Category

Supplemental Coverage

Baby Boomer Rescue

By | Life Insurance, Living Benefits, Supplemental Coverage

A study showed that boomers turning 65 in 2011 are expected to retiredlive until they are 85.2 years old.

If you were born between 1946-1964 you are a baby boomer.

You are probably living pretty well, but in the back of your mind, you know you have not saved enough for your retirement…and specifically you have not saved enough to take care of the biggest expense: high medical bills-

Now I’m NOT talking about medical bills like doctor or hospital bills – those will be taken care of by Medicare & your supplement.

I’m talking about the medical bills you will have for your home care and eventually nursing home care that are NOT covered by Medicare. These are costs you will incur once you’re no longer able to take care of yourself. Either from becoming mentally disabled, physically disabled, or suffering from a critical illness.

In these cases, family members will mean well and help with things like cooking and cleaning or taking you to a doctor’s visit. But when it comes to being able to take time off work, moving you into their home, or providing around the clock care that’s something else. Our children have their own lives and simply cannot afford that level of commitment.

Have you thought about how YOU want to live? How you will provide for yourself if YOU can’t take care of yourself?

Well some of you may consider 10 Countries where that social security check will let you retire: Cambodia, Malaysia, Nicaragua, Indonesia, Columbia, Thailand, Costa Rica, Mexico, or Panama.

But for the rest of us who don’t want to retire in a foreign country (away from our family!) we better have a plan to help stretch what savings…and make sure we don’t become a burden to our children and grandchildren.

In the 90’s planners offered Long Term Care Policies. They were great until they stopped being sold due to the unlimited benefits most of them offered.

This has left a coverage gap that, until recently, went unfilled. Now I’m happy to present what I believe to be the “poor man’s retirement plan”, The Living Benefit Life Insurance Policy.

A Living Benefit plan is like Neapolitan ice cream – remember that? You got 3 flavors Chocolate, Vanilla, and Strawberry all in one scoop. A Living Benefit plan is just like that, you get a Term Life Policy that provides a death benefit, Critical Illness coverage that provides a lump sum of cash if you suffer from any of 15 major illnesses that affect your life expectancy, and a Chronic Illness benefit that is triggered just like a long term care plan was.  The Chronic Illness plan covers cognitive loss or inability to preform 2 of 6 activities of daily living (eating, bathing, dressing, toileting, transferring-walking and continence).

In these cases your Living Benefits plan comes to the rescue – providing a large lump sum of cash exactly when you need it most.

More importantly the benefits are based upon a guaranteed level premium for a pre-determined number of years, this means you can transfer some of this risk for an affordable predetermined cost.

I highly recommend the purchase for anyone who can qualify. Trade in your old style life insurance that pays only upon death – to the new style of coverage that provides cash for YOUR life.

Failure to do so may hasten the depletion of your retirement nest egg – or worse, put you in poverty at the mercy of the welfare system. Take it from me – both of my parents had dementia and ended up bouncing around welfare nursing homes. This experience has branded me for life and made me determined to help as many people as I can.

Now’s the Time to Get the Help You Need.

Provide me a little information and let’s start a conversation about your needs, your budget, and what you qualify for – this way I can prepare a plan to enhance YOU and YOUR family’s future security…and help you retire with confidence and style.

Call right now! 1-800-257-1723 Or click here to schedule an appointment.

 

Younger People Need Long Term Care Coverage

By | Life Insurance, Supplemental Coverage

Long Term Care ChartMost small business employees and owner benefit packages have a glaring coverage gap that is becoming increasingly harder to ignore as baby boomers become older and younger employees become caregivers. I’m referring to insurance that covers long-term care. This is coverage that helps small business employees and owners protect their retirement assets and shoulder their responsibilities as caregivers should they or a family member need extended long-term care services.

Health insurance covers medical services such as doctor visits, hospitalizations and prescriptions. Life insurance provides a death benefit. Disability insurance provides supplemental income when employees can’t work due to illness or injury. And retirement plans help employees build a nest egg. But none of these types of insurance covers the cost of services and support that people need when they can no longer care for themselves because of an accident, illness or cognitive disorder.

That’s where Long Term Care Coverage (available through the purchase of a Living Benefits Life Insurance Policy) fits in. The benefits from Living Benefits Life Insurance can be used by policyholders of all ages who are permanently or temporarily unable to perform at least two activities of daily living (eating, bathing, dressing, toileting, transferring and continence) or who suffer from a cognitive disability. If, for example, you are injured in an auto accident and need help with bathing and dressing, and perhaps need some home modifications, your Living Benefits coverage likely would pay for that.

Long-term care services can be expensive. The cost of long-term care continues to rise year over year in most care settings, according to Genworth’s 2016 annual Cost of Care Study. These costs are increasing, especially for services in the home, which is where most people choose to receive care. Nationally, the median monthly costs for the services of a homemaker or an in-home health aide for 44 hours a week are $3,813 and $3,861, respectively. The national median monthly cost of a private nursing home room is $7,698; assisted living, $3,628 per month; and adult day care services, $1,473 per month.

Contrary to what many believe, long-term care is not for just older people. In fact, our Beyond Dollars Study found that long-term care is increasingly being used for younger policyholders. The percentage of care for recipients 65 years of age and older fell from 81 percent in 2010, the first year of the study, to 60 percent in 2015. This means that 40 percent of people requiring long-term care services are under the age of 65. That same survey also found more long-term claims stem from accidents than from illnesses.

For more information about Living Benefits Life Insurance call us now at 800-257-1723 or click here to set an appointment.

Surprise medical bills piling up for patients – supplemental coverage may assist in filling in these gaps

By | Supplemental Coverage

In February, Houston lawyer John Mastriani went to see an ophthalmologist after noticing a problem with his vision. The physician told Mastriani he’d suffered a detached retina and needed surgery as soon as possible.suprise-medical-bills-supplemental-insurance-may-help-min

Dr. Keith Bourgeois could do the operation, he said, but a company representative from Mastriani’s new Aetna insurance plan initially said the doctor wasn’t covered, even though his name was listed as in-network. Then, hours later, a different rep said he was.

The next morning, as Bourgeois prepared for surgery, he heard again from Aetna: Now they were saying he, in fact, wasn’t covered. By then it was too late; Bourgeois needed to operate right away to save Mastriani’s vision.

Within a few weeks, the bill came: Mastriani owed more than $5,000.

“This is how bad it is,” Bourgeois said. “It’s become so complicated, the insurance companies don’t even know their own coverage. That happens to us about once a week.”

It’s not just happening at his office. According to a recent report by the Texas Medical Association, which represents physicians, more and more patients are getting slapped with surprise medical bills each year in Texas and across the country. The group blames ever-growing deductibles and the rapid narrowing of insurance networks — the practice of covering only select doctors at certain hospitals — for the surge in billing surprises.

Worse in emergency rooms

In a recent survey of Texas physicians, 61 percent said they had found their name listed as in-network on insurance plans that no longer covered them; 56 percent said they found instances where they were not listed in a plan but should have been, according to the report.

“So even when patients do their due diligence, there’s still a chance that I’m not in that network anymore,” said Bourgeois, a Texas Medical Association board member.

The problem is especially pronounced at emergency rooms, according to research published last month in the New England Journal of Medicine. The study found that, nationally, one out of every five patients who went to a hospital covered by their plan received at least one bill from a doctor who wasn’t covered. On average, those patients had to shell out an extra $900; some paid thousands more.

There are no federal protections against such practices, the researchers wrote, and state regulators don’t do enough. The national study singled out McAllen, the Texas border town, as the worst in the country.

There, an astonishing 9 out of 10 emergency room visits resulted in surprise medical bills for patients who thought they were covered.

People assume that if a hospital is covered by their plan, the same will be true of any doctors they see there. But take Humana Health Plan of Texas for example: In about half of the Texas hospitals covered by the plan, the insurer has no contracts with emergency department physicians, the medical association report found. At those emergency facilities, Humana card holders are guaranteed to pay extra.

Market failures

Jamie Dudensing, CEO of the Texas Association of Health Plans, acknowledged that surprise billing — known in the industry as “balance billing” — is a growing problem. But she said Mastriani’s case is an outlier: The vast majority of surprise bills are the result of emergency room visits and are not the fault of insurance companies, but rather a market failure that must be addressed by lawmakers.

In short, Dudensing said, there’s no incentive for physicians to negotiate to ensure they’re covered by the same plans that cover emergency rooms where they practice. In Texas, providers actually are paid more if they’re out of network, she said.

“I truly believe this is not helping anyone for us to go around blaming each other,” she said. “I believe that most doctors are working very hard and doing the right thing and want to be in-network. Instead of going around blaming people, I’d rather have protections to ensure those outlying situations don’t happen to a consumer.”

‘Amazing, incredible nightmare’

Texas lawmakers have attempted to address the issue in recent years, drawing muted praise from consumer advocates who say much more is needed. Texas is the only state to actively collect data on surprise medical bills, and since 2009, patients in some instances have been allowed to petition the Texas Department of Insurance for help fighting unexpected medical bills. Through the first 10 months of this year, the agency has helped 1,363 patients, nearly 500 more than were helped two years ago, according to an agency spokesman.

The Texas Medical Association is calling on lawmakers in 2017 to increase state oversight and make it even easier for patients to seek mediation after a surprise bill. Dudensing, the Texas insurance industry representative, said she supports giving consumers more protections in addition to other reforms to ensure emergency rooms and physicians are covered by the same plans.

It will have been too late for Mastriani. Ten months later, he’s still fighting Aetna to pay up.

It helps that he’s a consumer protection lawyer. A few weeks ago, he sent the company a letter giving it 60 days to pay his bill before he sues under the Texas Deceptive Trade Practices Act.

An Aetna spokeswoman said the company is reviewing Mastriani’s appeal and couldn’t comment further on the matter.

“As a lawyer, I see stuff like this all the time,” Mastriani said. “This is the amazing, incredible nightmare.”

We can help

Want to avoid billing surprises?  Supplemental coverage may assist in filling these gaps.  Call us 800-257-1723 or click here now for an appointment.

 

2017 the Houston Chronicle

John Hancock Discontinues Long Term Care Insurance

By | Supplemental Coverage

After a recent analysis of the macro-economic trends facing the long-term care (LTC) insurance industry, John Hancock has made the difficult decision to discontinue sales of our individual LTC insurance policies in all states. As many of you well know, the distribution landscape for LTC insurance has shrunk significantly since the peak of the industry in 2002. Today, there are far fewer outlets through which individual LTC insurance is sold, impacting the growth potential of the product. In addition, consumer demand for individual LTC insurance has fallen and remains stagnant. These trends, combined with the significant capital requirements of the LTC insurance business, are the primary reasons for this decision, which was not taken lightly.

Please refer to the following schedule of important dates relating to the wind-down of current cases.

IMPORTANT DATES:

  • December 2nd, 2016 – last day to submit ‘in good order’ applications.
  • Please note LTC Quick Quotes will be discontinued effective immediately.
  • December 16th, 2016 – last day to complete paramedical exams.
  • February 10th, 2017 – all policies must be issued and paid for.

Please note that the decision to discontinue new sales does not impact our inforce LTC insurance business. We will continue to honor our commitments and provide high quality service and support to our existing LTC insurance policyholders and their families for many years to come.

We continue to believe in the importance and value of providing LTC protection for Americans, so as we look ahead, we will focus on offering LTC coverage as an accelerated benefit rider on our wide range of life insurance products, which has become an increasingly popular option for customers in recent years.

Sincerely,

John Hancock

How to Prevent the Cost of Critical Illnesses From Destroying Your Retirement Savings

By | Health Insurance, Health Reform, Supplemental Coverage

Understanding your total exposure to health care expenses is the best way to prevent the cost of critical illness from destroying your retirement savings.

Prevent Critical Illness From Destroying Your RetirementHealth care is clearly the greatest financial risk faced by retirees. The incidence of expensive chronic diseases is higher for today’s retiring baby boomers than it was for their parents. Longevity gains have added years to average life spans, but these extra years will be more of a curse than a blessing if they are spent dealing with serious illness and unaffordable medical bills.

The Employee Benefit Research Institute reports that a 65-year-old couple with median drug expenses would need $283,000 to have a 90 percent chance of covering their out-of-pocket drug expenses during the remainder of their lives. And this total does not include long-term care.

It is important to understand that basic Medicare leaves retirees on the hook for a 20 percent co-pay with no cap. Supplemental Medicare policies can close much of this gap. But they don’t cover most long-term care expenses, and neither does Medicare.

There is a solution for forward thinking couples and individuals who are interested in protecting their retirement savings:  Living Benefits Life Insurance.

Living benefits allow the insured to “accelerate” a portion of the death benefit on the policy so that the funds can be used to protect the policy holder’s financial well-being.

Insureds must qualify based on a health or medical condition to receive the cash.  Living benefit funds can be received either as one single lump sum, or they can be taken by the insured in regular installments. The funds may be used to pay off insurance deductibles, pay for medical procedures, or used in any other way the insured desires that may not be related to offsetting health insurance costs.

The amount of the cash that is accessed will be applied against the policy’s death benefit. So its important to consider how much survivors will need at the insured’s death and whether decreasing the amount of the death benefit will create a potential hardship for beneficiaries.

The money received by the insured is typically not subject to federal income tax, provided that the distribution meets certain criteria. This criteria includes the insured being classified as terminally ill when filing an income tax return.

Also, living benefits from life insurance policies aren’t subject to state income tax in most U.S. states. (There may still be some instances where taxes are due, though, so it is always best to check with a tax advisor in this situation).

Living benefits should be an integral part of everyone’s retirement planning.  For more information contact us at 800-257-1723 or click here to schedule an appointment.

 

Living Benefits Protect Against Affordable Care Act Drug Access Restrictions

By | Health Insurance, Health Reform, Supplemental Coverage

 The Affordable Care Act covers preexisting conditions except when it comes to prescription drugs.

Perscription DrugsAdvancements in specialty drugs have the potential to significantly improve the lives of patients suffering from serious, chronic and life-threatening conditions – from cancer to heart disease to rheumatoid arthritis. But, because these new pharmaceuticals often come from the latest breakthroughs in biotechnology are more expensive. Many Affordable Care Act insurance providers and pharmacy benefit managers, protective of their bottom line, are finding ways to restrict coverage despite the drugs’ effectiveness.

Two tactics are used.  The first, called step therapy, requires that an existing, cheaper drug be prescribed, rather than the new, potentially more effective drug. The second, called prior authorization requirements, involves subjecting the patient to onerous, bureaucratic red tape which makes it much harder for patients to access new drugs.

For critically ill patients these bureaucratic maneuvers create added stress on the patient and their family…not to mention the harmful effects the stress  of fighting the insurance company has on the patient’s recovery.

So how can you protect yourself and your family from this Affordable Care Act insurance provider health care rationing protocol?  By having a living benefits life insurance policy that pays in the event of a critical illness.  Living Benefits life insurance allows you to accelerate your death benefit while you’re still living if you suffer a heart attack, cancer diagnosis, stroke, or any other critical, chronic, or terminal illness.  Those funds can then be used to cover high deductibles, purchase premium pharmacology treatment or supplement your income while you recover.

 

Video: Living Benefits – HLD


Living Benefits Life Insurance available through Health Life Dental Insurance

How to be Legally Opt Out from Obamacare

By | Health Insurance, Health Reform, Supplemental Coverage, Uncategorized

 

We get asked, on a daily basis, if there are ways to legally avoid the high cost, low value of the Obamacare insurance exchange products AND not pay a penalty for purchasing insurance that best fits the insured’s needs.  Here are the options that we share:

1) If the lowest-priced “Obamacare plan” coverage available to you, through either a Marketplace or job-based plan, would cost more than 8.13% of your household income, you are exempt from the Obamacare Shared Responsibility Tax and can purchase alternative insurance without penalty.  Click on the links to get the forms and details for the Marketplace affordability exemption or the job-based affordability exemption.

By the way, there are other exemptions.  Here is a complete list:  https://www.irs.gov/Affordable-Care-Act/Individuals-and-Families/ACA-Individual-Shared-Responsibility-Provision-Exemptions

2) If you are comfortable with the Affordable Care Act’s specific instructions to the IRS that they may not “TAKE’ the money from you— only withhold it from a refund that is due you —  you may avoid the Obamacare Shared Responsibility Tax.  Learn more here: Obamacare Penalty: Proof Its Not Enforceable

3) If you are concerned about the IRS, you can join Christian Health Ministries (NO WE ARE NOT JOKING!) This is an excellent option if you combine it with other off-exchange insurance options.CropperCapture[119]

Christian Sharing Ministries is $45 per month for a single bronze membership, $90 for Husband & Wife or Parent with children or $135 for Family (remember you are not buying it to pay a claim as they NEVER guaranteed they would send a dime, you are just getting it to avoid the potential penalty).

IMPORTANT—- THIS IS THE MONTHLY RATE—- YOU ONLY NEED THIS 10 MONTHS A YEAR NOT 12 —- YOU HAVE A BUILT IN 2 MONTH EXEMPTION EACH YEAR COURTESY OF THE AFFORDABLE CARE ACT.

Click here to go to the Christian Health Ministries site.  Next, RUN A QUOTE  BY CLICKING ON THE RED INSTANT QUOTE BUTTON – CHOOSE BRONZE—- Buy it in February each year.  To claim the Christian Ministries Exemption click here. To view the Christian Health Ministries booklet, click here.

If you purchase the Christian Health Ministry program please contact us so we can set you up with an insurance program that you can count on for your health care needs.  NOTE: THIS COMBINATION FOR THE HEALTHY FAMILY IS LESS THAN HALF THE COST OF AN “OBAMACARE” PLAN.

One more thing:  When you sign up for Christian Health Ministries, please list Mark Deschenes’ member number: 278378  Christian sharing offers a free month to a referring member— So please list me! Thank You!

 

SEE ALSO: http://www.health-life-dental-insurance.com/2015/06/obamacare-penalty-is-it-enforceable/

 

A SHORT TERM HEALTH BENFIT PLAN IS NOT INTENDED TO QUALIFY AS THE MINIMUM ESSENTIAL COVERAGE REQUIRED BY THE AFFORDABLE CARE ACT (ACA). UNLESS YOU PURCHASE A PLAN THAT PROVIDES MINIMUM ESSENTIAL COVERAGE IN ACCORDANCE WITH THE ACA,( this is why we recommend the Christian Sharing Program in combination with the Short Term Medical), Without it, YOU MAY BE SUBJECT TO A FEDERAL TAX PENALTY. ALSO, THE TERMINATION OR LOSS OF THIS POLICY DOES NOT ENTITLE YOU TO A SPECIAL ENROLLMENT PERIOD TO PURCHASE A HEALTH BENEFIT PLAN THAT QUALIFIES AS MINIMUM ESSENTIAL COVERAGE OUTSIDE OF AN OPEN ENROLLMENT PERIOD.  THIS POLICY INCLUDES A PRE-EXISTING CONDITION EXCLUSION PROVISION.

Why You Need a Living Benefits Policy

By | Health Insurance, Health Reform, Supplemental Coverage

Ever wonder what it would feel like to survive a serious illness physically but end up financially devastated?  HowFinancially Devastated From An Illnesscan you protect yourself, your family, your assets, and the quality of life that you have built for them if faced with a life-threatening illness?  What if your doctors recommend a treatment that is not covered by insurance (a REAL possibility in today’s insurance environment)? If you have to go into a nursing home facility because of illness, who will pay for the cost?  Since the terminal illness will impact your ability to work, where will you get the money to pay for your household expenses and other financial responsibilities?

One in five American adults will struggle to pay medical bills this year. A sudden accident or terrifying diagnosis can touch virtually anyone, unleashing an avalanche of bills – even on the insured. In fact, bankruptcies resulting from unpaid medical bills will affect nearly 2 million people this year—making health care the No. 1 cause of such filings, and outpacing bankruptcies due to credit-card bills or unpaid mortgages.

The answer is to have a life insurance policy with a living benefits rider (also known as an accelerated benefits rider).  This benefit provides that all, or a portion of, the policy’s proceeds will be paid to the policy owner when certain events occur, including:

  • Terminal illness, with death expected within a specified period;
  • The occurrence of a specified catastrophic illness or the need for extraordinary medical intervention, such as an organ transplant or continued life support;
  • The need for long-term care due to an inability to perform a number of “activities of daily living,” such as bathing, dressing, eating etc.; and
  • Permanent nursing home confinement.

In today’s high deductible, restrictive insurance benefits environment a living benefits policy is a must-have component of your financial planning.  Click here to get a quote.

Need more proof why Living Benefits are essential?  Read this article and you’ll see why you need a backup to your health plan.  Call us today – 800-257-1723 – let’s protect your family.

Obamacare can’t restrict sale of fixed-payout health plans, judge says

By | Supplemental Coverage

A federal judge sided Friday with an insurance company that says the Obama administration had no right to restrict the sale of its products to people who also hold medical insurance that complies with Obamacare’s standards.

By Tom Howell Jr. – The Washington Times – Friday, September 11, 2015

The plaintiff, Central United Life, said a significant portion of its revenue is derived from the sale of fixed indemnity plans, which pay out a specific cash amount when a beneficiary receives a health service, regardless of what the hospital or other provider charges.Judge

In his ruling, U.S. District Court Judge Royce C. Lamberth said the administration went too far in interpreting the Affordable Care Act to mean they could require insurers, through rule making, to only sell fixed indemnity plans to people who attested they also had substantial, Obamacare-compliant insurance.

The administration passed the rule, effective last January, to fulfill Obamacare’s core mission of making sure people are adequately covered when they’re injured or get sick. It also didn’t want people to buy these supplemental plans and think it shielded them from Obamacare’s individual mandate penalty for lacking substantive coverage.

Yet a “net good result” isn’t good enough, the judge said. Nothing in the 2010 health law changed the way a previous law, the Public Health Service Act of 1944, defined benefits such as fixed indemnity plans, which were excepted from its standards, according to his opinion.

“Forcing federal agencies to comply with the law is undoubtedly in the public interest, and defendants have not shown to the court’s satisfaction that this clear benefit would be outweighed by the harms putatively caused by [the government’s] policies,” Judge Lamberth, appointed by President Ronald Reagan, wrote.

While the ruling doesn’t have sweeping ramifications for Obamacare in the way that other, better-known lawsuits against the law would, it could produce a ripple effect among companies who offer fixed-payout plans and feel they, too, should be shielded from the rule and its consequences.

“Most of Central United’s fixed indemnity plan customers will not purchase fixed indemnity plans if they have to purchase major medical insurance first, as the Fixed Indemnity Insurance Rule requires,” the company said in its lawsuit last November. “They would and do, however, purchase Central United’s fixed indemnity plans even if they must also pay the individual mandate penalty under the Affordable Care Act.”

The Department of Health and Human Services referred a request for comment to the Justice Department, which could not immediately be reached.

4 Complaints Providers Have with Medicare Advantage

By | Supplemental Coverage

Medicare Advantage plans are widely popular among Medicare-eligible consumers, but not everyone is fond of them.

September 12, 2014 | By Dina OverlandMedicare Advantage

Medicare Advantage plans are widely popular among Medicare-eligible consumers, but not everyone is fond of them. Many providers actually dislike the Medicare Advantage program and, therefore, are reluctant to contract with Medicare Advantage Insurers reported NerdWallet.

There are five common issues that providers have with the Medicare Advantage insurers, which continue to boost their enrollment numbers with broader coverage than traditional Medicare, FierceHealthPayer previously reported. Three of them are summarized below.

  1. Complicated authorization and reimbursement. Many providers complain that the Medicare Advantage authorization process is tedious and delayed, which drains resources and their staff’s time. Providers also frequently have to dispute claims far more often than for Medicare. “Even if the payment is eventually the same, the cost of the added paperwork, stress, processes, appeals, calls and staff time bites through any profit, quickly causing a practice to lose money,” Martine Brousse, a patient advocate and health industry expert, said in the NerdWalletarticle.
  2. Unclear policies. Unlike traditional Medicare, which has clear guidelines explaining which treatments are covered and at what price, Medicare Advantage requirements differ for each insurer. That means providers potentially must reach out to individual Medicare Advantage insurers each time a patient needs treatment. What’s more, Medicare Advantage insurers can require providers to take certain steps, including offering cheaper, non-surgical or less drastic treatments, so providers must call the companies to determine what treatment they can deliver to their patients.
  3. Unpaid patient balances. Providers worry that they risk losing payments from some patients with a Medicare Advantage plan because those patients have a high liability. Traditional Medicare patients often have secondary insurance to help them cover expensive healthcare bills, making it easier for providers to collect payment. But since few Medicare Advantage members have secondary insurance and many of their policies have higher deductibles and out-of-pocket costs, it’s often more challenging for them to pay their bills.