a website like www.medicoverage.com or http://www.healthgrades.com where you can get quotes quickly and by just entering your zip code, gender, date of birth and smoking status.  If the site is reputable, like these two are, all other information will be optional. If you are a senior looking for health insurance you can check out www.senior65.com

5. Identify the appropriate primary applicant.  If you’re applying for your family, the youngest spouse should be the primary applicant. Many insurance companies base their pricing on the age of the primary applicant, and the younger this person is, the more favorable the pricing will usually be.

6. When you’re ready to apply, set aside 20 minutes to fill out the online application completely and correctly.  You’ll need the following information for everyone you want to include on the application:

• Social security number

• Prescription names and doses

• Dates of recent hospitalizations

• Credit card info

7. Select a plan and fill out the online application.

8. Cross your fingers and wait to find out if you are approved!

See?  Not so bad.  It’s really just about decoding those key health insurance terms, deciding what you’re willing to pay for, then shopping around.  Now quit playing Glow-In-the-Dark-Family-Dodge-Ball and you’ll be just fine.

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By Alfred Smith | December 3, 2011

Some people purchase several insurance policies so that they can keep themselves and their family members protected from unusual mishaps, which can happen anytime. Buying dental insurance can be very important, particularly for families who tend face dental problems more often than not. However, if you happen to be single and have problem-free teeth, you may not need a dental insurance policy at all.  But for those who need dental insurance, you’ll find that if you shop carefully for an insurance plan, and identify one that’s best suited to your family’s needs, you can can get the most value from the premiums that you’ll pay for the policy.

A dental insurance plan works much the same way as a health insurance plan. In many cases, you’ll have to pay for the treatment up front, and then get your money back once you file a claim for it, however plans do vary.

Dental Insurance Terms to Know When Shopping for a Plan

Deductible amount – The minimum amount that has to be paid from your own pocket before the insurance kicks in.  For example, if the deductible on a plan is $200, then you will have to pay $200 from your own pocket before the insurance company starts paying your dental bills.

Co-Insurance – Once the deductible has been met, the insurance will cover part of the bill, and the patient will be responsible for paying the rest. The amount that the patient pays of the final bill is known as co-insurance. For example, if a plan has 20% co-insurance, it means that after your deductible is met, for the remainder of the year you’ll pay 20% of your dental bills and the insurance company will pay 80%.

Maximum amount of coverage – Once the deductible has been met and you are paying the co-insurance, another thing that needs to be taken into consideration is the maximum coverage on every insurance policy. You will find that most of the insurance policies list a maximum coverage per year. This maximum usually ranges from $750 to $2,000 every year. The more costly the insurance policy is, the higher will be the yearly maximum.

Waiting period of time – In most of the dental insurance plans, there is a definite time period to which the patient should wait before doing any important work. The waiting time period to do any dental work can range between 6 to 12 months in case of standard work, and 2 years for the removal of a tooth.

It is advisable that before you choose a dental insurance policy, you do the necessary calculations so that you get to know the cost for the coverage and the amount of coverage you would get every year. In case the insurance coverage does not beat the cost in a year, then you should not purchase the plan in question. If that turns out to be the case for your family, you might consider a dental discount plan rather than traditional dental insurance.

_____________________________________________________________________________________________________________________________________________

Alfred Smith is from New Jersey and writes for several finance websites.

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By Wendy Mihm | February 22, 2011

If you are self-employed, laid off or just in-between jobs, you no longer have an HR department to handle your health insurance for you.

You’re on your own to figure out how to shop for, and purchase a health insurance plan for yourself and, if you have them, your employees.

It can be a murky topic, and so I’ve compiled a list of 5 simple tips to clear up the waters and get you moving in the right direction.

Tip 1: There is no difference between “self employed” insurance and “individual” or “family” insurance.

It just means that you are not covered under a major employer’s plan any longer.  Stated a different way, there is no difference between health insurance for people who are self-employed and health insurance for and individuals and families.

Tip 2:  If you run your own small business or are simply buying health insurance for your family, there are no special prices or treatments just because your status is “self-employed” or “family.”

This does not mean that some unscrupulous health insurance salesperson might not try to offer you his or her “special discount” on an individual insurance policy.  Unfortunately there are dishonest people out there, but don’t believe it – there simply is no such thing.  Yes, there are plans tailored for individual and small companies, but there are no “special discounts” or “sales.”  The price this person is offering you is the same as any other agent can offer you.  Why?  Because if it’s a true insurance policy, any plan that offers the same benefits by the same provider, must be priced the same.  It’s the law. 

How To Use Online Insurance Quote Engines

As an individual, family or business owner, the most efficient way to shop for health insurance and compare plans is to use an online individual and/or family health insurance quote engine.  These will allow you find plans available in your geographic area, and then compare prices offered by different companies, head-to-head.

Tip 3:  Reputable quote engines will allow you to search for plans by just entering in basic information.

 
This information will most often include your birth date, gender, smoking status and zip code.  Other information will likely be requested, but it should be optional. The sign of a disreputable quote engine is one that requires you to enter details like a phone number, email or mailing address to get quotes.  This is a signal that a live agent wants to contact you to sell you a policy.  Incessantly.  If the info is optional, the sell is likely to be a much softer and appropriate one from a reputable site.

My two favorite two reputable quote engines are at Medicoverage.com and HealthyGrads.com because I know the owners personally, and they provide customer service that is second to none.  But there are many to choose from online if you simply Google the term health insurance quote engine.

Once you find a quote tool and enter in the basic information (again, other information will likely be requested, but it should be optional), you should be given the following information about health insurance policies to compare:

• Name of Plan and Provider

• Monthly Premium

• Annual Deductible

• Co-payment or Co-insurance amounts

If you need some help with the terms above, or just want some more in-depth understanding of the ins and outs of health insurance, our article called How to Find Health Insurance is a great place to start.

Tip #4:  Pre-existing conditions will close some doors for you.

If you have some serious medical conditions that are considered to be “pre-existing,” meaning you already had them when you applied for the health insurance plan, you are going to get turned down by many policies.  I am not going to sugar coat this one for you.

If the Obama Administration’s health care legislation stays in tact, by 2014 the law will prohibit insurers from denying coverage to sicker applicants; i.e., those with pre-existing conditions.  It remains to be seen how this will play out. 

In the mean time, many are left to shop for coverage against difficult odds.  Therefore, if you or someone in your family has a pre-existing condition, it is important to get familiar with the laws in your state, and find out if there is a clause for what is called “guaranteed issued health insurance.” While this type of coverage is often not as inclusive as other types, it will provide you with basic coverage for your health care needs.

Tip #5:  Sometimes humans are best. 

Quote engines are great – if you find a good one, they can be a lot like Orbitz, only for health insurance policies.  But because the health insurance industry is loaded with jargon and because the stakes with health insurance are a bit higher than they are with, say, a choosing a flight to Newark, you just might want to speak to an actual human.

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By Wendy Mihm | January 31, 2011

What is COBRA, Anyway?

A king cobra is a big, scary venomous snake found in the plains and rainforests of India, China and…

Oh come on, it’s a little bit funny.

What Does COBRA Stand For?

Ok, smarty pants.  Let’s start with the acronym then.  COBRA stands for Consolidated Omnibus Budget Reconciliation Act.  But since that’s probably not very helpful, let’s talk about what COBRA actually does. 

What Does COBRA Do?

COBRA allows employees and their dependents to remain on a former employer’s plan after they are no longer employed, as long as the employee left under certain qualifying conditions.  This can be especially helpful when either the employee or someone in her family has a pre-existing condition that would make it difficult to get insurance under an individual or family plan.  Now, there are some caveats to this previous statement, so let’s look at those next.

First, in 2014, if the recent “Obama Health Care” plan stays in place, “guaranteed issuance” will become the law.  This will mean that insurance companies will not be able to turn someone down because they have a preexisting condition.  At that time, COBRA may not be as appealing as an option. 

Second, if adult dependents 26 and under suddenly find themselves unemployed, they may now choose to go back on their parents’ plan and receive guaranteed issuance.  This may make COBRA a less appealing option for someone 26 or under. 

Finally, anyone under the age of 19 who successfully purchases health insurance today should also receive guaranteed issuance.  In theory, this should make COBRA less appealing to them, should they suddenly find themselves unemployed.  In reality, however, many health insurance companies are not offering plans at all to such young consumers.  Given that they are under 26, they still have the option to go back on their parents’ plan and receive guaranteed issuance.

How Expensive is COBRA?

COBRA has a reputation for being quite expensive.  In fact, it is precisely 102% of the total costs of the plan while the employee was still working.  It just seems expensive because now the enrollee must pay her share, plus the employer’s share, plus 2%.  Where this additional 2% came from, I do not know.

Here’s a video that sums up COBRA nicely.  I promise there are no snakes in it.

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