Health Insurance and Retirement

Health insurance for retirees or senior citizens can be confusing, especially with so many options and requirements. However, health insurance is crucial for retirees. As you grow older, your health obviously becomes more of an issue; you may visit the doctor more, need to fill more prescriptions, or even receive in-home care. Before you retire, prepare for health insurance to ensure that you receive the best benefits.

The first step in planning your health insurance coverage in your retirement is to see if your employer offers insurance coverage after you retire. If the company does, you should certainly consider it. Look at the plan, the deductible, and the coverage. Many near-retirees believe that Medicare will cover their medical payments, but this is not always the case. With this sort of coverage, you will most likely receive better health care but at a more expensive cost. As a retiree, you will certainly have a health insurance budget to maintain, and you will have to decide if the cost of your employer’s insurance is too expensive.

If your employer does not offer coverage, Medicare will be an important and integral part of your health insurance if you are 65 years of age or older. Medicare works like traditional health insurance plans in that you have been contributing a small portion of every paycheck you earn into this plan. Once Medicare begins, you will make co-payments for office visits or treatment. Medicare will also cover the expense of certain medical equipment or needs.

However, Medicare did not cover a number of items that are typical of health insurance. The government recently updated Medicare and divided it into three parts: Part A, B, and C. Part A covers hospital care, such as home health care, hospital stays, and hospice care. This part does not require a premium. Part B covers the more routine medical expenses, such as office visits and laboratory tests, while Part C enrolls you into a fee-for-service or managed care plan that reduces your out-of-pocket costs. Despite these different options, Medicare restricts your coverage by not covering certain kinds of care or illnesses and diseases. Thus, there is also Medigap coverage, which helps fill in the gaps in health insurance that Medicare leaves. Medigap coverage differs from state to state and has different payments.

Beyond Medicare and Medigap, there are also long-term care insurance plans that you can buy. You often see these plans advertised on the television at very low prices. These plans can help cover the costs of a nursing home or home health care. With so many different options and limitations, if you are retiring soon, you should take a look at your budget and what you can afford as well as what sort of coverage you feel you will need.

Ways of Paying for Health Insurance

When it comes to health insurance, many people don’t exactly know everything that there is to know about the subject. That only stands to reason, it is not something that is easily understood because of its complexity. For instance, when you visit the doctor you may be asked to pay something that is called the “co-pay”, and other times you may not have to do anything at all depending on your plan. Let’s look at some of the ways that health insurance is paid for.

Often times, your employer will sponsor your insurance and you only have to pay what is known as a “co-pay” or co payment. The co-pay is a set amount that is determined by your insurance company when you receive covered services. This is a significantly smaller fee than you would be paying without the co-pay. Many companies offer this type of payment option because it is easier on the employee to pay this way.

You may consider opening what is known as a Healthcare Savings Account (HSA). This will assure that you always have a location in which to retrieve payments for various medical expenses. The HSA is a pre-tax savings account where a portion of your pre-tax income, determined by you, is deposited into an account automatically. Since this account comes from your paycheck pre-tax, that means it will lower your overall taxable income. This means you are saving money in terms of taxes and saving lots of money towards your overall health care costs.

For certain disabled individuals and those above the age of 65, Medicare is also another way to pay for health insurance. While they will not pay all of your healthcare expenses, they will pay for most of them. Medicare, however, doesn’t cover prescription drugs and nursing homes. It is important that you check the different types of restrictions that may apply. There are low-cost prescription discount cards that have been proven to save people who require costly medications on a regular basis over 50% of what they would have been paying without any health care.

Paying for health insurance doesn’t have to be complicated as long as you understand just what is going on in terms of where you stand with your plan. Discuss any questions you may have about the plan before committing to one. While one plan may be right for many people, it does not always mean that it will fit your specific needs.

The Importance of Good Records

Keeping your own records of any medical care that you and your immediate family have received is the only way to be sure that your insurance and bills are free from mistakes. It may seem unimportant now, but later in life when you try to get life insurance or get treatment that is appropriate for you, the importance will be in the spotlight. Everything from your allergies to your payment records with medical facilities can hurt you if they are wrong in your report. You could be given improper treatment or even denied treatment at all. By keeping your own records, you can dispute anything that is false.

Would you believe that you could be denied a job because of something erroneous on your medical records? It is true; if you are reported to have a disability, whether it is true or not, you could be turned down. You would be labeled as a risk, especially if the company offers insurance; they would know that you are going to cost more money to employ. The same goes for applying for health insurance where your medical records show that you would require prescription drugs, doctor visits, and increased chance of emergencies. It is quite the ordeal if you do in fact have a disability, but imaging if you did not have one at all-you would be turned down for insurance, while also being completely ineligible for disability financial help.

An example of a mistake that could be made on your record would be a diagnosis error. Perhaps you request that your doctor check a suspicious lump in your breast. On the first visit he may suspect that it is cancer. Most people will get a second opinion or go for a more thorough conclusive examination. If the second doctor decides that it is only a cyst and has it removed, your personal records would show that you are cancer-free. However, if this visit was documented incorrectly, or not at all, you may have trouble getting insured and not know why. If you had a record of the second visit that found the cyst, this situation would be easily disputed and your record would be accurate.

Human error is simply a part of life, even on medical documents. It is important to always keep your own records so that insurance companies get accurate information about you and your health condition. If you are being turned down for insurance and do not know why, you are best advised to be sure that you are not being misrepresented within your medical records. This problem can be cleared up quickly and easily if you are responsible enough to keep your own personal records.

Insurance When You are Getting Married

Health insurance providers are not created equal. Before a couple is married, the option of sharing coverage is extremely unusual unless one of your insurers offers domestic partner insurance. As you become engaged, if you both have separate insurance it is important to talk about the both of you switching to the better plan once you are married. There are a few factors consider, which include deductibles, co-payments, and the benefits of each separate plan. Marriage is a big step, and it can be done with ease if the two of you settle important decisions such as your health insurance plan before you take the big leap.

Your deductible is the amount you must pay each year to start your policy. Once this payment is made you will be responsible for whatever amount of co-payment your insurance company requires for you to pay for the health expenses that are covered in your particular policy. The amount of co-payments that you will be responsible for is established at the time you agree to your health insurance policy. It is going to be a certain percentage of health expenses; for instance, you pay 10% while your insurer will be paying the other 90%. You and your fiancé should compare both of your plans and figure out which deductible and co-payment plan seems most appropriate for the two of you.

Married couples are usually eligible for certain benefits that unmarried couples are not. Being insured separately by the health care provider sponsored by your employers may no longer be the most beneficial option for you. If you or your fiancé has insurance, and the other does not, once the two of you are married they can be added to the other partner’s plan. Cost of adding an additional person is definitely something that should be examined. You should not be required to pay more for adding a spouse or even a child in the future because most plans are offered to immediate family at no extra cost. The best way to compare policies is to estimate a yearly amount of normal health expenses, emergencies, co-payments, and deductibles. Whichever plan has the lowest cost to you will almost always be the best choice.

In addition to sharing health insurance with your new spouse, you may also want to consider switching the rest of your insurance plans, such as the policies you have for your separate automobiles. This is because most companies will give you a discount on having more than one vehicle insured. You may also be interested in finding a company that can insure you home, automobile, and health in one place. If you carry more than one policy with a company, they will also usually give you some sort of discount on them. It is important to sit down and discuss insurance with your fiancé because the two of you could be saving money and stress by figuring out what decision is best before the time comes.

Dental Benefits

Dental insurance is often an afterthought when obtaining health insurance for a number of reasons. Some people may simply dislike the dentist and use the lack of dental insurance as a reason to not visit the dentist; others may feel that dental insurance is not worth the added cost to their monthly health insurance premium. Still others may simply feel that their teeth are in good shape and there is little need to spend the extra money to cover a part of their body that does not currently have any problems. Nevertheless, dental insurance is important because of several benefits.

When people think of the cost of dental work or procedures, they often think of costly bills. Even simple procedures like getting your wisdom teeth removed can average in the hundreds of dollars per tooth! However, one obvious benefit to dental insurance is the coverage of simple but costly dental procedures such as getting a tooth removed. In the end, the slight increase in a monthly premium may be worth it to avoid a high dental bill. Moreover, dental insurance also helps financially if a dental emergency develops. Perhaps you are in need of a root canal or dental implants – both extremely costly procedures that you often do not anticipate. Dental insurance will most likely cover a portion, if not all of these expensive procedures.

Also, while many feel that brushing and flossing daily is all the dental care they need this is simply not true – even for young, healthy adults. Dental disease is common and can affect your body in a number of ways. For instance, some dental diseases left untreated can lead to more serious medical issues such as kidney infections or even diabetes. Most people do now know of the connection between dental diseases and other illnesses. Thus, having dental insurance that covers routine visits to the dentist, which can help uncover dental diseases early, is extremely important. Dental insurance is designed to encourage preventative care, because spotting dental diseases or dental problems early reduces the overall cost of treatment.

Dental insurance may seem like just another gimmick to get a few more dollars out of you, but it is essential for your health. Your regular health insurance plan, whether it is through your employer as a group plan or an individual plan, should offer you the option of buying dental insurance coverage, and you should consider this piece of the plan thoroughly when purchasing health insurance.

Avoiding Insurance Fraud

Everyone knows that the health insurance industry is continually raising monthly premiums, and many feel this is unjust to you as the consumer. However, the health insurance industry has had to fight increasing health insurance fraud. The amount of money spent on investigating and prosecuting fraud is then passed on to policyholders. Many people do not understand what health insurance fraud entails, though. With reports estimating health insurance fraud is a $30 billion to over $100 billion industry per year, the topic should not be taken lightly. Every health insurance policyholder should understand what health insurance fraud is and its consequences. By doing so, you are more able to recognize and fight fraud.

Health insurance fraud is typically defined as intentionally deceiving, misrepresenting, or concealing information to receive benefits from the insurance company. Essentially this means that you assert that you paid for certain medical procedures or expenses out-of-pocket which you have not actually received, and you are submitting claims to the insurance company to receive reimbursement. Another example of member fraud is to conceal pre-existing conditions or to alter medical documents so that non-policyholders or ineligible members receive medical benefits under your policy. Perhaps your sister does not have insurance and needs medical attention. Having her use your name and policy to cover the expenses is health insurance fraud. While you may think that this is a small issue in comparison to your sister receiving treatment, it is actually very serious to your health insurance company and industry, and will result in fines and possible imprisonment if your are caught.

Not only policyholders commit fraud, but providers (physicians, hospitals, etc.) do as well. Since physicians and hospitals bill the insurance company for services they provide for you, they are also receiving reimbursement from the insurance company. When providers commit fraud, they may be billing the insurance company at higher rates for services rendered or they may bill for services you never received. In these cases, you will probably be asked to cooperate in the insurance company’s investigation.

Another type of health insurance fraud that has developed recently targets the policyholder more than the insurance company. Schemes have developed where fake insurance companies or agents sign unsuspecting customers for coverage at surprisingly low premium rates. They often act much like a regular insurance company for the first few months, paying for smaller medical claims like physicians visits. But once you have a more serious medical condition that needs treatment, the insurance company will disappear – along with the money you have been paying in premiums.

The rule with health insurance fraud is much like that of any other scam: if a deal seems too good to be true, just remember – it probably is. Remember to be honest in your dealings with health insurance companies and expect the same in the return from these companies, as well as your health care providers. Stay legal to avoid fines and prison and to continue receiving health insurance coverage.