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Senior Health Care Insurance

Health Insurance For Seniors On The Net

When a good friend of mine asked where he could get medical insurance information for his out-of-state, elderly mother, I told him to try the internet.

He reported to me about a week later, in despair: “I give up, I’m too confused.” He took on an overwhelming project with his widowed mother, living in another state. As the only child, and after the sudden death of his father, it was his responsibility to take care of his mother.

In this world of technology, the family unit often lives in different geographical areas and the family members are usually quite involved with their own lives, careers and families. In addition, when both parents are alive, often one or both parents are quite independent and do not require much help. As time passes things, of course, change, and sometimes change very suddenly. There may be an emergency regarding the health care needs of one or both aging parents.

With our baby boomers facing this problem in ever-increasing numbers, and with the information highway in full bloom, there is a definite need for planning.

Protecting your parents’ assets and health is a huge and daunting undertaking that requires tremendous education and practical application. Our seniors face many different responsibilities upon reaching the age of 65. To name just a few: Estate planning, taxation, Medicare, social security, wills, insurance and various other legal and financial issues. All of these different areas require expertise from accountants, attorneys, estate planners, insurers, real estate agents, financial advisors and others.

The Internet is a good starting point for most people to find resources for questions and solutions to your problems. However, there is no substitute for good solid smart advice from an expert.

Twenty years ago, insurance for seniors was sold by “high-end insurance specialists,” with only a handful of companies in each state. The programs were most often Medi-gap or Medicare supplement policies, which covered the expenses not covered by Medicare, including hospital and doctor deductibles, durable medical devices, and non-approved Medicare costs. Ironically these specialists did not sell many nursing policies, although Medicare paid a national average of less than 2% of these expenses. With the advent of “financial and estate planning” and more insurance companies entering that market, a broader and more varied product line became available to agents, brokers, planners, and seniors.

Part of this new diversification was the “home health care plan”, sold on its own, and in conjunction with senior health insurance products. The appeal of the “home health care policy” was that an elderly person could stay at home and continue to receive medical and guardianship benefits, allowing a person to recover in the comfort of their own home.

This was the answer to a huge problem. The last place an older person wanted to go was a “nursing home”, or “retirement home”, or, God forbid, the “nursing home”. It seemed that the elderly could now rely on this new innovation without worrying about having to move out of their home environment in case of a health problem.

As with most things, “if it’s too good to be true”…. The home health care policy is no exception. The problem is that there is not enough coverage for a long illness or recovery. In fact, the new trend is towards an “all in one” type facility, enabling various levels of care all in one place. In other words, a senior could start with little or no health care concerns in an independent, less expensive area, and then go to an assisted living or nursing home, all within the same compound.

A “nursing home” requires a nurse on site 24 hours a day, assisted living is only eight hours. The benefits of this are financial. The patient or elderly person is only charged according to the level of care required during the time he or she is admitted to that facility. Another advantage is that it alleviates a lot of planning because the care is delivered as it is needed. Medical attention is available to all residents regardless of their current health.

Some people are offered a lifetime package that covers their care for the rest of their lives, regardless of their current age. It also allows social outlets to an otherwise somewhat isolated group. Online shopping services have become a huge business. It is definitely here to stay and many insurance policies are purchased from online quotes and online applications.

There are literally hundreds of thousands of insurance companies and brokers advertising on the Internet. Most of them will provide instant online quotes and even applications for the potential insured. I highly discourage a layperson from buying insurance this way. A little knowledge can be dangerous.

The federal government has mandated to all states through legislation, the standardized senior health insurance guidelines, which are governed and regulated by each state insurance department.

There are plans for almost every level of health. Some are designed and priced for a less than healthy individual. Others are for a person with minimal health concerns. . The whole concept of insurance is to provide protection for “unforeseen” illness or injury, especially catastrophic expenses that would ruin a person’s net worth. The more small expenses a person is willing or able to pay (self-insure), the lower the rate. I recommend this strategy when evaluating your insurance options.

Another consideration when reviewing various insurance plans is to look at the company itself. How long has the company been selling this type of insurance? Do they have many complaints filed with the local insurance department? Are the rates stable? Does it pay claims on time? Service? Most agents talk about the estimate. These ratings are as follows: A+, A, A-, B+, B, B-, C+, C, C-, or “not rated”.

Don’t be fooled by rating alone. It’s good to have a high valuation, but it’s much better to have a company that has longevity, stability, innovation, service and expertise. The problem is that some companies enter a market and quickly leave without explanation. This does not give security to the owner.

The most important consideration should be a review of the profit/loss ratio for that product. This will establish stability and longevity in the market. An insurance company with a moderate profit in a particular line of business will remain in that market. On the other hand, a company with losses will make changes and maybe even retire. This is information not normally available to internet users.

Before entering into an insurance contract, the senior person, the family and other advisers must be realistic, and a careful evaluation of the whole picture must be examined. The age, the health of the senior, the financial resources, the personality and attitude of the senior, and most importantly the wishes of the senior, should all be considered.

Early planning is important, as eligibility becomes increasingly difficult as the applicant’s health declines. The senior health care market is complex. I will offer some advice to try to alleviate potential difficulties.

* Choose a well-informed, experienced and service-oriented agent or broker to assist in your decision-making process. The professional can offer invaluable information, but don’t be afraid to ask lots of questions and even get a second opinion.

* Don’t wait until your parent or loved one gets sick or injured. Plan ahead and take the time necessary to cover all options.

* Choose an experienced insurance company. A company that has been in the marketplace for a significant amount of time and has maintained a balance of rates and benefits and a solid risk selection with moderate rate increases over time is your best bet.

*The plan must be flexible, with a wide range of options and benefit choices to the insured. There should be no tricks, or complicated language for the coverage. An incredibly low rate is a red flag for problems in the future.

*Don’t rush or be rushed by an overly aggressive salesperson.

This policy will not be cheap and will need to be read and reviewed for a clear understanding of the contents. This is one advantage for the Internet. You are free to read endlessly before you act.

A long-term care program, with or without insurance coverage, will only work if the senior has input into the care selection process. If there are questions about a facility’s accreditation, please call the Commission on Continuing Care Accreditation at 202-783-7286.

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