Medicare and Long-Term Care What Advisors Need to Kno Medicare Marlene Lund.pdf · 2015-10-02 ·...
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Medicare and Long-Term Care What Advisors Need to Know Marlene Lund, CLTC, CSA Lund Insurance Agency, Inc. Speaking of Aging, Inc.
Transcript of Medicare and Long-Term Care What Advisors Need to Kno Medicare Marlene Lund.pdf · 2015-10-02 ·...
Medicare and Long-Term CareWhat Advisors Need to Know
Marlene Lund, CLTC, CSALund Insurance Agency, Inc.Speaking of Aging, Inc.
Consumer Concern and Confusion 61% of high net worth Americans who are close to retirement
are “terrified” of what health care costs may do to their retirement plans.¹
64% of these individuals have not discussed retirement health care costs with a financial advisor because they are unsure as to whether their advisor is knowledgeable about the issue.¹
4/5 baby boomers cite uncovered health expenses and the risk of becoming ill as their top financial concerns in retirement.²
1. Harris Interactive, 2013
2. Putnum Investments Lifetime Income Score Research 2012
When you enroll in Medicare, what percentage of your annual health care costs do you expect Medicare will cover?
- Female: 45%- Male: 37%
How did you arrive at this percentage? - Guessed:- Female: 85%- Male: 70%
Source: Harris Interactive, 2012
Healthcare Coverage in RetirementType of Care Covered By Monthly
PremiumsNotes
Hospital Care Medicare Part A $0 Can buy Medicare Supplement to coverDeductibles and Co‐insurance Costs
Doctor Care Medicare Part B $104.90 and updepending on income
Can buy Medicare Supplement Plans to cover deductibles, co‐insurance and excess charges
Prescriptions Medicare Part D Varies Shop for drug plans
Managed Health Care Medicare Part C (MA) Varies Med‐Supp plans not available for these plans
Long‐term care Medicare Part A and/or Part B
Included Medicare varies coverage at home and facilities –can cover remaining costs through Medicare Supplement plans and LTC Insurance
The biggest confusion –Does Medicare cover long-term care?
Medicare and Long-Term Care Medicare does cover:
Care in a long-term care hospital (LTCH)- LTCH’s specialize in treating patients who may have more than one serious condition, but who may improve with time and care,and return home.
Skilled nursing care in a skilled nursing facility. You pay:Days 1-20: $0 for each benefit period, Days 21-100: $157 coinsurance per day of each benefit periodDays 101 and beyond: all costs
LTC Insurance = Medicare supplement?
• You can’t market LTC insurance as Medicare Supplement – but maybe you should!
• THIS POLICY IS NOT A MEDICARE SUPPLEMENT POLICY.
Key facts about Medicare and Home Health Care
Intermittent skilled care nursing carePhysical therapy, speech language pathology, occupational therapy
Must be Medicare approved home health care provider and under doctor care
Must be homebound
Doesn’t cover24 hour a day care – average claim 6 hours per WEEK
Homemaker services
Personal Care – Dental, Hearing Aids, Normal Eye Maintenance
Source: Medicare.gov
Medicare and chronic care = careful!
Court Case: Jimmo vs. Sebelius
January 24th 2013 CMS issued revisions to benefit policy manual to cover chronic conditions such as Parkinson's, Multiple Sclerosis, or Alzheimer's
Advisors can no longer say Medicare onlypays for improving conditions.
Still a lot of confusion about this ruling and its implications.
Source: Advisory.com
Long-term care elimination periods
The vast majority of LTC policies include 90 day elimination periods.
Do LTC costs covered by Medicare or Medicare Supplement plans count towards the elimination periods?
• TransAmerica: “We will give you credit toward the Elimination Period for days of Long Term Care Facility confinement covered under this policy, even though they are paid or payable by Medicare”
• Mutual of Omaha: “Any days for which Medicare pays benefits for qualified long-term care services can be used to satisfy the elimination period”
• Genworth: “Any days for which Medicare pays benefits for qualified long-term care services can be used to satisfy the elimination period”
Medicare Certified Home Health Care Agency
Check your policies – some LTC contracts
or riders require that the home health care
agency be Medicare certified
The future of Medicare and LTC
Will there be a Medicare Part E covering long-term care? Voluntary or mandatory?
Will there be “Medicare-Supplement” LTC policies?Funding for Medicare in the future
What Medicare giveth, it can taketh away. On the other hand, the LTCi contract between the insurer and policyholder is written down.
Marlene Lund, CLTC, CSALong-Term Care Specialist
Speaking of Aging, Inc.Lund Insurance Agency, Inc.
6212 South 172nd StreetOmaha NE 68135
402-896-9193
[email protected]@msn.com
www.marlenelundinsurance.com
