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HEALTH INSURANCE & LONG TERM CARE INSURANCE COVERAGE

Medical crisis can many times be unforeseen. Many times a chronic illness could have been avoided with a full physical. Policy coverage does vary in type of benefits covered and premium cost. Having some type of coverage to meet our basic needs can be a good starting point.

Types of Health Insurance

• HMO (Health Maintenance Organization) You must select a primary care doctor and that individual will be in charge of filling out referrals to covered specialists under HMO network. Every time you need to see a specialist for an initial visit the primary care physician must fill out a referral form. There are no-copayments and the deductible if any are reasonable.

• PPO (Preferred Provider Organization) This network has many participating doctors in numerous fields of specialty. You can select a primary care physician; however this type of insurance does not mandate that you see this individual primary to seeing specialists within the network. If care is choosing from providers within the network deductibles. Co-insurance payments will be less than is went out of network (provided policy provided out of network benefits).

• POS (Point of Service) is a combination of benefits that encompasses both features of HMO & PPO. If you stay within network there are no deductibles and co-insurance payments are low.

• HSA (Health Savings Account) requires a high deductible but the plan allows flexibility. Both employers and employees can contribute. Your contributions are tax free yearly and there are not any limits to the amount that be contributed and the funds stay with you. Can pay for non-medical expenses; however those expenses are taxable. Funds are portable to the following year.

• HRA (Health Reimbursement Arrangement) This is funded solely by an employer. You cannot individually contribute. An employer can decided any limits on funding it wants to cap.

• FSA (Health Flexible Spending Arrangement) This is employee funded but employers can contribute as well. Amount you contribute is pre-tax dollars. NOTE: If funds are not used prior to March 15th of the following year, the money will not be refunded. The amount remaining with stay in the possession of the employer. The funds are not portable and cannot be used for non-medical expenses.

• MSA (Medical Savings Account) this type of policy is similar to SA HHSA except it was designed for self-employed individuals.

LONG TERM CARE INSURANCE

Most of us cannot predict or guarantee that we will not need long term care; however, if you were to need it the cost to adequately take care of yourself can be staggering. This coverage can ease your stress, frustration, and money burden as well as that of your loved ones and dependents.

What exactly is Long Term Care Insurance?

This coverage provides medical assistance to those suffering from chronic illnesses and/or is disabled. You can be taken care of in the long term care facility or in the comfort of your own home. Where your care is obtained from can be based on your doctor’s input; but where is solely your decision.

This policy also provides personal care and community services to its patients. In the event of incapacitation or you require emotional or psychological counseling, physical therapy. Further, long term care does not age restrict. It is not solely for the elderly who typically suffer from disabling ailments. The reality is unforeseen medical circumstances do occur-thus; having a long term care policy in place prior to such events is a wise choice.

Long Term Care Insurance Benefits

The benefits will receive will be determine by the type of coverage you purchase. Keep the following in mind when selecting coverage:

• The maximum daily benefit (dollar amount covered for daily care); but most policies calculate

this on a monthly basis.

• The maximum lifetime benefit (maximum amount the policy will cover).

• Comprehensive vs. facility coverage- will the plan cover you solely if you reside in a long term care facility or will be

comprehensive to give you choice to obtain care from your home.

• Home services- monitoring systems, durable medical equipment to assist you in the home such as

holding bars, rails, etc…

• Transportation costs to and from doctor appointments

• Will you prefer to have someone take care of household chores and meal preparation

Standard Long Term Care Policy Coverage

• Skilled nurses

• Therapy such as : speech, physical, or rehabilitative

• Assistance with personal care

• Hospice care

• Respite care

• Nursing home

• Assisted living or specialized care facilities