MEDIGAP (MEDICARE SUPPLEMENT INSURANCE)
These are health insurance policies sold by private insurance companies to fill gaps that Original Medicare does not cover. They are categorized by letters, A-N. Each plan letter has a different range of benefits. The gaps these plans cover could include co-payments, co-insurance, and deductibles. Some Medigap policies also provide coverage for services that Original Medicare does not cover. For example, medical care when you travel outside the United States. If you have Original Medicare and you purchase a Medigap policy, Medicare will pay its share of the Medicare approved amount for covered health care costs. Then your Medigap policy pays its share.
IMPORTANT FACTS OF A MEDIGAP POLICY INCLUDE:
1. You must have Medicare Part A and Part B.
2. If you have a Medicare Advantage Plan, you can apply for a Medigap policy, but make sure you can leave the Medicare Advantage Plan before your Medigap policy begins.
3. You pay the private insurance company a monthly premium for your Medigap policy in addition to the monthly Part B premium that you pay to Medicare.
4. A Medigap policy only covers one person. If you and your spouse both want Medigap coverage, you’ll each have to buy separate policies.
5. You can buy a Medigap policy from any insurance company that’s licensed in your state to sell one.
6. Any standardized Medigap policy is guaranteed renewable even if you have health problems. This means the insurance company can’t cancel your Medigap policy as long as you pay the premium.
7. Some Medigap policies sold in the past cover prescription drugs, but Medigap policies sold after January 1, 2006 aren’t allowed to include prescription drug coverage. If you want prescription drug coverage, you can join a Medicare Prescription Drug Plan (Part D).
8. It’s illegal for anyone to sell you a Medigap policy if you have a Medicare Medical Savings Account (MSA) Plan.
9. Medigap policies do not cover everything.
10. Medigap policies generally don’t cover long-term care, vision or dental care, hearing aids, eyeglasses, or private-duty nursing
MEDICARE ADVANTAGE PLANS (MAPD)
These are health plans usually in the form of a Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), Special Needs Plan (SNP), or a Private Fee for Service plan (PFFS). These plans are offered through private companies approved by Medicare. You must have Medicare Parts A and B, and live in the plan’s service area to be eligible. Each Medicare Advantage Plan charges different premiums and has different costs for services. Medicare pays a fixed amount for your care each month to the companies offering Medicare Advantage Plans. These companies must follow rules set by Medicare. You usually get prescription drug coverage (Part D) through the plan. In some types of plans that don’t offer drug coverage, you can join a Medicare Prescription Drug Plan through both an MAPD or a Medicare Prescription Drug Plan.
These plans are also known as Part “C” or “MA” plans. If you decide to join one of these plans you still keep your Medicare coverage. You will get your Part A (Hospital Insurance) and Part B (Medical Insurance) coverage from the Medicare Advantage Plan and not Original Medicare.
PRESCRIPTION DRUG PLANS (PDPS)
Most Medicare Prescription Drug Plans charge a monthly fee that varies by plan. You pay this in addition to the Medicare Part B premium. If you belong to a Medicare Advantage Plan (Part C) or a Medicare Cost Plan that includes Medicare prescription drug coverage, the monthly premium you pay to your plan may include an amount for drug coverage.
Each Medicare Prescription Drug Plan has its own list of covered drugs (called a formulary). Many Medicare drug plans place drugs into different “tiers” on their formularies. Drugs in each tier have a different cost.
A drug in a lower tier will generally cost you less than a drug in a higher tier. In some cases, if your drug is on a higher tier and your prescriber thinks you need that drug instead of a similar drug on a lower tier, you or your prescriber can ask your plan for an exception to get a lower copayment.
HEALTH INSURANCE – INDIVIDUAL AND GROUP
Individual insurance is, quite simply, coverage that an individual purchases for himself and/or his family. Individual insurance policies and provisions are regulated by the state where the policy is purchased.
When you apply for individual health insurance coverage, you are asked to provide health information about yourself and any family members to be covered. When determining rates, insurance companies use the medical information on these applications. Sometimes they will request additional information from an applicant’s physician or ask the applicant for clarification.
Group health insurance coverage is a policy that is purchased by an employer and is offered to eligible employees of the company (and often to the employees’ family members) as a benefit of working for that company. A group health insurance plan is a key component of many employee benefits packages that employers provide for employees. The majority of Americans have group health insurance coverage through their employer or the employer of a family member. One of the advantages for employees in a group health plan is the contribution most employers make toward the cost of the health coverage premium—in many cases, employers pay one-half or more of the monthly premium for an employee.
LONG TERM CARE INSURANCE
Long term care is care that you need if you can no longer perform everyday tasks (activities of daily living) by yourself due to a chronic illness, injury, disability or the aging process. Long term care also includes the supervision you might need due to a severe cognitive impairment (such as Alzheimer’s disease).
This type of care isn’t intended to cure you. It is chronic care that you might need for the rest of your life. You can receive long term care in your own home, a nursing home or another long term care facility, such as an assisted living facility.
People often confuse long term care with disability or short-term medical care.
Long Term Care is not:
• Care that you receive in the hospital or your doctor’s office
• Care you need to get well from a sickness or an injury
• Short-term rehabilitation from an accident
• Recuperation from surgery
Who Needs Long Term Care?
Anyone can need long term care at any time in their life. Automobile and sporting accidents; disabling events such as strokes, brain tumors, and spinal cord injuries; and disabling illnesses such as multiple sclerosis and Parkinson’s disease are examples of injuries and ailments that can happen to anyone at any age.
There are many people under the age of 65 who require long term care because they need help taking care of themselves due to diseases, disabling chronic conditions, injury, developmental disabilities, and severe mental illness. According to the U.S. Department of Health and Human Services (HHS), at least 70 percent of people over age 65 will require some long term care services at some point in their lives. Moreover, contrary to what many people believe, Medicare and private health insurance programs do not pay for the majority of long term care services that most people need. Planning is essential for you to be able to get the care you might need.
The main reason for life insurance is to provide income replacement to your beneficiaries if you die. But if you are interested in estate planning, cash accumulation, wealth transfer, and estate tax liquidity, life insurance can also help you achieve these goals.
Life insurance policies are now available from more than 2,000 life insurance companies in the U.S., as well as from financial institutions that are now getting into the marketplace. It’s just as important to understand the companies behind the products as it is to understand the products themselves. I will help you monitor the financial strength of the individual insurers. This is especially important when you’re buying life insurance, because policies will probably pay out many years from now, maybe even decades from now. Therefore, you’ll want to know whether the company you’re buying from will be solvent down the road.
VARIOUS TYPES OF LIFE INSURANCE
Final expense insurance can help ease that burden by paying for many of the costs associated with funerals. With the high cost of funerals, the last thing anyone wants to think about after they lose a loved one is paying for and planning final arrangements. However, it is a sad reality that may people have to face the problem of not having the proper coverage to prevent such occurrences.
Who Can Buy Final Expense Insurance Coverage?
Anyone can buy final expense insurance. Most often, however, it is purchased by those who are near to death and do not already have a regular life insurance policy in place. Many final expense insurance policies can be underwritten without the designated insured submitting to a medical exam. These no-exam policies contain higher rates for the insurance, but are still less expensive to buy than regular life insurance because of the low face value of the policy.
Term Life Insurance
Non-Guaranteed term life provides coverage only for a short time (usually 10, 20, or 30 years) and is pure death-benefit protection. The risk with term life is that your health might deteriorate and you could be unable to get another policy once the term is up. However, term life insurance is usually a sound choice for young people who can’t afford the higher expense of permanent insurance, or for people covering specific needs that will disappear in time, such as a car loan or a mortgage.
Yearly Renewable and Convertible Term
Yearly renewable term insurance offers a longer term, usually for five, 10, or 20 years. By buying a longer term policy, your costs can be stretched out to avoid the annual increases found in non-guaranteed term life.
Convertible term is like yearly renewable term but it also offers conversion to a permanent policy in the future — when regular term premiums might become cost-prohibitive or if your health declines. Convertible term policies usually provide the maximum protection with the smallest amount of cash outlay required. This is a good choice especially for young people who are unable to afford the higher cost of permanent insurance right now but need maximum life insurance and also want to have the option of converting to permanent coverage in the future.
Permanent Life Insurance
Similar to yearly renewable term and convertible term, whole life policies stretch the cost of insurance out over a longer period of time in order to level out the otherwise increasing cost of insurance. In this case, however, it is spread not over a few years but over your entire life. Your excess premium dollars are invested in the company’s general portfolio. Because you aren’t personally managing that investment, your selection of an insurance company is vitally important.
With this type of policy, however, the inflexibility of premium payments could become a burden if your expenses increase or if you lose your job.
This option offers greater flexibility than whole or term life. After your initial payment, you can reduce or increase the amount of your death benefit (although to increase the amount, you’ll probably have to give the insurance company medical proof that you are still in good health). Also, after your initial payment, you can pay premiums any time, in almost any amount within the policy’s required minimums and maximums.
An annuity is a contract between you and an insurance company that is designed to meet retirement and other long-range goals, under which you make a lump-sum payment or series of payments. In return, the insurer agrees to make periodic payments to you beginning immediately or at some future date.
Annuities typically offer tax-deferred growth of earnings and may include a death benefit that will pay your beneficiary a specified minimum amount, such as your total purchase payments. While tax is deferred on earnings growth, when withdrawals are taken from the annuity, gains are taxed at ordinary income rates, and not capital gains rates. If you withdraw your money early from an annuity, you may pay substantial surrender charges to the insurance company, as well as tax penalties.
There are generally three types of annuities — Fixed, Indexed, and Variable.
The insurance company agrees to pay you no less than a specified rate of interest during the time that your account is growing. The insurance company also agrees that the periodic payments will be a specified amount per dollar in your account. These periodic payments may last for a definite period, such as 20 years, or an indefinite period, such as your lifetime or the lifetime of you and your spouse.
The insurance company credits you with a return that is based on changes in an index, such as the S&P 500 Composite Stock Price Index. Indexed annuity contracts also provide that the contract value will be no less than a specified minimum, regardless of index performance.
You can choose to invest your purchase payments from among a range of different investment options, typically mutual funds. The rate of return on your purchase payments, and the amount of the periodic payments you eventually receive, will vary depending on the performance of the investment options you have selected.