Retiring Baby Boomers Healthcare

Retiring Baby Boomers healthcare costs are a big concern and need to be planned for … starting now!

When you think of retirement, you think of white sand beaches, or sipping coffee on the porch, or riding your Harley till you find that quaint little town and stop and the night … basically you leave the bump and grind and being your stress-free life, right?  Retiring baby boomers are not thinking of having to deal with the complicated world of Medicare or your retirement health insurance. Yuck!

So for those of you who like to look through the “rose-colored glasses”, we have listed a few key things about healthcare costs that retiring baby boomers should be aware of so you can prepare now as retirement nears.

Medicare isn’t FREE.

Shocker?  Most retiring baby boomers assume that all of a sudden once they stop working and get on Medicare, magically all of their medical bills will be paid.  It’s probably because we all paid so much in for so many years, it would seem justified, however it isn’t the case.  How it really works is Medicare Part A covers things in hospital and that part is FREE for most enrollees.  Then Medicare Part B, which covers outpatient services and Medicare Part D, which is the prescription part, isn’t FREE.  To add to it, all of the parts of Medicare come with varying deductibles and other out of pocket costs that can add up, not to mention it doesn’t have an annual out-of-pocket limit like most of us are used to with our health plans.

A typical retiring baby boomers healthcare costs will look something like this once enrolled in Medicare:

  • Part B premium, which for most people is $104.90 as of 2016, but those with higher incomes are subject to higher premiums.
  • Medicare Part A Deductible- $1,288 per benefit period (for 2016).  Now Medicare says a “benefit period” is the day your’re admitted to a hospital or skilled nursing facility up until you reach the point where you haven’t received inpatient care for 60 days in a row.  So basically, in a year you could pay that $1,288 deductible multiple times … there’s no limit to the number of “benefit periods” under Medicare Part A.  Plus, you are charged for each day you are confined, and there is no limit on that either.
  • Medicare Part B Deductible – $166 per year (for 2016).

So to boil it all down, when you are enrolled in Medicare alone, you will spend thousands of dollars each year out-of-pocket. In fact, in 2010, according to the Kaiser Family Foundation, Medicare beneficiaries spent an average of $4,745 on out-of-pocket healthcare expenses. That doesn’t sound FREE to me!

Retiring baby boomers need supplemental insurance.

Generally, Medicare will cover about 80% of the medical expenses, which is why most people use supplement insurance plans to cover the other 20%.   There are a lot of different Supplement Plans or Medigap plans available.  They are sold by individual carriers and vary by price and benefits.  Some do really good at picking up what Medicare doesn’t pay, and others have more out-of-pocket costs to you.  A Medigap plan with very little out-of-pocket cost will probably average you around $180 per month.

Now as we said, Medicare doesn’t cover everything, and may not meet all your retirement needs.  Just as Medicare doesn’t cover funeral expenses, it also doesn’t cover the cost of nursing home care or assisted living facilities, therefore you have long-term care insurance.  Key is, the best time to buy is when you are young and healthy, just like your life insurance.  The average 60-year-old couple pays about $3,400 per year in premium costs, but having a plan could save you and your loved ones thousands upon thousands in the long run. The American Association for Long-Term Care Insurance reports that more than 50% of applicants aged 50 to 59 qualify for long-term discounts based on their health, but that figure drops to 42% among 60- to 69-year-olds and 24% for 70- to 79-year-olds.  The facts show the older we get the less likely we are to qualify, so if you are interested in seeing about long-term care insurance, click here for a free quote.

“I’m not going to be 65 when I retire, what do I do for health insurance?”

So let’s say you are one of the “lucky” ones and will stop working before you get Medicare eligible, you will have to get health insurance on your own until you reach 65.  There are a few ways this can happen:

JOB:  If you had health insurance with your employer, you may can continue your coverage under that same plan, that is called COBRA, which allows you to keep the plan for up to 18 months.  If you elect COBRA, you will pay the full cost of your plan, whereas your employer most likely paid some of it.  Most COBRA premiums are high, but before you make the choice, you need to shop around, you generally have 60 days to elect it.

INDIVIDUAL:  If you didn’t have the option of COBRA, or you have exhausted your COBRA already but you still aren’t 65, you have the option of shopping individual plans.  Now days, everyone is talking about Obamacare, and on and off the exchange.  That is a whole other post you need to read … basically know it is available but keep in mind that the (2016) prices have gone up from when you shopped last, and plans have changed.  You may have to take a higher deductible or a plan with fewer copayments, but the main thing to look at is network.  Most carriers are only offering HMOs, so you must stay with a doctor in network – so make sure your doctor is in that network on the plan you choose, or you will have to change doctors.  Keep in mind, if you get a plan that is not ACA qualified, you will be subject to the penalty when you pay your taxes.

Good news!

Typically we see most retiring baby boomers are happier with the healthcare costs once they get on Medicare vs what they are paying on their individual plans.  However, once you retire, you’ll be on a fixed income, so the more you prepare now, either by putting back extra savings, or paying off more of your other liabilities, the better off you’ll be.

Life events can change insurance

Some of our biggest life events that trigger special enrollments and change our healthcare coverage too.

Under the Affordable Care Act, many life events, such as losing a job, having a baby, moving, divorcing and getting married, allow people to sign up for health insurance throughout the year, outside of the annual open enrollment period.

Obamacare enrollment runs from Nov. 1 through Jan. 31 for 2016 coverage.

Young adults are more likely than any other age group to experience a life event that qualifies them for special enrollment

Once people understand that getting married, having a kid or moving can be an opportunity to enroll in affordable care, people are interested in hearing about their options. Especially if they picked a plan they are not so happy with.

One thing to remember though, there is only a limited period of time to get a new health policy when these life events happen.

As a general rule, you have to enroll within 60 days of a qualifying event. It’s not an open window.

Not all big life events can alter your insurance coverage — at least not immediately.

Pregnancy

Having a baby, triggers an opportunity to switch health plans, but most people are suprised to find out that pregnancy does not trigger an opportunity. Pregnancy doesn’t allow you to switch plans, it only allows you to add the child to the plan.

Here are some common reasons people qualify for a special enrollment period under Obamacare:

Losing insurance

The reasons for losing insurance are varied – The loss of a job-based plan, aging out of a parent’s coverage at the age of 26, losing coverage through divorce, or losing eligibility for Medicaid or the state’s insurance program for people with low incomes, trigger a special enrollment period.

Most people feel COBRA is their only option. They aren’t aware that after leaving or losing their job they can sign up for a plan and even apply for a tax credit to lower their insurance costs.

Once you elect COBRA, you can’t just drop it. If you continue your current job-based health plan through COBRA, you’ll have to keep it until it ends or the next annual open enrollment comes around when you can sign up for a new plan. Canceling COBRA before it expires does not count as a qualifying event triggering a special enrollment period.

In fact, losing insurance because of something you do yourself — say, stopping payment because you believe that your plan is too pricey — won’t qualify you for a special enrollment period.

Moving

Most health plans operate within a specific geographic area. If you permanently move to a new city or ZIP Code, you may qualify for a special enrollment period and have the chance to pick a new plan.

If you move to a ZIP Code where another plan is now offered or a plan that was offered is no longer available, that’s a qualifying life event.

Marriage – Divorce – Adoption

You can add someone to your health plan if you get married, or if you have or adopt a child. Losing insurance coverage because of divorce also qualifies you to buy a new policy during a special enrollment period.

There are a few other special events that may trigger a special enrollment opportunity. To learn if you qualify for special enrollment email us directly or call 877-740-8683 and we will be happy to assist.

What is a Supplemental Accident Policy?

MILLIONS of people have accidents every year.

Rate of Nonfatal, Medically Consulted Fall Injury Episodes, by Age Group
Graphic source: MMWR Quickstats, 02/03/2012
In 2010, the overall rate of nonfatal fall injury episodes for which a health-care professional was contacted was 43 per 1,000 population. Persons aged ≥75 years had the highest rate (115).
Will you or your family be affected?

Accidents and disabilities can create serious financial worries. A supplemental accident plan can help protect you and your loved ones from those concerns by providing additional assurance that major medical plans can’t.

In addition to the routine expenses that medical insurance covers, there are additional costs that you must pay yourself – not to mention the possibility of lost wages.

Protect your most valuable asset . . . your income!

With a supplemental accident plan, you get these assurances:

  • Your benefits are paid directly to you or to whomever you choose, unless otherwise required.
  • Your benefits have no lifetime maximum limits, and are renewable as long as premiums are paid.*
  • Your benefits are paid regardless of any other insurance you carry.
  • Your rates cannot be increased unless all rates of that kind are raised in your state.

*Some disability benefits/rider may only be guaranteed renewable to the age of 70

Did You Know?

Worker’s compensation only covers injuries that occur on the job.

Major medical plans may cover only routine medical expenses for accidents or disability, leaving uncovered costs such as copays, transportation, physical therapy, emergency room and a host of other expenses for you to pay out of your own pocket.

Loss of income due to a disability can strip you of your wealth-and the lifestyle to which you’re accustomed.

An accident plan is a great supplement to a high-deductible health plan.

According to the National Safety Council

  • 66% of all accidents occur off-the-job.
  • More than 23.8 million injuries required medical attention in 2003.
  • In 2004, over 82% of all costs due to accidental injuries were non-medical costs and expenses.

How would YOU pay for unexpected costs?

  • Spend your savings
  • Sell off assets
  • Preserve your resources with supplemental accident insurance.
Resources:
National Safety Council, Injury Facts, 2005-2006 Edition, p2, p23
The above facts represent the U.S. population, are for information only and do not imply coverage under the policy or endorsement of the company or the policy by the cited sources

Click here for a quote on Supplemental Accident Insurance


Frequently Asked Questions

Q: What is Supplemental Insurance?

A: Supplemental insurance is extra or additional insurance that helps you pay for out-of-pocket costs that your major medical insurance doesn’t cover. Things such as loss of income, co-pays and co-insurance, travel and lodging, etc. The benefits are paid in cash directly to you so you can use the money however you choose to pay for those unexpected expenses due to illness or injury.

Q: Do I really need supplemental insurance?

Unexpected accidents and illnesses happen. When they do, it can leave you and your family vulnerable to out-of-pocket expenses that major medical insurance does not cover. Supplemental insurance benefits give you piece of mind and reduce the worry about how you will pay for those unexpected expenses. With less worry, you can focus on getting well rather than how you will get the money to pay your light bill.

Q: I am on Medicare, retired, or don’t have any income; can I still get accident insurance?

Of course!  Falls and broken hips are major concerns with people on Medicare.  As you can see by the chart above, our chances of a fall increase dramatically the older we get.  Eventhough you may have a plan that pays for the hospital and doctor bills, you may need extra money for someone to come help take care of you during that time. Supplemental insurance benefits give you piece of mind and reduce the worry about how you will pay for those unexpected expenses. With less worry, you can focus on getting well.  You don’t have to be employed to purchase an accident plan, however it will not pay in addition to Medicaid

Q: What happens when I have an accident?

A: Filing a claim is easy. You will simply visit our web site to download your claim forms, or call us at 1-877-740-8683 to have them mailed to you.

Q: How can I get supplemental insurance?

A: We make it easy as 1-2-3. 1. Just call us toll-free at 1-877-740-8683. 2. We take the application over the phone in less than 10 minutes. 3. You get your policy in the mail in 1-2 weeks. It’s that easy! Our knowledgable representatives will work with you to identify your protection needs, so you have the coverage you need to help meet those needs.

Q: How do I qualify; do I have to complete a physical?

A: Almost anyone can qualify for an accident policy even if they cannot get major medical. There are very few health questions, and no physical is required. Generally, as long as you can answer “No” to the health questions, the coverage is issued and can become effective within 15 days from the date of the application.

Q: What services are covered?

A: Most plans pay cash for things such as:

Admission to a hospital
Dislocations, fractures, eye injuries, broken teeth, paralysis, burns, lacerations, concussions, and others
Emergency transportation in an ambulance
Family lodging for a member of the immediate family
Emergency treatment in a hospital emergency room or even a physician’s office
Confinement in an intensive care unit
Physical therapy
Othes

Q: What is generally not covered on an accident plan?

A: Most plans will not pay benefits for the following:

Operating, learning to operate, serving as a crew member of or jumping or falling from any aircraft. Aircraft includes those which are not motor-driven.
Engaging in hang gliding, bungee jumping, parachuting, sailgliding, parakiting, or hot-air ballooning.
Participating or attempting to participate in an illegal activity.
Intentionally causing a self-inflicted injury.
Having any sickness, illness or bodily infirmity.
Committing or trying to commit suicide, whether sane or insane.
Dental care or treatment due to accidental injury to natural teeth.
War or any act of war (whether declared or undeclared) or participating in a riot or felony.
Alcoholism or drug addiction.
Injury originating prior to the effective date of the policy.
Injury to a covered person while practicing or being a part of organized or competitive football or rodeo, sky diving, or scuba diving.

Exclusions and limitations vary by policies by state, so always refer to your policy or outline for applicable exclusions and limitations.

View other supplemental coverages:

Critical Illness
Heart Disease / Heart Attack / Stroke
Cancer
Hospital Indemnity

Disability Income Insurance for Sickness

Many people mistakenly believe that Accidents are the leading cause of Disabilities. According to the Council for Disability Awareness, though, 90% of Disabilities are caused by Illnesses. While some people have Disability Insurance at work, it may not be enough to truly protect your paycheck. If you are self-employed, the outlook is even more grim. Studies show that the average Disability payment from the Government is only $1,111 per month, and can take months or even years to qualify for. To find out if you have enough Disability Income Insurance, and get a free quote, please call 877-740-8683, or visit www.freedomfreequote.com .