Health Insurance, A Serious Matter with Today's Rising Healthcare Costs

Author

Felice Johnson, Retirement Specialist

For more information about the author, click to view their website: Felice Johnson, Retirement Specialist

Posted on

Dec 20, 2023

Book/Edition

Pennsylvania - Greater Pittsburgh Area

Health insurance is a serious matter, especially with today's rising healthcare costs. 

What is Medicare?
Medicare is the federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD).

Medicare Part A (Hospital Insurance)
Helps to pay for inpatient hospital care, psychiatric hospital care, medically necessary short-term skilled nursing facility care following a hospital stay, home health care and hospice care. Most people do not pay a premium for Part A because they or a spouse already paid for it through their payroll taxes while working.

Medicare Part B (Medical Insurance)
Helps to pay for doctor's services, outpatient hospital services and various medical services and supplies. This is a voluntary program and a monthly premium must be paid. Assistance to pay for this premium may be available for individuals with low income. Visit www.Medicare.gov or contact your nearest Social Security Administration office for specific information about benefits.

Medicare Part C (Medicare Advantage Plans)
A type of Medicare health plan offered by a private insurance company that contracts with Medicare to provide you with all your Part A and Part B benefits (and possibly some additional benefits). A Medicare Advantage Plan essentially manages the healthcare of the plan's members. The government pays these companies money each month for each member. The company then helps to pay for medical care by doctors and hospitals that the member needs.
Medicare Advantage Plans include:
• Health Maintenance Organizations (HMO)
• Preferred Provider Organization Plans (PPO)
• Private Fee-for-Service Plans (PFFS)
• Medicare Medical Savings Account Plans [MSA)
• Medicare Specialty Plans

If you're enrolled in a Medicare Advantage Plan, most Medicare services are covered through the plan and are not paid for under Original Medicare. Must Medicare Advantage Plans offer prescription drug coverage. In addition to a monthly premium, you may be responsible for out-of-pocket costs including an annual deductible, co-pays and co-insurance for office visits, hospital stays and outpatient services like physical therapy. Depending on the type of Medicare Advantage plan you choose, you may need a referral from your primary care physician to see a specialist or get lab work.  Doctors and specialists outside your plan's provider network may be partially covered but you will pay more to use them instead of an in-network provider.  

Medicare Advantage Plans in Allegheny County:
• Aetna (855) 335-1407
• Allwell PA Health and Wellness (866) 224-1076
• Highmark (800) 576-6343
• Humana Insurance Company (800) 833-2312
• UnitedHealthcare Insurance (800) 281-7522
• UPMC for Life (877) 381-3765

Medicare Part D (prescription drug coverage)
Part D adds prescription drug coverage to Original Medicare, some Medicare Cost Plans, some Medicare Private-Fee-far- Service Plans, and Medicare Medical Savings Account Plans.  These plans are offered by insurance companies and other private companies approved by Medicare. Medicare Advantage Plans may also offer prescription drug coverage that follows the same rules as Medicare Prescription Drug Plans.

Are you new to Medicare?  Do you have questions regarding your existing Medicare coverage?  Get one-on-one help.  I have answers!    Felice Johnson, Retirement Specialist at 412-726-6450.

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The Surprising Connection Between Health and Estate Planning

You already know that taking care of your health allows you to prolong your life and enhance your quality of life. But have you given serious thought to how your health directly impacts your future? Your legacy? The ones you love the most? What were talking about here is estate planning, and its every bit as important as your physical health. I know, I know, it could sound weird to equate health with estate planning but hear me out. By the end of the article, the connection will be clear.  The Link Between Your Health and Estate PlanningEstate planning often brings to mind wills, trusts, and other legal paperwork, and in fact, thats maybe what you initially thought when you read the title of this article. However, I want to challenge that assumption with this: the documents are merely the byproduct of estate planning. You may be thinking, how are documents the byproduct of estate planning? Heres what I mean.Estate planning is all about ensuring your wishes are honored if you become incapacitated so you can live and die with dignity. Its also about ensuring that the people you love most will know you loved them, that theyre cared for when youre gone in a way you cared for them while you lived, and that youve removed all the pain, potential conflict and expense they will have to endure if you have no plan in place. Estate planning supports your loved ones to grieve in peace rather than face a long, expensive court process or confusion regarding how to find your assets or understand what to do when you are gone. Estate planning is also about leaving a legacy. Contrary to what you may be thinking - that legacy is not only related to money and reserved for the wealthy and philanthropic - legacy is about the mark you make on those you hold most dear. Its about defining your humanity and what you stood for. Putting your affairs in order now so your loved ones dont have to deal with a mess later is a legacy, too. Making it clear that you loved your family is a legacy. What about health? How does your health connect with estate planning?Your health plays a significant role in shaping your preparations for the future in general, and how you structure your estate plan in particular. I want to first say that while health can refer to mental health, emotional health and spiritual health, and all are important, well focus on physical health here. So lets take a look at the direct link between your physical health and estate planning. Youll come to see that by prioritizing your physical health, you can not only enjoy life with more ease, but also avoid complications in your estate planning. Longevity and Retirement Savings. Your physical health has a direct impact on your lifespan, which in turn affects how long your retirement savings need to last. If you maintain good physical health, youre likely to live longer (yay!) and will need a more extensive plan regarding your assets, for your longer life.Healthcare Decisions. Consider the potential need for long-term care. Alzheimer's or dementia could require long-term care solutions that you may or may not choose. In your estate plan, its crucial to not only make sure youre financially covered for these possibilities, but to also ensure youve made it clear how you want to be cared for, if you cannot make decisions for yourself. There comes a point in time at which its too late for you to make your wishes known and given that you are reading this now is the time to document what you would choose, if you could not choose.This is why you need a healthcare power of attorney, or a living will in your plan. These are documents that designate the person (or people) you choose to make medical decisions on your behalf if youre unable to do so. Your designated healthcare agent (or agents) will not only ensure that your healthcare preferences are respected but will also align your medical treatment with your personal wishes. Without these documents in place, a judge (i.e., a complete stranger) could appoint someone to act on your behalf. Maybe even someone you dont trust or wouldnt want making decisions for you. Or, in a worst-case scenario, a judge could even appoint a professional conservator who could drain your estate financially.Disability and Its Impact. Poor health can sometimes lead to disability, affecting your ability to manage your own affairs. Including a disability clause in your estate plan ensures that your assets are managed according to your wishes, even if youre not able to oversee them personally. A revocable living trust can be particularly useful here, as it allows your chosen person or entity to manage your affairs without the need for court intervention. Again, without a plan in place, a judge will make decisions for you, and those decisions may not be what you want.Having gone through the potential consequences of not prioritizing your physical health and its direct link to your estate planning, lets turn to practical steps you can take now to make sure you and your family dont have to experience any negative consequences. Practical Steps to Integrate Health and Estate PlanningUnless youre already incapacitated and cant make decisions for yourself, know that its not too late to take action. Its not too early, either. Death and incapacity dont discriminate based on age. When you face that fact, and then plan accordingly, you can live life with more ease, more joy, and less stress. Truly.So, if you havent planned for the future, here are some practical steps you can take now:Schedule Regular Check-Ups. It may seem obvious, but regular medical examinations are vital. They not only help in detecting illnesses early but also provide a clear picture of your health, which, as weve discussed above, is crucial for accurate estate planning. If you discover a new health condition, you can plan accordingly when youve caught it in time. If not, it could be too late to get your plan in place.Update Your Estate Plan Regularly: As your health changes, so should your estate plan. Make it a habit to review and update your plan on a regular basis or whenever there is a significant change in your health. As an Estate Planning Attorney, I can not only help you get your initial plan in place, but with a unique process I use called Life & Legacy Planning, I will always include a free review of your plan at least every three years. This ensures your plan works because it will be updated as your health, life and assets change over time. Without updates, your plan will fail, sending your family to court and increasing the probability of conflict. Discuss Your Plans Openly: Talk with your family about your healthcare wishes and how they relate to your estate plan. Taking this courageous, and maybe uncomfortable, step, makes a big difference when it comes to decreasing the likelihood of conflict in your family. Make sure to discuss your preferences for end-of-life care, which can create conflict in your family if you havent clarified your wishes. Consult A Professional Who Has Your Best Interests in Mind: I approach estate planning from a place of heart, always keeping your best interests, and by extension, your loved ones best interests, in mind. I not only help you to get your plan in place, but also help you keep your family out of court and conflict, so your legacy is one of love and care. I can also help you navigate difficult discussions with your family about your wishes, so you can feel confident knowing youve done all you can to preserve the family bonds. How We Support You and Your Loved OnesAs an Estate Planning Law Firm, we recognize the integral connection between your physical health and your estate planning needs. Our commitment goes beyond mere legal documentation; we aim to ensure your life's work and values are preserved with dignity and clarity. By understanding the specific challenges and opportunities that arise from your health, we tailor estate plans that not only protect your assets but also your well-being and your family's future. Contact Entrusted Legacy Law at 412-347-1731 or click here to schedule a complimentary 15-Minute call.

What is Medicare?

What is Medicare?Medicare is a federal health insurance program that gives you access to specific coverage and benefits. Medicare is different from health insurance you may have had before. It offers you a variety of coverage options and it has key enrollment dates and guidelines you need to follow. Were here to help you make sense of it all. How is Medicare Different From Other Health Insurance?You may be surprised at the differences between Medicare and other types of health insurance. If youve had health coverage through your employer, your plan likely included medical and prescription drug coverage, along with other benefits. It also may have covered both you and your spouse.Medicare only covers one person at a time. This means you and your spouse must enroll separately. In addition, Medicare gives you options that can make it possible to receive your benefits in a variety of different ways.You can:       Choose hospital and medical coverage delivered through the federal government.       Add prescription drug coverage delivered through a private company.       Purchase a supplemental insurance policy from a private insurer that can help cover some of the costs.       Choose coverage from a private insurer that combines hospital, medical and often prescription drug coverage into one plan.In short, with Medicare you can choose coverage that fits your needs, budget and lifestyle. We can help you take full advantage of that freedom. Who is Eligible for Medicare?      - Age 65+      - Under age 65 with certain disabilities      - Have End-Stage Renal Disease (ESRD) When and How Do I Apply?If youre like most people, youll enroll in Medicare around the time you turn 65. Your Initial Enrollment Period begins three months before your 65th birthday, includes the month you turn 65 and ends three months after that birthday.Keep in mind that if you dont get Medicare during this Initial Enrollment Period, you may have to pay Medicare Part B or Part D late enrollment penalties. Plus, you could be missing out on coverage and benefits that can help protect your health and finances. Thats why its generally a good idea to enroll as soon you can. How you enroll generally depends on if youre getting benefits from Social Security, the Railroad Retirement Board or the Office of Personnel Management.Contact me today at 724-554-7989 for a FREE consultation.  

Mistakes to Avoid When Looking for an Assisted Living Community

Mistakes to Avoid When Looking for an Assisted Living CommunitySearching for the best assisted living residence is tough, especially when your parents and loved ones are making the change. Fortunately, there are ways to help them learn how to find and choose an assisted living facility. Most of these come down to the following three steps:Determining what they needFinding locations that match their needs and signing up for toursUtilizing multiple resources to find the right locationWell help you focus on finding the right residence to keep your loved one safe, happy, and secure as soon as possible with as little worry as possible. There are a few common mistakes people make when considering an assisted living community.1. Making the decision based on superficial reasonsAssisted living is about more than a pretty building. Often, adult children choose living establishments they think their parents would enjoy without adequately thinking about their health and wellness needs.If your mom or dad is unable make the decision, very carefully weigh all the options available before making it. Most of the time, transportation, safety, and comradery with similarly aged adults are exactly what your parent wants. 2. Being unrealistic about health and memory needsIf your mom or dad has dementia, think about what they need now, rather than what they used to enjoy. Memory issues cause adults to become reclusive, scared, and confused. Aging causes stressors and other worries. Choose a residence that can best protect them, rather than one that is overly fancy.Many residents come to us because they chose places that didnt offer the quality of care or level of services that they need. We always recommend adult children seriously consider their parents health needs and ask doctors about the support seniors need as they age.3. Going it alone in the searchIts usually prudent to get several opinions regarding the best assisted living options. Theres a good chance other family or friends have gone through the same process. You might also consult qualified senior living advisors. Legend Senior Living provides advisors to help navigate the process every time we show people our community. Our senior living advisors are generally very helpful when it comes to the process of choosing the right home, even if Legend may not be the right fit for your particular needs.4. Not knowing what to look forStart your search online, but make sure to talk to people. When doing your research online, make sure the residence offers the following resources:Nutritious prepared mealsCompanion services that provide company, personal assistance, and supportLife enrichment activities to indulge, learn, and growWellness and other activities to keep seniors engaged and activeBut go to the source, too. Make sure to make time to visit the residences youre considering. On your visits, we suggest you talk to the people to see exactly how it operates. Speak privately with staff and residents to get their opinions about the level of care and their overall satisfaction. Cheerful residents are always a good sign to look for in an assisted living home.5.  Choosing the first residence you findYoull find that every residence is unique. We recommend visiting at least three homes before you make a decision. This allows you to compare, do your due diligence, and get a clearer picture of standards and options available. Take note of residence standards, their cultures, and how they treat people. Most of all, consider your peace of mind and the safety of your loved ones.Legend Senior Living Is here to answer your questions and give you a tourGenerally speaking, most questions about assisted living focus on how many members are on staff, how the staff handles maintenance, and activity schedules. Security for aging adults with memory needs is something to consider as well.At Legend Senior Living, we understand whats important to you family, friends, good care, and compassion. We understand the need to live your life and your standards for independence, dignity, and the right to personal choice. 

Local Services By This Author

Felice Johnson, Retirement Specialist

Medicare/Medicaid/Insurance 5 Curry Ct, Turtle Creek, Pennsylvania, 15145

Individual Retirement Planning SolutionsI am an independent licensed insurance agent that truly puts the client first.  Driven to provide the best solutions for my clients, I offer nothing but the best products from industry leaders from more than 180 companies.  I am passionate about changing people's lives and protecting them from financial catastrophe due to unforeseen illness and death.  I have a responsibility to always educate and make recommendations based on the needs of each individual client. Contact me today!- Medicare Planning / Health - education for your rights and options with the Medicare Program and associated supplemental services (Medicare Supplement, Medicare Advantage, Hospital Indemnity, Part D Prescription Drug, Cancer Protection, Denta/Vision/Hearing, Final Expense, Recovery Care/Post Hospital)- Insurance Planning - provide protection for loved ones for life events and/or catastrophes by transferring the risks. Ensuring lifestyle and asset protection (Life Insurance, Individual Health Insurance, Wealth Transfer, Retirement Supplements, Non-Qualified Deferred Compensation)- Retirement Planning - setting aide funds to provide deferred incomes benefits at retirement (Rollover/ROTH/Traditional IRA, SEP, CD Alternatives)- Income & Legacy Planning - helping individuals prepare for retirement's transition from asset accumulation to income generation and asset distribution and having a plan to provide continuation of your legacy.  (Guaranteed Life Income, Survivor Replacement Income, Pension Maximization, Disability Insurance, Gifting, Charitable Donations, Protection of Future Generations)- Personal & Business Insurance - providing coverage and security to individuals and businesses (Home & Renters Insurance, Auto Insurance, Business Insurance)