
| Insurance tips for our clients and
friends Life insurance is a crucial step in
planning for your future. Not only can it aid your family if you are no longer around,
there are several life insurance plans that provide benefits while you are living.
Determining Your Need
The need for life insurance depends on your personal and
financial needs. We can assist you in determining what type and amount of life insurance
is appropriate for you. Generally, you should consider life insurance if:
- You have a spouse,
- You have dependent children,
- You have an aging parent or a physically challenged relative
who depends on you for support,
- Your retirement savings are not enough to insure your
spouses future against a rising cost of living,
- You have a sizable estate, or
- You own a business.
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| Life Changes So Should Your Policy As your life changes, your life insurance coverage may need to
change as well to adapt to your current needs. Some life changes that may require a policy
"tune-up" include:
- You recently married or divorced.
- You have a new child or grandchild.
- Your health or your spouses health has deteriorated.
- You are providing care or financial assistance to a parent.
- You child or grandchild requires assistance or long-term
care.
- You recently purchased a new home.
- You are planning for the education of a child or grandchild.
- You are concerned about retirement income.
- You have refinanced your home mortgage in the past six
months.
- You or your spouse recently received an inheritance.
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Life insurance offers benefits in providing for your loved
ones in case something happens to you:
- Life insurance can be used to cover funeral expenses and pay
estate taxes. Consult you tax advisor or financial agent for more information.
- The cash value earned and borrowed from a permanent life
insurance policy can be used to help with large expenses, such as a college education or
down payment on a home.
Terms or Permanent?
Term insurance offers protection only for
a specified period of time. The death benefit is paid only if a loss occurs during the
term, instead of building up a cash value to assist with other financial needs. Most term
policies do have renewable and convertible features, allowing you to extend the term of
your policy without proof of insurability or to convert the policy to permanent coverage
for the same face amount. Premiums may be higher with the renewed or converted policy.
With term insurance, premiums are initially lower than for
permanent insurance, allowing the policy owner to buy higher face amounts at a younger
age, when the need for protection is greatest. It is a good option for covering specific
needs that will eventually disappear, such as a mortgage or other loans, to help prevent
the loans form becoming a financial burden to the survivors. New families often purchase
term insurance and convert to permanent insurance later.
Permanent insurance provides lifelong protection until
maturity, usually until the insured is age 95 or 100. It provides a cash value in addition
to a death benefit.
Permanent insurance is a good choice, if you want long-term
coverage with a predictable premium and a way to accumulate cash funds for emergency needs
or opportunities.
You may be able to borrow money against the policy to meet
financial commitments such as college expenses or purchasing a home. If loans remain
unpaid at the time of the insureds death, the insurance company deducts the loan
balance, plus interest accrued, from the death benefit proceeds.
Remember, however, life insurance is designed to provide
protection. Additional benefits, such as borrowing money from your policy are secondary
considerations.
Whole life, or ordinary life, is the
original and most common type of permanent insurance. Premiums are paid periodically
throughout the contract, and are generally level and constant over the life of the
contract. A portion of the whole life premium is invested in your policys behalf to
build up a cash value, rather than just going for insurance protection.
Regardless of the investment performance of the general
account, the insurance company guarantees the policys stated cash value and that a
death benefit will be paid to the beneficiary, as long as the required premiums have been
paid. The company makes the investment decisions and assumes all the investment risk.
Universal life insurance allows
flexibility with regard to the amount and frequency of premium payments. After the initial
payment a policy owner can increase or decrease the premiums, subject to certain minimums,
and maximums, at any time.
Universal life coverage will continue as long as there is
sufficient cash value in the policy to cover the monthly deductions. Death benefits may
also be decreased or increased, but usually require evidence of insurability before the
face amount may be increased.
Net premiums are applied to a cash accumulation fund that
earns a guaranteed interest rate.
Variable universal life also offers
fixed premium payments and a guaranteed minimum death benefit, but with added flexibility.
You are allowed personal control over the nature of the
cash accumulation portion of your policy through a range of investment choices including
equity and debt securities. These rate account, rather than the insurance companys
general account, where traditional product premiums are invested.
The policys cash value is not guaranteed and
different portfolios offer different levels of risk and growth potential. Variable life
offers policyholders greater potential for growth than does whole or universal life. Both
the policys cash value and death benefit, however, have the potential to fluctuate,
based on the performance of the investment portfolios.
Variable universal life should be considered a long-term
plan to meet your life insurance needs.
Let us help
We can help you determine your life insurance needs and
what coverages are appropriate for you. Give us a call.

The term health insurance refers to a wide variety
of insurance policies. These range from policies that cover the costs of doctors and
hospitals to those that meet a specific need, such as paying for long-term care. Even
disability insurance-- which replaces lost income if you cant work because of
illness or accident-- is considered health insurance, even though its not
specifically for medical expenses.
But when people talk about health insurance, they usually
mean the kind of insurance offered by employers to employees, the kind that covers medical
bills, surgery, and hospital expenses. You may have heard this kind of health insurance
referred to as comprehensive or major medical policies, alluding to the
broad protection they offer. But the fact is, neither of these terms is particularly
helpful to the consumer.
Today, when people talk about broad health care coverage,
instead of using the term major medical, they are more likely to refer to fee-for-service
or managed care. These terms apply to different kinds of coverage or health plans.
Moreover, youll also hear about specific kinds of managed care plans: health
maintenance organizations or HMOs, preferred provider organizations or PPOs,
and point-of-service (POS) plans.
While fee-for-service and managed care plans differ in
important ways, in some ways they are similar. Both cover an array of medical, surgical,
and hospital expenses. Most offer some coverage for prescription drugs; and some include
coverage for dentists and other providers. But there are many important differences that
will make one or the other form of coverage the right one for you.
The section below is designed to acquaint you with the
basics of fee-for-service and managed care plans. But remember: The detailed differences
between one plan and another can only be understood by careful reading of the materials
provided by insurers, or your employee benefits specialist, or your agent or broker.
Fee-for-service
This type of coverage generally assumes that the medical
provider (usually a doctor or hospital) will be paid a fee for each service rendered to
the patient-- you or a family member covered under your policy. With fee-for-service
insurance, you go to the doctor of your choice; and you or your doctor or hospital submits
a claim to your insurance company for reimbursement. You will only receive reimbursement
for covered medical expenses, the ones listed in your benefits summary.
When a service is covered under your policy, you can expect
to be reimbursed for some but generally not all of the cost. How much you will receive
depends on the provisions of the policy on co-insurance and deductibles.
Heres how it works:
- The portion of the covered medical expenses you pay is
called co-insurance.
Although there are variations, fee-for-service policies
often reimburse doctor bills at 80 percent of the reasonable and customary charge.
(This is the prevailing cost of a medical service in a given geographic area.) You pay the
other 20 percent-- your co-insurance.
However, if a medical provider charges more than the
reasonable and customary fee, you will have to pay the difference. For example, if the
reasonable and customary fee for a medical service is $100, the insurer will pay $80. If
your doctor charged $100, you will pay $20. But if the doctor charged $105, you will pay
$25.
Note that many fee-for-service plans pay hospital expenses
in full; some reimburse at the 80/20 level as described above.
- Deductibles are the amount of the covered expenses you must
pay each year before the insurer starts to reimburse you. These might range from $100 to
$300 per year per individual, or $500 or more per family. Generally, the higher the
deductible, the lower the premiums, which are the monthly, quarterly, or annual payments
for the insurance.
Policies typically have an out-of-pocket maximum. This
means that once your expenses reach a certain amount in a given calendar year, the
reasonable and customary fee for covered benefits will be paid in full by the insurer and
you no longer pay the co-insurance. (If your doctor bills you more than the reasonable and
customary charge, again you may still have to pay a portion of the bill.) Note that
Medicare limits how much a physician may charge you above the usual amount.
There also may be lifetime limits on benefits paid under
the policy. Most experts recommend that you look for a policy whose lifetime limit is at
least $1 million. Anything less may prove to be inadequate.
Managed Care
The three major types of managed care plans are health
maintenance organizations (HMOs), preferred provider organizations (PPOs), and point-of-service
(POS) plans.
Managed care plans generally provide comprehensive health
services to their members, and offer financial incentives for patients to use the
providers who belong to the plan. In managed care plans, instead of paying for each
service that you receive separately, your coverage is paid in advance. This is called
prepaid care.
For example, you may decide to join a local health
maintenance organization (HMO) where you pay a monthly or quarterly premium. That premium
is the same-- whether you use the plans services or not. The plan may charge a co-payment
for certain services-- for example, $10 for an office visit, or $5 for every prescription.
So, if you join this HMO, you may find that you have few out-of-pocket expenses for
medical care-- as long as you use doctors or hospitals that participate, or are part of,
the HMO. Your share may only be the small co-payments; generally, you will not have
deductibles or co-insurance.
One of the interesting things about health maintenance
organizations is that they deliver care directly to patients. Patients sometimes go to a
medical facility to see the nurses and doctors or to a specific doctors office.
Another common model is a network of individual practitioners. In these individual
practice associations (IPAs), you will get your care in a physicians office.
(More than half the people enrolled in HMOS are in IPAs.)
If you belong to an HMO, typically you must receive your
medical care through the plan. Generally, you will select a primary care physician
who coordinates your care. Primary care physicians may be family practice doctors,
internists, pediatricians, or other types of doctors. The primary care physician is
responsible for referring you to specialists when needed. While most of these specialists
will be participating providers in the HMO, there are circumstances in which patients
enrolled in an HMO may be referred to providers outside the HMO network and still receive
coverage.
Preferred provider organizations and point-of-service plans
are categorized as managed care plans. (Indeed, many people call POS plans an HMO with a
point-of-service option.) From the consumers point of view, these plans combine
features of fee-for-service and HMOs. They offer more flexibility than HMOs, but premiums
are likely to be somewhat higher.
With a PPO or a POS, unlike most HMOs, you will get some
reimbursement if you receive a covered service from a provider who is not in the plan. Of
course, choosing a provider outside the plans network will cost you more than
choosing a provider in the network. These plans will act like fee-for-service plans and
charge you co-insurance when you go outside the network.
What is the difference between a PPO and a POS plan? A POS
plan has primary care physicians who coordinate patient care; and in most cases, PPO plans
do not. But there are exceptions!
HMOs and PPOs have contracts with doctors, hospitals, and
other providers. They have negotiated certain fees with these providers-- and, as long as
you get your care from these providers, they should not ask you for additional payment.
(Of course, if your plan requires a co-payment at the time you receive care, you will have
to pay that.)
Always look carefully at the description of the plans you
are considering for the conditions of payment. Check with your employer, your benefits
manager, or your state department of insurance to find out about laws that may regulate
who is responsible for payment.
Self-insured Plans
Your employer may have set up a financial arrangement that
helps cover employees health care expenses. Sometimes employers do this and have the
health plan administered by an insurance company; but sometimes there is no outside
administrator. With self-insured health plans, certain federal laws may apply; thus, if
you have problems with a plan that isnt state regulated, its probably a good
idea to talk to an attorney who specializes in health law.
Appropriate Care
HMOs, PPOs, and fee-for-service plans often share certain
features, including preauthorization, utilization review, and discharge planning.
For example, you may be asked to get authorization from
your plan or insurer before admission to a hospital for certain types of surgery.
Utilization review is the process by which a plan determines whether a specific medical or
surgical service is appropriate and/or medically necessary. Discharge planning is an
approach that facilitates the transfer of a patient to a more cost-effective facility if
the patient no longer needs to stay in the hospital. (For example, if, following surgery,
you no longer need hospitalization, but cannot be cared for at home, you may be
transferred to a skilled nursing facility.) Almost all fee-for-service plans apply managed
care techniques to contain costs and guarantee appropriate care; and an increasing number
of managed care plans contain fee-for-service elements. While the distinctions among plans
are growing increasingly blurred, the number of options available to consumers increases
every day.
How Do I Get Health Coverage?
Health insurance is generally available through groups and
to individuals. Premiums-- the regular fee that you pay for health insurance coverage--
are generally lower for group coverage. When you receive group insurance at work, the
premium usually is paid through your employer.
Group insurance is typically offered through
employers, although unions, professional associations, and other organizations also offer
group insurance. As an employee benefit, group health insurance has many advantages.
Much-- although not all-- of the cost may be borne by the employer. Premium costs are
frequently lower because economies of scale in large groups make administration less
expensive. With group insurance, if you enroll when you first become eligible for
coverage, you generally will not be asked for evidence that you are insurable. (Enrollment
usually occurs when you first take a job, and/or during a specified period each year,
which is called open enrollment.) Some employers offer employees a choice of
fee-for-service and managed care plans. In addition, some group plans offer dental
insurance as well as medical.
Individual insurance is a good option if you work
for a small company that does not offer health insurance or if you are self-employed.
Buying individual insurance allows you to tailor a plan to fit your needs from the
insurance company of your choice. It requires careful shopping, because coverage and costs
vary from company to company. In evaluating policies, consider what medical services are
covered, what benefits are paid, and how much you must pay in deductibles and
co-insurance. You may keep premiums down by accepting a higher deductible.
Pre-existing Conditions: New Federal Law
Many people worry about coverage for pre-existing
conditions, especially when they change jobs. Recent changes in federal law help
assure continued health insurance coverage for employees and their dependents. Starting
July 1, 1997, insurers may impose only one 12-month waiting period for any pre- existing
condition treated or diagnosed in the previous six months. Your prior health insurance
coverage will be credited toward the pre-existing condition exclusion period as long as
you have maintained continuous coverage without a break of more than 62 days. Pregnancy is
not considered a pre-existing condition, and newborns and adopted children who are covered
within 30 days are not subject to the 12- month waiting period.
If you have had group health coverage for two years, and
you switch jobs and go to another plan, that new health plan cannot impose another
pre-existing condition exclusion period. If, for example, you have had prior coverage of
only eight months, you may be subject to a four month pre-existing exclusion period when
you switch jobs. If youve never been covered by an employers group plan, and
you get a job that offers such coverage, you may be subject to a 12-month pre-existing
condition waiting period.
Federal law also makes it easier for you to get individual
insurance under certain situations, including if you have left a job where you had group
health insurance, or had another plan for more than 18 months without a break of more than
62 days.
If you have not been covered under a group plan and have
found it difficult to get insurance on your own, check with your state insurance
department to see if your state has a risk pool. Similar to risk pools for automobile
insurance, these can provide health insurance for people who can not get it elsewhere.
What Is Not Covered?
While HMO benefits are generally more comprehensive than
those of traditional fee-for-service plans, no health plan will cover every medical
expense.
Very few plans cover eyeglasses and hearing aids because
these are considered budgetable expenses. Very few cover elective cosmetic surgery, except
to correct damage caused by a covered accidental injury. Some fee-for-service plans do not
cover checkups. Procedures that are considered experimental may not be covered either. And
some plans cover complications arising from pregnancy but do not cover normal pregnancy or
childbirth.
Health insurance policies frequently exclude coverage for
pre-existing conditions, but, as explained, federal law now limits exclusions based on
such conditions.
You should also remember that insurers will not pay
duplicate benefits. You and your spouse may each be covered under a health insurance plan
at work but, under what is called a coordination of benefits provision, the total you can
receive under both plans for a covered medical expense cannot exceed 100 percent of the
allowable cost. Also note that if neither of your plans covers 100 percent of your
expenses you will only be covered for the percentage of coverage (for example, 80 percent)
that your primary plan covers. This provision benefits everyone in the long run because it
helps to keep costs down.
What Happens to My Insurance if I Lose My Job?
If you have had health coverage as an employee benefit and
you leave your job, voluntarily or otherwise, one of your first concerns will be
maintaining protection against the costs of health care. You can do this in one of several
ways:
- First, you should know that under a federal law (the
Consolidated Omnibus Budget Reconciliation Act of 1985, commonly known as COBRA), group
health plans sponsored by employers with 20 or more employees are required to offer
continued coverage for you and your dependents for 18 months after your leave your job.
(Under the same law, following an employees death or divorce, the workers
family has the right to continue coverage for up to three years.) If you wish to continue
your group coverage under this option, you must notify your employer within 60 days. You
must also pay the entire premium, up to 102 percent of the cost of the coverage.
- If COBRA does not apply in your case-- perhaps because you
work for an employer with fewer than 20 employees-- you may be able to convert your group
policy to individual coverage. The advantage of that option is that you may not have to
pass a medical exam, although an exclusion based on a pre- existing condition may apply,
depending on your medical history and your insurance history.
- If COBRA doesnt apply and converting your group
coverage is not for you, then, if you are healthy, not yet eligible for Medicare, and
expect to take another job, you might consider an interim or short- term policy. These
policies are designed to provide medical insurance for people with a short-term need, such
as those temporarily between jobs or those making the transition between college and a
job. These policies, typically written for two to six months and renewable once, cover
hospitalization, intensive care, and surgical and doctors care provided in the
hospital, as well as expenses for related services performed outside the hospital, such as
X-rays or laboratory tests.
- Another possibility is obtaining coverage through an
association. Many trade and professional associations offer their members health
coverage-- often HMOs-- as well as basic hospital-surgical policies, and disability and
long-term care insurance. If you are self-employed, you may find association membership an
attractive route.
Frequently Asked Questions
Q. What is the first thing I should know about buying
health coverage?
A. Your aim should be to insure yourself and your family
against the most serious and financially disastrous losses that can result from an illness
or accident. If you are offered health benefits at work, carefully review the plans
literature to make sure the one you select fits your needs. If you purchase individual
coverage, buy a policy that will cover major expenses and pay them to the highest maximum
level. Save money on premiums, if necessary, by taking large deductibles and paying
smaller costs out-of- pocket.
Q. Can I buy a single health insurance policy that will
provide all the benefits Im likely to need?
A. No. Although you can select a plan or buy a policy that
should cover most medical, hospital, surgical, and pharmaceutical bills, no single policy
covers everything. Moreover, you may want to consider additional single-purpose policies
like long-term care or disability income insurance. If you are over 65, you may want a
Medicare supplement policy to fill in the gaps in Medicare coverage.
Q. Im planning to keep working after age 65. Will
I be covered by Medicare or by my companys health insurance?
A. If you work for a company with 20 or more employees,
your employer must offer you (through age 69) the same health insurance coverage offered
to younger employees. After you reach age 65, you may choose between Medicare and your
companys plan as your primary insurer. If you elect to remain in the company plan,
it will pay first-- for all benefits covered under the plan-- before Medicare is billed.
In most instances, it is to your advantage to accept continued employer coverage. But be
sure to enroll in Medicare Part A, which covers hospitalization and can supplement your
group coverage at no additional cost to you. You can save on Medicare premiums by not
enrolling in Medicare Part B until you finally retire. Bear in mind, though, that delayed
enrollment is more expensive and entails a waiting period for coverage.
Q. Ive had a serious health condition, which
appears to be stabilized. Can I buy individual health coverage?
A. Depending on what your condition is and when it was
diagnosed and treated, you can probably buy health coverage. However, the insurer may do
one of three things: provide full protection but with a higher premium, as might be the
case with a chronic disease, such as diabetes; modify the benefits to increase the
deductible; exclude the specific medical problem from coverage, if it is a clearly defined
condition, as long as the insurer abides by state and federal laws on exclusions.
Q. One of my medical bills was turned down by the
insurance company (or health plan). Is there anything I can do?
A. Ask the insurance company why the claim was rejected. If
the answer is that the service isnt covered under your policy, and youre sure
that it is, check to see that the provider entered the correct diagnosis or procedure code
on the insurance claim form. Also check that your deductible was correctly calculated.
Make sure that you didnt skip an essential step under your plan, such as
preadmission certification. If everything is in order, ask the insurer to review the
claim.
Comparing Plans
Whether you end up choosing a fee-for-service plan or a
form of managed care, you must examine a benefits summary or an outline of coverage-- the
description of policy benefits, exclusions, and provisions that makes it easier to
understand a particular policy and compare it with others.
Look at this information closely. Think about your personal
situation. After all, you may not mind that pregnancy is not covered; but you may want
coverage for psychological counseling. Do you want coverage for your whole family or just
yourself? Are you concerned with preventive care and checkups? Or would you be comfortable
in a managed care setting that might restrict your choice somewhat but give you broad
coverage and convenience? These are questions that only you can answer.
Other Forms of Health Insurance
In addition to broad coverage for medical, surgical, and
hospital expenses, there are many other kinds of health insurance.
Hospital-surgical policies, sometimes called basic
health insurance, provide benefits when you have a covered condition that requires
hospitalization. These benefits typically include room and board and other hospital
services, surgery, physicians nonsurgical services that are performed in a hospital,
expenses for diagnostic X-rays and laboratory tests, and room and board in an extended
care facility.
Benefits for hospital room and board may be a per-day
dollar amount or all or part of the hospitals daily rate for a semi-private room.
Benefits for surgery typically are listed, showing the maximum benefit for each type of
surgical procedure.
Hospital-surgical policies may provide first-dollar
coverage. That means that there is no deductible, or amount that you have to pay, for a
covered medical expense. Other policies may contain a small deductible.
Keep in mind that hospital-surgical policies usually do not
cover lengthy hospitalizations and costly medical care. In the event that you need these
types of services, you may incur large expenses that are difficult to meet unless you have
other insurance.
Catastrophic coverage pays hospital and medical
expenses above a certain deductible; this can provide additional protection if you hold
either a hospital-surgical policy or a major medical policy with a lower- than-adequate
lifetime limit. These policies typically contain a very high deductible ($15,000 or more),
and a maximum lifetime limit high enough to cover the costs of catastrophic illness.
Specified or dread disease policies provide benefits
only if you get the specific disease or group of diseases named in the policy. For
example, a policy might cover only medical care associated with cancer. Because benefits
are limited in amount, these policies are not a substitute for broad medical coverage. Nor
are specified disease policies available in every state.
Hospital indemnity insurance pays you a specified
amount of cash benefits for each day that you are hospitalized, generally up to a
designated number of days. These cash benefits are paid directly to you, can be used for
any purpose, and may be useful in meeting out-of-pocket expenses not covered by other
insurance.
Hospital indemnity policies frequently are available
directly from insurance companies by mail as well as through insurance agents. You will
find that these policies offer many choices, so be sure to ask questions and find the
right plan to meet your needs.
Some policies contain limitations on pre-existing medical
conditions that you may have before your insurance takes effect. Others contain an
elimination period, which means that benefits will not be paid until after you have been
hospitalized for a specified number of days. When you apply for the policy, you may be
allowed to choose among two or three elimination periods, with different premiums for
each. Although you can reduce your premiums by choosing a longer elimination period, you
should bear in mind that most patients are hospitalized for relatively brief periods of
time.
If you purchase a hospital indemnity policy, periodically
review it to see if you need to increase your daily benefits to keep pace with rising
health care costs.
Medicare supplement insurance, sometimes called Medigap
or MedSupp, is private insurance that helps cover some of the gaps in Medicare
coverage.
Medicare is the federal program of hospital and medical
insurance primarily for people age 65 and over who are not covered by an employers
plan; but Medicare doesnt cover all medical expenses. Thats where Medsupp
comes in.
All Medicare supplement policies must cover certain
expenses, such as the daily co-insurance amount for hospitalization and 90 percent of the
hospital charges that otherwise would have been paid by Medicare, after Medicare is
exhausted. Some policies may offer additional benefits, such as coverage for preventive
medical care, prescription drugs, or at-home recovery.
There are 10 standard Medicare supplement policies,
designated by the letters A through J. With these standardized policies, it is much easier
to compare the costs of policies issued by different insurers. While all 10 standard
policies may not be available to you, Plan A must be made available to Medicare recipients
everywhere.
Insurers are not permitted to sell policies that duplicate
benefits you already receive under Medicare or other policies. If you decide to replace an
existing Medicare supplement policy-- and you should do so only after careful evaluation--
you must sign a statement that you intend to replace your current policy and that you will
not keep both policies in force.
People who are 65 or older can buy Medicare supplement
insurance without having to worry about being rejected for existing medical problems, so
long as they apply within six months after enrolling in Medicare.
Long-term care policies cover the medical care,
nursing care, and other assistance you might need if you ever have a chronic illness or
disability that leaves you unable to care for yourself for an extended period of time.
These services generally are not covered by other health insurance. You may receive
long-term care in a nursing home or in your own home.
Long-term care can be very expensive. On average, a year in
a nursing home costs about $40,000. In some regions, it may cost much, much more. Home
care is less expensive, but it still adds up. (Home care can include part-time skilled
nursing care, speech therapy, physical or occupational therapy, home health aides, and
homemakers.)
Bringing an aide into your home just three times a week--
to help with dressing, bathing, preparing meals, and similar chores-- easily can cost
$1,000 a month, or $12,000 a year. Add in the cost of skilled help, such as physical
therapy, and the costs can be much greater.
Most long-term care policies pay a fixed dollar amount,
typically from $40 to more than $200 a day, for each day you receive covered care in a
nursing home. The daily benefit for at-home care is usually half the benefit for nursing
home care. Because the per-day benefit you buy today may be inadequate to cover higher
costs in the future, most policies also offer an inflation adjustment feature.
Keep in mind that unless you have a long-term care policy,
you are not covered for long-term care expenses under Medicare and most other types of
insurance. Recent changes in federal law may allow you to take certain income tax
deductions for some long-term care expenses and insurance premiums.
Disability insurance provides you with an income if
illness or injury prevents you from being able to work for an extended period of time. It
is an important but often overlooked form of insurance.
There are other possible sources of income if you are
disabled. Social Security provides protection, but only to those who are severely disabled
and unable to work at all; workers compensation provides benefits if the illness or
injury is work-related; civil service disability covers federal or state government
workers; and automobile insurance may pay benefits if the disability results from an
automobile accident. But these sources are limited.
Some employers offer short- and long-term disability
coverage; and if you are self-employed, you can buy individual disability income insurance
policies. Generally:
- Monthly benefits are usually 60 percent of your income at
the time of purchase, although cost-of- living adjustments may be available.
- If you pay the premiums for an individual disability policy,
payments you receive under the policy are not subject to income tax. If your employer has
paid some or all of the premiums under a group disability policy, some or all of the
benefits may be taxable.
Whether you are an employer shopping for a group disability
policy or someone thinking of purchasing disability income insurance, you will need to
evaluate different policies. Here are some things to look for:
- Some policies pay benefits only if someone is unable to
perform the duties of their customary occupation, while others pay only if the person can
engage in no gainful employment at all. Make sure that you know the insurers
definition of disability.
- Some policies pay only for accidents, but its
important to be insured for illness too. Be sure, as you evaluate policies, that both
accident and illness are covered.
- Benefits may begin anywhere from one month to six months or
more after the onset of disability. A later starting date can keep your premiums down. But
remember, if your policy only starts to pay (for example) three months after the
disability begins, you may lose a considerable amount of income.
Benefits may be payable for a period ranging anywhere from one year to a lifetime. Since
disability benefits replace income, most people do not need benefits beyond their working
years. But its generally wise to insure at least until age 65 since a lengthy
disability threatens financial security much more than a short disability.
Moran
Insurance
696 Ritchie Highway l Severna Park,
MD 21146
410-544-3422 | 800-544-3164 |
Fax 410-544-6834
info@moraninsurance.com
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