Does your health insurance cover you if you leave the good old USA? As many current health insurance plans now assign you to their Health Maintenance Organization (HMO) networks of doctors, hospitals and healthcare service providers, and no longer provide “out of network” benefits, leaving the US and its territories could leave you out on a limb should you suffer an accidental injury or fall ill.
If this is the year you take that long planned trip to Europe, to Peru’s Machu Piccu, or cruise through the Southern Caribbean, chances are your HMO will not cover you there. No problem, though…just obtain Travel Insurance before leaving home. Considering what it provides to you it’s relatively inexpensive.
Purchase your travel insurance through your travel agent or save some cash by obtaining it through a qualified insurance broker. It covers medical expenses incurred while outside the US, but covers much more than that. You buy it based on the number of days you intend to be away on your trip and sometimes, based on the cost of your trip including its air fare, if any.
Why based on the cost of your trip?…Because some travel insurance plans agree to refund the dollars you’ve already spent on non-refundable tickets if illness, an accident or family emergency makes it impossible for you to begin/complete your trip. Most contain a really important “repatriation” benefit. If a serious illness or injury strikes you while thousands of miles away in some foreign country, repatriation pays to fly you home in an air ambulance. If the worst happens and you do not survive the illness or injury, the insurance pays to fly your body home. It also picks up the tab for your spouse or other trusted person to accompany you home.
I know of a couple who traveled to east Asia to climb mountains and take pictures. While shooting a picture one of them suffered a slip and fall resulting in a compound fracture of a leg. After being rescued from the mountainside, stablized in the village at the foot of the mountain, then transported to the nearest hospital where the broken bone was set, an air ambulance was chartered to fly the couple to their home in San Francisco. The bills for all of that totaled more than $123,000.00. The couple paid less than $400.00 for their travel insurance. Stealing a line from American Express…”Don’t Leave Home Without It.”
Did you sign up for health insurance or continue last year’s health insurance into 2015? If so, good for you. If not, you have until February 15,2015 to enroll in an Affordable Care Act health insurance plan. Missing the 2/15/15 enrollment cut-off could cost you some serious cash when you file your 2015 income tax return. Maximum Tax Penalty…yes, it is a tax…just ask Chief Justice John Roberts…can be as high as $945.00 for not registering for health insurance in 2015.
Of course if you are locked-up in jail, a member of an indian tribe, an undocumented immigrant, or if your health insurance premiums exceed 8% of your annual household income, the tax penalty will not be imposed upon you…that’s in the law. However, all others must be covered by personal health insurance or by employer-sponsored group health insurance during the year 2015, otherwise the IRS (Insurance Reprobate Sackers) will come to your door, grab you by the ankles and hold you upside-down until they shake the fine from your jeans.
You get the government you elect…and the laws that government imposes on you…If you did not vote in 2012 or 2014, you cannot complain about the “Unaffordable Care Act”. Like a year old infant in a poop filled diaper you can now just sit in it and cry.
Open Enrollment period for 2015 Individual and Family health insurance plans starts November 15, 2014 and ends February 15, 2015. If you bought health insurance for yourself or for yourself and family this year and wish to change to a different plan or to a different health insurance company, you may do so starting 11/15/14.
If you bought a health insurance policy between March 10, 2010 and December 2013, a so-called non-grandfathered policy, your health insurance company may be willing to continue it into 2015, temporarily, as implementation of some features of the Affordable Care Act (Obamacare) have been postponed. However, some insurance companies have opted to switch non-grandfathered policies to new ones meeting the requirements of Obamacare now, with new insurance taking effect on January 1, 2015. By now you should have received a letter from your insurance company explaining their action. In any event you are free to shop for new health insurance starting November 15th.
The law of unintended consequences is always in play, and the Affordable Care Act (ACA) is loaded with them. Pre-ACA, the vast majority of health insurance policies renewed each year on their anniversary date, so roughly one-twelfth of an insurer’s book of business was up for renewal each month.
ACA policies all run through the calendar year (January through December), and may or may not be available on January 1st following the year they were purchased. ACA creates an administrative log jam at your health insurance company each December as its total book of business must be addressed. Some policies may renew as-is in January, or may be replaced, or canceled, or who-knows-what. Expect chaos.
If you are caught in the ACA whirlpool take solice in the fact that your federal government is taking good care of you. After all, your President promised your Obamacare premiums would go down $2,500, that you could keep your old insurance and you could keep your doctor. A famous scholar once said you don’t lose your freedoms all at once, but little by little while you are not paying attention.
Life Insurance…It really is “The Gift that keeps on giving”.
Think about it. Life insurance equals cash to pay for:
Food on the table
A roof over your family’s heads
Money to pay the monthly bills
A little red wagon under the Christmas tree
Clothes for the kids
A whole lot of other things, and most importantly…Peace of mind
Buying life insurance is a nobel unselfish act. Assuming you love your spouse and kids does that love end if an accident or illness takes your life too soon? Because, unless you have a jaw dropping balance in your investment account, your income stops when your heart does. When you own life insurance the event that creates the need creates the cash…income tax free.
Be loving, nobel and unselfish…Do the right thing. Call your life insurance broker today.
If you bought a personal/family health insurance policy this year, do you understand it will expire on December 31st? No? Well, it does.
Some history…prior to January 1, 2014, personal/family health insurance policies, unlike employer-sponsored group health insurance plans, were by contract “guaranteed renewable” on their policy anniversary dates from year to year.* Each year the issuing insurance company would recalculate a policy’s premium taking into account the beneficiaries’ increased ages, overall current and expected claims from that block of policies and other data, then provide the policy owner the opportunity to renew his/her insurance, without change, in exchange for paying the resulting renewal premium. Typically, that would occur on each policy anniversary date until the policy owner entered Medicare. That was the case regardless of any changes to beneficiaries’health. Individuals could not be singled out for premium increases because of claims paid on their behalf. Policy owners were free to accept the insurance company’s renewal premium offer, or reject it and seek coverage elsewhere.
Prior to passage of the Affordable Care Act (ACA), qualifying to purchase personal/family health insurance was an issue for those with significant health conditions or for those working in very hazardous occupations. Most states supported safety-net programs to provide healthcare assistance or to provide the needed insurance to those who qualified for help.
Fast forward to 2014. Personal/family health insurance is now “Guaranteed Issue”…no more concern about health histories or hazardous occupations. But no longer is such insurance “Guaranteed Renewable”. Instead, your insurance company can change the benefits structure of your insurance each January 1st, as long as those changes fulfill the strictures of ACA…and expect continued premium increases. If you bought an ACA qualified health insurance policy in 2014, look for a letter from your insurance company before year-end offering to keep you insured, but with changes to your present policy and changes to your premiums effective January 1, 2015…just the tip of the ACA iceburg.
Open Enrollment Period for 2015 ACA insurance plans begins November 15, 2014, ending on February 15, 2015. Work with a qualified agenty or broker, or take your chances with healthcare.gov. If you anticipate collecting a premium tax credit you must go through healthcare.gov, but working with a qualified agent or broker at your side will be to your benefit. Your premiums will be same whether or not you work with and agent or broker.
*In the distant past so-call Industrial Insurance Companies offered accident and health insurance policies which could be cancelled by the insurance company on short notice for any reason, but as the health insurance industry developed in the last century competition from more attractive health insurance products pushed industrial insurance out of the marketplace.
If you own a personal health insurance policy, not employer-sponsored group health insurance, AND if your personal health insurance policy went into effect prior to March 10, 2010, AND if you made no changes to your policy after 3/10/2010, such as changing its annual deductible amount or co-insurance percentages, your policy may be “Grandfathered”. Owners of grandfathered personal health insurance policies will not be forced to replace them with “Obamacare” policies in the future.
“If you like your insurance, you can keep your insurance.”…well not so much. Rules imposed by the Affordable Care Act (ACA) demand that personal health insurance policies which became effective after March 10, 2010, non-grandfathered plans, be replaced by health insurance plans meeting requirements imposed by ACA starting in January 2014. However, the effective date of the replacement rule has been postponed twice since ACA became law. Currently that replacement date has been pushed out to 2017. Most health insurance companies have opted to renew such policies through the end of 2015. Call the member service number on your insurance ID card to see what your health insurer intends to do regarding renewal of non-grandfathered policies.
ACA health insurance policies must provide benefits which may or may not be included in pre-2014 health insurance policies…items such as maternity benefits, juvenile vision/dental benefits. Your health history or occupation will not preclude your obtaining ACA health insurance plans. Premium rates are the same for men and women in ACA plans. Only age, number of family members to be covered, your zip code, and tobacco use are considered when determining the amount of premiums to be charged for ACA plans. Insureds’ Annual Out of Pocket claims costs for healthcare services received from in-network providers are capped at $6,350 for singles/$12,700 for a family in 2014. Insurers must pay out at least 80% of each year’s personal plan premium collections to cover claims, retaining only 20% to operate the company. If the claims pay-out is less than 80%, insurers must refund the difference to its policyowners.
Leaving insurers only 20% of premium income to operate the business while mandating they offer health insurance to anyone who applies forces them to seek ways to increase efficiencies and reduce operating costs. Thus ACA health insurance plans offer much less flexibility to their owners. No longer can one buy a health insurance policy containing a selection of annual deductibles and reduce his/her monthly premium by opting for a higher annual deductible. ACA plans contain one annual deductible…take it or leave it. ACA health insurance plans are open-ended…no annual benefit payout maximums. In the past most health insurance policies
expired after paying out a pre-determined dollar amount in benefits, most recently three to five million dollars.
“If you like your doctor, you can keep your doctor, period.”…well, not so much. Most ACA personal health insurance plans contain networks of doctors, hospitals and other healthcare service providers. Obtaining healthcare services from providers outside those networks greatly increases out-of-pocket costs. ACA plan healthcare service provider networks offer fewer choices of providers…and your family doc for the past twenty years may not be in your new ACA plan’s network.
So, if you own a grandfathered health insurance policy think long and hard before replacing it with an ACA compliant policy. Keeping much broader provider networks, avoiding forced-on premium costs for maternity, juvenile dental/vision services, and other add ons, makes owning grandfathered insurance quite attractive for the next several years.
Either way you cut it, living too long or dying too soon is a bummer for all of us. Either option has the potential for financial devastation. Dying too soon is the easy part for you. You’re gone…no more worries for you. However, your family is left holding the bag, and without your help to pay the bills your family’s future will be perilous. If you own a business your too soon death causes even more issues. Think about it.
Living too long is another issue. Better healthcare and lifestyle allows us to live longer, much longer on average, than our parents and grandparents. A new retiree can look forward to thirty or more remaining years, good news for many of us. Potentially running out of cash to pay the bills in our later years is the bad news. (If you don’t own one already set up an IRA now.) Compounding the issue is the possibility of declining health leading to the need for at home care or care in an assisted living facility.
The good news for you is that you may employ insurance to guarantee cash flow when it’s needed the most…life insurance to hedge dying too soon…long term care insurance to pay the bills for at home care or care in an assisted living facility later. Premiums for both are less when you buy it now, currently and over your lifetime, rather than putting it off until later.
On the living too long side of the question, whole life insurance provides instant cash as its death benefit plus it can provide needed cash to you after it has been in force for a number of years via its cash value, thus augmenting your retirement income stream.
Several days ago I received an irate call from a gentleman calling my office in Florida from Pennsylvania. It appears he bought health insurance over the phone back in February 2014, from a scammer using my name indicating scammer was calling from Florida. My irate caller, who sounded as if he were in his 40′s, said he had been paying $250.00 per month premiums via automatic checking account drafts since February. When he recently tried to use his over-the-phone health insurance …guess what? You are correct…his insurance is bogus.
Here’s a little tutorial: The several states regulate insurance, issue licenses to insurance companies and their agents to sell insurance products which must have been approved by the state in question prior to the sale. Should an insurance agent wish to sell insurance in every state he/she must apply to every state and meet their education/training and other requirements. Qualifying to sell insurance in every state means owning and qualifying for fifty (50) insurance agent licenses. A health insurance agent licensed in Florida must obtain a Pennsylvania non-resident agent’s license before attempting to sell health insurance in PA…and that agent may sell only insurance plans approved for sale in PA. If an insurance agent fails to act within a state’s insurance laws and their regulations, that agent will receive a visit from a guy carrying a badge and a gun…may be fined, lose his/her license, and may face jail time. Robbing banks is much more efficient than scamming people with phoney insurance schemes…but the low-lifes are always out there somewhere.
I fear my Pennsylvania caller will never recover his cash wasted on bogus insurance premiums…and will be forced to pay his medical bills out of pocket…PLUS, the Affordable Care Act (ACA) is lurking in the shadows. Should my called not be able to prove to the IRS that he owned credible health insurance this year he may be hit with the ACA penalty “Tax”. ( Tax is in quotes because it was originally an Un-Constutional fee before Chief Justice John Roberts turned into a tax in order to make it fit the Constution, thus ensuring he would continue to be invited to Washington, DC’s insider cocktail parties.)
But I digress…Long story short, don’t buy insurance, and most anything else, over the phone from someone you have never met and whom you cannot vet…and do not hesitate to ask to see an insurance agent’s license. He/she will carry it with them just as a driver’s license.
Ah yes, the Affordable Care Act of 2010, still kicking into gear in early summer 2014. Did you miss the ACA application cut off date on March 31, 2014? If so you are SOL until January 1, 2015. 2015 ACA open enrollment starts in November of this year, so get ready.
How about those ACA plan calendar year deductibles? If you have trouble scratching together several hundred dollars to pay ACA policy monthly premiums, then paying out-of-pocket several thousand dollars before your insurance kicks in must really be fun for you. Did you buy one of ACA’s “Catastrophic” policies?….you pay out $6,350.00 in cash, plus your monthly premiums, before your policy pays anything at all…and that means no outpatient prescription drug coverage until you have forked over $6,350.00 from your pocket, which is hanging inside out by then. (One insurance company took pity on you, and only makes you pay $6,250.00 out of pocket first…big whoop!)
Some Catastrophic plans “allow” you to visit a doc in exchange for a $20.00 co-payment for two or three office visits per year, without making you pony up the full annual deductible first…BUT, you must see one of their In-Network physicians…so go see the lowest bid-winner doc of your choice just as long as that doc is “in-network”. Do you have a family doctor whom you have relied on for several years…one you have confidence in, one you trust? Well, get ready…He or she will not be in your insurance company’s network! Murphy’s Law rules.
I keep reading that a vast majority of voters are unhappy with the Affordable Care Act and its impact on them and their families. Why then did those same voters send the same administration which brough you ACA back to Washington in 2012? You must really like the idea of having your neighbors pay your bills for you…but what happens when your neighbors get tapped out? Yep, “Change you can believe in”, don’t leave home without it.
When an accident or illness lays you low for months at a time, owning Long Term Care Insurance (LTCI) provides the cash to allow you to remain at home during your recovery. If recovering at home is not an option, LTCI pays the rent required by an assisted care facility. LTCI is not just for older folk. Owning it would be good for you too. As is true for most life/health insurance, younger people pay lower LTCI premiums both at the beginning and in the long run.
As a nation we are living longer than our parents and grand parents. That is good news/bad news for most of us. Now we are concerned about outliving our retirement dollars. Long run, Social Secuity and Medicare are paying out more than they take in. How much will be left for you in the future? Washington could tax everybody at 100% of income, and that still would not be enough, long term, to keep up Social Security and Medicare, as they exist today. When and if ever Washington begins to address those issues you can expect program cuts and “means testing” to reduce your Medicare and Social Security benefits.
Medicare does not pay a dime toward your long term care expenses. Owning LTCI today makes good business sense. Rely on yourself and your insurance company to provide long term care dollars when needed. That beats depending upon some government agency by a long shot.
Talk to your insurance broker about LTCI today. It will be time well spent.