Aging is inevitable, and so does the health problems, so with the growing age of the parents, children have to take the responsibility of their parents, and they need to help them have the best and affordable health insurance. With aging parents, it becomes important for children to know about their parents’ health plans and the type of coverage for which they are eligible. Children knowing about their parent’s health plan coverage as earlier as possible is better because this will save their time, prevent them from doing mistakes, and save them from tension.
Find below some of the important things which children need to know about their parent’s health care and coverage.
Type of Coverage They Have
Children after knowing about their parent’s coverage can make sound decisions, as far as their health and finances are concerned. Whether the parents are having Medicare, Medicaid, or a plan through the Affordable Care Act, or whether they were having employer-sponsored plans through the company from which they retired, knowing such facts will help them make an informed decision for their health insurance. Some of the seniors might be having a combination of benefits, so their children should know exactly what type of coverage they are having, and what are the other coverages that they should have.
Establish a Power of Attorney
In case, if the parents get injured or become disabled and they have given Power of Attorney to their children, then they can make medical decisions for them. Seniors should establish Power of Attorney before it is required, particularly if they are suffering from dementia or Alzheimer’s because they will have the ability to understand the legal proceedings.
Long-term Care Insurance
Children should know whether their parents have opted for long-term care insurance or not. Long-term care insurance provides in-home assistance that is generally not covered under standard health plans or Medicare and Medicaid.
Is their coverage enough?
Children need to ensure that their parents have sufficient health coverage. They may have a combination of different plans like Medicare, private care, Medigap, Medicaid, or some other form of coverage. Care review of their parents’ plans and coverage will allow children to know whether they have the right plan based on their health care requirements. In case of finding it difficult in understanding their parent’s health insurance and the way it works, children can take the help of organizations of their state that will help them understand the plan and its coverage. Children can also seek help from their parents’ primary care physicians to get in touch with the correct organization.
Key Things to Consider while Exploring Health Insurance Options for Senior Parents
Finding adequate health insurance for aging parents is increasingly difficult, though there are means using which the process can be eased and simplified. Certain factors should be carefully evaluated before helping senior parents find and choose the right health insurance. With different health insurance options available by the government, employers, health insurance companies, choosing the right and affordable health insurance require some serious consideration. Find below some key things to consider when exploring health insurance options for senior parents.
About Medicare Coverage
Original Medicare provides coverage for both Part A and Part B. Part A coverage includes inpatient hospital care, hospice care, etc. whereas Part B coverage includes physician office visits, preventive care, etc. Thus, while looking for proper health plans for senior parents, children should be aware that prescription drugs, vision care, dental care, and hearing services are covered under Original Medicare, but may be included under some Medicare Advantage plans. However, seniors can separately buy these coverages through insurance carriers.
Type of Insurance plans for which Seniors Are Eligible and Process to get them Covered
Seniors who are 65 or approaching 65, their children need to determine the types of health plans they are eligible for. Some of the plans for which they may qualify include:
If the seniors have been permanent U.S. residents or a citizen for 5 years and paid ten years of Social Security taxes, then they will qualify for Medicare plans. If seniors are still employed at organizations having 20 or more employees and are covered under their employer-sponsored plans, then they do not require any more coverage until their retirement. However, if their company has less than 20 employees, then they need to enroll in Medicare Part A and Part B. Seniors who start receiving Social Security benefits automatically get enrolled in Medicare. After turning 65, seniors should sign up for Medicare provided they don’t have employer-sponsored coverage to avoid late enrollment penalties. To expand their coverage, seniors can obtain Medicare Advantage or Medigap plans along with Original Medicare.
Seniors who are not eligible for Medicare can buy ACA-plans from their state health insurance exchange. However, it is important to note that if seniors are eligible for Medicare plans, but they opt to buy plans through exchanges, they will not receive any tax credits. Seniors are not allowed to sign up for both Medicare and ACA plans through the health exchanges, as they can sign up for any one of the plans.
Private Health Insurance Providers
Seniors also have the option to buy health insurance from private health insurance companies. However, there is a possibility that health insurance companies’ direct seniors toward Medicare specific products like Medicare Advantage plan or Medigap plans.
Retiree or Employer Insurance
Most of the seniors are working even after turning 65 or have retiree health benefits. At the time of their retirement, seniors can sign up during a special enrollment period without being charged a late enrollment penalty. In case if they have retiree health insurance, then they need to enroll in Medicare Part A and Part B, because according to the coordination rules, Medicare is the primary payer. In a situation when more than one plan is offering health coverage, there is a coordination of benefits rule, which determines the plan which pays first.
Cost of the Plans
Understanding the cost of health plans is a key component in selecting a plan for seniors. Seniors and their children while selecting a plan should consider the total cost of the plans, and must be aware of the plan’s premium, deductible, co-insurance, and copayments. They should be aware of the premium amount which they will have to pay every month. Besides premium, they should also know the amount which they should spend before their insurance kicks in, a certain percentage of the health services cost they are responsible, and a flat fee for their healthcare services. It is important to understand that some plans have low premiums and allow them to save money in the short-term, but obtaining coverage for significant health issues can be costly if they choose a plan with higher out-of-pocket expenses.
Access to Healthcare Providers
To have access to any participating Medicare provider, seniors should have Original Medicare or a combination of Medicare and a Medigap policy. Seniors can have HMO Medicare Advantage plans in which they have access to in-network providers and with PPO Medicare Advantage plans, they can continue with their existing healthcare provider. However, if that provider is not within their plan network, then they would likely pay more. Seniors should know that in-network doctors and other healthcare providers can change with little notice and they should be aware of the financial liability while going out of network.
Way to Cover Senior’s Out-of-Pocket Expenses
Seniors who have earlier contributed to health saving accounts can use this tax-free and penalty-free contributions for covering some out-of-pocket expenses. After enrolling in Medicare, seniors are not eligible to contribute to Health Savings Account but can use the funds to pay for the approved medical costs.
Some of the other factors to consider:
To help their senior parents pick the right health plans, children should also give importance to the below factors:
- They should ask for their parent’s list of doctors.
- Check their health conditions and know about their annual healthcare expenses, as this will help them pick the right coverage as per their medical need.
- Know about the different Medicare options.
- Irrespective of the Medicare plans they are looking to opt, children should directly request quotes either from licensed brokers or reputed individual health insurance companies.
- If the seniors are planning to work after 65 years of age, then their children should know how long their parents wish to work. This will help them to avoid missing some important deadlines coverage.
- Children should carefully review the coverage options available for their senior parents, as this might help them compare the options available through different sources.
- Once the seniors are covered, children should continuously remind them to avail benefit of the preventive and screening services covered under Medicare.
It takes some time and research of the market to select the best and affordable plan for the senior parents. Children should have a good understanding of coverage, eligibility, network, and expenses to narrow down their choices and avoid paying the unnecessary cost in the future.