HEALTH INSURANCE
There are essentially two kinds of heath insurance: Fee-for-Service and Managed Care. Although these plans differ, they both cover an array of medical, surgical and hospital expenses. Most cover prescription drugs and some also offer dental coverage.
Fee-for-Service
These plans generally assume that the medical professional will be paid a fee for each service provided to the patient. Patients are seen by a doctor of their choice and the claim is filed by either the medical provider or the patient.
Managed Care
More than half of all Americans have some kind of managed-care plan. Various plans work differently and can include: health maintenance organizations (HM0s), preferred provider organizations (PPOs) and point-of-service (POS) plans. These plans provide comprehensive health services to their members and offer financial incentives to patients who use the providers in the plan.
LONG TERM CARE INSURANCE - LTC
What is LTC?
Long term care is something you may need if you can no longer perform everyday tasks by yourself. For example, there may come a time when you need help getting dressed, eating or bathing. It also includes the kind of care you would need if you had a severe cognitive impairment like Alzheimer's disease. You can receive this care in a variety of settings, including your home, an assisted living facility or a nursing home.
Why Would I Ever Need LTC?
The need for long term care usually arises from age or chronic illness, injury or disability. In fact, approximately 60% of us who reach age 65 will need long term care at some time in our lives. But it's not just a retiree's issue.
It Can Happen at Any Age
Many people don't realize that the need for long term care can strike at any time. Statistics show that 40% of people receiving long term care services are working age adults, between the ages of 18 and 64. Would you be prepared for long term care, if you suddenly required it?
What It Is and What It Isn't
What It Is
Long term care is the type of care that you may need if you can no longer perform "activities of daily living" by yourself, such as eating, bathing or getting dressed. It also includes the kind of care you would need if you had a severe cognitive impairment like Alzheimer's disease. Care can be received in a variety of settings, including your own home, assisted living facilities, adult day care centers or hospice facilities.
Long term care can be covered completely or in part by long term care insurance. Most plans let you choose the amount of the coverage you want, as well as how and where you want to use your benefits. A comprehensive plan includes benefits for all levels of care, custodial to skilled.
What It Isn't
Long term care isn't the type of care that you receive in the hospital or your doctor's office. It isn't the medical care you need to get well from a sickness or an injury. It isn't short-term rehabilitation from an accident or recuperation from surgery.
Long term care is not always administered in a nursing home. In fact, more than 80% of all people receiving long term care assistance are not in nursing homes.
DISABILITY INSURANCE
When a physical injury keeps you from working, disability insurance can help get the bills paid.
In reality, disability insurance is as important as (and in some cases, even more important than) life insurance.
More become disabled than die that’s because at any given age the odds of becoming disabled are much higher than dying. In fact, every year 12% of the adult U.S. population suffers a long-term disability. One out of every seven workers will suffer a five-year or longer period of disability before age 65, and if you’re 35 now, your chances of experiencing a three-month or longer disability before you reach age 65 are 50%. If you’re 45, the figure is 44%.
These odds would not be a problem if people had substantial savings that could be drawn on in the event of a disability. But that’s rarely the case, and any money that has been set aside has likely been earmarked for goals such as college or retirement.
There are many kinds of disability policies and options, however, the basics are simple. The first variable is the amount of monthly benefit. Most disability policies have a fixed monthly benefit that does not increase with time, although you can purchase extra coverage, or riders, that offer higher payment schedules
The second variable is the definition of disability -- whether it is “own occ,” or the inability to perform the duties of your specific occupation, or “any occ,” the inability to perform the duties of any job for which your education and training make you qualified.
The third variable is the waiting period, or the amount of time you must be disabled before benefits kick in. These waiting periods can range from one week to two years, and the longer you wait the less your disability policy will cost.
The fourth variable is the benefit period, or how long you will receive monthly benefits once your policy starts paying. The benefit period can range from six months to life, depending on what you choose as well as what your insurance company is willing to offer you.
In addition to these variables, there are other coverage options, as well as a variety of other riders. The most important is a rider that pays if you can only remain or return to work part-time. The Social Security offset rider guarantees that if you qualify for disability payments under your insurance policy but not for Social Security (a frequent occurrence) your disability policy will pay what Social Security should have.
Another important option is the additional purchase option, which guarantees you the right to buy additional disability insurance in the future regardless of your health at that time.
If you have any questions about Disability Insurance or not sure if you need coverage please contact us for a needs assessment.
In addition to the traditional disability policies, there are several options you should consider when purchasing a policy:
- Additional purchase options
Your insurance company gives you the right to buy additional insurance at a later time.
- Coordination of benefits
The amount of benefits you receive from your insurance company is dependent on other benefits you receive because of your disability. Your policy specifies a target amount you will receive from all the policies combined, so this policy will make up the difference not paid by other policies.
- Cost of living adjustment (COLA)
The COLA increases your disability benefits over time based on the increased cost of living measured by the Consumer Price Index. You will pay a higher premium if you select the COLA.
- Residual or partial disability rider
This provision allows you to return to work part-time, collect part of your salary and receive a partial disability payment if you are still partially disabled.
- Return of premium
This provision requires the insurance company to refund part of your premium if no claims are made for a specific period of time declared in the policy.
- Waiver of premium provision
This clause means that you do not have to pay premiums on the policy after you’re disabled for 90 days.