14 Mar 2008 02:10:56 | William Pritchett
Health Insurance For Seniors On The Net
When a good friend of mine inquired where he could obtain
information about medical insurance for his out-of-state,
elderly mother, I told him to try the Internet.
He reported back to me about a week later, in desperation: "I am
giving up, I am too confused." He had taken on an overwhelming
project with his widowed mother, living in another state. As the
only child, and following the sudden death of his father, it was
his responsibility to care for his mother.
In this world of technology, the family unit is often living 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 a lot of assistance. As
time goes on things, of course, change, and sometimes change
very suddenly. There can be a crisis, with regard to 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 parent's assets and health is a huge and
daunting undertaking, which requires a tremendous amount of
education and practical application. Our seniors face many
diverse responsibilities upon reaching age 65. To name just a
few: Estate planning, taxation, Medicare, social security,
wills, insurance, and various other legal and financial matters.
All of these different areas require expertise from accountants,
lawyers, estate planners, insurance agents, home brokers,
financial advisors, and others.
The Internet is a good starting point for most people to find
resources for questions and solutions for your problems. There
is, however, no replacement for good solid intelligent advice
from an expert.
Twenty years ago, insurance for elders was sold by "senior
insurance specialists", with just a handful of companies in each
state. The programs were most often Medi-gap or Medicare
supplemental 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 a lot of nursing care policies,
even though 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 this market, a
more broad and diversified product line became available to
agents, brokers, planners, and seniors.
Part of this new diversification was the "home health care
plan", sold by itself, and in conjunction with senior health
insurance products. The appeal of the "home health care policy"
was that a senior could stay at home and still receive medical
and custodial benefits, allowing a person to recuperate 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 "retirement home", or "rest home", or,
God forbid, the "nursing home." It appeared that seniors could
now rely on this new innovation without worry of having to move
out of their home environment in the event of a health problem.
As with most things," if it is too good to be true".... The home
health care policy is no exception. The problem is, there is not
enough coverage for a lengthy illness or recuperation time. The
fact is, the new trend is toward an "all in one" type facility,
allowing for a variety of levels of care all in one location. In
other words a senior could start off with little or no health
care concerns in an independent, less expensive area, and then
go to an assisted living, or nursing care facility, all within
the same compound.
A "nursing home" requires a nurse on the premises 24 hours per
day, assisted living is just eight hours. The advantages to this
are financial. The patient or senior is only charged according
to the care level required during the time he or she is admitted
to that facility. Another benefit is it alleviates a lot of
planning because the care is delivered, as it is needed. The
medical attention is available to all residents regardless of
their current health.
Some people are offered a lifetime package, which covers their
care for the rest of their life, regardless of their current
age. It also allows for social outlets to an otherwise somewhat
isolated group. On-line shopping services have become a huge
business. It is definitely here to stay and many insurance
policies are purchased from Internet quotes and on-line
applications.
There are literally hundreds of thousands of insurance agents
and brokers advertising on the Internet. Most of them will
provide instant on-line quotes and even applications for the
potential insured. I highly discourage a layperson to purchase
insurance in this fashion. A little knowledge can be dangerous.
The federal government has mandated to all states through
legislation, the standardized senior health insurance policy
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
"unanticipated" sickness or injury, especially catastrophic
expenses, which would devastate 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 a lot of complaints
filed with the local department of insurance? Are the rates
stable? Does it pay claims on time? Service? Most agents talk
about the rating. These ratings are as follows: A+, A, A-, B+,
B, B-, C+, C, C-, or "not rated".
Do not be fooled by rating alone. It is good to have a high
rating, but it is far better to have a company that has
longevity, stability, innovation, service, and expertise. The
problem is that some companies enter into a market and quickly
leave without explanation. This does not give security to the
policyholder.
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 possibly even withdraw. This is
information not normally available to Internet users.
Before entering into an insurance contract, the senior person,
the family, and other advisors must be realistic, and a careful
evaluation of the entire 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 desires of
the senior, should all be considered.
Early planning is important, as qualification becomes
increasingly more difficult as the applicant's health declines.
The senior health care market is complex. I will offer some
words of advice to attempt to alleviate potential pitfalls.
*Choose a well-informed, seasoned, and service oriented agent or
broker to assist your decision making process. The professional
can offer invaluable information, but do not be afraid to ask a
lot of questions and even get a second opinion. *Do not wait
until your parent or loved one is sick, or injured. Plan ahead
and take the time needed to cover all the options. *Choose an
experienced insurance company. A Company that has been in the
marketplace for a significant time and has maintained a balance
of rates and benefits and sound risk selection with moderate
rate increases over time is your best bet. *The plan should be
flexible, with a broad range of options and benefit selections
to the insured. There should be no tricks, or complicated
language for the coverage. An incredibly low rate is a red flag
for trouble in the future. *Do not rush or be rushed by an over
aggressive sales person.
This policy will not be inexpensive and will need to be read and
reviewed for a clear understanding of the contents. This is one
advantage to the Internet. You are allowed to read indefinitely
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 any questions about the accreditation of a
facility please call the "Continuing Care Accreditation
Commission at 202-783-7286.
As I have mentioned in my article, the best way to avoid
potential problems are to plan ahead. I have found a company,
that I highly reccommend as they are professional senior care
specialist's and offer sound, practicle, individualized, advice
for caregivers, family members, seniors, and guardians. They
will advise on tax, legal, financial, health care, and other
family issues, and are available nationwide.
author: William H. Pritchett Jr.
About Author :
Mr. Pritchett is a certified estate planner with over 25 years
of experience in long term care, medicare, and custodial care
health insurance products. Mr. Pritchett was a pioneer in this
market and developed the first "Home Health Care" insurance plan
available in the United States in 1983. He has written many
articles, is a national public speaker on the subject and sits
on the board of directors for several large corporations.