What every boomer needs to know
Rohn K. Robbins Part two of a continuing seriesIn Part I of this series, we considered what every senior – or soon-to-be-senior – should know about Social Security, “delayed retirement credits,” “representative payees,” SSI (or Supplemental Security Income) and reverse mortgages. Contact information was provided for each of these programs in order to avail and apprise yourself of the various benefits. In Part II, we will explore certain health care and health benefits.One potential uncertainty when facing retirement is the preservation of health care benefits. Perhaps a threshold questions is, can you keep your health care coverage under your employer’s group plan? The answer is that you may be entitled to continue coverage under the plan for at least a short period of time. A few employers – fewer and fewer all the time – actually maintain health care coverage for their retired employees. But don’t count on it…Obtaining individual health coverage can be outrageously expensive and difficult at any stage in life, but particularly for seniors, and particularly so for seniors with a pre-existing health condition. There are, however, other options such as Medicare and Medigap policies, health maintenance organizations (HMOs), long-term care insurance and, where appropriate, veteran’s benefits.Medicare is a federal health insurance program that provides coverage primarily to Social Security recipients who are at least 65 years old. In some circumstances, younger persons may be covered too, generally those with certain disabilities or who need kidney dialysis or a kidney transplant. Happily, a person’s income level and assets have no bearing on an individual’s eligibility for coverage.Medicare participants may generally choose between what is known as the Original Medicare Plan, a Medicare Advantage Plan and other Medicare health plans which are available only in certain parts of the country. Medicare Advantage Plans may include HMOs, PPOs (Preferred Provider Organizations), special needs and various private fee-for-service plans. With each, the participant pays the applicable deductibles and co-payments (and, in some instances, a monthly premium) and Medicare picks up the rest… at least for covered services.The Medicare program consists of three basic components. Part A, known as hospital insurance, covers in-patient hospital care, limited skilled nursing and home health care and hospice care. Part B, which beginning in 2006 requires an $88.50 monthly premium, helps pay for additional medical services (which may include some medically necessary home health care and physical and occupational therapy). Part D (no, this is not a typo – D, not C) is new, having been launched in 2006 to provide for prescription drug coverage. As a Medicare beneficiary, you can select from a menu of often complicated Medicare-approved prescription drug plans. You can learn more on the Medicare Web site, http://www.medicare.gov, or call 1-800-633.4227.Medigap is supplemental health insurance meant to cover some of the expenses that are not covered by Medicare – filling in the “gap” between what is covered and what is not, under Medicare. To help you determine what coverage – if any – is right for you, you may want to obtain a free Medicare publication, “Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare.” Needless to say, you can obtain the publication by contacting Medicare.Veterans may be entitled to additional benefits through the Department of Veteran Affairs, http://www.va.gov or 1-800-827-1000. Health care services and benefits are available to eligible recipients at medical centers and clinics located in every state. In Colorado, there are a dozen and a half such facilities. Unfortunately, the closest of these to the Vail Valley is in Denver. Depending upon income, a veteran may pay as little as $15 to see a primary care physician and $50 to see a specialist. Additionally, medicine may cost no more that $7 per prescription. Dental benefits may also be available.Long-term care insurance generally concerns assistance with daily tasks of life. Long-term care insurance covers custodial care. Medicare covers nursing facility and home health care but only if it is “skilled” care, medically necessary and only for a limited period of time. Long-term care insurance, on the other hand, contemplates home health care, adult day care, nursing home care, the costs of an assisted living facility and respite care. Whether you need this kind of insurance depends upon many factors. Some of them include: your health, your financial resources, your arrangement for future care, family medical history and family support and your own wishes. As these policies may vary widely, care in choosing the right policy under the right circumstances is essential.Next, in this series, we will visit “forward planning,” including living wills, estate planning and conservatorship. Stayed tuned. As Dr. Seuss once observed, “growing old is not for sissies.”Rohn K. Robbins is an attorney licensed before the Bars of Colorado and California who practices in the Vail Valley. Robbins lectures for Continuing Legal Education for attorneys in the areas of real estate, business law and legal ethics. He may be heard at 7 p.m. Wednesdays on KZYR radio (97.7 FM) as host of “Community Focus.” Call him at 926.4461 or e-mail email@example.com.
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