How to Budget for Insurance

The cost of insurance can be a big hit to your personal bottom line. That’s especially true when you consider all the types of coverage you may need to pay for, including auto, health, and life insurance plans. Here are some tips for how to budget for insurance without compromising your lifestyle.

A young Asian woman sits at a tabletop writing in a notebook about how to budget for insurance.

Steps for Budgeting for Insurance

In addition to being legally required in many instances, insurance is often a good investment for your wallet and your peace of mind. The expense of insurance can actually save you money in the long run.

Budgeting for insurance may seem complicated, but it really comes down to two simple actions: First, decide what type of insurance you need. Then, start budgeting for it. Here are five steps for incorporating insurance into your personal finances.

1. Decide how much insurance you need

For each type of insurance you decide to get, you’ll need to decide how much coverage to buy. When it comes to insurance, cost shouldn’t be the only factor in your purchase decision. Instead, think critically about how much coverage you need. If you’re not sure how much insurance or what type to get, consider talking with an insurance agent for advice.

Do you need your homeowner’s insurance to include liability in case someone else is injured on your property? Is term life or whole life insurance better for your situation? Who needs to be covered by your auto insurance?

2. Get quotes from agents or online

Once you know what type of insurance you want and how much coverage you need, get some quotes. Shop around and get quotes from multiple companies. Remember to compare the coverage and not just the premium price—you might find that you’re getting a much better value when paying only a little more a month with one company over another.

3. Find out what the payment schedule is

Discuss the payment schedule before you agree to an insurance policy. It’s common for auto insurance companies to offer a significant discount if you can pay for six months of insurance at a time, for example. Here are some common pay schedule options for various types of coverage.

  • Home Insurance: Paid annually or biannually, often out of escrow if you have a current mortgage
  • Car insurance: Paid every six months or monthly
  • Life insurance: Paid monthly
  • Health insurance: Paid monthly or via pretax deductions from your paycheck if the coverage is through your employer

Understanding the payment schedule will help you budget for insurance more effectively.

4. Set aside enough money monthly

However you plan to pay for insurance, break the amount down into a monthly budgeted amount. For example, if your home insurance is $900 every six months, set aside $150 every month. It’s much easier to budget for $150 than it is to come up with $900 all at once.

5. “Pay” the bill monthly

If you do pay monthly, go ahead and budget so that you can pay your insurance bill at least a week before it’s due. That leaves you plenty of wiggle room if something ever comes up.

If you don’t pay monthly, act like you do. Move the monthly budgeted amount into a savings account and don’t touch it. Act like it’s not there so you’re not tempted to use it on something else and risk not having the money when the bill comes due.

How to Budget for Different Types of Insurance

Trying to include a large insurance expense in an already tight budget can be difficult. Here are some tips for making various types of insurance potentially more affordable so they are easier to budget for.

Car Insurance

The average American pays around $2,388 per year on auto insurance. But your actual expense can vary widely depending on your age, state of residence, type of car, credit score, and many other factors. Here are some tips for saving money on car insurance.

  • Increase your deductible. You may need to shell out a bit more in the event of an accident, but you can save a lot of money on your premiums.
  • Ask about discounts if you’re married, have multiple cars, are buying different types of insurance from the same company, or are a good driver. Some insurance companies also offer discounts for students with good grades.
  • Lower your liability amounts. This can reduce premiums, but you should ensure that it’s a good move for you financially overall.

Health Insurance

According to numbers from the Kaiser Family Foundation in 2018, the average amount people were contributing to their employer-sponsored health care plans each year was $1,186 for single coverage. You don’t have to pay that much for health insurance, though. Some ways you can save on this expense, especially if you’re purchasing as an individual through the marketplace, include:

  • Buy a plan with a higher deductible.
  • Enter all your income data into the marketplace application form to see if you qualify for subsidies or credits.
  • Apply for Medicaid if you’re eligible.

Life Insurance

The cost of life insurance depends heavily on your age, the type of insurance, and how much you’re purchasing. If you’re young, you might want to buy a whole-life policy that you can pay for now and still have when you’re older. If you’re older, you may want to opt for term life insurance, which is cheaper than other types.

Homeowner’s or Renter’s Insurance

One of the reasons insurance costs might be lower is because the company sees you as less of a risk. Homeowner’s and renter’s insurance may be cheaper for those that invest in security measures such as home security systems.

The Bottom Line on How to Budget for Insurance

You can get discounts and great deals on insurance if you’re willing to do your research. But, in most cases, insurance may still be a sizeable expense. Planning ahead and budgeting every month for these expenses is one of the best ways to ensure you can afford the coverage you need.

And since your insurance costs are sometimes impacted by your credit score, make sure you’re keeping up on all your other bills and reviewing your credit reports regularly.

DISCLAIMER. The information provided in this article does not, and is not intended to be,  legal, financial or credit advice; instead, it is for general informational purposes only. 

Source: credit.com

Understanding Your Health Insurance Deductible

Most health plans have an annual deductible—the amount you are responsible for paying before your insurance starts to cover you. If you’re lucky, you’ll have a very low deductible, or even none at all.

In many ways, the deductible is what stands in between you and your full health insurance benefits. It’s like the first hurdle you have to clear before your health plan starts to give back those premiums you paid. So, managing your deductible is key to understanding your plan and saving money.

If you’re one of the many people who find it difficult to keep track of where they are on their deductible, you might try one of the new online services, like Simplee or Cake Health, which are designed to make this much easier. In this post, we’ll explain what a health insurance deductible is, what you need to know about them, and more. Use the links below to jump to the section that best answers your query, or read through for a more detailed overview on the subject.

What is a Health Insurance Deductible?

Health Insurance Deductible Definition: A health insurance deductible is defined by HealthCare.gov as the minimum balance you pay before your insurance company starts to cover medical costs. If your deductible is $2,500 and your medical visit costs $5,000, for example, you would be responsible for the $2,500 portion. In other words, you are responsible for paying a certain amount of your medical expenses yourself, and your insurance company will begin to cover costs only after you have paid that deductible.

How do Deductibles Work?

After you’ve met your deductible, your provider will typically only ask that you cover a portion through coinsurance or copayment while they handle the rest. Keep in mind, every insurance plan is different, so it’s important that you not only understand how deductibles work, but also how they fit into your plan specifically.

Certain insurance plans will cover services such as checkups or preventative care even before your deductible is met, so be sure that you know your plan details through and through before you do or do not seek care.

Example of health insurance deductible

Let’s take a look at an example of how deductibles work to get a clearer understanding:

Let’s pretend that you have a health insurance plan with a $700 deductible. One day, you require a medical procedure that costs $7,000, which is covered in your plan. Your health insurance provider will help pay for these costs, but only after you’ve met your $700 deductible. Here’s what happens next:

  1. You pay your $700 deductible out of pocket to the provider
  2. Then, after you meet the deductible, your health insurance plan begins to cover the remaining balance of $6,300
  3. Depending on your plan’s copay or coinsurance policies, you may still be required to pay a percentage of these costs

High-deductible plans vs. low-deductible plans

  • High-Deductible Health Plans (HDHPs) have higher deductible rates than most insurance policies, but offer up some flexibility and tax advantages that can come in handy for some individuals, plus, HDHPs typically have lower monthly premiums. HDHPs come with a Health Savings Account or a Health Reimbursement Arrangement (HRA), a tax free account where you can deposit money specifically to be used for future medical costs. Aim to have saved in your Health Savings Account at least as much as the deductible. What counts as an HDHP? For 2021, the deductible is at least $1,400 for individual plans or $2,800 for family.
  • Low-Deductible Health Plans typically have lower deductibles but lower monthly premiums than plans with higher deductibles. If you need a considerable amount of care or require expensive medical services, a low-deductible plan may be worth considering because your insurer will start covering costs at a lower rate than high-deductible plans.

Essential Things to Know About Your Annual Deductible

Enrolling in a healthcare plan can be an overwhelming experience — from unfamiliar terminology to crunching costs, there’s a lot to learn before you can find the best coverage for your needs. Whether you’re planning to enroll soon or just need to clear up some long-held confusion, here are some of the most important things to know about how deductibles work, and what you should know about yours.

1. How much is your deductible?

You should know how much your deductible is before you ever enroll in a plan. If the plan has a low premium, there is a good chance the deductible will be high. You should ideally have the money to pay your deductible ready on hand—or at least be saving for it. Remember, before your insurance company will pitch in for your medical expenses, you’ll need to pay the deductible you agreed upon first.

2.  The date your deductible rolls over

Health insurance deductibles usually roll over every January, but some plans may use a different date—for example, health plans through schools or universities may use the academic year. This date is important because you may want to plan your appointments and procedures to occur after your deductible is met and before the year rolls over. Or, you may need to budget more money for the early part of the year.

Let’s say you have a $1,000 deductible and you meet it in June. Any other services you get for the rest of the year will only cost you copays or coinsurance. But if you wait until January, you will have to pay $1,000 all over again. You might consider scheduling bigger procedures before January to save you some cash if you are not planning other expensive services (that will again exceed $1,000) for the next year.

3.  What doesn’t count towards your deductible

Many health plans waive the deductible for services such as preventive care or the emergency room fee if you are admitted to the hospital. Check your policy so you know where you get a free pass, and take advantage of it.

4. Whether you have different deductibles

Some plans have separate deductibles for in-network care versus out-of-network care. This could cost you more money unnecessarily if you’ve met one deductible and then see a doctor that counts towards the other.  So, find out the rules and always check whether providers are in-network before you go (don’t make assumptions—doctors in the same office may not all take the same insurance).

If you have a family policy, check if there are separate or combined deductibles for each member that is covered. The rules can vary on this one, too.

5. How often you actually meet your deductible

Odds are, if you purchased health insurance, you hope that it will pay for the health care you use. So if you find that every year you come close to meeting your deductible but never do, you may be tempted to get a plan with a lower deductible so that you end up paying less out of pocket. Be aware, though: premiums for lower-deductible plans might be higher than you would end up saving. Make sure you consider the full cost spectrum of premiums, copays, coinsurance, and how much health care you expect to get that year when you weigh this decision.

Choosing the Right Deductible Amount

Now that you know how deductibles work, you may be wondering how you should choose the right deductible for your health care needs and financial situation. In this section, we’ll discuss some of the things you may want to consider as you evaluate your health insurance options.

Things to consider when assessing health insurance deductibles:

  • Necessary coverage: Ultimately, the health care plan that you choose should empower you to get the best care for your needs. Whether you visit the doctor on a frequent or infrequent basis, your health history should be a primary part of your decision-making process. As you weigh your options, think about what the expenses that you’d be liable for would look like with a high, low, or middleroad deductible. 
  • Budget: Not only does your health insurance determine the kind of care you’re entitled to, but it’s also a major financial commitment. In addition to deductible costs, consumers are responsible for premiums and other out-of-pocket costs. Before selecting a health insurance plan, be sure to consider the full insurance terms as well as all of the costs you may be held responsible for.

Note: As you calculate your budget and insurance costs, don’t forget that there are ways to maximize your health care deductions to lessen the financial burden.

Tomer Shoval is the CEO and Co-Founder of Simplee, a free online personal health care expense management tool. Connect with him on twitter, facebook or email.

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What to Do When You Lose Your Health Insurance

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Disclaimer

Losing your job is stressful. Losing your health insurance on top of that is even worse. And whether you have health concerns now or want to safeguard yourself and family for the future, you might be worried about how to cover medical expenses if you’re out of work. Find out what to do when you lose your health insurance because you lost your job.

Ask About COBRA

COBRA is a health insurance continuation option that many employers offer. It allows you to voluntarily extend the health coverage you have under your former employer’s plan. If you qualify for COBRA, you must be given the option to extend your coverage up to 18 or 36 months, depending on what event qualified you for COBRA.

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However, your employer does not have to continue
contributing to cover the premiums of this plan as they did when you were
employed. If they elect to not offer contributions to the premium, COBRA
coverage can be fairly expensive.

Check the Health Care Marketplace

Job loss that causes you to lose employer-sponsored or provided health insurance counts as a qualifying event. That means you’re eligible for a special enrollment period.

Normally, you can only sign up for insurance plans through
the health care marketplaces during open enrollment periods, which typically run
from November to January. Exact dates for enrollment depend on the state.

Special enrollment periods occur for people who have a
qualifying event, such as a change in marriage status, a death in the family or
job loss. You qualify for this special period whether you were fired, laid off
or quit your job.

You must apply within 60 days of losing your insurance coverage. If your employee gives you notice and you know you’ll be losing your insurance, you can apply proactively up to 60 days before that happens.

Purchase Short-Term Coverage

Short-term insurance policies are meant to bridge the gap when you’re between jobs. Not all states allow for short-term insurance—eleven states currently prohibit their sale. But, depending on your state, short-term insurance could cover you for up to 364 days. These aren’t qualified plans under the ACA, which means they don’t offer all the benefits that the ACA requires by law. Typically, these are major medical plans meant to help cover the costs of a catastrophic illness or accident and not routine health care.

Make
sure you understand what benefits are included and how the plan works if you
opt for short-term coverage.

See If You
Qualify for Medicaid

A man holds the hand of a young child while they walk down the street.

If you have lost your job, that probably means your income has been reduced. That could mean that you’re eligible for Medicaid or the Children’s Health Insurance Program (CHIP). The income requirements vary by state, but you can find out more about eligibility from the Department of Health and Human Services.

You
can apply for Medicaid and CHIP at any time, but remember that you can lose
your Medicaid benefits if your income changes. Have a plan in place to budget
for health insurance if you get a job that doesn’t offer benefits or has a
waiting period before benefits start.

Go Without Health Insurance

You can choose to go without health insurance until you find another job or until open enrollment happens again. This can be a risky move because a health emergency or accident could lead to mounting medical expenses that leave you in serious debt.

But if you’re healthy and think there’s a good chance you’ll get a new job with coverage soon, you might decide to take the gamble. If you do, it’s a good idea to set aside some money in savings to help cover the cost of doctor’s visits or other necessary medical care should the need arise. For example, during COVD-19, you might use your stimulus check for this purpose.

You Have Options

Losing your job and your health insurance is scary, but you’re not alone. Credit.com has resources to help you through. Check out our additional resources below—and if you need more help, you can reach out to tipswithtiff@credit.com for help from Credit Tips with Tiff.


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Source: credit.com

4 Ways Health Insurance Can Save you Money

December 26, 2019 &• 6 min read by Alice Stevens Comments 0 Comments

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Many health insurance shoppers will consider premium costs when purchasing health insurance. The full cost of a health planalso includes your out-of-pocket expenses, like the deductible, copays, and coinsurance.

As important as it is that your health plan is affordableand that the monthly premiums fit into your budget, it’s also important to consider the value health insurance offers. If you’re considering opting out of health insurance next year, evaluate the value of the following health plan offerings before you finalize your decision:

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  • Discounted rates
  • Cost-sharing
  • Preventive care coverage
  • Additional features

While everyone has a different financial situation with varying constraints, health insurance is a worthwhile investment.

1. Discounted Rates 

Health insurance companies negotiate costs directly with hospitals and other medical care providers. These rates are then included with the health plans offered by the company. 

Some plans only have negotiated rates for in-network providers. Others have different negotiated rates for in-network care and out-of-network care. All health plans offer coverage for emergency services when a patient is admitted—whether or not the care was received from an in-network provider.

The amount the hospital or clinic usually charges is higher than the negotiated rate. The differences between the negotiated rate and the standard rate varies depending on how the insurance company has negotiated. 

However, when you receive an Explanation of Benefits (EOB) with the breakdown of costs, you’ll see:

  • What the hospital or clinic usually charges
  • What the negotiated cost actually was
  • What portion of the bill your health insurance company paid
  • The amount left for you to pay

2. Cost-Sharing 

Health insurance plans come with an annual deductible and annual out-of-pocket maximum. The deductible is the amount of money the insured must pay in cost-sharing over the course of the year before the insurance company takes on a greater responsibility for the costs. The out-of-pocket maximum is higher than the deductible. Once it is reached, the insurance company is responsible for the remainder of your covered medical expenses.

Health insurance plans often have separate deductibles for prescriptions and medical care. Health insurance plans that offer out-of-network coverage will have a different deductible and out-of-pocket expenses maximum for out-of-network care and in-network care. 

Health insurance companies determine cost sharing in a few different ways depending on how your plan works. With a traditional plan, you’ll have copays and coinsurance. Coinsurance means that the insured pays a certain percentage of the discounted medical bill.

Copays are a set amount that the insured pay when they receive health care services. There are usually set amounts for prescriptions, primary care visits, specialist visits, and emergency services. Payment may also be required beyond the copay after the bill is processed by the insurance company. The copay contributes to this payment.

High-Deductible Health Plans (HDHPs) with Health Savings Accounts (HSAs) work differently. Instead of having copays and coinsurance, you pay for your medical expenses as you receive medical care. You can use the funds in your HSA to pay these costs.

Funds in your HSA roll over year to year and can be invested. The money you put into your HSA is tax-free. The monthly premiums for HDHPs tend to have lower premiums because a greater cost responsibility is on the policyholder. Some people take advantage of these plans while they are healthy and save funds for medical expenses later in life.

The specifics of cost-sharing differ from plan to plan, so carefully reviewing your plan before signing up will help you understand how the cost-sharing works.

3. Preventive Care Coverage 

Because of the Affordable Care Act, health insurance plans cover preventive care fully. While the future of the Affordable Care Act is uncertain, coverage for preventive care is an important way that health insurance protects your finances.

Doctors can detect some health problems early on and implement treatment plans to prevent the issue from developing further. Regular visits to the doctor go a long way in avoiding expensive bills later, especially for preventable issues.

It’s especially important for people with some diagnoses and conditions to visit a specialist regularly as needed because some health issues can be managed successfully and future complications can also be avoided.

4. Additional Features 

Health insurance companies also offer the following helpful features with their plans:

  • Telemedicine
  • Nurse help lines
  • Care management

These additional features are helpful resources for people. Telemedicine allows plan members to work with a doctor over the phone or through video chat in non-emergency situations. Some companies offer this service to plan members for free, like Oscar. Other companies also offer it as an a la carte supplement to health insurance, like GoHealth.

Others may charge a fee when you use the telemedicine service. The fee for the telemedicine service may vary based on your plan and your insurer and can be cheaper and faster than setting an appointment with your doctor or visiting an urgent care.

Nurse help lines are another common offering among health insurance companies, including Cigna. This hotline gives people quick access to a nurse without needing to leave their home. In non-emergency situations, the nurse can answer questions and give advice on scheduling appointments. 

While these benefits are nice and do not require you to establish care with a doctor, you can always call your doctor’s office with questions to get similar assistance. If the doctor can’t take your call, one of the assistants can take a message and get back to you with a response in a non-emergency situation. Even after hours, there’s usually a doctor on-call. 

Another benefit some health insurers offer is care management. These can be helpful to people who want support with improving their health. Companies like Kaiser Permanente offer this with many of their plans to help members with chronic conditions.

Is the Investment Worth It? 

It’s easy to see how much your health insurance plan saves you on medical care when you review the EOB.

It’s trickier to determine if the cost of monthly premiums is worth the savings. If you have health insurance, you can keep track of how much you are spending on medical care, prescriptions, and premiums. Evaluate you EOBs over the course of the year to understand what the costs would have been without insurance.

Medical procedures, surgeries, and emergency medical treatment are more expensive than preventive care. Some of these events can be planned for in advance, but many cannot. 

Because of the high financial cost of these services, not having health insurance is a risk for your financial stability.


Alice Stevens loves learning languages and traveling. She currently manages content for BestCompany.com, specializing in personal finance, health insurance, Medicare, and life insurance.

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Understanding Long-Term Care Insurance

  • Health Insurance

A lot of us don’t like to think about this, but inevitably there will come a time where we will all need help taking care of ourselves. So how can we start preparing for this financially?

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Many people opt to purchase long-term care insurance in advance as a way to prepare for their golden years. Long-term care insurance includes services relating to day-to-day activities such as help with taking baths, getting dressed and getting around the house. Most long-term care insurance policies will front the fees for this type of care if you are suffering from a chronic illness, injury or disability, like Alzheimer’s disease, for example. 

If this is something you think you’ll need later on, it’s crucial that you don’t wait until you’re sick to apply. If you apply for long-term care insurance after becoming ill or disabled, you will not qualify. Most people apply around the ages of 50-60 years old. 

In this article, we will discuss long-term care insurance, how it works and why you might consider getting it.   

How long-term care insurance works

The process of applying for long-term care insurance is pretty straight forward. Generally, you will have to fill out an application and then you’ll have to answer a series of questions about your health. During this point in the process, you may or may not have to submit medical records or other documents proving the status of your health. 

With most long-term care policies, you will get to choose between different plans depending on the amount of coverage you want. 

Many long-term care policies will deem you eligible for benefits once you are unable to do certain activities on your own. These activities are called “activities of daily living” or ADLs:

  • Bathing
  • Incontinence assistance
  • Dressing
  • Eating
  • Getting off and/or on the toilet
  • Getting in and out of a bed or other furniture

In most cases, you must be incapable of performing at least two of these activities on your own in order to qualify for long-term care. When it’s time for you to start receiving care, you will need to file a claim. Your insurer will review your application, records and make contact with your doctor to find out more about your condition. In some cases, the insurer will send a nurse to evaluate you before your claim gets approved. 

It’s very common for insurers to require an “elimination period” before they start reimbursing you for your care. What this means is that after you have been approved for benefits and started receiving regular care, you will need to pay out of pocket for your treatments for a period of anywhere from 30-90 days. After this period, you will get reimbursed for your out-of-pocket expenses and from there.

Who should consider long-term care insurance

Unfortunately, the statistics are against our odds when it comes to whether or not we will eventually need some type of long-term care. Approximately half of people in the U.S. at the age of 65 will eventually acquire a disability where they will need to receive long-term care insurance.  Of course, the problem is, long-term care can be really expensive. Unless you have insurance, you’ll be paying for your long-term care completely out-of-pocket should you ever need it.

Your standard health insurance plan, including Medicare, will not cover your long-term care. The benefits of buying long-term care insurance are that:

  • You can hold on to your savings: Many uninsured seniors have to dip into their savings account in order to pay for their long-term care. Because it’s not cheap, many of them drain their life savings just to be able to pay for it.
  • You’ll be able to choose from a larger variety of options: Being insured gives you the benefit of being able to choose the quality of care that you prefer. Just like with anything else, you get what you pay for when it comes to healthcare. Medicaid offers some help with long-term care, but you’ll end up in a government-funded nursing home. 

How to buy long-term care insurance

If you’ve recently started thinking about shopping for long term-care insurance, you’ll want to keep a few things in mind:

  • Do you mind being insured on a policy with an elimination period?
  • Can you afford all of the costs including living adjustments?
  • Are you interested in a policy that covers both you and your spouse, otherwise known as “shared care”?

There are a few different ways to go about getting long-term care benefits. You can either buy a policy from an insurance broker, an individual insurance company, or in some cases, your employer. Obtaining long-term care insurance through your employer is probably going to be cheaper than getting it as an individual. Ask your employer if it’s included in your benefits. 

Many people also opt to shop for hybrid benefits insurance policies. This is when a long-term care policy is packaged in with a standard life insurance policy. This is becoming a lot more common in the world of insurance. Keep in mind that the approval process may be slightly different for a hybrid insurance policy than of that of a stand-alone long-term care insurance policy. Make sure to ask about the requirements before you apply. 

Best long-term care insurance packages

There are not very many long-term care insurance companies that exist as there once was. It’s hard to wrap our heads around purchasing something that we don’t yet need. However, here are a few examples of companies that offer competitive long-term care packages:

  • Mutual of Omaha: This company offers benefits of anywhere between $1,500 and $10,000. While the main disadvantage of this company’s packages is that they do not cover doctor’s charges, transportation, personal expense, lab charges, or prescriptions, you CAN choose to receive cash benefits instead of reimbursements. This company also offers discounts for things like good health and marital status. This company’s insurance policies offer a wide range of options and add-ons so you can make sure that all your bases are covered.
  • Transamerica: This company’s long-term policy, TransCare III, is good if you don’t want to hassle with an elimination period. If you live in California, this may not be the best choice for you because California’s rates are a lot higher than the rates in other states. Your maximum daily benefit can be up to $500 with this program, with a total of anywhere between $18,250-$1,095,000. 
  • MassMutual: Popular for their SignatureCare 500 policy which comes in both base and comprehensive packages, is a long-term care and life insurance hybrid. This is very appealing to many seniors wanting to kill two birds with one stone. This company also has a 6-year period as one of their term options, which is pretty high.
  • Nationwide: This program sets itself apart from many other programs available because it allows you to have informal caregivers like family, friends, or neighbors. You will receive your entire cash benefit every month and it is up to you to disperse the funds as you would like. Currently, this company does not have their pricing available online, so you will need to speak with an agent to discuss prices.

Source: pocketyourdollars.com

What is a Health Savings Account (HSA)?

  • Health Insurance

A Health Savings Account (HSA) is a convenient way to store funds specifically for medical expenses. If you qualify for an HSA, you will get to enjoy a few tax advantages as well. While this might sound like an ideal setup, not everyone is eligible for a health savings account. To qualify for a health savings account, you must be enrolled in a high-deductible health insurance plan (HDHP). The details of these plans are revised every year by the Internal Service Revenue (IRS), which sets the bar for:

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  • The minimum deductible a plan must have to be considered a HDHP.
  • The maximum amount that a customer who purchases a plan is able to spend out-of-pocket.

The benefits of a health savings account

Here are some of the key advantages of having a health savings account:

  • It covers a large variety of medical expenses: There are many different kinds of medical expenses that are eligible, such as medical, dental and mental health services.
  • Pretty much anyone can make contributions: Contributions to your health savings account don’t have to be made by you or your spouse. Employers, relatives, friends or anyone who would like to contribute to your account can do so. There are limits, however. For example, in 2019, the limit for individuals was $3,500 and $7,000 for families.
  • Pre-tax contributions: Since contributions are generally made at your employer pre-taxes, they are not considered to be part of your gross income and are not federally taxed. This is usually the same case when it comes to state level taxes as well.
  • After-tax contributions are tax-deductible: Any contributions made after taxes are deductible from your gross income on your tax return. Doing so minimizes the amount you would owe on taxes for that year.
  • Tax-free withdrawals: You can withdrawal money from your account for approved health care costs without having to worry about federal taxes. Most states do not tax, either.
  • Annual rollover: Any unused HSA funds that are left over by the end of the year get rolled over to the following year.
  • Portability: Even if you change health insurance plans, employers, or retire, the money in your health savings account will continue to be available for qualifying health care expenses.
  • Having a health savings account is convenient: Most of the time, you will receive a debit card that is connected to your health savings account. This way, you can use your debit card to start paying for eligible expenses and prescription drugs on the spot.

The drawbacks to having a health savings account

While there are many advantages to having a health savings account, there are a few things to consider. For one, in order to qualify for an HSA, you must hold a high-deductible health insurance plan. The tax benefits might entice you to purposely sign up for insurance coverage under one of these health plans but think before doing this. Here are some of the disadvantages to having a health savings account:

  • The High-Deductible Health Plan: These types of health plans can end up being a lot more expensive in the long run, even with an HSA. If you have other options for health insurance that offer lower deductible, definitely consider those and don’t only choose a High-Deductible plan so that you can open an HSA.
  • You need to stay on top of your spending: If you have an HSA, you need to be willing to hold yourself responsible for recordkeeping. Keep track of all of your receipts so that you can prove you spent your HSA funds on eligible expenses.
  • Taxes and penalties: Using money from your HSA on other expenses that do not qualify as eligible health care expenses could result in you owing taxes. If you do this before the age of 65, you will have to pay taxes with a 20% penalty tacked on. If you are 65 or older, you will be responsible for paying taxes, but the penalty gets waived.
  • Fees: Sometimes, health savings accounts will charge additional fees, either per month or per transaction. Check with your HSA institution for more information on extra fees.

How an HSA works

In many cases, if your employer offers high-deductible health plans, they probably offer health savings accounts as well. Talk to your employer to find out what they offer. If your employer doesn’t offer HSAs, then you can sign up for a separate one through a different institution.

You get to decide how much you would like to contribute to your HSA annually, but keep in mind that you cannot exceed the HSA contribution limit. Once you are set up with an account, you will either receive a debit card or a series of checks that are linked to your HSA. Right away, you will be able to use the funds in your account for:

  • Deductibles
  • Copays
  • Coinsurance
  • Other eligible health care expenses that your insurance does not cover.

Generally, you cannot use HSA funds to pay your insurance premiums.  HSAs are not the same as flexible spending accounts, because HSAs rollover. Once you turn 65, you are no longer eligible to make contributions to your account, but you can still use the available funds for eligible out-of-pocket expenses. If you use the funds for non-eligible expenses, you will owe taxes on these amounts.

Investment Opportunities

Another benefit of HSA that you may or may not have heard of is that you can invest the money in mutual funds and stocks. If this is something that you are interested in, seek advice from a financial advisor for more information.

Source: pocketyourdollars.com

How Much Does Long-Term Care Insurance Cost?

How Much Does Long-Term Care Insurance Cost? – SmartAsset

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A 55-year-old can expect to pay a long-term care insurance premium of $2,050 per year on average, according to a 2019 price index survey of leading insurers conducted by the American Association for Long-Term Care Insurance (AALTC). That will cover $164,000 in benefits when the policyholder takes out the insurance and $386,500 at age 85. (Policies often include an inflation rider.) However, long-term care insurance costs vary widely, depending on factors like your age, health condition and the specific policies of your insurance carrier. The AALTC estimates that a single 55-year-old can pay around $1,325 to $2,550 a year for a policy. That’s why it’s important to shop around to find the best rates and terms. You should also speak with a financial advisor who can help you plan the future.

How Much Does Long-Term Care Insurance Cost?

The AALTC provides the following estimates of annual premiums based on its 2019 study of different long-term care insurance carriers.

Annual Premium Estimates
Single Male 55 $2,050
Single Female 55 $2,700
Couple 55 $3,050 (Combined cost)

Keep in mind, though, that these are only averages based on a pool of data gathered from leading insurance carriers. The costs of long-term care insurance can vary widely,  depending on several key factors. We explore some of these below.

Health: Some medical conditions will disqualify you from even being able to purchase a policy, including muscular dystrophy, cystic fibrosis and dementia. That’s because insurers will likely lose money on those policies. Generally, the healthier you are, the less likely you’ll ever need to file a claim – and so the lower your premium.

Age: In general, you’ll pay more in long-term care insurance if you take out a policy when you’re older, since you’re probably less healthy and you’re closer to needing the assistance the policy covers. This is why the AALTCI recommends you begin shopping for long-term care insurance between the ages of 52 of 64.

Marital status: When combined, premiums tend to be lower for married couples than they would be for individuals paying for a personal policy.

Gender: Because women tend to live longer than men and make claims more frequently than their male counter parts, women tend to pay more for insurance premiums. The AALTCI study showed that a single female pays an annual premium of $3,050 on average while the single man that age paid $2,050.

Carrier policies: Each insurance carrier sets its own rates and underwriting standards. In fact, costs for the same services can vary widely from one company to another. This is why you should gather quotes from various carriers. You can also work with an experienced long-term care insurance agent who can gather these for you and help you understand the differences between insurance policies. They can also help you determine the kind of coverage you’re likely to need, so you don’t over-insure.

Should I Get Long-Term Care Insurance?

The average 65-year-old today has a 70% chance of needing some kind of long-term care eventually, according to the Urban Institute and the U.S. Department of Health and Human Services. Of those who need it, most would use it for about two years, but around 20% would require it for more than five years.

The smart money, then, would prepare for this significant cost. To give you a sense of how much bills can run, below are the estimated annual costs of different types of long-term care services, according to Genworth Financial, which has been tracking them since 2004.

Estimated Annual Costs
Private room nursing home $102,000
Assisted living facility $48,612
Home care aide $52,624
Home care homemaker $51,480

What’s more, costs have been rising faster than even inflation. Genworth found that the average cost of home-care services increased about $892 annually each year between 2004 and 2019. The average cost for a private room in a nursing home jumped by about $2,468 each year during the same time period, currently putting the average cost of a semi-private room in a nursing home at $89,297 per year. As noted before, about 20% of Americans will require more than five years of care.

Unfortunately, with these costs, many retirement nest eggs will come up short. And contrary to popular belief, Medicare covers only limited medical costs, e.g., brief nursing home stays and narrow amounts of skilled nursing or rehabilitation services. The scope for Medicaid is even smaller. On average, it covers about 22 days of home care services if you meet very low income thresholds.

Of course, there’s no way of knowing how much long-term care coverage you’ll need. But knowing what long-term care insurance does and doesn’t cover is key to making sure you’re not over- or under-protected.

What Does Long-Term Care Insurance Cover?

Long-term health insurance typically covers services not provided for by regular health insurance. This can include assistance with completing daily tasks like eating, bathing and moving around. In the industry, these are known as activities of daily living (ADLs). Long-term care insurance policies generally would reimburse you for these services in such locations as:

Some policies also cover care related to chronic medical conditions such as Alzheimer’s disease and other cognitive disorders.

But keep in mind that these are generalizations. There is no industry standard that sets ADL requirements for claim eligibility or what kinds of illnesses long-term care insurance will cover. Each insurance carrier makes its own rules.

So it’s essential to understand when coverage kicks in – and for how long. Policies used to provide coverage for life, but now most cap benefits at one to five years. If possible, some experts recommend extending the initial period when you are not compensated for costs (it’s often 90 days) in exchange for a longer period on the other end of receiving benefits. You also will want to know how premiums may increase over time and whether the cap on benefits will, too. Some carriers allow you to place an inflation rider that increases your daily benefit every year. That increase can be up to 3%.

How Does Long-Term Care Insurance Work?

After you apply for long-term care insurance, the insurer may request your medical records and ask you some questions about your health. You can choose the type of coverage you want, but the insurer must approve you.

When the company issues you a policy, you begin paying premiums every year. Once you qualify for benefits, which is often defined by not being able to perform a set number of ADLs, and the required waiting period has passed, you can file a claim. The insurance company then reviews your submitted medical records and may send a nurse to perform an evaluation before approving a payout. Once approved, you will be reimbursed for paid services, up to the cap on your policy.

Ideally, you’ll stay healthy and your long-term care needs will be minimal. Though your premiums will add up over time, this is one situation where you hope not to get your money’s worth. On the bright side, to lessen the hit to your wallet, the government may give you a tax break.

Tax Relief for Long-Term Care Premiums

Some or all of the long-term care premiums you pay may be tax deductible at the federal and state level. But you must make these payments toward a tax-qualified insurance policy. Also, you must meet certain income thresholds.

Maximum Deductible Premium

40 or under $420
41 to 50 $790
51 to 60 $1,580
61 to 70 $4,220
71 and over $5,220

How to Buy Long-Term Care Insurance

You can purchase long-term care insurance directly from carriers or through a sales agent. The agent can help you shop around for comparable rates. This professional can also help you understand how different policies work and what they offer.

Also, you may be able to get long-term care insurance through your employer. Some allow you to purchase policies at discounted group rates. However, you should get quotes from multiple insurance companies. In some cases, you may find better rates for more suitable policies that aren’t through your employer.

How to Calculate Your Long-Term Care Insurance Costs

Some websites such as Genworth Financial provide interactive calculators that can estimate what long-term care premiums may be like in your area. Prices and policies can vary, depending on the state.

Tips on Paying for Long-Term Care 

  • If you have a health savings account (HSA), you may want to start socking away more money in it for long-term care. Also called health IRAs, these plans allow your money to grow tax deferred. (But you have to have a high-deductible health plan to open an HSA). To find out more, check out our report on the best HSAs.
  • Don’t go it alone. A financial advisor can help you devise an insurance plan and figure out how you’re going to pay for it. If you are in the market to buy insurance now, some advisors are also licensed insurance agents. Use our matching tool to find the right advisor for you.

Photo credit: ©iStock.com/FangXiaNuo, ©iStock.com/tumsasedgars, ©iStock.com/syahrir maulana

Javier Simon, CEPF® Javier Simon is a banking, investing and retirement expert for SmartAsset. The personal finance writer’s work has been featured in Investopedia, PLANADVISER and iGrad. Javier is a member of the Society for Advancing Business Editing and Writing. He has a degree in journalism from SUNY Plattsburgh. Javier is passionate about helping others beyond their personal finances. He has volunteered and raised funds for charities including Fight Cancer Together, Children’s Miracle Network Hospitals and the National Center for Missing and Exploited Children.
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Health Insurance Myths Debunked

  • Health Insurance

A health insurance policy is essential for anyone seeking to safeguard their future and avoid the catastrophic consequences of high medical bills. Whether you’re buying coverage for yourself or a health plan for your family, it’s important to get complete coverage. But despite this fact, millions of Americans remain uninsured, often because they believe one of the following health insurance myths.

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Myth 1: I’m Young and Healthy; I Don’t Need Health Insurance

You’re never too young to start shopping for health insurance plans because you don’t know what’s around the corner. Medical expenses can be astronomical at any age and anyone can have an accident, fall ill or be diagnosed with a serious disease. 

It’s not pleasant to think about and many people prefer to bury their heads in the sand and live as if they are invincible, but they’re not. No one is.

Health care is very expensive in the United States, there’s no escaping that fact. This is one of the few developed nations in the world where being the victim of an accident or attack could lead to insurmountable medical expenses and essentially ruin your life. You can’t rely on luck and you can’t assume you’ll be safe just because you’re young, fit, and healthy.

In fact, buying at this young age has many benefits, including the fact that you’ll likely clear all exclusion periods by the time you actually need to start claiming.

Myth 2: The Benefits are Lost if I Don’t Renew by the Due Date

You should always try to pay your monthly premium on time, thus avoiding any issues and ensuring you are covered at all times. However, your health insurance coverage does not end the minute you miss a payment.

Insurance companies have a grace period, during which time your policy will remain active. This period allows you to gather the funds needed and to pay your monthly premium, thus keeping your policy active. 

Typically, this grace period lasts for between 7 and 15 days, but it differs from provider to provider. Check your policy for more details but try to avoid playing fast and loose with your payments as they could be the only thing protecting you.

Myth 3: It’s All About the Deductible

The deductible is the amount of money you pay before the health insurance policy takes over and to many consumers, it is the single most important part of any health insurance policy. However, while it is important to consider the deductible, you should not choose your policies based solely on which one has the lowest deductible.

Look for the sort of cover that they provide and whether this will suit your needs or not, and then focus on the deductible. 

It’s also important to find the right balance between a deductible that is cheap enough for you to afford when the time comes, but is not so cheap that it sends the premiums through the roof. To do this, avoid focusing on how much your first monthly payment will cost and ask yourself what you would do if you had to pay for a medical expense today.

Would you have an issue paying the deductible? Would it require you to borrow money from friends or family? If so, it’s too high and it’s time to go back to the drawing board.

Myth 4: I Have Insurance from My Employer so I Don’t Need any Additional Cover

If your employer offers any kind of group health insurance cover, take it, but don’t assume that it will cover you for everything you need. Read the small print, look for gaps, and seek to fill those gaps with your own cover.

With your own policy, you’ll also be protected if you lose your life. If anything happens in the time it takes you to find a new job, you could be left to foot the bill, making this an even scarier and more stressful time. But if you’re covered, you can take your time as you search for a suitable role.

Myth 5: It’s Not a Pre-Existing Condition if I Didn’t Know About it

If you have any pre-existing medical conditions you will be subject to an exclusion period, one that may last for up to 48 months. During this time, your insurance company will not pay out for any issues related to this condition and contrary to popular belief, not knowing about the condition is not enough to avoid this exclusion period.

If, somehow, it is proven that you had a medical condition that was simply not discovered at the time you applied, it will still be subject to an exclusion period. The good news, however, is that you can no longer be refused because of pre-existing medical conditions, which means that everyone can benefit from health insurance.

Myth 6: I Don’t Need Health Insurance If I Have a Life Insurance Plan

A life insurance policy can cover you for critical illness, which could be used to cover health care costs. You can also purchase accident and dismemberment insurance to cover you in the event you lose a limb. However, life insurance is designed to pay out a death benefit when you die. It goes to your loved ones, not you, and is therefore not a viable replacement for health insurance.

For complete cover, you should look into getting both life insurance and health insurance. You can find low-cost options for both.

Summary: Common Myths Debunked

If you don’t have any health insurance coverage, it’s time to change that and start looking for coverage today. Take a look at our guide to choosing a health plan to get started. We also have guides on everything from life insurance (term life insurance, whole life insurance, and other life insurance coverage) car insurance and pretty much all other insurance products.

By purchasing all of these together you could even save some money while getting essential coverage! Just remember to do your research, plan ahead, and never settle for less than you need as you may live to regret it in the future.

Source: pocketyourdollars.com

A Guide to Coinsurance and Copays

A Guide to Coinsurance and Copays – SmartAsset

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Having health insurance makes it possible to receive medical care while only paying a fraction of that care’s true cost. Insurance doesn’t cover everything, however. Some of the cost of your care is still up to you to pay, and that cost comes in two primary forms: copays and coinsurance.

What Is a Copay?

A copay is a flat amount of money that you’re responsible for paying for a health care service. Copays typically apply for things like a doctor’s appointment, prescription drug or medical test. The amount of your copay is dependent on your specific health insurance plan.

You can typically expect to pay your copay when you check in for your service, be it an annual physical, dental cleaning or blood test. Copays are typically lower amounts ranging from $10 for something like a generic drug prescription to around $65 for a visit to a medical specialist.

Depending on your insurance plan, copays may not take effect until after you reach your deductible. Your deductible is the amount of money you must pay out-of-pocket before your insurance provider starts to pitch in. Deductibles reset at the beginning of every year.

When you are reviewing your plan information and you see the phrase “after deductible” or “deductible applies” in reference to your copays, that’s an indication that the copay is only in place once you meet your deductible. On the other hand, if you see “deductible waived,” that’s a sign that your copay is in place from the beginning. It may go without saying, but the latter situation is vastly preferable to you.

What Is Coinsurance?

Coinsurance is another method of splitting the cost of medical coverage with your insurance plan. A coinsurance is a percentage of the cost of services. You pay the percentage, and your insurance company foots the rest of the bill. So, if you have a $8,000 medical bill and a 20% coinsurance, you would be on the hook for $1,600.

Coinsurance typically only comes into play after you hit your deductible. Further, you may have differing coinsurance percentages for the same services depending on your provider network. If you have a preferred provider organization (PPO) plan, your coinsurance could be a higher percentage for providers outside your network than it is for providers in your network.

Similarly, your coinsurance may not apply to providers outside your network if you have a health maintenance organization (HMO) plan or an exclusive provider organization (EPO) plan. That’s because these plans typically don’t provide any out-of-network coverage.

Copay vs. Coinsurance

Copay and coinsurance are very similar terms. They both have to do with portions of the cost of your health care that’s under your responsibility. Because of that, and their similar names, it’s easy to confuse the two. There are a couple of important distinctions to keep in mind, however.

The most notable difference between copays and coinsurance is that copays are always a flat amount and coinsurance is always a percentage of the cost of the service. Another difference is that some copays can be in place before you hit your deductible, depending on the specifics of your plan. With coinsurance, you have to hit your deductible first.

Bottom Line

If you’re choosing between health insurance plans, make sure to examine the provided copays and coinsurance for each option. While they may not be the most important factor to consider, a high copay can be quite a pain, especially over the course of years of appointments and procedures.

Tips for Staying on Top of Medical Expenses

  • One of the best ways to stay ahead of surprise medical expenses is to have an emergency fund in place for just such a situation. If you can manage it, have three to six months worth of expenses stashed away in a high-yield savings account. That way, if you’re dealing with medical bills or have to step away from work, you’ll have a bit of a cushion.
  • If you’re not sure how an unexpected medical expenses would fit into your finances, consider working with a financial advisor to develop a financial plan. Finding the right financial advisor that fits your needs doesn’t have to be hard. SmartAsset’s free tool matches you with financial advisors in your area in 5 minutes. If you’re ready to be matched with local advisors that will help you achieve your financial goals, get started now.

Photo Credit: ©iStock.com/DuxX, ©iStock.com/SARINYAPINNGAM, ©iStock.com/Aja Koska

Hunter Kuffel, CEPF® Hunter Kuffel is a personal finance writer with expertise in savings, retirement and investing. Hunter is a Certified Educator in Personal Finance® (CEPF®) and a member of the Society for Advancing Business Editing and Writing. He graduated from the University of Notre Dame and currently lives in New York City.
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Source: smartasset.com