Penalties for Seniors Who Delay Filing for Medicare

Posted on February 3, 2012 by admin

Seniors just aging into the Medicare market, must know about the penalties they will pay if they do not sign up for Medicare Part B at the right time. For those seniors who have already filed for Social Security, they will automatically be enrolled in Medicare at age sixty-five. However, seniors who continue in the workforce, either by choice or necessity, and delay their Medicare coverage need to notify Medicare of their decision. Otherwise they will face a 10% Part B penalty for each year that they do not file. So someone filing for the first time at age seventy will face a 50% Part B penalty. The penalty is permanent and can translate into thousands of dollars in unnecessary penalty charges.

If you decide to continue working, notify Medicare of your decision as soon as you turn sixty-five to ensure you will avoid penalties later. Especially, if you are a senior who works at a company with over twenty employees, as your employer will continue to provide your benefits. You can do this by choosing the option on the back of the Medicare card that is sent, calling the Social Security Administration, or visiting the SSA website. For their Part D prescription coverage, you can delay filing as long as your employer provides equal or better coverage.

Those seniors earning more there is a surcharge on high-income seniors. Currently, this affects only 5% of seniors, however those still in the workforce are more likely than those retired to fall into the income bracket. The extra charges can be applied not only to Part B, but also Medicare Advantage and Part D coverage.

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Oregon Health Insurance

Posted on February 2, 2012 by admin

What is a Health Insurance Exchange?

A Health Insurance Exchange is a new marketplace that offers health insurance and coverage options to individuals, families, and small employers. An Exchange will offer a choice of insurance plans and provide information to help you understand what plan best fits your needs. After comparison shopping using easy-to-understand plan summaries, you will be able enroll in a health plan and may be eligible for tax credits to help you pay your insurance premium.

Under national health reform, states must have an Exchange in place by Jan. 1, 2014. Exchanges can be developed and implemented by the state or by the federal Department of Health and Human Services. Oregon lawmakers have chosen to develop a state-specific Exchange that fits Oregon’s unique needs and insurance market.

Is the Exchange an insurance company?

No, the Exchange is not an insurance company. The Exchange is a marketplace where individuals, families and small employers can buy private health insurance, access federal tax credits, and qualify for Medicaid-based health coverage. Oregon’s Exchange is a publicly accountable organization, overseen by a nine-member board of directors, appointed by the Governor and confirmed by the Senate.

To whom is the Exchange accountable to?

The Exchange is accountable to the public and works for the benefit of the people and businesses that obtain health insurance coverage through the Exchange. Exchange board meetings are open to the public and always allow for public participation through a public comment period. The public can also submit comments through the Exchange website at https://orhix.org/public_comment.html.

Who can buy health insurance in the Exchange?

Individual and families who do not have access to affordable coverage through an employer can buy in the Exchange. Small employers with 50 or fewer employees also can buy insurance through the Exchange.

When can I buy health insurance in the Exchange?

You can shop for coverage at the Exchange starting in October 2013. Insurance coverage for plans bought in the Exchange will start Jan. 1, 2014.

How will I buy insurance through the Exchange?

Consumers will be able to compare health insurance plans and buy insurance in a variety of ways through the Exchange. You may use our website, call our hotline or work with the help of a specially trained navigator or insurance agent.

Are there special standards for insurers selling health plans within the Exchange?

Yes. The Exchange board will establish standards for participating insurers and the plans they sell in the Exchange. This will give people and small employers who buy insurance through the Exchange a choice of high-quality health plans.

Will the Exchange help me pay my insurance premium?

In some cases, yes. Tax credits will be available for individuals and families buying in the Exchange with incomes up to 400% of the federal poverty level ($89,400 for a family of four). Based on income, some will also get additional help with cost-sharing expenses, such as co-pays and deductibles.

Will small employers receive tax credits?

In some cases, yes. Small employers that employ low- and moderate-income workers may be eligible for tax credits to help cover the cost of employee coverage. The credit, which is available today, is designed to encourage small employers to offer health insurance coverage for the first time or maintain coverage they already have. You can learn more at the IRS website.

What is Oregon doing to develop its Exchange?

During the 2011 Oregon Legislative Session, Oregon lawmakers passed Senate Bill 99, establishing the Oregon Health Insurance Exchange Corporation. In February 2012, the Exchange will present a business plan to lawmakers for review and approval. Click here to read the business plan. Over the next 18 months, the Exchange will focus on developing its technology system, working with stakeholders on designing Exchange operations, and providing education and outreach around the state.

How is the Exchange funded?

Through the end of 2014, the Oregon Health Insurance Exchange is funded by federal grant dollars. Beginning Jan. 1, 2015, the Exchange must be self-sustaining. To cover its costs, the Exchange will collect an administrative fee from insurance carriers that sell health plans in the Exchange.

What happens if the Supreme Court overturns the Affordable Care Act’s requirement that all Americans have health insurance?

Oregon has been on a path toward a health exchange for many years, long before the Affordable Care Act. The Exchange will offer valuable services to Oregonians, such as a central place for consumers to compare health insurance plans and a way for small employers to offer more choice for their employees with less administrative burden. These services still will be needed, and the corporation’s goal is to build an Exchange where consumers will want to purchase insurance, with or without a mandate. If the mandate is overturned, the Exchange Corporation will consult with legislators and the Governor to determine whether it needs to make any changes to its business plan.

What happens if federal funding for subsidies and tax credits are reduced?

The subsidies and tax credits made available as part of the Affordable Care Act will help drive enrollment to the Exchange. If this federal assistance is lowered or eliminated, the Exchange Corporation may have to adjust its enrollment projections.

If the Exchange loses its federal funding, is the state of Oregon at any financial risk?

No. The Exchange is a public corporation independent of state government and has not received any state funding. If the federal start-up funding is reduced or eliminated, the state is under no obligation to move forward with the Exchange. If this occurs, the Exchange Corporation will consult with legislators and the Governor on next steps.

What are the consequences of Oregon not receiving federal readiness certification in January 2013?

The Oregon Health Insurance Exchange undergoes periodic reviews by its federal partners to ensure it is on track to receive readiness certification in January 2013.

If the federal government determines in January 2013 that any states are not  ready to operate an Exchange, it may grant provisional certification. In that  case, the state could address the federal government’s concerns and receive certification later. If the federal government finds that a state will not be ready to operate an Exchange, it will move forward on implementing a federal Exchange for that state.

How is Oregon moving forward with its Exchange without federal requirements?

There are a number of critical areas where the federal government has not yet released regulations, such as standards for qualified health plans, the functions of navigators and agents, and eligibility determinations, appeals, and exemptions. The Exchange Corporation is watching the federal rules process closely and coordinating statewide responses to requests for comments. The Exchange is developing its web portal using a three-week, iterative process so it can adapt quickly to evolving requirements.

Long Term Care Insurance

Posted on December 1, 2011 by admin

Long term care insurance can be confusing, no matter who you are, especially if you don’t know who to turn to for expert advice.

The Facts Are Clear
Anyone with even a passing experience with Alzheimer’s, stroke, Parkinson’s or elder frailty can appreciate the severity and financial devastation of these all-too-common life events and the inevitable care required. This is why we want protection.

* The average Ancient Greek lived until age 18. The median life span of a Puritan was 33. The average American life expectancy is now about 75 years for men, 84 for women. Over half of

Americans will spend part of these these extended years in long term care situations.

* By 2030, one in five Americans will be a senior citizen. If you are a Baby Boomer, this includes you. Americans are living longer and healthier, thanks to better diet, better medical care and safer living & working environments. Yet no one is immune to the effects of aging and longevity – effects that often result in reduced physical or mental ability.

* In 1994, 7.3 million Americans needed long term care (LTC) services at an average cost of nearly $43,800 per year. By 2000, this number rose to 9 million Americans at nearly $55,750 per year. It’s currently near $75,000 per year. By 2030 those needing LTC will skyrocket to 23+ million Americans, with projected, individual long term care costs reaching $300,000 annually per individual!

Will you have that kind of money to spare?

With a history of millions of Americans in care situations living with longevity, elder frailty, stroke, Multiple Sclerosis, Parkinson’s, Alzheimer’s, Spinal Cord Injury, Cerebral Palsy, accidents and other conditions that affect 50+% of folks over age 65 , we can testify to the need for mature thinking and adult decisions when it comes to long term care planning.

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Is preventive care really free?

Posted on November 28, 2011 by admin

BY AMANDA MCGRORY
October 26, 2011

In an effort to keep health care costs down and encourage better usage, the Affordable Care Act includes a provision that requires preventive care to be offered free of charge. While that may sound good in theory, some benefits experts do not buy into this “free” health care.
“Very simply, nothing is free,” says Gary Bernabe, RHU, CHC, vice president of Strategic Employee Benefit Services. “Somebody‟s paying for it. There‟s no free lunch.”

Before this provision was passed, preventive care was generally well covered, says Joanne Denise, employee benefits specialist of Strategic Employee Benefit Services. With a small copay, an insured participant could get the necessary preventive care services. However, the perception that preventive care was not well covered took over, and there was a prevailing thought that plan participants would become more engaged in their own health if these services were free, prompting the Obama administration to introduce this provision.

“They might have had a $20 or $30 copay, but that‟s really not unreasonable for a pap smear, mammogram, cholesterol checks or immunizations for the kids,” Denise says. “In some areas, there are even community health clinics, where people can get their preventive shots for next to nothing. A lot of people just don‟t know those health clinics are there for the average person.”

Premiums, in particular, are facing rate hikes to counterbalance not only the new preventive services provision but also other aspects of health care reform, Bernabe says. As more services are added to required coverage, the expense of health care just gets that much bigger.

“Most people want to blame insurance companies, but all insurance companies are doing is increasing their costs to keep pace with the increased cost of the care,” Bernabe says. “You have to account for the fact that, all of a sudden, you have to cover adult children for another three years. You just throw them in there, and if they have issues, they‟re all paid for. Now contraception will be covered. All these things are great, but everything costs money.”

Deductible costs are also being affected because of the free preventive care provision, Denise says. Previously, plan participants could receive their preventive services by simply paying a copay. A routine checkup often includes blood work that is processed at a lab, which was typically covered by the copay; however, now preventive services are defined by the U.S. Preventive Taskforce, and lab work is no longer eligible under the new guidelines. Instead, the lab work cost is being applied to the deductible – much to the surprise of the plan participant.

“We are seeing patients who once paid a $20 or $35 copayment for an annual checkup now faced with $300- $700 charges or higher applied to the deductible,” Denise says. “They are asking, „What happened to the free preventive care?‟ and „Why does my checkup cost so much this year?‟ So how many will go get their free annual checkup next year? Some will still be paying for last year‟s expense.”

While Denise believes it is the insurance carrier‟s responsibility to communicate these changes to plan participants, brokers and employers should also play a role. Many plan participants go in assuming their checkup is covered, as free preventive care implies. They don‟t know what services are included or what questions to ask.

“It‟s a great idea to make sure you get this information in the hands of all your employees, one way or another,” Denise says. “Maybe it is an email. Maybe it is a text message, but you can‟t just say, „Oh, well, we put this on the carrier‟s website. There is drastic confusion among consumers about what‟s covered with my free preventive physical, so you need to be proactive in communication.”

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With Economic Uncertainty, Perceived Value of Benefits Rises

Posted on November 16, 2011 by admin

Nearly eight out of 10 employees said the benefits package offered by their company is one of the reasons why they work there, according to the 2011 Mercer Workplace Survey, a proprietary research program. Even more, 91% of employees said getting health benefits through their company is just as important as their salary. Companies have “an opportunity to position their benefits program as a differentiating strategy, which can be especially valuable as they strive to be an ‘employer of choice’,” said Suzanne Nolan, a partner in Mercer’s U.S. outsourcing business. “The positive implications of this heightened benefits awareness extend far beyond recruiting and retention – often leading employees toward greater engagement, personal accountability, and overall satisfaction.” The survey also shows employees perceptions of health care reform.

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Why do I need life insurance?

Posted on November 9, 2011 by admin

Answer:

Life insurance has several purposes. Its most important function is to replace the earnings that would cease at the death of the insured. For businesses, life insurance is a way to protect key employees and the business itself. A third purpose is to use life insurance to pay potential estate taxes.

If you die during your earning years, your family could suffer a severe economic loss as a result of losing your current and future income. Unfortunately, your family would still have to pay its regular bills, the mortgage, and outstanding debts, and perhaps even continue saving for college and retirement. Unless you’re independently wealthy, achieving these goals may be virtually impossible for your family with the loss of your steady income. Life insurance offers a way for your family to continue living comfortably and without worry.

Employers often purchase life insurance policies on key employees to insure against the loss of services or income that might result after an employee’s death. Here, the proceeds from the policy are paid to the company. Life insurance works for business partners too, where one business partner purchases a policy to insure against the financial loss that might result from the other partner’s death or to buy out the partner’s heirs.

Life insurance is also used to pay potential federal estate taxes. Since these taxes must be paid in cash, life insurance can be a good way to ensure the fulfillment of this obligation.

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It’s Medicare Season!

Posted on October 24, 2011 by admin

Fall is Leaf-Peeping Season and Hunting Season. It’s also Medicare Season. Time to do that all-important check on your policies and make sure they are the right ones for next year. The Medicare Season is open from October 15 to December 7. After that date, you can’t make any changes until next year’s Medicare Season.

What do you need to check? Your Medicare Part D (prescription drug insurance) coverage. Each year the prescription drug plans change – both their premiums and the drugs they cover. You need to check your drugs against the available plans to make sure which one is best for you.

It’s also a great time to see if you’re eligible for a Medicare Savings Plan. You might be able to save significant money.
How do you check? Call Coast Professional Services, make an appointment and have Ron or Dennis help you!

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Medicare Plans Quick Overview

Posted on October 5, 2011 by admin

Medicare Plans Explained Simply

Assistance with health care has been a growing issue in the United States for years. Many individuals, especially seniors, find that they are unable to afford medical bills or insurance for coverage. This leaves them with some tough decisions. Too often, one must choose between good health and finances. There’s no middle ground. The Medicare program was developed by the government to help those who are eligible with their overwhelming health care bills.

There is a lot of information to process when considering Medicare. Knowing what Medicare is and how it works will help you choose the program that will best meet your individual needs. Use this helpful guide to get an understanding of the Medicare program and how it can benefit you.

What is Medicare?

Medicare is a government health insurance program administered by the Centers for Medicare & Medicaid Services (CMS). Medicare is the largest health insurance service in the country, with around 40 million Americans participating. To be eligible you must be a citizen of the United States and meet certain requirements. If you are not a citizen of the United States, you can contact the Social Security Administration office to learn if you would be eligible.

Can you answer yes to at least one of the following statements?

 I am 65 years of age or older.
 I am under 65, but I have certain disabilities.
 I have End-Stage Renal Disease (kidney failure that requires a transplant or dialysis).

If so, then you are likely to be eligible for Medicare benefits.

Medicare Benefits: A Brief Summary

Medicare is basically broken down into two main categories: the “Original Medicare Plan” and the “Medicare Advantage Plan.” Each category is made up of four sub-categories: Part A, Part B, Part C and Part D.

The Original Medicare Plan

The Original Medicare Plan consists of Part A. You do have the option of adding Part B and D. You will automatically be enrolled in the Original Medicare Plan unless you specifically choose to join a Medicare Advantage Plan (Part C).

The federal government manages the Original Medicare Plan. It operates on a fee-for-service plan. Most people pay a deductible and then a co-pay or co-insurance.

Medicare Advantage Plan

The Medicare Advantage Plan or Plan C combines your Part A and B coverage, but is provided by private insurance companies. You have the option of adding Part D if coverage is not already included. Medicare Advantage Plans include HMO, PPO, private fee-for-service plans, and Medicare special needs plans.

Part A Overview

Part A is hospital insurance provided by Medicare. Most people do not pay a premium for this coverage. Part A covers inpatient care in skilled nursing facilities, critical access hospitals, and hospitals. Hospice and home health care are also covered by Part A.

Go To: Medicare Part A

Part B Overview

Part B is medical insurance to pay for medically necessary services and supplies provided by Medicare. Most people will have to pay a premium to receive this coverage. Part B covers outpatient care, doctor’s services, physical or occupational therapists, and additional home health care.

Go To: Medicare Part B

Part C Overview (Medicare Advantage Plan)

Part C is the combination of Part A and Part B. The main difference in Part C is that it is provided through private insurance companies approved by Medicare. With this program, you may have lower costs and receive extra benefits.

Go To: Medicare Part C

Part D Overview

Part D is stand-alone prescription drug coverage insurance. Most people do have to pay a premium for this coverage. Plans vary and cover different drugs, but all medically necessary drugs are covered. You can choose what drug plan will be best suited to your needs.

Go To: Medicare Part D

How Can I Cover Additional Expenses?

Original Medicare Plans do not cover everything. Costs that you may incur include co-insurance, co-pays, deductibles, etc. These costs are called gaps. To help cover these costs you might want to buy a Medigap policy.

Another option is Medicaid. Medicaid is a combination of federal and state programs to help cover medical costs. Eligibility depends on your income as well as the ability to meet specific requirements.

If you are new to Medicare, the first thing you need to do is decide which Medicare plan will fit your needs. Be sure to check if your current insurance works with Medicare and determine if you need help paying for additional health care costs. You will also need to schedule a “Welcome to Medicare” physical exam with a doctor. Don’t forget to ask your doctor about any preventive services he might recommend. Decide if you need prescription drug coverage. Then, you should contact a Medicare representative to enroll.

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Top ten reasons you need life insurance

Posted on September 23, 2011 by admin

This article is from:
Futurity First Insurance Group, Inc.
500 Enterprise Drive, Suite 4B | Rocky Hill, CT 06067 | 860-838-4800

Top ten reasons you need life insurance.

Let’s talk about life insurance — it’s never a “fun” conversation to have. But when you sit down with an expert who has your best interests in mind, you may find that life insurance is something you not only need, but truly want, as well — to protect your family, dependents, business and legacy.

Why?
1. You never know.

Dying suddenly — in an accident, by unexpected illness or even of natural causes — can happen at any time. Life insurance helps your loved ones pay the mortgage, bills, even college costs, after you’re gone.

It also provides tax-free cash to pay estate and death duties. Nothing can replace you in their hearts, but planning ahead with life insurance can make things easier for those you leave behind.

2. Funerals are expensive.

In some cases, upwards of $7,000 to $10,000 — and we’re not talking about extravagant funeral services. This is the average cost of a burial ceremony that will be faced by your loved ones. At an already difficult and emotional time, your life insurance can cover these expenses without financial hardship or further stress.

3. Protect those you love.

In your life, you work hard to make sure those you love — spouse, partner, children, family members — are taken care of. It’s just as important to consider providing financial support for the future living costs of surviving dependents. After all, they will have to go on without you. Make sure they’re protected, too.

4. Death shouldn’t mean debt.

Life Insurance can help your dependents cover any financial responsibilities that are left after your death. Debt can be a tremendous burden, on top of the already emotional toll your absence creates in their lives.

5. Anything can happen.

If you develop a serious illness, you may not be able to get life insurance to the extent you need it — or at all. If you have a terminal illness, life insurance can provide you with financial support. Life insurance can also be used in case of emergencies by requesting a withdrawal or loan.

6. Take care of business.

Life Insurance isn’t just for individuals. It can protect a business from financial loss, liabilities or instability in the case of the death of a business owner/partner. Whether providing necessary short-term cash or keeping operations going until things settle, life insurance can be invaluable in maintaining the business you’ve worked so hard to build.

7. Supplement your retirement.

You can use life insurance to make sure your retirement savings lasts as long as you do. An annuity is like a do-it-yourself pension plan — you put an amount of money into a life insurance product and in return you get a guaranteed stream of income month after month, for as long as you live.

8. It makes financial sense.

Life insurance is considered a financial asset, which can help increase your credit and help you to get a loan or health insurance. Many policies have cash value, which even in case of bankruptcy cannot be touched by creditors.

9. Give to charity.

Life Insurance can enable you to leaving a lasting gift to a favorite cause or charity that is much larger than you would otherwise set aside for donation.

10. Peace of mind, plain and simple.

No amount of money can ever replace a person. But more than anything, life insurance can help provide protection for the uncertainties in life.

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