Insurance

If you’ve turned 65 or are getting close to it, you’re likely swamped with information about Medicare plan options such as prescription drug plans, supplemental health insurance policies and Medicare Advantage plans.

Some folks may enjoy the challenge of figuring out the process of choosing health insurance coverage. After all, it’s important to choose the right coverage for your needs. However, if you’re not one of them, consider an appointment with a licensed sales agent who can help you navigate through the various options and help you get the right coverage for your health care needs.

Finding a Fit

Brokers (or agents) are licensed by the state and undergo annual required training and testing by the plans they sell.

There’s no cost for the service offered by a licensed sales agent because the agent is paid a commission by the private insurance carrier based on your enrollment in the plan.

 Consider meeting with an agent before you turn 65 so you can anticipate costs and coverage. Caregivers or family members who are helping make these decisions can participate in the meeting, too.

A licensed sales agent assures that your enrollment application gets properly completed, follows up with the carrier to ensure timely processing, and provides notification of your enrollment status.

The agent also will research prescription drug plans (PDP) because each has a list of covered drugs. An agent can help determine if your drugs are covered,  the co-pays associated with a plan and which plans to offer the best benefits for your situation.

In addition, the sales agent also verifies that your doctors, hospitals and other medical providers are in-network. This is an important step before selecting a plan because many Medicare plans have a network of doctors that they use.

An agent follows up annually to discuss changes to your medical needs, to discuss any upcoming changes to your current policy, and to provide updates on the health insurance industry.

Each year when “life happens,” we’re reminded of the importance of life insurance.

You may recall the story of former NFL quarterback and now radio and TV sports broadcaster Boomer Esiason and the effects of having no life insurance.

Boomer was 7 when his mother died of cancer. She had no life insurance. His father was left to raise him and his two sisters alone.

Boomer related, “We lived paycheck to paycheck, but my dad did an incredible job taking care of our family. He taught me the true meaning of what it means to be a responsible dad.”

It was his father’s sacrifice that motivated Boomer to protect his family with life insurance. Boomer explained to an interviewer, “Life insurance is about protecting the future and the people you love, which is especially the case when you are caring for someone with special needs.”

Boomer’s oldest son, Gunnar, was diagnosed with cystic fibrosis at age 2.

DO YOU HAVE WHAT YOU NEED?

Life insurance can do some pretty amazing things for loved ones. It can buy time to grieve when clients utilize Final Expense Life Insurance, which takes care of funeral, burial and other end-of-life expenses. Life insurance also reduces stress on surviving family members and may provide financial security.

If you own an old policy, it may be time to review it for expiration dates, named beneficiaries and death benefits. Any policy written before 2006 needs reviewed. Those in the retirement planning business see policies every day that are underfunded, which means the policy is not going to be considered valid.

Do you remember the beneficiaries in all of your policies? With an out- dated policy, a beneficiary you want now might not be who is listed. That can cause strain for family members left behind.

After you review your life insurance policies, encourage your children and loved ones to get life insurance.

Ohio has made a significant change regarding homeowners who apply for Medicaid benefits for nursing home or assisted living care.

Until July 31, 2016, an unmarried homeowner who wanted Medicaid to pay for long-term care costs had 13 months to put his home up for sale. If the Medicaid applicant was married and the spouse still lived in the home, there was no obligation to sell.

That 13-month time period is gone. As part of the Aug. 1, 2016 change in rules, Ohio Medicaid rescinded the 13-month rule. Now, the unmarried applicant must decide to keep the house or to sell before applying for Medicaid.

THE RULES

If the person decides not to sell, he can choose to invoke Medicaid’s “intent to return home” condition. That means he is not required to sell the house before getting Medicaid coverage. The intent must be expressed in a written, signed statement. This exemption ends if he later establishes a “principal place of residence” elsewhere.

This new “principal place of residence” condition can jeopardize Medicaid coverage.

If someone has been in a nursing home or assisted living community for many months (not for rehabilitation purposes) it’s unlikely his home can still be called his principal place of residence.

If the person’s health isn’t likely to improve, the principal place of residence has probably become the nursing home or assisted liv- ing community. Even if the intent to return home is real, it may not be realistic. As a result, Ohio Medicaid may stop paying expenses for someone whose intent to return home is not realistic.

For now, it’s uncertain if Medicaid will challenge an applicant’s written statement of intent to return home. Upon renewal of Medicaid benefits, however, if he remains in the nursing home or assisted living community, Medicaid officials may rule the person’s house is no longer his “principal place of residence” because, by the time of the first renewal, he will have lived out of the house for at least a year.