Medicare beneficiaries fill in Medicare's coverage gaps in a number of different ways, including:
Government Programs (Medicaid/QMB/SLMB);
Group Retirement Policies (Non-Standardized);
Non-Standardized Individual Medigap Policies (Issued Prior to July 31, 1992);
Standardized Individual Medigap Policies (Issued After July 31, 1992).
Medicare beneficiaries who are also eligible for Medicaid (Title 19) do not need Medigap insurance since Medicaid will cover the cost of their health care expenses. People who do not qualify for Medicaid but are within 100% of the federal poverty level are eligible for coverage under a program known as the Qualified Medicare Beneficiary Program (QMB). QMB program benefits include:
Payment of Medicare premiums.
Payment of Medicare annual deductibles.
Payment of Medicare coinsurance amounts.
Thus individuals who qualify for the QMB program generally also do not need, and should not pay for, Medicare Supplement Insurance. The qualifying income figures change in April each year. Contact the Department of Social Services office in your area to find out more about Title 19 and QMB eligibility and enrollment.
Individuals who do not qualify for QMB because of excess income may qualify for the Specified Low-Income Medicare Beneficiary Program (SLMB) or Qualified Individual Program (QI). People who have incomes within 120% - 135% of the federal poverty level are eligible for SLMB or QI coverage. However, SLMB and QI only pay for the Medicare Part B monthly premium. Therefore, SLMB and QI individuals may still want to purchase Medigap insurance if they can afford to do so. Like QMB, the qualifying income figures change in April each year and the programs are administered by the Department of Social Services.
Some employers offer health insurance coverage to their retirees. Retirees who are covered by such group plans may not need to purchase an individual policy. While a retiree may choose to switch to an individual plan, this may not be a good choice because group retiree plans usually do not cost anything to the individual and the group coverage is often as good or better than most individual Medigap policies. Thus the individual should compare his company's policy costs and coverage with the ten Medigap policies. The retiree should also consider the stability of his company. If it is conceivable that the company will falter, that his costs will rise, or that coverage will diminish, the individual may wish to purchase an independent policy. Remember, however, that if a new policy is purchased the old policy must be dropped.
Most Medicare beneficiaries are not eligible for Medicaid or QMB, however, and may want to obtain Medigap insurance. Approximately two-thirds purchase Medigap policies. As of July 31, 1992, Medigap policies were standardized throughout the United States. This mandatory standardization was a result of legislation passed by Congress through the Omnibus Budget Reconciliation Act of 1990. There are ten specific benefit plans which federal law permits to be sold as Medigap policies. Two new plans were added in 2006. States may allow all or some of these plans to be marketed. Insurance companies may sell all or some of the plans which the individual state allows them to market. However, there is a basic benefit package, known as the "core benefit" plan, which must be allowed in all states and which must be offered by any company which sells Medigap insurance.
Although individual Medigap policies have been standardized since 1992, some seniors are still covered by previously issued non-standardized plans. These policies are no longer available for purchase. However, individuals may continue to keep their old policies and many people have chosen to do so. Individuals covered by an old policy should consider changing to a new "standardized" plan, and should compare the benefits and costs of each of the policies. Then an informed decision can be made. An individual who purchases a new standardized policy can only have one Medigap policy and must therefore drop the old, non-standardized plan. This protects people from the unnecessary costs of duplicate coverage.
Before you are totally decided on a health insurance provider
a good measure to take is to ensure that you have adequate outpatient service provider coverage. If you already have a health insurance coverage plan
you should check with your current HMO, PPO, or health care provider to determine what level of service you do or do not have.
Equally as important is finding a quality outpatient service provider in your area well before having a medical procedure done so that you know the care you are provided with will be top notch. You can always ask friends and family how their personal experiences with their outpatient service provider was and your doctor is also an excellent reference point. But before you claim an outpatient service provider as your own you should ask yourself and the facilities themselves the following questions:
- Do they accept your HOM, PPO, or current health care plan?
- Is there more than one facility in your area that can service your needs?
- Will your health insurance cover all expected costs?
- Is the facility located at a reasonable distance from your home?
- Will they communicate well with your doctor and let your doctor verify tests and test results that are conducted?
- Is the outpatient facility accredited by a national medical board or other accredited agency?
- What is the staff like, how experienced are they, and how long has the facility itself been in operation?
- Will you be able to be fully treated at the facility or be forced to go elsewhere for follow up care?
- How obliging is the facility when it comes to helping with financial assistance if needed?
- Will they give you clear instructions before, during, and after any procedures?
- How well equipped is the facility to be able to handle any special needs that you may have during and after a procedure?
- Does your doctor approve of the facility?
- What is the facility's reputation around the community?
Additionally, you should always visit the facility in person before you have any procedures done. This will give you the opportunity to see firsthand how clean the facility is and how friendly a knowledgeable the staff seems. You can also ascertain whether or not there are some of the little things that you might like to see in an outpatient service provider such as a waiting room for your family that is going to be comfortable for them.
Only by asking questions, and lot of them, will you be able to determine if in fact you are going to get the best possible out patience service for your particular needs. While talking with friends, family, and your doctor are a great place to start, you should never take anybody's word for it and always plan a trip to the facilities in advance with a list of questions in hand.
Working out the details of a divorce is an emotionally draining period of dividing up the aspects of a life once shared. Everything must be considered and difficult decisions made, in order to avoid future conflicts, omissions and errors that could prove costly and inconvenient for either side. Amongst the many things to divvy up in a divorce is the auto insurance policy. There are several different aspects to consider when deciding what to do with the auto insurance policy for a couple that is splitting up.
If each of you has separate policies, the process is simple. You remove the other person from your coverage and you are done. However, in most cases married couples have joint policies, in order to get discounts that they would not otherwise be entitled to. If you have only one car, you will need to begin by deciding who gets the car. Logic says that the one who has the car will also need the car insurance policy. This simplifies things greatly.
However, if you have more than one vehicle and each of you gets to keep one or more of them, typically only one person will get to keep the policy. The choice of who gets it should not create an unfair advantage for one person or the other. Talking to your insurance agent or shopping around for prices before making a decision will help you. If you have joint custody of your children and an amicable divorce, you may want to consider keeping the policy as is. You can share the joint insurance policy for a period of time following the divorce if your relationship allows for it.
Occasionally, the division of property in a divorce case in court will even include things like auto insurance policies. If the details of dividing up property have become cumbersome, often the lawyers for each side and a judge will end up making the final decisions. You can make requests to your lawyer in such cases, but things may not end up exactly as you wish.
Divorce is complicated and multi-faceted. Avoid getting bogged down in the details of dividing up things. Sometimes it is beneficial to give up some of the small easily replaceable things like the auto insurance policy in order to get more important things. Use common sense in your dealings with your ex-spouse and follow your lawyer's advice. By doing so, you will reduce the tension and stress surrounding you at this difficult time.
If you are one of the many Americans who will face divorce, you know that there are many things to consider. One of those things is the security of your alimony payments. If your former spouse becomes disabled and can't work, what will become of your alimony payments? Luckily, you can request that an individual disability insurance policy be maintained by your ex, to make sure alimony continues even if he can not work. Many good lawyers make this a standard request when negotiating divorce settlements these days.
The facts are that an individual has a 30% risk of becoming disabled for 3 months or more between now and the time he or she is 65. Average disability duration is 3.2 years in length. If your ex were to suffer a disability that kept him from work for a long time period, how would your alimony get paid?
Different Types of Disability Insurance
Disability insurance is exactly what is needed to ensure that an individual can survive and meet his or her financial obligations in the case of becoming disabled. There are three different types to choose from. Long-term disability coverage is available through your workplace. Plans are also available through professional groups and unions. Individual disability insurance is the third option and the best one. It is typically the option that provides the best benefits with the loosest set of qualifications, making it easier to become eligible. While this is also the most expensive of the three types, it is the most secure. If you are looking to protect your alimony, make sure that your lawyer includes a clause in the divorce agreement that your ex must maintain a private individual insurance plan.
The Reality of Disability
More than 90% of disability claims result from common illnesses such as heart disease, diabetes, cancer, stroke, MS and back and neck problems. Such illnesses often begin without warning unless you have major risk factors for them. Despite the fact that it is rather unfortunate when illnesses happen to anyone, you would still be concerned about your alimony should your former spouse fall ill. However if he or she carries disability insurance, you can feel more at ease about it.
Even though a disability insurance policy is just one of the multitudes of things to think about when planning a divorce, it can make a huge difference to your financial future. Get started today looking for an individual policy for yourself and get the information you need to pass along to your former spouse.
Division of property is one of the most complicated aspects of divorce. Disability benefits are one of the many things that couples have issues about in the division of property. However, differing state laws affect how such benefits are treated. Those who receive disability benefits do so in lieu of earned income because they are ill or injured. In the case of divorce, the division of such benefits depends on a variety of factors. Some states consider such benefits to be marital property while others consider it separate property. How is it considered by the courts will help to determine the way it is dealt with during the divorce. What helps to determine this is when the payments began and the findings of a purpose analysis concerning the benefits.
The Timing of Benefits
In many states, anything acquired during the marriage is considered to be marital property, including disability benefits. Certain states like Montana, New Jersey, Louisiana, Illinois, Arkansas and Delaware, even consider disability payments after the marriage is over to be marital property if they were based on work during the marriage. In such cases, the date that eligibility for disability benefits was determined is important for the divorce and division of property.
In other states, only income that originates during the marriage is considered to be marital property. In this case, if the person was eligible for benefits prior to the marriage and they continued during it, the spouse is not entitled to claim such benefits as marital property. New Mexico, Minnesota, Arkansas, Idaho, Maryland, Delaware, Minnesota and in some circumstances Texas, subscribe to this theory.
States including Florida, Alaska, Idaho, Indiana, Colorado, Louisiana, North Carolina, Maine, Missouri, Maryland, Pennsylvania, Oregon, Washington and Rhode Island take the replacement approach when it comes to the subject of disability income. This means that the disability benefits are only marital property because they replace income. Such benefits are therefore limited to the duration of the marriage only. Benefits received following divorce are considered separate property even if the qualifying disability occurred during the marriage.
The Analysis of the Purpose of Benefits
In many situations, a court will analyze the exact nature of the disability payments and determine if they are to be considered marital property or separate property. If they are deemed to be deferred payments based on work done during the marriage, they will be considered to be marital property.
Anyone who has a private disability insurance pension is subject to even more scrutiny concerning the purpose of the benefits he or she is receiving. Often they will be deemed to be a combination of both separate property and marital property. The percentage will depend on how long the marriage lasted, how long the contributing employment lasted and what the pension is intended for. If it is for pain and suffering and as a replacement for the lost ability to earn income, it is separate property. If it is in lieu of a retirement package, it is more likely to be deemed marital property.
If you are embroiled in a divorce it is important to understand the role of disability benefits in it. Ask your lawyer if you are eligible to receive some of your spouse's disability income following divorce. Ask about the state laws concerning the divisibility of such benefits. Ask if private disability benefits are considered marital or separate property. It is important to be forearmed with knowledge prior to working on a divorce settlement.
Individuals facing a divorce and an uncertain future for themselves and their family need to make some important financial decisions. A crucial part of any financial plan is to plan for risk and worst-case scenarios. Therefore looking at two important types of insurance that every person in the workforce should carry is crucial. These are life insurance and disability insurance.
Life Insurance Concerns Following Divorce
Life insurance will pay your survivors a pre-set amount of money in the case of your death. This is extremely important to carry if you have a family. If you have become the main source of income in the family due to divorce, you may need additional life insurance coverage. If you pay child support, you should establish a life insurance policy which will continue those payments if you were to die. If your former spouse pays child support, consider making such a policy a part of the divorce agreement.
Be sure to change the beneficiary of your life insurance policy following the divorce. Even if you have a policy in place to continue your child support payments, do not have your ex-spouse as the beneficiary. It is also important to remember to review all other beneficiary designations following divorce. Most people prefer to remove former spouses as beneficiaries but it can easily be overlooked especially with older policies.
Understanding Disability Insurance
Disability insurance will provide a monthly income for you if you become unable to work due to illness or injury. The insurer that you pay your premium to each month will pay out disability benefits if you need them. Surprisingly those between the ages of 25 and 55 are at double the risk of becoming disabled compared to dying, however fewer of them carry disability insurance than life insurance. Disability insurance is a very necessary type of coverage for most people of that age group to carry because they do not have the financial security to live for long periods of time without an income. This is especially true following divorce.
There are different types of disability insurance policies. How a policy defines a disability affects the price and allure of it. If an insurance policy has a broad scope it will allow for disability payments to be paid as long as the individual cannot perform usual tasks of his or her job. This is the more expensive type of disability insurance. The cheaper kind limits the definition of disabled, so that the policyholder must not be able to perform any type of gainful employment in order to receive benefits.
When purchasing disability insurance it is important to consider your monthly expenses in order to figure out how much coverage you will need. Tally the basics and then consider additional expenses that may increase due to a disability. Subtract any investment income, disability benefits from your employer and other income not affected by your ability to work. This will tell you how much individual disability insurance you need to purchase. Insurers usually allow you to purchase coverage for 60 to 70 percent of your regular gross income, as an incentive to return to work. However, if you have paid for your premiums with after-tax dollars, you will be receiving your benefits tax-free.
If you consider Social Security to be your own method of disability insurance, you might want to reconsider. It is very hard to qualify for those benefits. Typically you must have a fatal illness or be completed incapacitated so that you can do no work of any kind for a minimum of 1 year. It also takes approximately 6 months to receive any payments.
If you are under the age of 65, you have twice the chance of suffering a disability that will last three months or more, than you are of dying. For this reason, it is important to carry disability insurance. Following a divorce it is even more critical. Without the security of a spouse's income to help cover necessary expenses, they all fall on your shoulders. Protect everything you have worked for with an independent disability insurance policy.
Statistics prove that women have three times the chance of suffering a disability that prevents them from working as men. The Bureau of Labor Statistics has observed the growth of women in the workforce is twice as fast as that of men. Today, women supply 30 to 40% of the average household's income. These are significant numbers. The Journal of the American Society of Certified Life Underwriters states that professional women who are 35 years old have three times the risk that their male counterparts have of becoming disabled for 3 months or more. These factors all contribute to the increasing need for women to carry individual disability insurance
Disability Insurance Through Your Employer
Despite the real risk of disability, a significant number of companies do not offer any sort of disability insurance because the law does not require them to. If you happen to work for a company that does offer coverage, it is important to be aware that employer-provided disability insurance is often minimal at best. Typically it covers only about 60% of your gross income, which is inadequate for most people. It is important to fully understand the limitations and restrictions of your workplace policy, and to know how much you would actually receive if you needed those benefits.
Disability Insurance Through the Government
There are many men and women who think the government will take care of them in case of disability. They are relying on Social Security benefits to replace their income. The amount that would come from such benefits is typically inadequate to cover monthly expenditures, even for those who qualify. However, qualifying is the most difficult part. In order to be eligible for benefits, five calendar months must have passed, the disability must preclude all types of employment and it must last for a minimum of 1 year or be the individual's anticipated cause of death.
Determining How Much Disability Coverage To Get
Prior to taking out a disability insurance policy, be sure to analyze exactly how much you need in order to cover your monthly expenses. This means you will need to tally how much you spend on transportation, housing, food, utilities and other expenses. Subtract any income that is not affected by your ability to work. A point to remember is that benefits are tax free if you have paid for them with earnings that have already been taxed.
How To Save Money on Disability Insurance
Women should expect to pay higher premiums than men for disability insurance simply because there are more at risk of needing it. In fact, premiums for women are approximately 40% more than for men. For this reason, it is necessary to try to get discounts on premiums. One particularly good way to obtain a discount is to use insurers who offer unisex rates. You may also be able to get a group rate if more than one person from the same employer applies for a policy. Therefore, find a colleague, preferably male, and apply for disability insurance together for maximum savings.
With a disability insurance policy in place, women can feel secure in their future, despite their higher than average risk of needing to draw disability benefits.
Your income-earning potential is one of the most important assets you have, whether you realize it or not. If suddenly you could not work, how would your lifestyle suffer? Do you have enough money to continue living as you do now? Could you support yourself and your family? If so, how long could you continue to do so? These are all valid questions that should be considered by any adult who is in the workforce.
The facts are startling. One of every seven employees will be disabled for five years or more, with 2.5 years being the average. This chart breaks down the causes of disability for individuals. These numbers are significant because the things that we typically insure against have much lower rates of incidence. The chance of your home being destroyed by fire is 1 in 1200 and the chance of completely wrecking your car is 5 in 1200. Disability is typically caused by very common things like illnesses such as heart disease and cancer. Because it is so common, it is important to consider disability insurance as a normal part of your financial plan.
Governmental Disability Coverage
There is state disability coverage that pays 55% of an individual's income for up to one year. However, that amount is typically insufficient and does not last long enough. Social Security is another option. However, only 39% of those who applied for it in 2008 qualified to receive it. With an average of $1004 per month paid out, it is also very inadequate. In addition, both these types of coverage can take months before payments actually begin to arrive.
Individual Disability Coverage
Individual disability insurance coverage is a much more realistic way of replacing your income if you become disabled. It is paid out in addition to governmental disability coverage and is not limited to a certain percentage of your income. You can insure yourself for as much as it takes to be able to pay your bills and relieve yourself and your family of the stress and worry that comes with illness or injury.
Before you look to buying individual disability coverage, you will need to find out if you already have coverage through your employer. If so, take the time to review the policy so you know the terms and conditions of the policy, as well as how much it would provide for you if you were eligible for benefits. Often such plans have a time cap or a maximum amount payable, so it is important to understand the policy fully. Talk over your options with an experienced insurance agent.
Know What You Are Getting
It is equally important to understand the details of an individual disability insurance policy before taking one out. This is a relatively expensive insurance plan, as it is meant to replace your income and is more likely to pay out than many other types of insurance. Do not let yourself be tempted by policies that are much less expensive than other disability insurance policies as they often have limitations and restrictions that make it more difficult to get paid. You don't want to be stuck having to work in a field you are overqualified for just because you can no longer work in your chosen career but your insurance is too restrictive to pay you benefits.
Next to health insurance, disability insurance is the most important type of insurance you can invest in. Check it out today.
Losing your ability to earn an income due to an illness or injury is one of the most devastating things that can happen to an individual. In addition to the fact that you cannot fulfill your financial obligations, even those people with good health insurance will end up incurring new bills from co-pays, out-of-pocket expenses and additional medical care needs that are simply not covered by your policy. When you need to replace your income because you are incapable of working, disability insurance will provide it for you so you can pay those bills, as well as your regular monthly expenses.
With disability insurance you can feel confident that your financial situation is secure, should you become unable to work. Long-term disability insurance coverage allows you to meet your financial obligations without having to drain retirement funds, college accounts or other savings you may have. You can continue to contribute to your household and your family, despite disability. However, you must have the forethought to put such insurance in place.
Factors To Consider
If you are looking to put an individual disability insurance plan in place, there are several factors you should look at. Start by speaking with a licensed financial professional in your area, who can counsel you on the regulations for your state. He or she can also help you select a disability policy that best meets your needs, as they vary from company to company.
You will need to know whether or not you already have disability insurance through your employer or another group you belong to; how much coverage the policy provides; and if there are any restrictions concerning eligibility. By knowing how much you would receive in case of disability, you can best determine how much extra, if any, additional disability insurance you need.
Before choosing an individual disability insurance plan, you need to know how much the premiums will cost. You should also know how much you would receive in case you need the benefits. You also need to know whether or not basic healthcare costs are covered by the policy you are considering. By carefully considering these variables, you will be best able to choose the disability insurance policy that meets your needs.
No matter how busy you are, don't put off investigating the need for disability insurance. You secure your own future and that of your family by making sure that your income will continue even if you can't earn it.
Women are at a threefold risk of becoming
disabled in the workplace compared to men.
Practically, any woman in the workforce today is in need of disability insurance. From young, single mothers just starting out to established professionals and business owners, disability insurance is an important investment. In fact, as more women realize the importance of it, increasing numbers of companies that care, and especially those run by women, reimburse the cost of individual disability insurance. This allows benefits to be paid tax-free, which is not the case if the company foots the bill through payroll.
Women in the know should even consider maintaining individual disability insurance in cases where employers provide benefits. Upon investigation, it is found that many employee disability plans have tighter restrictions on eligibility than individual plans.
Essentially, if a policyholder is unable to perform the tasks of her job, due to illness or injury, she is considered disabled and benefits should be paid under disability insurance. However, many policies differ and contain restrictions concerning the degree of disability required. Some policies will not pay out if you can still perform some of your work tasks. This means that if you are bedridden but can talk on a phone and that is a part of your job, you can be denied benefits.
By understanding the fine print that comes with disability policies, you can avoid being stuck in this type of situation. Make sure that the individual insurance policy that you take out covers you adequately and does not make unreasonable demands of you in the case of needing benefits. This may make the difference between being able to follow your doctor's orders or not. In the case of being put on bed rest during a pregnancy, that can make the difference between the life and death of your child.
Women Are More At Risk
Today's women make up 30 to 40 % of household income. In fact, the total of women in the workplace is increasing twice as fast as the number of men in the workplace, says the Bureau of Labor Statistics. However, women are at a much higher risk than men of becoming temporarily or permanently disabled during their work life. Statistically speaking, a 35-year-old professional female has three times the chance of being disabled for a period of over 90 days than a male, says the Journal of the American Society of Certified Life Underwriters.
Unfortunately, there is no law requiring companies to provide long-term disability insurance. Because of this many companies do not do so. If you are lucky enough to work for one of those that do, be sure you understand the policy completely. Apart from restrictions concerning eligibility, many plans pay only up to 60% of your salary. This is often insufficient, especially if you are the primary income in the family.
Another misconception that women must become aware of is that Social Security benefits will take care of them in the case of disability. The 1998 Social Security Handbook outlines the fact that the federal government will only be able to provide benefits after five calendar months have passed. The disability must also stop you from doing any type of paid work. It must also be at least 12 months in duration or be expected to cause death.
How To Determine Sufficient Coverage
Recommendations from the California Department of Insurance on how to figure out how much disability insurance you need begin with a total of all your monthly expenses for necessities. This includes home loans, transportations costs, groceries, utilities and childcare costs. If you have other income such as investment income, you will need to subtract it from this total in order to arrive at your necessary monthly expenditures that need to be covered in the case of disability.
Next you need to total your household income if you were unable to work. This typically includes your spouse's income and any disability benefits you would be eligible for from your employer. If this is equal to or surpasses the monthly expenditures for your household, your coverage is sufficient. If not, you should look at getting disability insurance coverage to at least take care of the difference.
As women become an increasingly important contributor to the family budget, having disability insurance to insure that contribution is a necessity and something that should not be simply overlooked.
Disability insurance is as important for medical residents as it is for anyone. If a person's income earning potential is taken away, he or she can be looking at a bleak future. In the case of medical residents, hard work has poised them to earn a higher than average salary in a matter of a few years. Illness or injury now or at some future point can completely nullify that potential. Disability insurance is security for an insecure world in case the worse happens and you are robbed of those dreams. By getting it in place now, you can even guarantee your rates up to age 65.
Disability Coverage Available for Medical Residents
Many insurance companies offer special amounts of disability insurance coverage specifically for resident physicians and interns. These higher than usual limits do not reflect present salaries but rather future-earning levels that are all but guaranteed once you have made it to that point in your studies. Insurers recognize the path you have taken and where you are going financially. For this reason it is common to find disability insurance coverage of $3500 per month and more for residents. By opting to put this coverage in place now, you can even lock in the cost and coverage through age 65.
As soon as you have a written employment contract in the final year of your residency, you can put in place an even higher level of disability insurance. The agreement serves as your income verification, which is needed for the higher levels of coverage.
The standard offerings for disability insurance coverage include: $2500 monthly for medical interns, $3500 for medical residents and $4500 for physicians in their first year of practice. These numbers are guidelines and specific circumstances can be higher.
Residents Can Save on The Cost of Disability Insurance
While residents and physicians in their first years of practice know that higher income levels are on the horizon, that doesn't change the fact that they are living on a budget now. Therefore, keeping spending under control is as important for them as it is for anyone. A graded premium disability insurance program can help save money during this time, even as much as 25% of the guaranteed level insurance cost.
Basically the graded premium policy starts lower than the guaranteed level coverage and increases annually. However for those starting out it is a great option to save money. Just be sure there is an option in the policy to convert to a guaranteed level policy and do so as soon as possible. This preserves your insurability and gives you the best coverage you can get at the lowest rate possible.
Put specialized disability insurance for medical residents in place now and secure your future in a tangible way.