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Home Care Services vs. Senior Assisted Living

Nearly half of everyone over the age of 65 needs some form of assistance in their daily routine. That’s approximately 18 million seniors! When choosing between home care services and senior assisted living, it’s important to consider the costs, qualifications, and available services before making a final decision.

Home care services allow you to get the assistance you need in the comfort of your own home and is great for anyone who is chronically ill, disabled, recovering from surgery, or needing basic assistance. Senior assisted living is an affordable way to get 24/7 care that includes interaction with other residents and eliminates the need of hiring, scheduling, or managing caregivers. This is great for those who have difficulty moving around and require more medical supervision. Both home care and assisted living focus on providing care, but the specifics of what is provided differ.

What Services Does Home Care Provide?

The three major types of home care services are:

Personal Care and Companionship

Personal care and companionship can provide assistance with self-care including bathing, grooming, and dressing. They also help with fall prevention by assisting with movement around the home. Meal preparation, cooking, light housekeeping, laundry, and other errands are included. Plus, this type of care allows you or a loved one to have companionship which can help with isolation issues, especially in the winter. Personal care and companionship can be long or short-term and is great for those who need basic help around the home.

Private Duty Nursing

Private duty nursing can help with basic medical services inside the home. This includes monitoring vital signs and administering medications. Ventilator, tracheostomy, gastrostomy, catheter, and feeding tube care may also be included. Private duty nursing care is typically long-term and is ideal for those who have a chronic illness, injury, or disability.

Home Health Care

Home health care includes several short-term nursing services. This includes physical therapy, occupational therapy, speech-language pathology, medical social work, and other home health aide services. Home health care is often short-term and is recommended by a physician. Home health care can help patients recover from an injury, illness, or hospital stay.

What is Assisted Living for Seniors and Medicare Eligibles?

Senior assisted living provides 24/7 care, meals, housekeeping, laundry, transportation, recreational activities, and wellness programs. Plus, facilities may offer on-site pharmacies, physical therapy, and even salon services.

Another large benefit of assisted living is social activities and entertainment. Many facilities have common areas including libraries, cafes, and game rooms. Plus, there are several social activities offered like gardening groups, book clubs, and movie nights.

Senior assisted living can help you or a loved one rest easy knowing that all care is personalized to meet any and all health needs.  Emergency first aid, medication management, pharmaceutical services, and maintenance of medical records is often provided to residents. Some facilities have a staff physician who provides routine checkups.

Senior Assisted Living and Home Care Services Costs

It’s important to look at the price tag when making a decision. Home care and assisted living offer different services and their prices reflect that.

What Does Home Care Cost?

The cost of home care services is unique to each situation. According to NPR, the average costs for home care services are:

  • Personal Care and Companionship: $70/day or $18,200/ year
  • Private Duty Nursing: $19/hour or $19,760/year
  • Home Health Care: $21/hour or $21,840/year

There are several companies that provide home care services, but the prices will vary. Plus, there are several other costs that are not included. Keep these in mind when looking at your budget. These costs include groceries, personal hygiene items, household items, transportation, rent or mortgage, utilities, and maintenance.

What is the Average Cost of Senior Assisted Living?

The type of residence, size of the apartment, services included, and location of the community are all factors that can increase the overall cost of senior assisted living. Costs can range from $2,200 to $6,000 per month depending on the cost of living for each state. However, keep in mind these are all-inclusive costs and eliminate the cost of rent, utilities, maintenance, meals, and personal care if you or a loved one lived at home.

Senior Assisted Living and Home Care Services Qualifications

Assisted living and home care each have a specific set of qualifications. Before finalizing on a plan option it’s crucial to know if you qualify.

How Do You Qualify for Home Care?

Within the three types of home care, personal care and companionship is the only type that doesn’t require a prescription. Plus, if Medicare or Medicaid is covering some of the costs, there are different qualifications. To qualify you must meet the “homebound” criteria as established by the Centers for Medicare and Medicaid and require skilled care on a part-time basis in order to improve or maintain your health issue. If you meet these requirements, Medicare will cover your costs, but only if you receive your care from a Medicare-approved home health agency.

Who Qualifies for Assisted Living Facilities?

Qualification for senior assisted living is largely dependent on the level of care a resident needs. You or a loved one may qualify if assistance with daily living facilities like personal care, hygiene assistance, mobility, meals, and medication management is needed.

Those who require daily nursing services from extensive medical needs may not qualify. The application process is the same regardless if you or a loved one lives in a private residence, rehabilitation center, nursing facility, or a hospital. The typical application process includes facility admission paperwork, medical history, physical, and tuberculosis (TB) test or chest x-ray.

Role of Medicare and Medicaid

Medicare only covers the third type of home care services: home health care. The only cost you may have is 20% of the Medicare-approved amount for durable medical equipment. Medicare typically does not cover the costs of senior assisted living. However, Medicare may cover qualified healthcare costs while living in the facility. This includes doctor visits, lab tests, certain preventive services, physical therapy, and medical supplies.

Medicaid may cover some of the costs of home care services, but the coverage will vary by state. In some cases, Medicaid can be used to pay for some assisted living costs through a Medicaid waiver, but there is often a waiting list.

Making a Decision

Home care services and senior assisted living are two options that could greatly impact you or a loved one’s quality of life. There is an abundance of information available which can make finzaling a decision difficult. Are you a caregiver and looking to help a loved one? Our Ultimate Aging Parents Checklist can help you prepare for what is often a tough decision and discussion.

Medicare and Medicaid may only cover a small amount of the total costs. However, Medicare Advantage plans may provide additional coverage beyond Original Medicare and include benefits like hearing, dental, or vision coverage.

At Medicare Plan Finder, our goal is to make sure you have the coverage and benefits that enable you to live the healthiest lifestyle possible. Plus, we make sure you are informed on important information like the Medicaid look-back period and how Medicare and Medicaid work together. Our licensed agents can help answer any questions you may have about Medicare Advantage, prescription drug coverage, and Medicare supplements. If you’re interested in arranging a no-cost, no-obligation appointment, call us today at 833-438-3676 or fill out this form.

Vitamin D for Seniors and Medicare Eligibles

Vitamin D, also known as the “sunshine vitamin,” is essential. It helps absorb calcium, which is necessary for bone health and strength. Over an extended period of time, vitamin D deficiency can result in obesity, diabetes, hypertension, depression, Osteoporosis, and more. Vitamin D for seniors and Medicare eligibles becomes increasingly important with age, so it is important to understand the recommended dosage and the symptoms of deficiency.

Why is Vitamin D Important in the Elderly?

If you are deficient in vitamin D, your body may start to lose bone tissue. This can lead to bone pain, muscle weakness, and even skeletal deformity. Seniors and Medicare eligibles who get the recommended dose of vitamin D every day are more likely to lower their risk of cardiovascular issues, cancers, bone disorders, and diabetes. Plus, it can lower the chance of early nursing home admission, encourage physical independence, and act as a form of fall prevention.

How Much Vitamin D Does a Senior Need?

It can be extremely difficult to get enough vitamin D through diet alone. Sunshine and vitamin D supplements are beneficial alternatives. The recommended dose of vitamin D for seniors age 70+ is, at a minimum, 800 IU* per day. For those less than 70 years old, the adequate intake is, at a minimum, 600 IU per day. Blood tests are a great way to see if you are getting the right amount of vitamin D. However, it’s important to understand that you can have too much vitamin D. An excess can cause vomiting, weakness, and excess urination. Your daily vitamin D intake should never exceed 4,000 IU per day.

*IU stands for international units and is used to measure fat-soluble vitamins. This includes vitamins A, D, and E. You will notice that these vitamins will use “IU” on their labels instead of MG.

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Typical D3 Dosage for Seniors and Medicare Beneficiaries

There are two main forms of vitamin D for seniors and Medicare eligibles – vitamin D2 (ergocalciferol) and vitamin D3 (cholecalciferol). D2 can be found in plant foods like mushrooms and D3 can be found in sunlight and animal foods like salmon or eggs. D2 does not occur naturally in your body, but D3 is produced in the skin when exposed to sunlight. Experts believe that D3 is at least three times more potent than D2 and is more stable, safe, and beneficial to the body.

Symptoms of Vitamin D Deficiency in Elderly People

Vitamin D Deficiency in elderly people is common due to smaller food intake, less exposure to sunlight, and reduced skin thickness. It’s important to listen to your body so you can take the proper steps to rectify the issue. Symptoms of vitamin D deficiency in elderly people include:

Weak Muscles

In general, adults often feel their muscles get heavier with age. This can actually be linked to a Vitamin D Deficiency. This means that if you have difficulty standing up or climbing the stairs, you may not be getting enough vitamin D.

Common Sicknesses

Vitamin D makes sure your immune system is strong and helps fight off illness-causing viruses and bacteria. If you get sick easily and often, especially with colds or the flu, low vitamin D could be a contributing factor. Plus, researchers have found links between vitamin D deficiency and respiratory infections. Studies have shown that increasing your vitamin D intake can decrease your risk of infection.

Weight Gain

Researchers claim that vitamin D and a hormone called leptin work together to regulate your weight. Leptin works by signaling your brain that you are full and to stop eating. If you are deficient in vitamin D, the leptin signaling process may not function properly. Overeating and weight gain can be an indicator that you need more vitamin D.

Fatigue

There are many reasons you may be feeling tired, but a vitamin D deficiency is often overlooked. There have been several observational studies that show correlations between low vitamin D levels and fatigue. When the vitamin D dosage was increased, the tiredness and fatigue subsided.

Stomach Problems

Since vitamin D is a fat-soluble vitamin, a deficiency can trigger digestive problems like inflammatory bowel disease. Digestion problems can be extremely uncomfortable and negatively impact the fat absorption process.

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Medicare Advantage and Part D Plans

If you think you may have a vitamin D deficiency, visit your doctor before taking corrective action. A blood test is the most accurate way to measure vitamin D in your body. Unfortunately, in most cases, Original Medicare only covers blood tests for at-risk individuals.

Medicare Advantage plans can provide additional coverage for bloodwork. In some cases, MA plans with prescription drug coverage will even include some coverage for over-the-counter medications like vitamin D supplements! Talk to a licensed agent about finding out whether a plan in your area offers these benefits. A great first step is to download our Part D checklist that can help you figure out what prescription coverage you need out of your health care plan.

Our licensed agents can help you understand all of your plan options and enroll you in a plan that fits your needs and budget. If you’re interested in arranging a no-cost, no-obligation appointment, fill out this form or call us at 833-438-3676.

What is the CVS and Aetna deal?

Last year, CVS provided prescriptions to an estimated 94 million customers while Aetna provided coverage to an estimated 22 million. In a $69 million dollar deal, CVS officially purchased Aetna on November 28, 2018. The CVS and Aetna deal will strengthen the two companies, create better care coordination, and improve costs for beneficiaries like you.

CVS and Aetna Merger Status

CVS and Aetna had a long road ahead starting in December of 2017 when CVS first announced its plan to purchase Aetna. In March of 2018, shareholders for both parties approved the merger. In early October, the Justice Department granted approval. Finally, on November 26, 2018, New York was the last state to approve the merger. CVS completed the acquisition of Aetna on November 28, 2018.*

*There has been a delay in the integration of Aetna and CVS. We will update with more information as it becomes available.

Change in CVS Stores

Many CVS stores currently offer healthcare services through their Minute Clinics. The Aetna and CVS deal will allow CVS locations to become a one-stop-shop for all health and wellness needs. This includes clinical and pharmacy services, vision, hearing, etc. Aetna’s CEO, Mark Bertolini, has plans to create healthcare-focused hubs similar to Apple’s Genius Bars. Apple focuses on concierge-style support and CVS plans to follow suit. These hubs will provide basic healthcare products and information. If you have questions or concerns about health conditions, prescription drugs, or coverage, the hub can answer quickly and effectively.

Change in the Healthcare Industry

CVS plans to address several issues that surround the healthcare industry. They want to introduce competitive Medicare Advantage and Part D offerings and create more market access for beneficiaries. They also strive to promote lower-cost care and enhance their clinical care programs.

Both companies agree that the Aetna and CVS deal, with the help of their data, will lower costs and provide better care. When this data is combined with the expected changes to CVS stores, you may be offered new health products at lower prices. The data from the Aetna and CVS deal is also expected to create tech-focused projects like remote monitoring tools. For example, if you have diabetes, you could have your blood glucose levels monitored remotely and receive text messages if your levels are too high or low. This allows patients to have additional medical supervision beyond their average appointment.

How will this deal impact you?

The CVS and Aetna merger is a great example of how Medicare and the healthcare industry can evolve. However, it will take time for these new plans to be implemented and the results are speculative at this time. If you have any questions or concerns about your Medicare coverage, our agents are happy to help! Call us at 833-438-3676 or fill out this form to get in contact with a licensed agent.

Remembering President George H.W. Bush

President George H.W. Bush was a humble and ambitious leader who died on November 30, 2018, at the age of 94. He was responsible for walking the U.S. through important milestones like the Americans with Disabilities Act, Strategic Arms Reduction Treaty, and Operation Just Cause. He will be remembered as a veteran, congressman, vice president, legacy leader, and of course, our 41st president.

President George H.W. Bush’s Top Accomplishments

1941: Joined the U.S. Navy and the fight against the attack on Pearl Harbor.

1948: Graduated from Yale University.

1966: Elected into the House of Representatives.

1971: Appointed as Ambassador to the United Nations by President Nixon.

1976: Appointed as Director of the Central Intelligence Agency (CIA).

1981: Elected as Vice President alongside President Ronald Reagan.

1988: Elected as the 41st president of the United States. Fun fact: President George H.W. Bush was the second president, after Martin van Buren, to be elected while sitting as a vice president.

1989: Sent troops to Panama for Operation Just Cause to oust the dictator of an international drug trade.

1990: Signed the Americans with Disabilities Act into law.

1990: Negotiated a budget deal to reduce the federal deficit.

1991: Signed the Strategic Arms Reduction Treaty with Soviet President Mikhail Gorbachev.

History and Impacts of Americans with Disabilities Act

The Americans with Disabilities Act (ADA) signed into law on July 26, 1990, is considered George H.W. Bush’s landmark presidential legislation. The law ensures that individuals with disabilities have the same rights and opportunities as everyone else and are not discriminated against. This equal opportunity applies to housing accommodations, employment opportunities, public transportation, government services, and telecommunications.

The ADA classifies a disabled person as “a person who has a physical or mental impairment that substantially limits one or more major life activities, a person who has a history or record of such an impairment, or a person who is perceived by others as having such an impairment.”

An estimated 55 million Americans are protected by the ADA and are directly impacted by this life-changing law. Many changes brought by the ADA are seen everywhere we look, including the use of wheelchair-accessible transit, braille in public buildings, closed captioning for television and movies, and fire alarms that can be both heard and seen.

Dual-Eligibility and Special Needs Plans

If you are one of the 55 million Americans protected by the ADA, you may qualify for a Special Needs Plan. These plans are a type of Medicare Advantage plan and help cover doctor, hospital, and prescription drug costs. Plus, you may have a special enrollment period which means you can enroll during almost any time of the year! If you have questions regarding your special needs plan eligibility or plan options, a licensed agent may be able to help! Call us today at 833-438-3676 or fill out this form.

The Medicaid Look Back Period: What You Need to Know

What is the Medicaid look back period?

Medicaid is designed to provide health care to those with low income or limited assets and is administered through each state. When applying for Medicaid, the state social security office is responsible for confirming you have limited income and assets. The Medicaid look back period is a period of time the office will review to see if you sold, donated, transferred, or gifted any of your assets. The period is 5 years for every state except California where it is 2.5 years. This period starts on the date you apply for Medicaid.

Is there a penalty?

Yes, there is! If the social security agency finds that you sold, donated, transferred, or gifted any of your assets beyond the granted exemptions, you will have a penalty. The penalty is a length of time that you will be ineligible for Medicaid. This is called the penalty period, and there is no limit on the amount of time you can be penalized for.

The penalty is based on the dollar amount of sold, donated, transferred, or gifted assets divided by the monthly private patient rate of care in a nursing home. For example, if you gifted $60,000 during the look back period and the average monthly cost of nursing home care is $4,000, your penalty would be 15 months of Medicaid ineligibility ($60,000 gift/$4,000 average month cost = 15 months).

 Can you avoid the penalty?

Planning is key in an attempt to avoid the penalty. Did you know you can gift up to $15,000 a year without paying a gift tax? This is a great option if you’re wanting to leave a certain amount of your savings to a child or loved one. If you want to gift $60,000 it will take 4 years to avoid taxation. This means that you would need to start gifting 9 years before applying for Medicaid to avoid the look back penalty.

Are there exemptions?

Fortunately, there are exceptions that allow applicants to transfer assets without a penalty. The exceptions include:

  • Spouses

Medicaid applicants can transfer a certain amount of their assets to their spouse. The spouse cannot be in the Medicaid application process and must plan to live independently in the community. The total amount of assets able to be transferred will change annually, but in 2018 the limit is $123,600.

  • Disabled Children

Applicants can transfer their assets or establish trust funds for disabled children who are under the age of 21, including children who are legally blind.

  • Siblings

A home can be transferred to a sibling who has equity in the home and resided in the home for a minimum of one year prior to a nursing home placement.

  • Caregivers

Applicants can transfer their home to their adult children if they lived in the home for a minimum of two years before the Medicaid application was started. The child must be the primary caregiver.

  • Debt

Applicants can pay off their debt without a penalty.

If you’re interested in learning more Medicaid information that is specific to your state, visit our Medicaid by State page. Plus, you may be eligible for both Medicare and Medicaid! Our licensed agents can help answer any questions you may have and help you sort through your health care options. To get started, fill out this form or call us at 833-438-3676.

Drug Price Transparency: Everything You Need to Know

Drug Price Transparency: Everything You Need to Know

The Henry J Kaiser Family Foundation estimates that $1 out of every $6 in Medicare spending is for prescription drugs. These medications play an important role in the health of 59 million seniors and Medicare eligibles. Drug price transparency is crucial in informing consumers and developing new strategies that address the issue of rising drug costs.

How is CMS involved?

Earlier this month, CMS proposed a new drug price transparency rule that was targeted at direct-to-consumer television advertising. This rule would require drug manufacturers to publish wholesale prices during commercials. This will allow beneficiaries to make informed drug purchasing decisions, especially beneficiaries with high deductibles and drug costs.

Direct-to-consumer television advertising can dramatically impact a beneficiary’s purchasing decisions. These commercials can spark informational discussions between beneficiaries and their health care providers, but understanding the costs is crucial when making a final decision.

State vs Federal Legislation

Several states across the US are implementing new bills and laws that require drug companies to not only report but also justify any dramatic increases in their drug prices. Since early August, there have been over 100 bills introduced into legislation addressing the different issues of drug price increases. 30 states have drafted a total of 60 drug price transparency bills.

States are feeling the pressure to improve the sustainability of their budget and promote coverage access to all of their residents. As the push for drug price transparency rises, more states may begin to explore new laws and federal legislation could be impacted. Many of these proposed changes are in the works and may be finalized in the near future.

How should you choose a pharmacy, doctor, or Part D plan?

Do you already have a primary pharmacy? Are you concerned about enrolling in a plan where your doctor is out of network?  Our agents at Medicare Plan Finder work with nearly every carrier in your state. Agents can help you enroll in the plan that best fits your needs, budget, and network requirements. Ready to learn more? Call us at 833-438-3676 or fill out this form to arrange a no-cost, no-obligation appointment with a top agent.

Understanding Your Best Cancer Insurance, Heart Attack Insurance, and Stroke Insurance Options

Medicare is designed to provide coverage for the most basic healthcare that everybody needs. Therefore, it does not include extensive cancer, heart attack, or stroke coverage. That’s why many Medicare beneficiaries enroll in secondary health insurance plans to supplement their current coverage gaps.

Original Medicare Part A covers hospital costs, and Original Medicare Part B covers doctor visits. Medicare Advantage adds on prescription drug coverage as well as other benefits like fitness incentives, dental, vision, and hearing.

Medicare Supplement plans add on extra coverage for your deductibles, copayments, and coinsurance (and sometimes cover prescriptions as well). While those Medicare options are certainly useful for both your wallet and your health, they simply won’t cover all of your health care needs. That’s where ancillary plans, (also known as secondary health insurance plans) come in.

Do you Need Supplemental Insurance?

Finding Medicare Plans

Supplemental insurance plans provide coverage for medical procedures and needs that Medicare won’t. You might wonder, “why doesn’t Medicare just cover everything in one plan?” Well, Medicare is a government program, and everyone’s healthcare needs are different. It is not lucrative for Medicare to cover everything. That’s why people who need extra financial help can add on ancillary coverage to help cover their extra healthcare costs.

If you have a medical history that includes cancer, heart disease, or stroke symptoms, you may benefit from an ancillary plan that specifically covers your symptoms or can give you extra cash. That’s why you should always disclose all your healthcare and financial information to your agent – they can’t help you get the right amount of coverage if they don’t know how much coverage you need!

Most ancillary plans work by sending reimbursement checks (usually upon diagnosis). You’ll tell your plan when you are diagnosed with a disease, and they will send you a check based on your policy value (sometimes all at once, sometimes annually, etc.). Since your money will come in the form of a reimbursement, you can technically use it for whatever you need – loss of income, childcare, travel to facilities, home health care, rehabilitation/therapy, and any other out-of-pocket costs that Medicare does not touch.

What Does Cancer Insurance Cover?

Cancer insurance plans can vary greatly. In general, you’ll find policies that cover services like: 

  • Blood and plasma
  • Breast reconstruction
  • Chemotherapy
  • Child/pet care expenses
  • Extended care facility stays
  • Hospice
  • Hospitalization
  • Initial diagnosis
  • Medical imaging
  • Organ transplants
  • Prosthetics
  • Radiation
  • Rehabilitative therapy
  • Surgery
  • Transportation and lodging related to hospital stays

What are the Best Cancer Insurance Plans?

No other disease statistics come close to cancer. Men have about a 50% chance of developing cancer, while women have about a 33.3% chance. Cancer kills about 1,600 Americans every day and includes about 10% of American healthcare expenses.

There really isn’t one best cancer insurance policy, because everyone’s financial and healthcare needs are different. However, one of the “best” and most common options is a lump sum policy. For a monthly payment of even as little as $20 per month, you can invest in a policy worth anywhere from a couple thousand to a hundred thousand dollars. If you are then diagnosed with cancer, you will receive the lump sum of your policy’s cash value to help you cover your cancer costs.

Lump sum cancer insurance is a good idea if you have a family history of cancer or if you meet any risk factors, such as a history of tobacco use, increased sun exposure, or obesity. If you already have a cancer diagnosis, you may not be able to enroll in this type of cancer insurance. A Medicare Advantage or Medicare Supplement plan might be a better option, as pre-existing conditions will not prevent you from enrolling. Plus, you can choose a Medicare Advantage plan or Medicare Supplement plan with great prescription drug benefits.

Cancer Insurance Pros and Cons

Cancer Insurance Pros:

  • Financial Relief – While you’re worrying about your health, you don’t want to have to worry about your finances. Not only is cancer treatment expensive, but you may have to leave your job to adequately receive the treatment you need! Not only can cancer policies help you pay for your care, but they can also help you recover from lost income.
  • Extra Medical Coverage – Original Medicare covers basic hospital and doctor costs, and you might have a prescription drug plan, but Medicare alone does not cover all cancer-related costs. A cancer plan will help you pay for extra prescriptions and procedures.
  • Peace-of-Mind – If you have a family history of cancer or if you’ve shown signs, having a cancer policy can give you the peace-of-mind to know that you’re covered in the event of a diagnosis.

Cancer Insurance Cons:

  • Availability – Cancer insurance can be harder to find than other health insurance options. However, our licensed agents are able to sell plans from most cancer insurers in your area. A MedicarePlanFinder agent can help you find what you need.
  • Pre-existing Conditions – If you’ve had any cancer symptoms in the past, it may be hard for you to find a cancer policy. It is really designed for those who have a family history of cancer and want to make a smart decision early on. That’s why you should buy now, BEFORE your diagnosis.

Types of Cancer Insurance

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Lump Sum Cancer Insurance

A lump sum cancer insurance plan is meant to provide extra cash when you need it most: while you’re undergoing treatment. You will receive a payment for the value of your policy (usually between $5,000 and $100,000), at the time of your diagnosis.

Indemnity Cancer Plans

Indemnity plans are designed to help you pay for the costs of staying in a hospital for an extended period of time. Instead of paying out your benefits all at once in a lump sum, an indemnity cancer plan can pay you per day. For example, it might pay out $300 for each day you spend in the hospital.

Top Cancer Insurance Plans

While there are seemingly endless possibilities for getting cancer coverage, these are some of the top cancer insurance plans that Medicare Plan Finder agents currently offer (subject to change):

Aetna Cancer Insurance

Aetna offers a cancer, heart attack, and stroke insurance policy for seniors and Medicare eligibles. You or a person that you designate will receive a lump sum based on your policy value upon your cancer diagnosis. The policy can be valued at anywhere from $5,000 to $75,000.

Aetna cancer policies give you a 30-day “look” period. That means that if you decide within 30 days of your purchase that you do not like the plan you chose, you can back out.

Cigna Cancer Insurance

Cigna’s cancer policies can cost you as little as $19 per month and can cover you for as little as $5,000 or as much as $100,000. Cigna cancer coverage is available to anyone ages 18-99. For an added premium, you can also receive coverage for cancer recurrence, heart attacks, and strokes.

Mutual of Omaha Cancer Insurance

Mutual of Omaha offers both a cancer only insurance plan and a cancer, heart attack, and stroke insurance plan. Since the policy pays out as a lump sum at the time of diagnosis, you can use it however you want, regardless of who your doctors are.

GTL Cancer Insurance

Guarantee Trust Life (GTL) cancer insurance is wrapped into one policy including cancer, heart attack, and stroke coverage. They pay a lump-sum upon diagnosis regardless of what other health insurance you may have. GTL benefits are flexible but range up to $75,000.

Medico Cancer Insurance

Medico will pay a lump sum benefit upon your internal cancer or malignant melanoma diagnosis. It is a one-time benefit paid directly to you – you can use it in any way you see fit!

Frequently Asked Questions About Cancer Insurance

Can I get cancer insurance after diagnosis?

It can be a challenge to get a good cancer insurance policy after you’ve already been diagnosed. That’s why we recommend that you look at your cancer insurance options NOW, to avoid any financial surprises later.

Is Cancer Insurance Worth it?

In short, yes! Wouldn’t you rather pay a small fee every month now instead of paying thousands upon thousands later? Investing in your health now allows you to plan for the finer things in life, like a beautiful retirement!

Can I buy cancer insurance online?

We don’t recommend buying without speaking to a licensed agent. Medicare Plan Finder agents are licensed with multiple insurance carriers, which means they can help you find quotes for several different plans and help you choose the best one for your needs.

How much does cancer insurance cost?

This really is going to depend on what you need. All carriers offer different types of plans that offer different amounts of coverage. If you do not have a personal history of cancer, you can get $5,000 of coverage for about $16/month! Of course, the more coverage you want, the higher your monthly costs will be.

Who sells the cheapest cancer insurance?

Cigna offers one of the cheapest plans at as little as $19 per month, and Mutual of Omaha boasts of rates as low as $10 per month! Your choice will depend on your healthcare needs, how much coverage you want, and your geographic area. Remember, not all plans are available in every state or county. It’s more important to look at the coverage that you’re getting first, THEN consider the cost. Our agents can help you find the best balance.

What other types of coverage are included in cancer insurance?

Cancer, stroke, and heart attacks are three of the most common ailments in America. Some cancer insurance policies are wrapped into one policy that includes stroke and heart attack coverage. This means that if you develop a heart condition now and develop cancer symptoms later, your one cancer, heart attack, and stroke policy will likely cover all or most of your conditions.

What Does Stroke Insurance Cover?

According to stroke.org, a stroke occurs every 40 seconds and is the 5th leading cause of death in the United States. A stroke happens when blood flow is cut off from an area of the brain, resulting in brain cells losing oxygen and dying. The dying cells lead to memory and muscle control loss. Small strokes may only result in temporary weakness, while large strokes can permanently paralyze a person.

Shockingly, nearly 80% of strokes are preventable. You can help prevent strokes by keeping a healthy weight and blood pressure, exercising regularly, avoiding excess alcohol consumption, and not smoking.

When looking for stroke insurance, Medicare Advantage and Medicare Supplement plans are great places to start. Having extra Medicare coverage will most likely give you access to more affordable healthcare through your doctors and pharmacies.

If that is not enough coverage, you can invest in a stroke policy. Most stroke policies are combined with heart attack policies. Stroke insurance is usually paid out as a lump sum (ranging from as low as $5,000 to as much as $100,000), which means it can cover anything from relevant surgeries to income replacement, instead of covering individual benefits.

Heart Attack Insurance

The CDC states that about 610,000 Americans die of heart disease every year. As common as heart disease is, it’s not cheap to handle. It can cost upwards of $20,000 for a hospital stay alone, not including the costs of any surgeries and prescriptions that follow.

While your Medicare plan may cover your hospital stay costs, it may not completely cover the surgeries and prescriptions you need. In fact, Original Medicare does not cover prescriptions at all. You will need to enroll in either a separate prescription drug plan (otherwise known as Part D) or either a Medicare Advantage or Medicare Supplement plan that includes prescription drug coverage. That’s why a heart attack/stroke plan is a great option. After a heart attack, you can receive a lump sum based on your policy value to help you pay for care or replace lost income.  

Cancer, Heart Attack, and Stroke Insurance

Some cancer, heart attack, and stroke insurance policies are looped into one policy. The same policy can cover heart transplants, physical therapy, patient and family member transportation and lodging, bypass surgeries, anesthesia, replacement of lost income, and help with home expenses.

Costs for cancer, heart attack, and stroke policies will vary based on your needs and how much coverage you want to pay for. If you prefer, you can pay as little as $20 per month (but will have less coverage than if you paid a higher monthly premium).

Help Us Help You

If your family medical history includes strokes or heart attacks, be sure to disclose that information to your Medicare agent. They can help you pick a plan that best encompasses your needs, and then help you decide whether or not you need to add an ancillary policy.

Do you have an agent? Our agents are able to sell countless different plans, so they can help you find the one that truly works best for you. Submit your contact information on Medicare Plan Finder so we can have one of our licensed agents reach out to you. If you’d prefer, give us a call today at 833-438-3676.

This post was originally published on March 23, 2017. It was updated on October 23, 2018, and again on July 18th, 2019.

Understanding The Benefits Of Medicare Advantage

Medicare Advantage is a coverage option that provides more benefits than basic plans. It includes Original Medicare, which is made of Medicare Part A (hospital care) and Part B (medical/doctor care), plus additional services such as prescription drug coverage, dental, and vision coverage.

Medicare Advantage plans are sometimes confused with Medicare Supplement (Med Supp) plans, but they are completely different. While Medicare Advantage (MA) includes extra service coverage, Medicare Supplement plans provide more financial coverage (but not more services).

 Medicare Advantage Benefits

  • Hospital stays, skilled nursing care, home health care, etc. (essentially Part A)
  • Doctor visits, outpatient care, preventative services, etc. (essentially Part B)
  • Hearing care, vision care, fitness programs, wellness services, nurse help lines, prescription drug coverage, etc. (Part C)
  • Prescription drug coverage (essentially Part D)

Types of Medicare Advantage Plans

  • HMO Plans (Health Maintenance Organization) You’ll select one primary physician and only see that doctor, unless your doctor recommends another specialist (such as a cardiologist or dentist). 
  • HMO-POS Plans (Point-Of-Service) You’ll select one primary physician but can also visit other specialists in your network for a fee (like a cardiologist or dentist) even without a doctor recommendation. 
  • PPO Plans (Preferred Provider Organization) You can see any doctor, but in-network doctors will be much cheaper for you. 
  • PFFS Plans (Private Fee-For-Service) You will not need referrals or a primary physician, but not all doctors will accept this plan. 
  • SNP (Special Needs Plans) You are only eligible if you have a chronic illness or disability, live in a nursing home, or are dual-eligible for Medicare and Medicaid. 
  • MSA (Medical Savings Account) Medicare will deposit money into a separate bank account for you to use for Medical expenses.

Enrollment Periods

There is a seven-month window during which you can enroll in Medicare. It lasts from three months before your 65th birthday through three months after. During this period, you can purchase a Medicare Advantage plan for the first time or add any additional coverage. Additionally, you can always add or change your plan during the annual enrollment period, or AEP (October 15th through December 7th every year).

You may qualify for a SEP (Special Election Period), during which you can enroll even though it is not during AEP or your initial enrollment period. You can qualify if you:

  • Move residences to an area where different plan options are available
  • Move to an area where the nearest hospital or doctor’s office is out-of-network
  • Are released from incarceration
  • Lose Medicaid eligibility
  • Leave a job or start a new job that offers different plans
  • Were in a plan that is now discontinued

Do you still have questions about Medicare Advantage or are you hoping to purchase a plan? Set up an appointment with one of our licensed agents today. Call us now at 1-844-431-1832.

 

MA Benefits | MedicarePlanFinder

 

Understanding Medicare Enrollment Periods

Did you know that most people can only enroll in Medicare during a few months out of the year? Read through to figure out what medicare enrollment periods you are eligible to enroll during. If you still need help, one of your licensed agents can answer your questions!

IEP (Initial Enrollment Period)

Most seniors and Medicare eligibles will begin with an IEP. Your IEP begins three months before your 65 birthday and ends three months after, for a total of a seven-month timeframe. Some seniors and Medicare eligibles will be automatically enrolled in Part A and Part B and will receive a Medicare card three months before their 65 birthday. Others will need to elect to enroll and will start to receive coverage within a few months.

If you have an IEP but choose not to enroll, you may be faced with a higher premium because you enrolled late. You will be able to complete your late enrollment during the General Enrollment Period.

(GEP) General Enrollment Period

The GEP is exclusively for those who are enrolling in Medicare for the first time and missed their IEP. It runs from January 1 through May 31 of each year for Original Medicare and April 1 through June 30 for prescription drug plans and Medicare Advantage. If you enroll during the GEP, your coverage will begin in July.

General Enrollment Period | MedicarePlanFinder

(AEP) Annual Enrollment Period

AEP starts on October 15 of each year and runs through December 7. This is when every Medicare beneficiary can change plans or enroll in new plans. It’s a good chance for you to look at your current coverage, compare it to your healthcare and financial needs, and make adjustments if necessary. If you wait too long, you’ll have to wait a whole year before you can make changes again.

Annual Enrollment Period | MedicarePlanFinder

(SEP) Special Enrollment Period

If you qualify for Medicaid, Social Security, or another financial assistance program, you may be eligible for a Special Enrollment Period. If you have an SEP, you do not have to wait until AEP to make changes to your Medicare. Some people will have a continuous SEP, meaning they can make changes at any time. Those who have special circumstances such as moving, losing a job, or moving into a facility will have a 60-day SEP.

Special Enrollment Period | MedicarePlanFinder

Get Help Understanding Your Enrollment Period

Still not sure when you can enroll? That’s ok, it can be confusing. Call us at Medicare Plan Finder and we can help you figure out whether or not you can get into a better plan. Just click here to request a call or call us at 1-844-431-1832.

Get Medicare Financial Assistance with the Medicare Extra Help Program

Did you know that Medicare offers financial assistance programs to those who cannot afford to pay their monthly premiums? The Medicare Extra Help program can help you afford your prescription drug plan.

What is a Low Income Subsidy?

LIS (Low Income Subsidies) is a federal program commonly referred to as Medicare Extra Help. It helps Medicare beneficiaries like you pay for prescription drugs. The program is designed to help those who do not qualify for Medicaid but still need financial assistance.

Medicare beneficiaries with LIS save an average of $3,900 per year on their prescription drugs. Therefore, beneficiaries might pay about $2 for a prescription instead of, say, $40.

What does Medicare Extra Help Cover?

The LIS program provides tremendous support for prescription drug coverage as long as you have a Medicare Part D drug plan or Medicare Advantage. LIS provides help with premiums, deductibles, coinsurance, and copayments. Also, LIS beneficiaries have a continuous SEP (Special Election Period) which means they can change plans or enroll any time of year! No more waiting for AEP (October 15 – December 7).

Additionally, LIS can help you pay for any late enrollment fees you may have. You might have a late fee if you wait too long to enroll in a Medicare prescription drug plan.

You will start by paying for 100% of your drug costs until you hit your deductible ($435 in 2020). Then, you will only pay a small percentage of your drug costs. Once you spend $4,020, you will pay 25% of brand-name drug costs and up to 25% of generic drug costs..

Medicare Extra Help Application

A senior or Medicare beneficiary is eligible for LIS at 150% of the Federal Poverty Level with (2017):

Income ($18,090/yr individual, $24,360/yr marital)

  • Wages
  • Social Security Income
  • Annuities
  • Family Support

Resources/Assets ($13,820 individual, $27,600 marital)

  • Real Estate
  • Stocks and bonds
  • Mutual Funds
  • Individual Retirement Accounts (IRAs)

If you think you may be eligible, click here to download the Medicare Extra Help application and get started. Send your completed Medicare Extra Help application to:

Social Security Administration
Wilkes-Barre Data Operations Center
P.O. Box 1020
Wilkes-Barre, PA 18767-9910

Medicare Savings Program

If you do not qualify for Low Income Subsidies, you may still qualify for another Medicare Savings Program. Much like LIS, Medicare Savings Programs help those who are not eligible for Medicaid but still need help paying for Medicare costs. Medicare Savings Programs have certain qualifications that include your monthly income and assets (stocks, bonds, savings accounts). The programs are as follows:

Qualified Medicare Beneficiary (QMB) Program:

Helps pay Part A premiums, Part B premiums, and deductibles, coinsurance, and copayments.

Qualification Limits:

  • Married couple monthly income of $1,392 or less
  • Married assets valuing $11,340 or less
  • Individual assets valuing $7,560 or less
  • Individual monthly income of $1,032 or less

Specified Low-Income Medicare Beneficiary (SLMB) Program:

Helps pay for Part B premiums

Qualification limits:

  • Individual monthly income of $1,234 or less
  • Married monthly income of $1,666 or less
  • Individual assets valuing $7,560 or less
  • Married assets valuing $11,340 or less

Qualifying Individual (QI) Program:

Helps pay for Part B premiums

Qualification limits:

  • Individual monthly income of $1,386 or less
  • Married monthly income of $1,872 or less
  • Individual assets valuing $7,560 or less
  • Monthly assets valuing $11,340 or less

Qualified Disabled and Working Individuals (QDWI) Program:

Helps pay for Part A premiums for those who are working, disabled, and under 65 or who returned to work and lost their premium-free Part A. This is not for those who are already receiving state medical assistance (Medicaid).

Qualification limits:

  • Individual monthly income of $4,132 or less
  • Married monthly income of $5,572 or less
  • Individual assets valuing $4,000 or less
  • Married assets valuing $6,000 or less

Social Security Help

If you receive social security benefits, you may be able to get a greater benefit by enrolling in certain Medicare plans. That’s right, some Medicare Advantage plans (offered by private carriers) include benefits that pay for part of your Part B premiums, which will result in you getting a slightly larger check from Social Security. Talk to a Medicare Plan Finder agent to see if this type of benefit is available to you.

Get Help Completing Your Medicare Extra Help Application

Some Medicare beneficiaries go years without realizing they qualify for Medicare Extra Help (LIS). Licensed agents in your area may be able to help you apply for LIS. If you haven’t already spoken to an agent about applying for LIS, call Medicare Plan Finder now at 833-438-3676 or click here to request a call.

This post was originally published on November 9, 2017, and updated on December 31, 2019. 

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