What You Can Do If You Are Concerned About Cancer, Heart Attack Or Stroke In The Future?


Cancer patientLast Friday I wrote, “Why Are Hospital Bills So Expensive?”

Over the weekend a reader from the midwest asked me about a similar problem.  She asked about Medigap for people who qualify for Medicare prior to reaching age 65.

Apparently, she has been diagnosed with cancer before she saw her 65th birthday and the state in which she lives does not offer Medigap for people who are not yet 65.

Below, is a copy of the email that I sent to her.  In it are some options for people who have a similar dilemma.

There are some strategies that I can recommend but they depend on your circumstance.
 
The first thing to know is that in October you will be able to enroll in an Essential Benefit Health insurance plan, regardless of any pre-existing conditions.  I have added your email address to my weekly email so that you can keep informed on what is happening and what is required of you.
 
The next thing that I would recommend is that if you elect to continue on Medicare next year, take a close look at the Medicare Advantage plans that are available in your area.  I do not recommend them for people who do a great deal of traveling but if the doctors and hospitals that you use are members of the Medicare Advantage plan that is in your area, your Out-Of-Pocket expenses, for everything but your prescription drugs, will be limited to $6500 or less for the year.  The biggest problem is that Medicare Advantage is not available to you until January and you must enroll in it during Medicare’s Open Enrollment. 
 
However, things may be a little different for you.  If you recently became eligible for Medicare, you may still be able to get a Medicare Advantage plan.  Call your Medicare office first thing on Monday.  If you can still get Medicare Advantage, call the NE Department of Insurance to see what plans are available in your area.
 
The third option, is for you to call your local Medicaid office and see if you qualify for what is called “Dual-Eligible.”  The Sequestration that started last night is not supposed to have a significant effect on either Medicaid or Medicare.
Use the form to ask your insurance question.
Use the form to ask your insurance question.

However, I do believe the wisdom of the old proverb, “An ounce of prevention is worth a pound of cure.”  At the risk of sounding heartless (and that is not my intent since I am a pretty compassionate person by nature), all of her financial problems could have been avoided with the proper supplements to her health insurance portfolio.

The Essential Benefit Plans that are mandatory for all Americans who are not otherwise exempt from Obamacare, do not cover everything.  If you have had a parent or sibling suffer from cancer, heart attack or stroke, I highly recommend that you consider getting a Critical Illness insurance policy as a supplement to your Essential Benefit Plan.

There are 3 major limitations to what the planned Essential Benefit Plans will cover.

  1. All of the Essential Benefit Plans have “Cost Sharing” requirements.  That means that regardless of which plan you elect, you will still be liable to pay some of your medical bills.
  2. None of the Essential Benefit Plans will help you pay your regular, non-medical bills while you are recovering.
  3. None of the Essential Benefit Plans will help you pay for non-skilled help with Activities of Daily Living, Assisted Living or Adult Day-Care.  Help with skilled nursing may be available as long as it is “medically necessary.”

If all you are concerned with is paying your Medical Bills in the event of cancer, heart attack or stoke, you will only need $10,000 worth of Critical Illness insurance.  That amount is generally pretty inexpensive.

If, however, you are concerned about replacing your income while you are side-lined or hiring someone to help you if you are incapacitated, you will probably need more coverage.

The link below will allow you to see how much coverage would cost you with one insurance company.  It is just one of several insurance companies that offer Critical Illness insurance.

If you are curious, click on the banner below.  Just be advised that since I live in Texas, if you find a plan that meets your needs and budget, you will need to find a licensed insurance agent in your state to help you.

However, if you live in Texas and find a plan that you like, you will be able to submit your application over your computer.

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