If you or a loved one you know is nearing retirement, you may find yourself wondering more frequently about Medicare. In this blog article, we break down the three most important things every retiree needs to take note of with regards to Medicare – BEFORE making a final decision.

What are the minimum eligibility criteria to NOT have to pay excessive premiums for Medicare?

Generally speaking, Medicare is available for people age 65 or older, younger people with disabilities, and people with permanent kidney failure requiring dialysis or a transplant. 

Remember that Medicare has two parts, Part A (Hospital Insurance) and Part B (Medicare Insurance). 

Retirees are eligible for premium-free Part A if they are age 65 or older and you or your spouse worked and paid Medicare taxes for a minimum of 10 years. You can get Part A at age 65 without having to pay premiums permitted you adhere to the following criteria:

• You are receiving retirement benefits from Social Security.
• You are receiving retirement benefits from the Railroad Retirement Board.
• You are eligible to receive Social Security or Railroad benefits but you have not yet filed for them.
• You or your spouse had Medicare-covered government employment.

2. What if I’m younger than 65 and took an earlier retirement package, do I still qualify?

In short, yes. If you are under age 65 and you opted for early retirement, you can get Part A (Hospital Insurance) without having to pay premiums if:

• You have been entitled to Social Security or Railroad Retirement Board disability benefits for 24 months. (Note: If you have Lou Gehrig’s disease, your Medicare benefits begin the first month you get disability benefits.)
• You are a kidney dialysis or kidney transplant patient.

It’s important to note that while most people do not have to pay a premium for Part A, everyone must pay for Part B (Medicare Insurance) if they want it. This monthly premium is deducted from your Social Security, Railroad Retirement, or Civil Service Retirement check. If you do not get any of these payments, Medicare sends you a bill for your Part B premium every 3 months.

3. Will my prescription drugs be covered by Medicare in full?

Mostly. Since January 1, 2006, everyone with Medicare, regardless of income, health status, or prescription drug usage has had access to prescription drug coverage.

Most Medicare drug plans (Medicare drug plans and Medicare Advantage Plans with prescription drug coverage) have their own list of what drugs are covered, called a formulary. Plans include both brand-name prescription drugs and generic drug coverage. The formulary includes at least 2 drugs in the most commonly prescribed categories and classes.

The formulary might not include your specific drug. However, in most cases, a similar drug should be available. If you or your prescriber (your doctor or other health care provider who’s legally allowed to write prescriptions) believes none of the drugs on your plan’s formulary will work for your condition, you can ask for an exception.

It is also worth noting that your plan may raise the copayment or coinsurance you pay for a particular drug when the manufacturer raises their price, or when a plan starts to offer a generic form of a drug, but you keep taking the brand name drug.

If you would like to explore more about Medicare and senior insurance, you can reach out to Innovative Broker Partners. As part of our trusted coalition here at Senior Resource Connectors, they will be able to guide you on the next best steps for your new journey. Alternatively, get in touch with our clinical concierge at no cost to you for the best referral within our trusted network of companies.

Our mission at Senior Resource Connectors is to provide Arizona seniors and their loved ones easy access to the most trusted and highly professional resources for care as they encounter the many physical and emotional challenges that come with aging today.

Life insurance can leave a lot of people scratching their heads in confusion. There is a lot of jargon to decipher, and the insurance industry has seen its fair share of scandal and fraud, leaving many people skeptical about its effectiveness and relevance in today’s world. This article sheds some light on some of the most pressing questions about insurance for seniors who reside in Arizona.

What is the difference between whole life insurance and guaranteed universal life insurance?

Whole life insurance can provide lifelong coverage and long-term peace of mind because the death benefit will payout regardless of when you die, as long as you pay the premiums. Like other permanent policies, whole life builds cash value by investing a portion of your premiums into a savings account. You can then withdraw the cash or take out a loan against the value. However, it can take time for the cash value in life insurance to build — sometimes a decade or more.

This type of life insurance is typically more expensive than term products, especially if you purchase a policy later in life. This is because your health can decline as you age, and your life expectancy is shorter, which means the insurer might have to pay out the policy sooner.

Guaranteed universal whole life insurance is a blend of term and permanent life insurance. Guaranteed universal, sometimes called “term for life,” is similar to term coverage in that the policies expire after a certain amount of time. However, instead of choosing several years to cover, you select an age at which the policy will expire, such as 90, 110, or 121.

Guaranteed universal life has lower monthly premiums than whole life, but it typically offers a small cash value while providing high coverage amounts. Guaranteed universal policies usually require you to pass a medical exam to qualify, and coverage is not always assured. The word “guaranteed” refers to a guaranteed death benefit permitted you pay your premiums.

How much insurance do I really need at my age? And how does one calculate this?

This figure can vary significantly as it is dependent on a couple of factors. Finding affordable life insurance for seniors is not always easy, as the cost of coverage typically increases as you age. But affordable options may be available, especially if you’re in good health. Here’s the average cost of life insurance for older adults, including seniors over 80, noted by gender:

• For women aged 65 and older, whole life insurance coverage of up to $100,000 can cost anything from $349 and upwards a month.

• For men aged 65 and older, whole life insurance coverage of the same amount can cost anything from $414 and upwards a month.

• For women aged 65 and older, guaranteed universal life insurance coverage of up to $10,000 can cost anything from $66 a month.

• For men aged 65 and older, guaranteed universal life insurance coverage of up to $10,000 can cost anything from $88 a month.

I’m retired and have no debt. Do I really still need life insurance?

If you’re debt-free and have healthy savings or funds set aside for final expenses, you might not need life insurance coverage. Although it’s always best to double-check with a professional if you’re unsure. A life insurance policy might make sense if you:

• Have outstanding debt that others would have to repay.

• Support a spouse, child, or other dependents with your income.

• Want to cover your funeral and burial costs.

• Have a high net worth and want to cover estate taxes.

• Want to provide an inheritance to those you leave behind.

I already have a lot of savings in different accounts. Is life insurance still relevant/necessary?

It may be challenging to say. Rather chat to a professional financial advisor to determine whether these accounts or savings will serve the needs of those you leave behind after your passing or whether your loved ones will still feel the pinch in your absence. 

If your death would financially harm no one in your life, you can likely put off investing in a life insurance policy. For now, you may find that saving and investing your money in other assets — stocks, bonds, your retirement funds, or real estate, perhaps — is a better move.

If you would like to explore more about senior insurance, you can reach out to Innovative Broker Partners. As part of our trusted coalition here at Senior Resource Connectors, they will be able to guide you on the next best steps for your new journey. Alternatively, get in touch with our clinical concierge at no cost to you for the best referral within our trusted network of companies.

ALTCS or Arizona Long Term Care Services is an Arizona Medicaid program that is designed to help fixed-income seniors and other disabled individuals afford the care that they need. ALTCS pays for the care that you need after savings are exhausted.

How do I apply for ALTCS?

To apply, you need to complete an application.

Another person can act on your behalf during the application process, such as a finance professional.

You will need to provide documents to show that you meet financial and non-financial eligibility requirements.

It must be determined that you require a nursing home level of care.

But what are the Non-Financial Eligibility Requirements?

• To be eligible for ALTCS, you must:

• Be determined in need of a nursing home level of care as determined by AHCCCS; Be a citizen or qualified immigrant;

• Have a Social Security Number (SSN) or apply for one; Be an Arizona resident;

• Apply for all cash benefits that you may be entitled to, such as Pensions or VA benefits;

• Live in an approved living arrangement, such as your own home, or an AHCCCS certified nursing facility or assisted living facility.

What are the Different Types of ALTCS Services?

Once you have been determined eligible for ALTCS services, you will be enrolled with a Program Contractor and assigned to a case manager. The case manager will meet with you and your family to develop a service plan. Covered services may include the following:

• Institutional Care in a Nursing Facility;
• Home and Community Based Services, combining out-patient and in-home care;
• Medical Services, such as Doctor’s office visits and prescriptions (prescription coverage is limited for people with Medicare);
• Behavioral health services;
• Preventive and well care for children; and Hospice services.

How does ALTCS Determine if I am Medically Eligible?

Once you have been determined financially eligible, a registered nurse or social worker will decide if you are medically eligible in a face-to-face interview. To meet medical requirements, you must be at immediate risk of institutionalization in a nursing facility or intermediate care facility for individuals with intellectual disabilities (you must require that level of care, but you do not necessarily need to reside in a facility).

Will I Have to Pay Any of My Income Toward the Cost of My Care?

Not necessarily. Once you have been determined eligible for ALTCS, a calculation will be made to determine if, or how much, you will need to pay towards the cost of your nursing home or home and community-based services. 

This amount is called the Share of Cost. First, your monthly gross income will be totaled, and then the following deductions may be allowed:

• A personal needs allowance;
• A Community Spouse allowance for the needs of your spouse still living in the home; A family allowance for any dependents living in your home;
• A home maintenance allowance if you are in a nursing home but will go home within 6 months; Your medical insurance premiums; and
• Medical expenses that ALTCS does not pay for like hearing aids, eyeglasses, and dental care.

If you would like to explore more about ALTCS and senior insurance, you can reach out to Innovative Broker Partners. As part of our trusted coalition here at Senior Resource Connectors, they will be able to guide you on the next best steps for your new journey. Alternatively, get in touch with our clinical concierge at no cost to you for the best referral within our trusted network of companies.

Our mission at Senior Resource Connectors is to provide Arizona seniors and their loved ones easy access to the most trusted and highly professional resources for care as they encounter the many physical and emotional challenges that come with aging today.

These are the burning questions that we all have, but we don’t have the answers to. ‘What will long-term care cost for my senior?’ The answer to this question will vary from person to person. Most seniors who get to the point of needing long-term care will not come out of needing it. However, there are examples such as after a surgery or fall. One might need specialized care for only a short while. These situations usually will have a better answer as to how long your senior will need maintenance and what long-term care will cost.

Long-term Care

There are many options for long-term care, from aging in place to assisted living and more. Many will have their children or other relatives help them. However, this can quickly become a financial burden on that person as they may not be able to perform their regular job anymore.

Society isn’t the same as it has been in the past where people have someone staying at home caring for children, or there were even housewives. Those positions are pretty much a thing of the past, and everyone has to work due to the overall cost of living.

Though the cost of living is rising with the price of housing, healthcare, and basic necessities, it is often overlooked that this cost will increase exponentially once seniors are faced with the decision to age in place or have to move to an assisted living facility.

If the person’s home is paid off, then aging in place is far more economical, in most cases, to stay at home.

Assisted Living Options for Long-Term Care

However, assisted living facilities all have different pricing structures. Some structures will take over all of a person’s assets as payment until the end. This means they will not leave any inheritance to their families but also will not become a burden on them for any reason.

All these factors must be considered when you are looking at the cost. The cost of aging is only increasing with inflation over time. How long a person will need this sort of care is entirely unknown and unique to that person.

As of 2020, the average cost of assisted living is $4300/month, according to Genworth’s Cost of Care Survey. If you are looking at a private room, it is about $8,821/mo, with semi-private being a little less at $7,756/mo. That is money that many of the elderly in the upcoming generations simply don’t have.

We are not living in the times of pensions as we once were either. Times have changed the costs are only increasing.

Long-Term Care Insurance

There are options for long-term care insurance. However, this insurance typically has some rules that need to be met before it will kick in. These rules might be over what a person needs. However, the patient still needs care. These rules are things such as they need help with at least two daily activities. They could also insist on a high deductible that must be paid before the benefits kick in.

When it comes to the long-term planning of your loved one or yourself, determining what is suitable for you is a very personal choice. There are many options, even some that take over your assets to give you lifelong care.

However, these choices shouldn’t be made overnight. Be sure to do your research and determine what would work best for your situation. While we wish there were easy answers about how long and how much it will be, it is anyone’s guess.

What is the difference between nursing home and long-term care?

While long-term care is generally used for situations in which the senior is unlikely to come out of the care, skilled nursing is generally designed to rehabilitate a patient so that he can return home if at all possible.

Who needs long-term care?

People often need long-term care when they have a serious, ongoing health condition or disability. The need for long-term care can arise suddenly, such as after a fall or stroke. Most often, though, it develops gradually, as people get older and frailer or as an illness or disability gets worse.

Contact Senior Resource Connectors

Your roadmap when it comes to determining the best care plan for your senior loved one in Arizona – at any age or stage. Visit our resource center, view our business directory, or connect with us below.

Watch as Scott chats with Michael Cyrino from Medicare Mike.

Mike shares some of his experiences with particularly challenging Medicare obstacles and how his ethos remains that of an unfaltering serviceman, providing his clients with accessible, honest, and speedy information.

By literally coming to the rescue of countless families in need, Mike and his team of Medicare superheroes can help you understand the fine print and put you at ease about what’s included vs what’s excluded from your coverage option.

For more resources on Medicare, how to get in touch with Mike, or any other challenge you may be facing as you navigate caring for a senior loved one while balancing the needs of your own family. Senior Resource Connectors is here to help.

Reach out to us in the following ways:

Visit Us Online: www.seniorresourceconnectors.com

Call Us: (602) 698-9720