The first of these Medicare Advantage plans is the Chronic Condition SPN (Chronic Condition Special Needs Plan, abbreviated C-SPN and pronounced C-snip for short). You may have one or more severe or disabling chronic conditions to include cancer, chronic heart failure, dementia, diabetes mellitus, end-state liver disease, neurologic disorders or end stage kidney disease that requires dialysis.

The second SNP is called the Institutional SNP (shortened to I-SNP) where you reside in an institution like a nursing home or require nursing care at home.

The third SNP is the plans for people that are dual-eligible for both Medicare and Medicaid. and commonly called D-SNP plans.

These Medicare SNPs are approved by Medicare and run by private companies. You will see the providers who belong to the plan or use in- network hospitals to get covered services. These plans offer specifically tailored services for a particular medical condition plus other services like emergency care or care at an urgent care facility.

Please give us a call at (845) 723-5055 if you have any questions about these plans.

October 15, 2023 to December 7, 2023: You can change your Medicare health or drug coverage for 2024 if you wish to. This period is called Medicare’s annual open enrollment. If you switch to a new plan, always make sure that your current doctors, hospitals and drugs are covered in your new plan. You can join, switch or drop a Medicare Advantage plan or drug plan.

January 1, 2024: This is the effective date of plan coverage if you switched to a new Medicare plan. It is also the starting date of your current plan’s changes for 2024.

January 1 to March 31, 2024: If you are in a Medicare Advantage plan, you can change to a new Medicare Advantage plan or return to Original Medicare coverage (Parts A and B) and join a separate Medicare drug plan. The new effective date of coverage will begin on the first day of the month after the plan gets requested. This period is called the General Enrollment Period. You can also use this period of time if you missed your initial enrollment period at age 65 or do not qualify for a Special Enrollment Period.

Please call (845) 723-5055 if you have any questions about this information.

If you currently have Medicare Supplement Plan F, you will be able to maintain Medicare Supplement Plan F as long as you wish and are current with your premiums.

These plans are also called “Medigap” plans since they will pay the out of pocket costs that are found in Medicare Parts A & B. For example, Medicare Plan F will pay the Medicare Part B co-insurance (20% of the Part B bills) , the Part A & B deductibles and the inpatient hospital costs and co-insurance under Medicare Part A for an additional 365 days after Medicare coverage runs out.

Medicare Supplement Plan G generally has the same basic benefits as Plan F except you will be paying a Part B deductible of $185 in 2019. This Plan G is available now in 2019 as well as into 2020. There are other Medicare Supplement Plans besides Plans F & G.

Please call me at (845) 723-5055 if you have any questions about your Medicare plan options or eligibility.

You can make changes during this time window. For example:

1. You can switch from Original Medicare (Parts A and B) to a Medicare Advantage plan (Plan C ) or vice versa.
2. You can switch from one Medicare Advantage plan to another.
3. Switch from one Medicare Part D plan (prescription drug plan) to another Medicare Part D plan.

Review your current Medicare plan(s) now. Have there been significant changes in your health or prescription drugs? Or changes in your doctors, healthcare providers or hospitals since last year or recently?

You can call me at (845) 723-5055 if you have any questions about your Medicare health insurance plans, eligibility or coverage.

1. You can surrender the policy to receive a lump sum payment from the insurance carrier, assuming that there is cash value at this time in the policy. The cash proceeds may be subject to income taxes if the amount of the check you receive is in excess of the total amount of premiums that you paid into the policy. Or you can borrow the remaining cash value from the policy, generally income tax free.
2. You can take a reduced paid up insurance option. If your original face amount was $250,000, the insurance carrier will issue a new whole life policy with a reduced face amount of say $160,000 and no premiums will be due during the insured’s lifetime.
3. The third option is to convert the $250,000 whole life policy to a $250,000 term policy. There will be no premium for this new term policy for say ten years, six month and 25 days. But after ten years, six months and 25 days, there will be no life insurance coverage.

Where can you find these details about your policy? These three non-forfeiture options are explained right in your whole life policy as well as the expected policy values also. Can’t find your policy? No problem, just contact your insurance carrier to request a duplicate policy.

If you have a term life insurance policy, there is no cash value. If you do not make a premium payment, the term life insurance policy will be generally terminated after 30 days (called a grace period) when the premium was due.

Always check with your tax advisor first on any potential taxation issues that may involve the policy options that we discussed here.

First, what is a rider? A rider changes the policy in some manner. For example, a common rider will waive (not have to pay) your premium if you remain disabled after six months. Most riders will add new features to your policy and bump up your premium. The more common riders include:

1. Accelerated Death Benefit Rider is also called the Living Benefit Rider. If you are terminally ill (normally within 12 months of dying), you can obtain up to 60% of the face amount (death benefit) of your policy and these funds will be received income tax free. You can use these funds for any purpose…pay medical bills, take a trip or give money away. This feature is often a standard feature today in many life insurance policies sold today. Either way, make sure your policy has this feature. Good news…there is NO premium for this feature.
2. Long Term Care Rider. Proceeds from the Long Term Care Rider can be used to pay for qualified services such as care in your own home, care in a nursing home or living in an assisted living community. Funds that are used for your long term care will reduce the amount of money when you die. For example, you have a $250,000 whole life policy with a Long Term Care rider. You use $50,000 for your long term care services. At your passing, your beneficiary will receive the remaining $200,000. This rider can only be attached to a permanent life insurance policy like whole life or universal life policy; it can’t be attached to a term life insurance policy. This type of policy is called today a “Hybrid” policy- one part life insurance and the other part for long term care. This policy will be definitely a blessing, either as a death benefit to someone and/or for your long term care.
3. Waiver of Premium Rider to any life insurance policy at the time of application — either a permanent policy or to a term life policy. You don’t need to pay the premium as long as you are disabled, usually for a period of least six months. You must pay the premium for the first six months of your disability; however, in the seventh month, the insurance carrier will send you back to you the premiums that you paid during the first six months.
4. Accidental Death Rider that will double or triple the death benefit if you die as a result of an accident. A good rider for young adults who are under-insured since accidents are a major reason for deaths among young adults.
5. Guaranteed Insurability Rider will allow you to buy more life insurance every three years or if you marry, birth of a child or an adoption up to age 40. No medical questions will be asked.
6. Insured Term Rider will allow you to add a term life insurance rider for more life insurance to your policy. For example, you are applying for $150,000 whole life policy ; you can add an additional $250,000 term life insurance to your policy to increase the total death benefit to your policy. Now you will have a permanent life policy (whole life insurance) for the rest of your life and more protection with an affordable term life insurance rider on the same policy.

I am frequently asked this question. Can I add a rider after my policy has been issued. Answer is no, sadly. Riders must be selected at the time of application.

There are other riders too, besides the ones above. . Inquire about them too. Call me, Bob Quinlan at (845) 723-5055 if I can help you.

….extended care in your home due to an injury or illness

….care in a skilled nursing facility (nursing home)

….reside in an assisted living community

…spending time in an adult day care center

…or need changes in your home to accommodate a wheel chair or to modify your bathroom.

These life changes are challenging in the best scenarios or to downright not doable. We need the desire and determination to explore Long Term Care Planning:

…What options for long tern care are available today under your present health insurance plan?

…What care services are available under Medicare if you are age 65 and older? Good news, Medicare will pay for some SHORT TERM care services in a nursing home or at home. Medicare does not cover Long Term Care services in a nursing home or an assisted living community, care that can cost over $10,000 per month.

…Long Term Care Insurance is still in favor. It is available in three different formats to match your needs:

— Traditional long term care insurance that you reimburse you from $50 per day to up to $500 per day; you pay an annual premium.

— Hybrid permanent policy (like whole life or universal life, no term life insurance is permitted) that will provide you with both life insurance protection and long term care expense reimbursement.. You pay an annual premium.

— Single Premium Permanent Policy that will provide you with both life insurance protection and long term care insurance to pay your long term care expenses. You will pay the lifetime premium once in a single payment.

Call my office at (845) 723-5055 or my mobile phone at (845) 325-8680 if you need an advice or help about long term care planning. You will never regret your time spent planning for these “what ifs” that will likely occur to many of us.

EPIC also covers many Medicare Part D excluded drugs. All EPIC members must have Part D coverage in order to receive EPIC benefits.

Another big plus to this program is seniors can change their Medicare Part D plan one time during the year. They do not have to wait until Medicare’s Annual Open Enrollment period (October 15 to December 7) in the Fall.

For more information you can call EPIC at (800) 332-3742 (TTY 800-290-9138) or download an application at http://health.ny.gov_care/epic/application_contact.htm.

There is no fee to enroll. The application should take you about 5 -10 minutes to complete. Hope this information will be beneficial to you.

It allows the insured to withdraw up to 60% (varies with each carrier) of the policy’s face amount (the death benefit) today and pay no income taxes on the amount withdrawn. The funds can be used for any purpose like pay medical bills, take a trip or gift money to anyone.

There is no premium for this rider or provision. Just notify the insurance carrier along with your medical doctor’s letter of your terminal diagnosis.

This provision or rider can be attached to any term life insurance policy or permanent policy like a whole life or universal life policy. However, this provision (like all riders) must be added at the time of application. You cannot routinely add riders or provisions to your policy after the policy has been issued.

Ok, all sounds good. What if you outlive the twelve month grim prognosis? No problem. There is no requirement to repay the amount of money that was withdrawn from the policy. Say someone has a $500,000 face amount life insurance policy and withdraws $200,000 today due to a terminal illness. The person lived another 15 years. The person’s beneficiary will receive $300,000 at his/her passing.

Sadly tens of millions of dollars that could have paid out to terminally ill people were not paid to insureds for one sad fact. Many people today were unaware of this provision. So, simply find your life insurance policy today and look for this important feature. Can’t find your policy? Contact your insurance carrier and ask about the key features in your policy. And also request a duplicate policy. And if you completing a life insurance application now, always make sure that the Accelerated Death/Living Benefit feature is included in your policy. We never know when this feature will make a significant difference in our everyday lives.

The big premium increase will be felt by single woman applying for long term care insurance with middle aged men generally enjoying a decline in premium for the first time.  The reason for this premium change is to recognize the big difference in claims submitted by men and women. Women account for two-thirds of the $6.6 billion in claims paid by insurers in 2013.   Women have longer life expectancy than men.

Carriers have not obtained state insurance approval for this new premium structure in all fifty states.  For example, John Hancock is still using old unisex (blended) premiums for both men and women in New York today.  They have awaiting approval from the NYS Department of Financial Services for approval to offer the new male/female premiums.

The best age bracket for long term care planning is between age 50-59 or even younger if you are a business owner. Call Bob Quinlan at (845) 534-4360 or him at BobQ@QuinlanCare.com if you have any questions or would like start a discussion on long term care planning.