Use the ACA for Pre-Retirement Medical Insurance - the Affordable Care Act

People between the ages of 50 and 65 often pay extremely high medical insurance premiums.  What they may not realize is that many of them may qualify for a discount on their medical insurance if they take advantage of the ACA or Affordable Care Act.  This is an income based discount and may only be available if you apply during the annual open enrollment period.  Currently, those who want to investigate whether or not they qualify for lower medical insurance premiums through the ACA need to apply between November 1 and December 15. 

Those who miss the deadline but have what is considered a special qualifying event, such as an adult child who recently lost coverage under their parents' plan, or someone who has lost their employer sponsored or COBRA insurance, can apply at any time of year.  However, they must apply within 60 days of the time the "qualifying event" occurred.    This program is available even if you only need the coverage for a few months until you get a new job or qualify for Medicare.

Apply Even if you did not Qualify in the Past

If you have not been eligible for a discount through the Affordable Care Act in the past, you may still want to try again this year.  Several states, including Idaho, Utah and Nebraska, have recently passed Medicaid expansions, which means hundreds of thousands of people who previously were not eligible to receive help from the Affordable Care Act are now eligible.  Other states have also expanded their programs.

How to Apply Online or in Person

The official national website for the Affordable Care Act is:  healthcare.gov.  On the website you can either apply immediately for medical insurance or learn how to get personal help in the state where you live from a local agent or broker.  There is even a "Quick Start" guide on the website to make the application process easier.

If you live in California, the official site for receiving information about the Affordable Care Act is:  Covered California.  You can apply online or you can use the website to find the location of offices where you can get personal help with the application process.  You may also see small offices for Covered California in malls and shopping centers, manned by experts who can help you through the application process.

Pre-existing Conditions

According to the healthcare.gov website, "Under current law, health insurance companies can’t refuse to cover you or charge you more just because you have a “pre-existing condition” — that is, a health problem you had before the date that new health coverage starts."

Preventive Care

The website also explains that the Affordable Care Act provides the following preventive care:

"You and your family may be eligible for some important preventive services at no additional cost to you.

If your plan is subject to the new requirements, you may not have to pay a copayment, co-insurance, or deductible to receive recommended preventive health services, such as screenings, vaccinations, and counseling.

For example, depending on your age, you may have access — at no cost — to preventive services such as:

• Blood pressure, diabetes, and cholesterol tests
• Many cancer screenings, including mammograms and colonoscopies
• Counseling on such topics as quitting smoking, losing weight, eating healthfully, treating depression, and reducing alcohol use
• Regular well-baby and well-child visits, from birth to age 21
• Routine vaccinations against diseases such as measles, polio, or meningitis
• Counseling, screening, and vaccines to ensure healthy pregnancies
• Flu and pneumonia shots - Visit Vaccines.gov to learn more

Please Help Share this Information

It is important to pass this information to anyone you know who may benefit from the ACA, including your adult children who may no longer be eligible to be covered by your insurance.  Getting them insured under the Affordable Care Act could save you a great deal of money if they become injured or ill.

The advertising budget for the ACA has been drastically cut, so many people do not realize they are eligible and that we are currently in the open enrollment period.  There are virtually no television ads for the program. 

Feel free to email this information to friends you believe could benefit, or post a link to this article on Facebook, Twitter or other social media you use.  By sharing this information, you could make life much easier for someone who is not old enough to be eligible for Medicare, and may be feeling overwhelmed by the high cost of their medical insurance premiums.

If you are interested in learning more about Medicare, Social Security, common health problems as you age, where to retire in the US and abroad, financial planning and other retirement related issues, please use the tabs or pull down menu at the top of the page to find links to hundreds of additional helpful articles.

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Inflammation Link to Dementia and Alzheimer's Disease!

Many of the articles on this blog have dealt with how to reduce your risk of dementia and Alzheimer's Disease by focusing on eating the proper diet, exercising, getting enough sleep, treating symptoms of dementia and staying socially active.  Some of these behaviors, especially improving your diet, can also lower the level of systemic inflammation in your body.

Inflammation has now been connected to a number of health problems, including diabetes, heart disease, high blood pressure, cancer, Alzheimer's Disease and other forms of dementia.  According to Dr. Douglas DiSiena, the co-author of "Possibility Thinking: Adding Years to Your Life and Life to Your Years," one-third of the cases of Alzheimer's Disease and dementia could be prevented through dietary and lifestyle changes.  This is significant, because people over the age of 85 have a 47 percent chance of developing some cognitive decline.  If you do not want to suffer from this cognitive decline as you age, below are the actions you can take to protect your brain health.

Lab Tests to Determine Your Level of Inflammation

In a lecture by Dr. DiSiena, which I attended, he recommended that people first need to determine the current level of inflammation in their body.  In order to do this, they should ask their doctor for the following blood tests in order to determine their level of inflammation:

HS CPR or High Sensitive C-Reactive Protein - a level of 1 or lower is ideal.

A1C - This tests your blood sugar levels over the preceding three months - A score of 4.4 to 5.2 is ideal, although a score of 5.3 to 5.5 is OK.  This test will determine if you are pre-diabetic or diabetic. (Scores over 5.6 indicate pre-diabetes; high scores indicate diabetes.)

Test Your Current Level of Cognitive Function

Take a Standardized Mini-Mental State Examination (SMMSE) - You can find examples of the test online and ask a friend to give it to you.  You can also ask your doctor or therapist to give it to you. The websites explain how to score the test.  After making some of the healthy changes recommended in this article, take the test again and see if your scores have improved.

Causes of Inflammation

If you have inflammation anywhere in your body (such as gum disease or an injury), it will affect your brain and cause increased brain shrinkage.  There are a number of possible causes of any inflammation you may be experiencing:

A high carb diet which is heavy on grains and processed foods
Toxins, including drugs and heavy metals like aluminum in the blood
Trauma, such as a concussion or other injuries
Negative thoughts

Your Brain Can Recover at Any Age

The good news is that your brain has neuroplasticity.  If you currently have impaired cognitive function, it is almost never to late to reverse course and make diet and lifestyle changes which can reduce your inflammation and improve your test scores and brain function.

Try to eat a Mediterranean based diet, which relies heavily on vegetables, followed by nuts, fish like salmon or tuna, and olive oil.  This diet should increase the amount of Omega-3 fatty acids you consume and reduce the amount of Omega-6 fatty acids.  Taking an Omega-3 capsule can help you maintain the proper balance.

Neurofeedback training has also been shown to directly improve brain function.  In some studies, after 20 neurofeedback sessions the patients were able to improve their scores on the SMMSE (Standardized Mini-Mental State Examination) by six points.  That can make the difference between having a score which indicates cognitive decline and one which indicates healthy brain function.

Making the right dietary and lifestyle changes can be the difference between slowly losing your cognitive function and remaining mentally sharp for the rest of your life.  

If you want to learn more about preventing dementia and other common medical problems as we age, as well as retirement planning, where to retire, Social Security, Medicare and more, use the tabs or pull-down menu at the top of the page for links to hundreds of additional articles.

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Social Security Changes in 2019

Every year, the Social Security Administration makes a few changes to the program. The changes are intended to help retirees keep pace with inflation while, at the same time, maintaining the program's solvency.  It can be a difficult balancing act which does not always achieve its goals.

In 2019, beneficiaries can expect to get the largest cost-of-living increase in several years, which is wonderful news for the millions of people who depend on Social Security to cover all or most of their living expenses.  Even better, the cost-of-living increase should not get eaten up by an increase in Medicare premiums, which has happened in the past. However, this is not the only change we can expect to see in 2019.  Below is a list of some of the most significant changes to Social Security in 2019.

Largest Social Security Increase in Years

For many people, the most significant important change will be the 2.8 percent cost-of-living increase.  This means the average monthly payment will rise to $1,461 and the average married couple with receive $2,448 per month, if both of them receive benefits.  For those of you who have not begun to collect, this gives you an idea of what to expect.  For those who are already collecting, this will help you determine how your benefits compare with those of other recipients.

A Small Increase in Medicare Part B Premiums

In 2018, the Social Security COLA was so small that it was entirely eaten up by the increase in Medicare premiums for many beneficiaries.  Next year, the increase in Medicare Part B premiums is so small that things should be much better for most people.  The premiums are going to increase to $135.50 in 2019 from $134 in 2018.  This $1.50 increase in premiums is unlikely to have a negative impact on many Social Security beneficiaries.

However, there were some people whose Medicare premiums were less than $134 in 2018 because
they did not get a large enough raise last year to cover their increase in Medicare premium.  For those people, their Medicare premium this year could be greater than $1.50 and, therefore, might take all or most of their Social Security increase.  

An Increase in the Maximum Social Security Benefit

If you have been fortunate enough to earn a high income during the 35 best years of your working career, the maximum amount of Social Security you could receive in benefits has increased.  For those people at the top of the income range who retire at age 62, they could receive up to $2,209 a month; at age 65 they could receive up to $2,757; and at age 70 they could receive up to $3,770.

Workers will Have Slightly More Income Subject to Taxation

If you are still working, you will see a small increase in the amount of your income which will be, subject to Social Security taxes.  The 2019 maximum taxable earnings will rise from $128,400 to $132,900.  Workers will be pleased to know that the tax rate itself will not change from its current rate of 12.4 percent, split evenly between employee and employer.

Normal Retirement Age will Increase by Two Months

Workers who want to collect their full Social Security benefits will need to work two months longer.  If you are turning 62 in 2019, your full retirement age will be age 66 years and six months.

You Can Earn More if You Work while Collecting Social Security

Many people find they need to continue to work and earn extra income, even after they begin to collect their Social Security benefits.  If you are under your full retirement age, collecting Social Security and working at the same time, the amount you can earn without having your benefits reduced will rise from $17,040 to $17,640.  You can earn more than that, but if you do, the Social Security Administration will withhold $1 for every $2 you earn above the $17,640 limit.

You should also know that if you reach your full retirement age in 2019 and earn over $46,920 in the months leading up to your retirement, Social Security will withhold $1 for every $3 you earn in excess of $46,920, but just for that one year.

Once you reach full retirement age, you can earn as much as you want without having your benefits reduced.  Today, we are seeing many people continue to work, either in their previous career or in a new career, for years after reaching full retirement age.

New Calculations for Your Social Security Benefits

Without going into complicated mathematical calculations, the government is making a few slight tweaks to how they calculate your past earnings, inflation adjusted.  These numbers are used to determine how much people will receive in benefits when they claim their Social Security, so the changes will benefit people who have not yet begun to collect.

Be Aware of More Changes Which Could be Coming

After the election, it is likely that Social Security and Medicare could be put on the cutting block by Congress.  Because of the 2018 income tax changes, government revenues have dropped dramatically and the deficit is increasing rapidly.  Some factions in Congress are proposing dramatic changes to these two programs which could result in cuts to both Social Security and Medicare.

Some of the changes could be very subtle.  For example, there is a faction which wants to change the way future cost-of-living increases are calculated, by using a different CPI or Consumer Price Index.  Currently, they use a CPI-W, which estimates the cost of living for a typical worker.  Some groups would like the government to use a CPI-E, which considers the cost of items typically used by the elderly, such as healthcare.  This would increase the size of future cost-of-living increases.

Unfortunately, a large group in Congress have stated they want to go with a Chained-CPI, which would be devastating for many senior citizens because they would only get extremely tiny increases, or none at all, because this CPI calculation assumes the elderly will just keep cutting down on what they pay for things by purchasing cheaper items.  Since many elderly already are living on very tight budgets, the possibility of the government using a Chained-CPI is very alarming for many senior citizens.

All older Americans, whether they are retired or not, should follow the debate over Social Security carefully, because it will affect nearly everyone in the nation.  Even if you have a private pension or you are wealthy, it is likely that some people in your family will be affected by changes to Social Security.  You can learn more about the changes being discussed at the website for The National Committee to Preserve Social Security and Medicare.

If you are interested in reading more about Medicare, Social Security, financial planning, where to retire, changing family relationships, common health problems, travel and more, use the tabs or pull down menu at the top of the page to find links to hundreds of additional articles.

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Medicare Open Enrollment - Expert Answers Your Questions

Are you thinking about changing to a different Medicare plan or making changes to your current one?  There are certain rules regarding when you can make these types of changes. This week we have another special post from our Medicare expert, Danielle Roberts.  She is highly qualified to answer your questions about Medicare, how it works and the timing of changes you may want to make.  If you still have questions after reading this post, her contact information is in the sidebar and there is a link to her site in the "About the Author section."

 

Getting Ready for Medicare Open Enrollment

Medicare has several periods each year when beneficiaries can make important plan changes and coverage elections. However, we often find that many beneficiaries are not certain what each of these election periods is for and what they should be doing each year to review their coverage.
  

In this post, we’ll explain the upcoming windows and how you can prepare for them.

 

Medicare Open Enrollment Period vs Annual Election Period

 

Medicare uses the term “open enrollment” for multiple different election periods, so it’s easy to get them confused. We find it easiest if beneficiaries refer to the fall enrollment period as the Annual Election Period (AEP). This helps to keep the election periods straight in your mind.

The Annual Election Period begins October 15^th and goes until December 7^th. There is also a new Medicare Open Enrollment Period for 2019 which will go from January 1^st to March 31^st.  Let’s go over what changes you can make in each period because they are different.

 

Medicare’s Annual Election Period: October 15 – December 7

 

When you enroll in a Medicare Advantage plan or a Part D drug plan, you are locked in for the rest of the calendar year. You must wait until the Annual Election Period to make changes to your plan(s).

During the AEP you can switch from one Medicare Advantage plan to another and you can switch from one Part D drug plan to another drug plan. You can also switch from a Medicare Advantage plan back to Original Medicare and vice versa. 

When you make any of these changes during the AEP, your new plan goes into effect January 1^st of the following year. (If you don’t make any changes to your current plan, your current plan will auto-renew for the next year.)

 

Medicare’s New Open Enrollment Period: Jan 1 – March 31

 

Sometimes people who enroll in a Medicare Advantage plan during the AEP find that they do not like their new plan. It could be that they did not understand their coverage, or it might also be that they learned too late that one of their doctors is not in the network.

In recent years, these beneficiaries would be locked into that plan for the entire year. However, beginning in 2019, Medicare has a new Open Enrollment period from January 1^st to March 31^st that will allow beneficiaries who are enrolled in a Medicare Advantage plan to make a one-time change.

During this OEP, they can change to a different Medicare Advantage plan or they can disenroll from their Advantage plan to return to Original Medicare and elect a new standalone Part D drug plan to go alongside that coverage.

It’s important to note that if you drop your Advantage plan and decide not to enroll in a Part D plan, you can be penalized for the time you go without creditable drug coverage.

Here’s a recap:

The Medicare Annual Election period in the fall is for all Medicare beneficiaries. It is for enrolling in, disenrolling from or changing either your Medicare Advantage plan or your Part D drug plan. The last plan selection that you make prior to December 7^th will become effective January 1^st. 

The Medicare Open Enrollment Period which begins in January only applies to beneficiaries who are enrolled in a Medicare Advantage plan. These beneficiaries can either switch from one Medicare Advantage plan to another or they can switch from a Medicare Advantage plan back to Original Medicare.

You cannot switch from one Part D drug plan to another during the OEP. That’s the main difference between the AEP and the OEP.

 

Your Annual Notice of Change Letter

 

The first step to getting ready for the AEP is to review your Annual Notice of Change (ANOC). Your ANOC is a letter sent to you by your current Medicare Advantage plan or Part D drug plan.

This letter states all changes that your current insurance carrier is making for the following year. It lists changes in monthly premiums, copays, coverage, deductibles, and drug formularies. You will want to review this thoroughly to ensure you make the right decision during the AEP.

 

Medigap Open Enrollment

 

To add to the confusion around the term “open enrollment,” there is also a one-time Open Enrollment period for Medigap plans.

The Medigap Open Enrollment is a one-time window that begins with your Part B effective date. During the six months directly after your Part B effective date, all Medicare beneficiaries have a one-time chance to enroll in a Medigap plan without having to answer health questions. This is a “use it or lose it” enrollment period. Once it has passed, it does not recur again.

This does not mean that later you cannot attempt to change your Medigap plan. In fact, Medicare beneficiaries can apply for new Medigap plans anytime throughout the year. However, unless you live in a specific state with different rules or have a guaranteed issue window because you are leaving employer group health coverage, you will have to answer health questions whenever you apply for a Medigap plan outside of your one-time Medigap open enrollment period. Depending on your answers and your medical record, you could be denied coverage for a new Medigap plan.

 

Get Ready with A Medicare Broker

 

Working with a Medicare broker can take the stress out of the decision making. A broker can evaluate each of your plan options in your area and explain any applicable rules. This will help you have more confidence in your choice.

About Guest Post Author, Danielle Roberts:  This guest post was written by our Medicare expert, Danielle Roberts, one of the co-founders of Boomer Benefits and a frequent contributor to this blog.  As always, we greatly appreciate her willingness to share her expertise and her ability to calmly explain these difficult-to-understand issues in clear terms.

If you want to learn more about Medicare, Social Security, where to retire, financial planning, and more, use the tabs or pull down menu at the top of the page to find links to hundreds of additional articles.

You are reading from the blog:  http://www.baby-boomer-retirement.com

Photo credit:  morguefile.com