Help Soon for Boomers Without Health Insurance

Several Baby Boomer women I know are in the uncomfortable position of having lost their health insurance.  This happened because they were paying for their insurance through their husband's employer.  When the husband retired, sometimes sooner than they had planned because of an illness or job loss, the husband was able to go on Medicare if he was at least 65 years old.  Unfortunately, if the wife was under 65, they were not eligible for Medicare.  Some of these women have been able to obtain expensive personal policies, often through COBRA.  However, others are just hoping and praying they stay healthy until they are old enough to go on Medicare, too, especially if the high cost of COBRA or a pre-existing medical condition makes the cost of health insurance prohibitive.  I'm sure this same situation has happened to men who are dependent on their wife's employer for health insurance, too. 

New Health Insurance Exchanges

Fortunately, this should no longer be a problem after the end of this year. Beginning in 2014, insurance companies can no longer refuse to insure adults who have pre-existing conditions.  Starting this October, most states will have online insurance exchanges that will enable people of any age to begin shopping for affordable insurance policies, whether they have a pre-existing condition or not. The AARP Bulletin for January - February, 2013 recently reported on the status of the new health insurance exchanges, which were mandated by the Affordable Healthcare Act.

According to AARP, most states have already begun to decide how they will handle these exchanges.  Seventeen states and the District of Columbia have announced that they will operate their own exchanges; five states will partner with the federal government; eighteen states have said they will accept the default exchange that will be operated by the federal government; the remaining states have not made a decision.

How the Health Insurance Exchanges will Work

These exchanges will operate online.  They will be open to small businesses and individuals who cannot get affordable insurance through their employer.  The exchanges will also help people identify if they are eligible for any financial assistance through tax credit premium subsidies.  This will make it possible for even low income people to afford health insurance.

The goal of a health insurance exchange is to help anyone who does not have insurance, or who loses their insurance for any reason, to be able to replace their policy quickly, efficiently and at a reasonable price, even if they have a pre-existing condition such as a history of cancer, kidney disease or diabetes.  If the exchanges work as planned, they will give couples on the verge of retirement one less reason for worry.

There is another reason why we may experience some financial relief as a result of these exchanges.  Many Baby Boomers I know have been helping their adult children pay for health insurance.  Others are assisting their adult children by helping to pay off large medical bills their children incurred because they were uninsured.  The new insurance exchanges should bring us all some peace of mind.

If you are a Baby Boomer concerned about health issues, you may also be interested in reading these articles:

Sexually Transmitted Diseases After Age 50
Doctor Housecalls Provide Home Medical Care
How to Avoid Phony Online Pharmacies
Planning for Long Term Medical Care

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Photo of senior couple courtesy of www.morguefile.com

How the Affordable Healthcare Act Affects You

The Affordable Heathcare Act has been upheld by the U.S. Supreme Court and is the law of the land.  While millions of people have been able to obtain insurance under it, some for the first time, many other people are confused about how it will affect them.  If you are interested in reading the full text of the Healthcare Act, you can find it on the government's website at HHS.gov.  It has detailed information that will pertain to people of all ages.  However, below are some key provisions that will be of interest to those of us who are 50 and older.

If You are on Medicare

If you are already on Medicare, it means that you now qualify for a yearly wellness visit and other preventive services for free, including no-cost screenings for cancer, diabetes and other chronic diseases.  There will be better discounts on drugs for senior citizens. Improvements will be made to care for seniors after they leave the hospital. You may also receive help if you need to stop smoking. On regular Medicare, there will be no co-payment or deductible for screenings such as:

Bone mass measurement
Cervical cancer
Cholesterol and other cardiovascular screenings
Most colorectal screenings
Diabetes screenings
HIV screenings, if requested
Mammograms
Prostate cancer screening

You should also be able to get free flu shots, pneumonia shots and the hepatitis B shot.

If you are in a Medicare Advantage Plan, you need to check with your provider for information about their benefits.  However, Medicare Advantage Plans are required to provide the same minimum benefits as regular Medicare and, in some cases, may even be better.

If you have a Medicare Supplement Plan, you will have basic Medicare plus whatever additional benefits your supplement plan provides.

Whatever type of Medicare you have, you may also want to supplement your insurance with a vision and dental plan.  Most Medicare plans do not include these benefits; you must purchase a separate plan for them.

If You are Not Yet on Medicare

For those people over the age of 50 who are still working and not yet old enough for Medicare, the Affordable Healthcare Act was completely implemented by January 1, 2014.  Here are some of the significant changes taking place:

Small Business Health Insurance Tax Credits to make it easier for small companies to provide insurance for their employees.

Federal matching funds that help states cover more people on Medicaid.  Unfortunately, some states have opted out of accepting these matching funds, which means that insurance is unnecessarily expensive for middle class residents of those states.  Some states, however, are beginning to change their minds and reducing the barriers to accepting the matching funds.  You will have to check with insurance representatives in your state to see if you could be eligible for financial assistance with your premiums.

A program to provide financial help for employment based insurance plans so they can continue to cover people who retire between ages 55 and 65, as well as their spouses and dependents.

You cannot be denied health insurance because of a pre-existing condition.

Young adults can now stay on their parent's insurance plan until they are 26 years old.  This has been a tremendous help to young adults who are in graduate school, student teaching or doing internships for little or not pay.

No deductible, co-pay or coinsurance payment for certain preventive services such as mammograms and colonoscopies.

Insurance cannot be cancelled if you get sick.

Insurance cannot be dropped if you participate in a clinical trial.  (Personally, I didn't know this was even possible before.  My husband has been participating in a clinical trial of a drug for chronic kidney disease.)

No annual or lifetime limits on your insurance coverage.

Children cannot be denied insurance coverage because of pre-existing conditions.

Women will no longer be charged more for their health insurance.

Insurance companies have to justify premium increases and show that a significant portion of the premiums they collect are going to provide healthcare benefits.  This requirement seems to work better in some states than others.  In some states, like California, the Insurance Commissioner cannot block premium increases.  Some state legislators are working to change this.

Expansion of community health centers; incentives to increase the numbers of doctors, nurses and other heathcare professionals.

There are many more details than could possibly be included in this blog.  Although there remain glitches in the Healthcare Act and people who still fall through the cracks, millions of uninsured people have obtained insurance through it and this trend is expected to continue in coming years.

If you are interested in learning more about health issues affecting senior citizens, changing family relationships, where to retire or financial planning, use the tabs or pull down menu at the top of this page to find links to hundreds of additional useful articles.

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Photo of patient courtesy of morguefile.com/