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Healthcare.Gov (ACA) and Long-Term Care

October 23, 2013 by Honey Leveen Leave a Comment

Thanks to my colleague, Romeo Raabe, for permission to re-publish his blog, “Heathcare.gov (ACA) and Long-Term Care”.

No, long term care is not directly affected by the Affordable Care Act (ACA, AKA Obamacare) but there are some scary correlations between the two. I refer to this morning’s Wall Street Journal article about what is coming – in both healthcare and long term care.

Doctors are retiring in droves. Those near are taking early retirement to avoid the losses of treating people for less than they are reimbursed. Medicare payments are being cut way back just as 10,000 Americans a day are coming on board (and will each day for the next 18-19 years). The ACA takes large sums from Medicare to fund the ACA. Doctors are reimbursed less and less, as more people are starting to use Medicare, hoping to get doctor appointments scheduled. Doctors often discourage their children from entering the profession. Others won’t accept new patients over the age of 50 (who will get Medicare in 15 years).

Medicaid, the primary payer of long term care in America, is being stretched to millions of uninsured Americans for medical care now. This leaves less for the already under-reimbursed long term care facilities. Nursing facilities tell me they lose between $2000 and $3400 per month on every resident on Medicaid. They cannot make you leave if you run out of funds and turn to Medicaid, but they can – and do – say no to your entrance. If you lose money on every customer, you cannot make it up on volume! They do it gently, asking about what care you will need, and then apologizing that they do not have the staff, currently, to deal with those needs. If the “desirable” LTC facilities turn you away, what choice does this leave you? The less desirable facilities, or one far away that will accept you? I wonder if the people who “wisely” divested their homes and fortunes years ago realized the box they have put themselves in.

More doctors are going into “concierge” medicine, accepting only those patients willing to pay an annual retainer of $500-$3000 a year for ready access and longer consultations. Some LTC facilities also are turning away all Medicaid entrants. The ambience will be nicer, with more staff and better activities and food, and all will pay their fair share with no cost shifting. That is where I want to go when needed, and I have the income from my LTC insurance policy to pay for it. Wouldn’t you like to be in a position to choose such care as well?

With the ACA starting enrollments just as the Medicare Advantage season starts, there is confusion with some going to the wrong site for information and to sign up. Many Americans already believe that LTC is free from the government, and do not realize that Medicaid is not given because you are old, or disabled, it is given because you are impoverished – a fancy word for broke. Why would someone plan to end up that way and dependent on a government that you may have heard rumors of being short on funds itself? LTC insurance is often less expensive than people imagine, and most do not need as much as they initially suspect. Wouldn’t it be prudent to at least investigate?

Blue Cross Plans Jump to An Early Lead: Coincidence or not?

October 14, 2013 by Honey Leveen Leave a Comment

An article in the October 11, 2013 New York Times titled Blue Cross Plans Jump to an Early Lead caught my attention. It reports that Blue Cross Blue Shield carriers are emerging as the most competitive of the new Affordable Care Act (ACA, or Obamacare) plans. It states that the majority of Blue Cross Blue Shield companies are “not-for-profit” corporations. This unique status can be very important when it comes to creating affordable insurance policies.

Here is a reputable link that describes what a Not-For-Profit corporation is. Here’s a quote from that link, ” A not-for-profit corporation may not be formed for pecuniary profit or financial gain and the corporation’s assets, income or profit may not be distributed to or otherwise used to benefit the corporation’s members, directors or officers except as permitted by the Not-for-Profit Corporation Law, e.g., as reasonable compensation for services to the corporation.”

I am growing to love not-for-profit insurance companies. When we look at accurate cross-comparisons of long-term care insurance (LTCi) policies here in TX, we discover that MedAmerica Insurance Company and LifeSecure Insurance Company often have the most competitive LTCi rates. Neither company is not-for-profit, but each is a wholly owned subsidiary of a not-for-profit Blue Cross Blue Shield parent company.

Not-for-profit status requires insurance companies to spend more money paying claims and less money on administrative costs, like salaries and other expenses. I asked my LifeSecure Regional Representative to read this blog and check it for accuracy. She confirmed that the tight budgeting and fiscally responsible management of the not-for-profit-parent is an integral part of LifeSecure’s management and culture.

I used to wonder why these two carriers had such competitive rates and whether they were charging policy holders enough to ensure stable enough premiums in the long haul. Now I better understand a big part of why their LTCi plans are safe and very competitive.

Rolling Out the ACA Plans

October 13, 2013 by Honey Leveen Leave a Comment

I can’t remember a more exciting week in the world of health insurance. I’ve been closely watching the rollout of the new Affordable Care Act (ACA) health insurance plans. The plans were put on the market on October 1, 2013. Shopping for an ACA plan is supposed to be easily done through official ACA websites. The new plans are supposed to be so reasonable that they will be affordable for many who are presently uninsured.

My peers who sell a lot of health insurance, plus mainstream media, tell me that registering online for an ACA plan is currently riddled with delays and glitches. I believe this is due to a huge public interest in learning about the new coverage.

The government continues to promise to fix the glitches and make enrollment in an ACA plan smooth and easy.

I advise using perspective and patience with the ACA rollout.

In some states, the ACA rollout is rocking and rolling along, with a good success rate, according to the article “Heath Act Embraced in California“, from the October 11, 2013 New York Times.

Here’s another article from the October 11, 2013 New York Times, titled, “In Florida, Opposition by the State and Snags in Signing Up on the Web”. It describes a high rate, at least so far, of failure to enroll in ACA plans. Florida’s experience is dismal and nearly the opposite of California’s.

In TX, I’ve heard almost no good news of people being served and successfully finding coverage. Texas did not create its own healthcare exchange. California did. California also spent a lot of money enlisting volunteers to assist the public with the ACA enrollment process. Texas did not. Also like Texas, Florida has fought against the ACA and gone to no effort to support its implementation.

Small wonder successful enrollments in ACA plans here in TX have been next to nil.

I advise patience. These are exciting times for me.

National Commission on Long-Term Care Finds No Solutions to LTC Crisis

September 20, 2013 by Honey Leveen Leave a Comment

On March 23, 2013 I blogged on the official demise of the CLASS Act LTC program.

The CLASS (Community Living Assistance Services and Supports) Act was supposed to create a voluntary, worker-paid long-term care (LTC) benefits program. Health and Human Services Secretary Kathleen Sebelius announced that the CLASS Act program was actuarially sustainable. Of course, we in the long-term care insurance (LTCi) industry knew the CLASS Act was “deader than a doornail” for a long time, way before CLASS was enacted. This legislation just makes its demise official.

The formal repeal of the CLASS Act on January 1, 2013 included the establishment of a national commission on long-term care.

The committee was tasked with creating solutions for our nation’s looming long-term care crisis, which I’ve often blogged about.

On Thursday, September 12, 2013, the Commission submitted its recommendations, right on their deadline.

This Forbes Column by Howard Gleckman, on September 13, 2013, reports that Commission members were unable to come to consensus on adopting Commission recommendations, primarily because the committee was unable to broach the subject of LTC financing, which is obviously the crux of the problem.

Quoting from Mr. Gleckman, “Sources say there was never much chance the commission–operating with limited resources, deep partisan divisions, and a painfully short time-frame—could tackle the controversial financing issue. Instead, the report will do little more than identify the two prime alternatives—expanding private savings and insurance options or a creating a public social insurance program– without endorsing either.”

Horrible Stress That Could Have Been Avoided with Long-Term Care Insurance

September 9, 2013 by Honey Leave a Comment

Once again, thank you, Dear Abby, for giving me additional blog fodder. In Sunday, September 9, 2013’s column, “Mom is caregiver, referee between husband, sons”, a tragic situation in which Mom is the primary caregiver is described. The husband is 99% bed-bound with multiple sclerosis, one son is bipolar and the other has Asperger’s. Both sons have behavioral problems that infuriate their bitter and angry father who tells them that he would hit them if he could. Needless to say, this verbal abuse just increases Mom’s stress.

What a horrible situation!! Imagine how much this family could have benefited from reasonably priced long-term care insurance! The policy would have provided funds to cover some if not all of the cost of a full-time caregiver for Dad and taken a huge load off Mom. Consequently, she could put more energy into caring for her sons.

Please note: the father described must be relatively young. While most long-term care claims come late in life, younger people often file claim on long-term care insurance policies. This is just one reason why it doesn’t make sense to wait to buy long-term care insurance.

I wish I could say that this situation is unusual, but since the odds of needing long-term care are nearly 70% for people over 65, I hear about comparable predicaments almost every day. And until the American public takes these odds seriously – and plans accordingly – we will all continue to read such stories or worse, find ourselves living a similar nightmare.

Healthcare.Gov (ACA) and Long-Term Care

Blue Cross Plans Jump to An Early Lead: Coincidence or not?

Rolling Out the ACA Plans

National Commission on Long-Term Care Finds No Solutions to LTC Crisis

Horrible Stress That Could Have Been Avoided with Long-Term Care Insurance

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