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December 10, 2018

Avoid surprises with Your Medicare Benefits – What’s not covered

health coverageWhen people turn 65 and become eligible for Medicare, they are sometimes surprised to learn that Medicare doesn’t cover all of their healthcare expenses and services.

On average, Medicare covers around 80% of your inpatient and outpatient services. There are also some items which are not covered by Medicare at all.

Learning what Medicare covers ahead of time will certainly help you not to experience any unwelcome surprises. doesn’t cover will help you be better prepared for your enrollment ahead of time.

Items That Medicare Doesn’t Cover

When Medicare was first rolled out in the 1960’s, it was designed to cover hospital services and medical services. There are several things that fall outside of these that are not covered by Medicare at all.

These include routine dental, vision, hearing and foot care. Original Medicare also does not cover cosmetic surgery, most medical care in foreign countries, or long-term care like nursing home or assisted living facility care.

Medicare also did not cover any outpatient prescription drugs for many years. However, in 2006, Congress rolled out a voluntary program to help with outpatient medication expenses called Medicare Part D.

For many years, Medicare didn’t cover preventive care, but in 2010 this was changed and now Medicare offers an annual physical as well as a number of other preventive care procedures.

Fortunately, there are also many individual insurance policies on the private marketplace to help with some of the other items, such as dental, vision and hearing insurance or long-term care insurance.

Covering the Gaps

We mentioned that Medicare covers only about 80% of your medical expenses. You pay the rest in the form of deductibles, coinsurance, and copays.

You can purchase insurance coverage that helps you to pay these expenses when they arise. There are two primary types of additional coverage that you can choose.

You can choose to enroll in a Medigap plan or you can opt to get your Original Medicare benefits through a private insurance program instead, called a Medicare Advantage plan.

Medigap plans are sometimes called Medicare supplements. These plans pay after Medicare first pays its share. The plans help to cover the deductibles, copays, and coinsuranceon your behalf. There are ten standardized plans to choose from in most states, and there are several plan options provide a foreign travel emergency benefit up to $50,000 as well.

You can use your Medigap plan at any Medicare provider nationwide and you never need to get a referral.

Medicare Advantage plans are also called Medicare Part C plans. These private insurance plans typically involve treating with the plan’s network of providers. Typical networks include HMO-style networks where you must choose a primary care doctor or PPO networks where you can see any doctor in the network and even treat outside the network at additional costs.

You will pay copays for various medical services as you go along, and these expectations will be outlined in the plan’s Evidence of Coverage booklet.

Part C Medicare Advantage plans can also build in some extras that Original Medicare doesn’t usually cover, such asdental care, vision exams, and eyeglasses, hearing aids, and even gym memberships. Each plan must cover all of the same medical services as Original Medicare, but how you pay for your share of these services is different. Approximately 30% of Medicare beneficiaries enroll in a Medicare Advantage plan.

Prepare Ahead of Time

Though Medicare isn’t free, you can work with a financial planner or Medicare insurance broker to estimate your costs for Medicare ahead of time. This will help you avoid any unwelcome financial surprises and also help you to fully understand how your coverage will operate.

Danielle Roberts is the co-founder at Boomer Benefits, where she and her team help new Medicare beneficiaries to learn about their coverage and benefits. You can visit her website to learn more about your eligibility for Medicare.

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August 25, 2018

Cancer Insurance: Need of the Hour

insurance for cancerAmongst all the other health insurances, cancer insurance is becoming more and popular day by day. This is because the rate of the diagnosis of cancer is increasing worldwide so speedily and the cost of the treatment of this disease sometimes exceeds our capacity. Now before going further, you must know what cancer insurance is first. This specialized policy provides a limited coverage when you are diagnosed with cancer. This supplemental insurance policy reduces the cost related to the treatments and diagnosis which includes radiation, hospitalization, surgery, chemotherapy, blood transfusions, nursing care and the medicines prescribed by the doctors. The total of the assured amount depends on which stage of cancer you are being diagnosed a- major, minor or critical. Here are reasons why you should invest in this policy:-

  • Cancer Runs in the History of The Family:-The cost of the treatment of cancer is tremendously increasing with the increased number of cancer patients today. If you have a family history of cancer, then the chance of you being diagnosed with cancer at some point in your life is very high. In this case, choosing a cancer insurance policy can actually help you in the future.
  • Not Enough Financial Backup: In the case of medical emergencies, financial affluence can make a huge difference. Deadly diseases like cancer can leave you without a single penny. If you have a cancer insurance policy then it works as a backup and covers the costs of the treatment and makes you financially stable during hard times so that you can bear the medical expenses further. You do not need to worry about any sudden financial crisis as your chosen cancer insurance policy will surely have a pay-out option where you will be paid a lump sum amount if you are diagnosed with cancer. You can spend this money in any form you wish- to spend on travel expenses if you have to travel to some other place for the treatment or to pay the everyday hospital bills.
  • Can be used as a Supplementary to the current policy:-The premium of a cancer policy is lesser than the traditional health insurance policies. You must go for a comprehensive health insurance policy which is budget friendly and meets every need if you have a family history which indicates even the faintest chance of you, developing cancer. If you do not have any kind of health insurance yet and you have that little risk of being diagnosed with cancer, then based upon your financial capacity, you should go for this cancer insurance plan. Don’t think that in every case, having both comprehensive health insurance and a cancer insurance policy will provide you double coverage of non-cancerous diseases and cancer. There is a ‘co-ordination of benefits’ cause complementing with other health insurance plans, as mentioned in the cancer insurance plan. According to this clause, the benefits of the other health insurance plans are not provided. So if you are going only for a cancer policy then you must go through the exclusions and inclusions of the policy first.
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March 9, 2018

Reasons Why Your Health Insurance Claim Can Be Denied

health insurance coverageIn this time of rising medical inflation, investing in a medical insurance policy has become the need of the hour. The benefits of a health care plan indeed out weigh the cost. Many individuals, therefore, invest in a health care policy to enjoy financial protection in case of a medical emergency.

You may either opt for a reimbursement of the medical expenses incurred by you, or you may file a cashless claim. Though the procedure for filing a claim is quick and hassle-free, sometimes it may get rejected.

Following are six major reasons why your health insurance claim may be denied.

1. Providing inaccurate or incomplete details

One of the reasons for denial of the claim is a failure to furnish complete or accurate details. These details may pertain to your health condition, pre-existing conditions, or nature of employment, among others. Since these factors are crucial in helping the insurance provider to determine your eligibility and premium, they may deny the claim if they find out that crucial information has been withheld or if facts have been misrepresented.

2. Seeking claims for exclusions

Most medical health insurance plans come with a list of diseases and ailments that are beyond the scope of coverage. Making a claim for any conditions or ailments in the exclusion list will fail to qualify for coverage and hence the claim will be rejected.

3. Making a claim during the waiting period

Waiting period refers to the specified time frame that you must wait for, before beginning to enjoy benefits of the policy. This is the period during which pre-specified illnesses are not covered by your policy. Hence, making any health insurance claim during the waiting period will result in it being rejected.

4. Admission to a non-network hospital

Insurance companies have a network list of hospitals. In order to avail of a cashless facility, it is imperative to get admitted at any of the hospitals in the insurer’s network. The insurance provider may reject your cashless claim in an event that you are admitted to a non-network hospital. In such a case, however, you may seek reimbursement of the hospital expenses incurred by you. You may submit the original bills, medical reports, and fill the claim form while seeking reimbursement.

5. Claims made on lapsed policies

Your policy may stand lapsed in case you have failed to make premium payment before the due date. Making a claim once your policy has lapsed will mostly result in denial of the filed claims. It is, therefore, necessary to make timely payment of your medical health insurance premiums in order to enjoy uninterrupted benefits of your health policy.

6. Failure to notify the insurer within the stipulated time frame

Your medical health insurance policy states the period within which you must inform the insurance provider of your hospitalization. If the claim has not been brought to the notice of the insurer within the time frame stipulated in the terms and conditions of the policy document, the insurance claim will be rejected. You may, therefore, submit the insurance claim request within the time frame. You may also submit the original hospital bills as well as post-hospitalization expenses if any.

A medical health insurance claim denial may threaten your financial security and the ability to receive medical care. It is, therefore, necessary to identify the possible causes of rejection. Once you are well aware of the possible causes of claim denial, you may follow the guidelines to ensure that your claims are honored.

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March 25, 2017

Health Insurance that makes your Grand parents happy

health insurance for grand parentsThe right thing to know – The world we live in is full of risks and insecurities. Families, individuals, businesses, assets and properties are exposed to numerous types and certain levels of high risks. These definitely include the risk of health, life, property, assets, etc. We know that it’s difficult to prevent these risks, especially sudden miss happenings so the financial world has taken the responsibility to protect business and individuals against losses by compensating them with finance. Therefore, insurance is required with the full pace that eliminates or reduces the loss caused by any risk.

When we talk about health insurance, the first thing that comes to our mind is ‘Grandparents’. Ever thought health is such an important thing, especially when it’s about growing age. Sometimes, we initially don’t take a risk of traveling with them to abroad; we suffer from a fear of bad health. But every time this tact can’t be followed rather we need to find some solution for this. The best and relevant to this is – Super Visa Health Insurance.

Now, what exactly is Super Visa?

Super visa is a long term multiple entry visa for both grandparents and parents of Canadian citizens or permanent residents. They can stay up to maximum 2 years in Canada for every visit. This is valid up to 10 years. However, a regular multiple entry visa is also valid up to 10 years; but you can stay for 6 months only for every visit.

Eligibility for Super Visa

Super Visa is for grandparents and parents for Canadian citizens or permanent residents. Apparently, the grandparent or parent must be admissible to Canada and meet all the terms and conditions. Read on:

  • The applicant need to show Canadian medical insurance that meets the basic requirements and also covers then for minimum 1 year.
  • The applicant needs a letter of finance support from their grandchild or child in Canada, who earns the minimum required income.
  • Private medical insurance proof is required for the minimum time slot of one year with a copy of Canadian insurance company that covers hospitalization, repatriation, and health care and provides a minimum coverage of the certain amount, also is valid for the entry in Canada.
  • A copy of employment insurance pay stubs for grandchild or child.

Importance Generated

Although, the procedure can be little different if a grandparent or a parent is from another country, therefore, a visa is strictly required to enter Canada as a visitor. Health Insurance plays a key role in Super Visa, so make sure this is not ignored.

Validity for Super Visa

The maximum validity for Super Visa is 10 years, or it can be an addition to one month prior if the passport expires (whichever is earlier). Within this time Super Visa holders can stay up to two years.

On That Note

We truly know, how important is health insurance in today’s life, especially for our parents and grandparents. Therefore, in every limit, we need to make sure that this insurance is taken care.

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April 20, 2016

Health insurance through the ages 20 to 60

health insurance investmentsThe same health insurance policy can cost you differently at different life stages. We explain why this happens.

Taking life insurance in today’s times of uncertainty is de rigueur for any responsible person. While lifestyle diseases and serious illnesses like cancer are on the rise, the world is also witnessing unprecedented acts of terrorism and natural disasters. All in all, life is quite unsafe all over the world. But while we can exercise no control over how the world behaves and affects us, we can certainly safeguard ourselves and our families with life and health insurance policies.

However, the timing of purchase is crucial: any financial planner and insurance advisor will tell you that the younger you are when you buy life and health insurance plans in India, the lower your premium payments will be. There is a curious correlation between one’s age and how affordable or expensive the insurance plans become. This correlation changes with:

The 20s: A person has a job with a modest income, possibly a first job. The policy holder has relatively lesser family responsibilities and can easily pay the health insurance policy premiums. A person in their 20s is also healthier and fitter than his older counterparts, so the chance of disease is lower. Also, insurers estimate a larger life span for the policy holder, hence the sum assured will be higher while the premium payments will be lower.

The 30s: By this time, a person is married and has a family, while also having a stable job. His income is also higher than in the previous decade, while his health profile may not be as good as earlier. Insurers anticipate that certain lifestyle diseases like diabetes and cardiac problems take root in this decade. Also, your profession and lifestyle can have a bearing on the premiums of your health insurance policy. If you are employed in a line of work that puts you in danger (such as the police force, fire brigade, mining and construction, etc.) the insurer will insist on a higher premium payment for you.

The 40s and 50s: Premiums on health insurance plans will be much higher as compared to those a person in his 20s would pay. Insurers anticipate a lower life expectancy for the customer at this stage, along with many varied expenses at home (children’s higher education, medical treatment costs for self and parents, home mortgage payments, etc.) and so, the premiums will be larger. Insurers will also insist on a detailed health profile to eliminate the possibility of unknown diseases, critical illnesses, disorders arising out of smoking and substance abuse, etc.

The 60s: Most insurers do not give health insurance policies in India to people who have crossed the age of 60 years. People in this age group have retired from active duty, hence they do not have an income from which they can pay their health premiums. Secondly, it is costlier to insure a person past the age of 60 because of a high incidence of poor health and diseases. Instead of taking individual health plans in their 60s, people in this age group should look at getting included in the family health plans of their children.

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