Tailoring a Caregiving Plan to Your Family
Tailoring a Caregiving Plan to Your Family

Tailoring a Caregiving Plan to Your Family

Tailoring a Caregiving Plan to Your Family.

If you have a family member who needs ongoing assistance because of a disability, severe medical issue, or a chronic illness, you might need to create a schedule within the family for providing care to that loved one. Few of us can afford to hire a private nurse for a family member. Many people who need caregiving need someone available 24 hours a day, even if some of that time is watching over the person rather than providing medical attention.

Public assistance programs provide limited, if any services, so most families have to figure out who can pitch in and help care for the loved one. If you are like most people, you could use some suggestions on tailoring a caregiving plan to your family. Recent legislation could make that task easier.

The Inherent Problems of Caregiving

People who are already working full-time and raising their families, often end up taking shifts, along with other relatives. The situation can go on like this for years. The caregivers become exhausted, physically, emotionally and financially.

Resentment can build, if some of the family caregivers feel they are doing more than their share, while others are not doing their part. Years later, the primary caregivers can get accused of undue influence, if the person who received help gives a larger portion of the estate to the primary caregivers out of gratitude.

Why Congress is Paying Attention to the Challenges of Family Caregiving

Our population is aging. By 2026, the baby boomer generation will start to turn 80 years old. Many people in their eighties need long-term care, either in the home or a facility. The high numbers of baby boomers and the declining birthrates mean there will be more people needing family caregiving and fewer relatives available to provide those services.

Family caregiving takes a massive chunk out of our economy each year. Experts say 40 million people in the United States provide unpaid caregiving services to their adult loved ones, who have limitations in their daily activities. The experts on aging value these services at around $470 billion a year.

Another 3.7 million Americans take care of a disabled child under the age of 18. Some people have to provide caregiving for both an older adult and a child. People in the field estimate that about 6.5 million people in our country fall into this category.

The caregivers face immediate and long-term financial crises, because of the time they devote to the needs of their vulnerable loved ones. In the moment, the caregiver might have to cut back on work hours or leave a paying job to be there for the family member in need. Losing a paycheck and benefits, can put a caregiver into economic hardship. Many caregivers live in poverty in the future, because it was impossible to contribute to retirement savings or the Social Security system during the long years of caregiving.

Congress is working on measures to provide more public resources for family caregivers. The “Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act” contains strategies for state and communities to support caregiving families. Increased assessments and service planning dovetailed with education, supports and respite options can impact financial security and workplace issues of caregivers. The new law centers on both caregivers and people receiving the care.

References:

AARP. “Building a Family Caregiving Strategy to Align with the Real Needs of Families.” (accessed October 31, 2019) https://blog.aarp.org/thinking-policy/building-a-family-caregiving-strategy-to-align-with-the-real-needs-of-families

 

What Worries Retirees the Most?
What Worries Retirees the Most?

What Worries Retirees the Most?

What Worries Retirees the Most?

Retirees don’t want to run out of money. However, homeowners over 62 who have considerable equity in their homes may want to look at a strategy that can minimize their money anxiety. A reverse mortgage will let them tap into home equity, by providing funds to keep them financially stable. Could the reverse mortgage payments take a bite out of their Social Security or Medicare benefits?

Motley Fool’s recent article asks, “Can a Reverse Mortgage Impact Your Social Security or Medicare Benefits?” The article explains that reverse mortgages, also called home equity conversion mortgages (HECM), were created in 1980 to help seniors stay solvent, while remaining in their homes.

You know that in a regular mortgage, you pay the bank monthly installments. However, with a reverse mortgage, the bank pays you. You take out money against the equity in your home, and the loan doesn’t come due until you sell the home, move out of it, or die. The amount you can get is based on a formula that takes into account your age, the equity in your home, its market value and the interest rate you’ll be paying. You can get your reverse mortgage funds as a lump sum, a monthly payment, or a line of credit.

There are some drawbacks to a reverse mortgage. This type of loan can have big fees, including origination fees, closing costs (similar to a regular mortgage) and mortgage insurance premiums.  These fees can usually be rolled into the loan. It will, however, increase the amount the bank is entitled to receive once the loan ends.

A reverse mortgage isn’t for you, if you want to leave your home to your family. Perhaps they can pay off the balance of your HECM once you die or move out, but that could be costly. If you want to sell it (perhaps to simplify the splitting up of that inheritance), the share your heirs will receive from the proceeds may not be as much as you’d anticipated. If you’re having a hard time keeping up with the day-to-day costs of running the house, a reverse mortgage may not be the best option. However, if you’re just looking to add to your retirement income for peace of mind, it’s a decent financial planning tool to consider.

The good news is that it has no impact on your Social Security benefits, because the program is not means-tested. Therefore, the amount of income you have won’t affect your monthly benefit when you file. As a result, you don’t need to take Social Security into account when you’re thinking about this type of loan.

Likewise, Medicare is a non-means-tested program. However, a reverse mortgage can have an impact on Medicaid and Supplemental Security Income (SSI) benefits, because those are based on your current financial assets. If you’re receiving either of those, talk to an elder law attorney or estate planning attorney to discuss how a reverse mortgage might have an effect on your specific circumstances.

Reference: Motley Fool (November 1, 2019) “Can a Reverse Mortgage Impact Your Social Security or Medicare Benefits?”

 

Making Inheritance Talks Easier
Making Inheritance Talks Easier

Making Inheritance Talks Easier

Making Inheritance Talks Easier.

Conversations about money and finances can be problematic for many families. Those very same people you grew up with, aren’t always on the same page, especially when the inheritance is the topic, says The New York Times in a recent article “Tips to Ease Family Inheritance Tensions.”

Find a common interest. You may be very different, but you also have a lot in common. The sibling relationship is a long-running one, so focus on preserving or repairing that relationship.

Bring in help to facilitate discussions. If family history makes it too difficult to manage, bring in an estate planning attorney or financial advisor to mediate the conversation. Having an unbiased person to run the show can keep things on track, make sure all viewpoints are recognized and help the group get to a productive conclusion.

Listen to each other. The simplest task may also be the hardest. It’s so easy to fall into old behavior patterns (i.e., the bossy older sister, the brother who goes along to get along). Don’t interrupt each other and check in to make sure everyone is feeling okay about how the conversation is going.

Advice to parents. Even if you don’t have a mega-wealthy family, you may all benefit from having an outside person, like an estate planning attorney or corporate trustee, to be named as a trustee. The more financially competent sibling could be the trust advisor, who can give advice but does not make the final decision. This keeps everyone a little more arm’s length from the decision making.

Talk with your family about money. Inheritances are frequent sources of friction among siblings. Not knowing how they are going to share in the family assets, how it is going to be structured and what expectations are, can create considerable tension within the family. Many families do not talk with their children about money, but that’s a big mistake. Not comfortable with the idea of a conversation? Then write down your motivation for your decisions about how the family wealth is going to be distributed and ask your estate planning attorney to make it part of your documents. It won’t be legally binding, but it may provide your children with some further insights.

Reference: The New York Times (Nov. 6, 2019) “Tips to Ease Family Inheritance Tensions.”

Making Inheritance Talks Easier.

Blended Families Need More Thoughtful Estate Plans
Blended Families Need More Thoughtful Estate Plans

Blended Families Need More Thoughtful Estate Plans

Blended Families Need More Thoughtful Estate Plans.

Estate planning for blended families is like playing chess in three dimensions: even those who are very good at chess can struggle with so many moving parts in so many dimensions. Preparing an estate plan requires careful consideration of family dynamics, and those are multiplied in blended families. This is another reason why estate plans need to be tailored for each family’s circumstances, as described in the article “Blended families have unique considerations in estate planning” from The News Enterprise.

The last will and testament is often considered the key document in an estate plan. But while the will is very important, it has certain limitations and a few commonly used estate planning strategies can result in unpleasant endings, if this is the only document used.

Spouses often leave everything to each other as the primary beneficiary on death, with all of their children as contingent beneficiaries. This is based on the assumption that the second spouse will remain in the family home, then will distribute any proceeds equally between the children, if and when they move or die. However, the will can be changed at any time before death, as long as the person making the will has mental capacity. If when the first spouse dies, the relationship with the surviving children is not strong, it is possible that the surviving spouse may have their will changed.

If stepchildren don’t have a strong connection with the surviving spouse, which occurs frequently when the second marriage occurs after the children are adults, things can go wrong. Their mutual grief at the passing of the first spouse does not always draw stepchildren and stepparents together. Often, it divides them.

The couple may also select different successor beneficiaries. The husband may name his wife first, then only his children in his will, while the wife may name her husband and then her children in her will. This creates a “survival race.” Winner takes all. The surviving spouse receives the property and the children of the spouse who passed won’t know when or if they will receive any assets.

Some couples plan on using trusts for property distribution upon death. This can be more successful, if planned properly. It can also be just as bad as a will.

Trust provisions can be categorized according to the level of control the surviving spouse has after the death of the first spouse. A trust can be structured to lock down half of the trust assets on the death of the first spouse. The surviving spouse remains as a beneficiary but does not have the ability to change the ultimate distribution of the decedent’s portion. This allows the survivor the financial support they need, giving flexibility for the survivor to change their beneficiaries for their remaining share.

Not all blended families actually “blend,” but for those who do, a candid discussion with all, possibly in the office of the estate planning attorney, to plan for the future, is one way to ensure that the family remains a family, when both parents are gone.

Reference: The News Enterprise (November 4, 2019) “Blended families have unique considerations in estate planning”

Blended Families Need More Thoughtful Estate Plans.

What Are the Rules About an Inheritance Received During Marriage?
What Are the Rules About an Inheritance Received During Marriage?

What Are the Rules About an Inheritance Received During Marriage?

What Are the Rules About an Inheritance Received During Marriage?

A good add-on to that sentence is something like, “provided that it is kept separate from marital assets.” To say it another way, when an inheritance or any other exempt asset (like a premarital asset) is “commingled” with marital assets, it can lose its exempt status. Another way to say this is inheritance is never marital property unless you take an action to convert it to marital property.

Trust Advisor’s recent article asks, “Do I Have To Divide The Inheritance I Received During My Marriage?” As the article explains, this is the basic rule, but it’s not iron-clad.

A few courts say that an inheritance was exempt, even when it was left for only a short time in a joint account. This can happen after a parent’s death. The proceeds of a life insurance policy that an adult child beneficiary receives, are put into the family account to save time in a stressful situation. You may be too distraught to deal with this issue when the insurance check arrives, so you or your spouse might deposit it into a joint account. However, in one case, the wife took the check and opened an investment account with the money. That insurance money deposited in the investment account was never touched, but the wife still wanted half of it when the couple divorced a few years later. However, in that case, the judge ruled that the proceeds from the insurance policy were the husband’s separate property.

The law generally says that assets exempt from equitable distribution (like insurance proceeds) may become subject to equitable distribution, if the recipient intends them to become marital assets. The comingling of these assets with marital assets may make them subject to a division in a divorce. However, if there’s no intent for the assets to become martial property, the assets may remain the recipient spouse’s property.

Courts will look at “donative intent,” which asks if the spouse had the intent to gift the inheritance to the marriage, making it a marital asset. Courts may look at a commingled inheritance for donative intent, but also examine other factors. This can include the proximity in time between the inheritance and the divorce. Therefore, if a spouse deposited an inheritance into a joint account a year before the divorce, she could argue that there should be a disproportionate distribution in her favor or that she should get back the whole amount. Of course, the longer amount of time between the inheritance and the divorce, the more difficult this argument becomes.

Be sure to speak with your estate planning attorney about the specific laws in your state. If there is a hint of trouble in the marriage, it might be wiser to simply open a new account for the inheritance.

Reference: Trust Advisor (October 29, 2019) “Do I Have To Divide The Inheritance I Received During My Marriage?”

 

Strategies for the “Sandwich” Generation
Strategies for the “Sandwich” Generation

Strategies for the “Sandwich” Generation

Strategies for the “Sandwich” Generation.

If you are taking care of your aging parents and still helping your own children, you are part of the “sandwich” generation. If you feel as if you will never be able to go off duty because of all the people who make demands on your time and money, here are some strategies for the “sandwich” generation.

Quite a few people start having children when they are in their forties. Your parents could already be in their sixties and seventies, when you have toddlers. By the time your children are in high school, you will be in your fifties with parents in their seventies or eighties. You should be focused on plowing lots of money into your retirement account. However, instead you find yourself pulled in many different directions, without the energy or resources you need for yourself.

How People with Adult Children Can Get Pulled at Both Ends: Strategies for the “Sandwich” Generation

You do not have to be raising young children to be in the sandwich generation. Your children might be adults but need financial help because of student loans or other financial pressures. Additional reasons you might need to assist your adult children include things like:

  • You have a child with a disability.
  • One of your children struggles with substance abuse.
  • You might have a child who does not manage his money well.
  • You have a twenty-something or older child, who is in graduate school.
  • You provide much of the childcare for or you raise one of your grandchildren.

These are only a few examples of the reasons you might find yourself having to lend a helping hand to your parents and your adult children.

The Financial Impact of Taking Care of Two Generations: Strategies for the “Sandwich” Generation

Any of these situations can put demands on your time, energy and finances. People who take care of their older parents and their own children often suffer as a result. For example, these caregivers drive everyone else to their medical appointments but do not have to time to go for routine checkups. There are not enough hours in the day to go for a walk to de-stress or get physical exercise. Sleep deprivation is common among “sandwichers.”

The financial impact of dual caregiving can be both short-term and long-term. If you are constantly picking up medications and groceries for your elderly parents and helping your children financially, you might find yourself having a cash flow strain. The time the double caregiving takes from your schedule can also make it impossible for you to engage in the amount of gainful employment you would like, so you can increase your retirement savings.

How to Handle the Stress and Exhaustion of Dual Caregiving: Strategies for the “Sandwich” Generation

You are not alone. Many people have walked this path before you. They offer these suggestions:

  • Contact your local government agencies, community groups, senior organizations and charitable entities to find as many resources as possible to take some of the weight off of your shoulders. Adult day programs, respite care and other services can be a godsend.
  • Find sources of funding to ease your financial strain. Your aging parents might qualify for more benefits than they currently receive. You can use the website Benefit Finder to locate additional financial help, like Medicare, Medicaid, veterans benefits and many other programs.
  • Change your expectations. Your house does not have to be perfect. Your teens can get rides with friends, or you can set up a carpool.
  • Set a daily sleep goal of at least seven hours and stick to it. You cannot help anyone, if you get so exhausted that your health deteriorates.
  • Try to find the humor in daily situations.

Remember, this stage and every stage is temporary. You are creating memories that you will treasure.

References:

HuffPost. “This Is What No One Told Me About Suddenly Joining The Sandwich Generation.” (accessed November 8, 2019) https://www.huffpost.com/entry/sandwich-generation-caring-for-kids-parents_n_5d24c00ee4b07e698c418fc9

Benefits.gov. “Benefit Finder.” (accessed November 14, 2019) https://www.benefits.gov/benefit-finder

 

What Is an Ethical Will and Do You Need One?
What Is an Ethical Will and Do You Need One?

What Is an Ethical Will and Do You Need One?

What Is an Ethical Will and Do You Need One?

When an estate planning attorney suggests that clients create ethical wills, they aren’t asking the clients to create another last will and testament. Instead, it is to create something that can explain their intentions to their loved ones. According to the article “How to create an ethical will” from Herald Net, a ethical will is also known as a legacy letter.

An Ethical will is a document that passes ethical values from one generation to the next. Rabbis and Jewish laypeople have continued to write ethical wills during the nineteenth and twentieth centuries. In recent years, the practice has been more widely used by the general public. Wikipedia

This can be a kind and loving gift to your family, since it allows you to express your feelings and thoughts. If you’re not accustomed to sharing your feelings, that will make it even more special to your loved ones. It’s an opportunity to say all the things you never felt comfortable saying. You may want to express your wishes, regrets and gratitude. You may also want to pass long the life lessons that have been valuable for you.

It is a way to share your ethical culture. Your values, life lessons, hopes and dreams for the future. You can share your blessings, love, and forgiveness with your family and friends. An ethical will is not a legal document.

An ethical will does not distribute your material wealth. It also provides an opportunity for you to explain how you came to the decisions you did about your will and the money and possessions you are passing along. You might want to explain why a certain child is being given a piece of artwork or why another is being left assets in a trust and not an outright gift.

If you are more comfortable with making a video, you can also do that. An audio or video recording often becomes a treasured piece of family history, since it allows generations who may have never met you to see and hear you.

Start by writing down some notes about what matters to you and what you think you might want to share with the family. Take your time. Remember you aren’t writing the Great American Novel but creating a gift of love; a heartfelt expression of what truly matters most in your life.

Once you’ve gathered your thoughts, move on to the next draft. Once it’s complete, to keep this document safe and in a secure location. If you have a waterproof and fireproof safe where you keep important papers in the home, the ethical will should also go in there. Remember that safe deposit boxes are sealed at death, so if you want your loved ones to read this, it should not go in the safe deposit box.

One last thought—some people like to share their ethical will with family and friends, while they are still living. This allows them to enjoy their reactions and have a discussion about whatever they have shared in the document. Others prefer to wait until after they have passed. It’s a very personal decision.

Talk with your estate planning attorney about how the ethical will works with your estate plan.  Make sure there’s nothing in the ethical will that contradicts your last will and testament. That could create problems for the family.

Reference: Herald Net (Nov. 6, 2029) “How to create an ethical will”

 

When Should I Start Looking into Long-Term Care?
When Should I Start Looking into Long-Term Care?

When Should I Start Looking into Long-Term Care?

When Should I Start Looking into Long-Term Care? Sooner than you probably think.

You can bet that you won’t need long-term care in your lifetime, but it’s not a sure thing: about 70% of seniors 65 and older require long-term care at some point. That could be just a few months with a home health aide or it could mean a year (or more) of nursing home care. You can’t know for sure. However, without long-term care insurance, you run the risk that you’ll be forced to cover a very large expense on your own.

The Motley Fool’s recent article, “75% of Older Americans Risk This Major Expense in the Future,” says many older workers are going into retirement without long-term care coverage in place. In a recent Nationwide survey, 75% of future retirees aged 50 and over said they that don’t have long-term care insurance. If that’s you, you should begin considering it, because the older you get, the more difficult it becomes to qualify, and the more expensive it becomes.

Long-term care insurance can be costly, which is why many people don’t buy it. However, the odds are that your policy won’t be anywhere near as expensive as the actual price for the care you could end up needing. That’s why it’s important to look at your options for long-term care insurance. The ideal time to apply is in your mid-50s. At that age, you’re more likely to be approved along with some discounts on your premiums. If you wait too long, you’ll risk being denied or seeing premiums that are prohibitively expensive.

All policies are not the same. Therefore, you should look at what items are outside of your premium costs. This may include things such as the maximum daily benefit the policy permits or the maximum time frame covered by your policy. It should really be two years at a minimum. There are policies written that have a waiting period for having your benefits kick in and others that either don’t have one or have shorter time frames. Compare your options and see what makes the most sense.

You don’t necessarily need the most expensive long-term care policy available. If you’ve saved a good amount for retirement, you’ll have the option of tapping your IRA or 401(k) to cover the cost of your care. The same is true if you own a home worth a lot of money, because you can sell it or borrow against it.

When Should I Start Looking into Long-Term Care? It’s important to remember to explore your options for long-term care insurance, before that window of opportunity shuts because of age or health problems. Failing to secure a policy could leave you to cover what could be a devastatingly expensive bill.

Reference: Motley Fool (September 23, 2019) “75% of Older Americans Risk This Major Expense in the Future”

 

What Does Medicare Plan G Cover?
What Does Medicare Plan G Cover?

What Does Medicare Plan G Cover?

What Does Medicare Plan G Cover?  Today is the fifth part of a multi-part series on Medicare. Plan G is medigap coverage. It is important to anyone looking to obtain Medigap coverage after January 1, 2020 because that is a plan available to new enrollees since Part F has now been closed for new initial enrollees.

Medicare Plan G is a Medigap supplement plan that has lower premiums than Medigap (Plan F), in exchange for a small annual deductible. Plan F has no deductible. With Plan G, you get the same benefits as you would with the “Cadillac” version of Medicare, Plan F, but at a more affordable price. Let’s take a closer look to answer the question What does Medicare Plan G cover?

Let’s say you do not want to get hit with a mountain of healthcare bills after a medical crisis. Millions of Americans have lost their life savings and declared “medical bankruptcy” because of astronomical out-of-pocket costs, even though they have Medicare Parts A and B, also called “original Medicare.” A stroke, heart attack, or car crash could cause devastating consequences.

In response to this problem, private insurance companies created Medigap coverage (Plan F), which pays your out-of-pocket costs, like copays and deductibles, when you receive healthcare services that Medicare covers. The problem with Plan F is the premiums are quite expensive, such that many people cannot afford this excellent coverage.

The Difference Between Plan F and Plan G

The only thing that Plan G does not cover that Plan F (Medigap) pays, is the Medicare Part B (outpatient services) deductible. Since that deductible is only $198 in 2020, many people choose Plan G coverage. Because the premiums for Plan G policies tend to be much less expensive than with Plan F, people tend to save hundreds of dollars with Plan G, even if they have to pay a deductible.

The Part B deductible can change from one year to the next, but so do the premiums for Plans F and G. Premiums tend to keep pace with the risk of loss for the insurance company. You will likely continue to save money on premiums by choosing Plan G instead of Plan F, even factoring in the deductible, but you should do the math every year to make sure.

What Plan G Covers

Other than the Plan B deductible, Plan G pays everything that Plan F covers, including:

  • Coinsurance and hospital bills for Medicare Part A (inpatient services and hospitalization), at 20 percent of the total expense
  • Up to 365 more days of Part A coverage than “original” Medical provides
  • Coinsurance for Medicare Part B, at 20 percent
  • Blood transfusions, up to three units
  • Part A coinsurance or copay for hospice care
  • Coinsurance for skilled nursing facility
  • Deductible for Part A
  • Part B “excess charges.” Some doctors charge their patients 15 percent over what Medicare pays. If you choose one of these physicians, you will have to pay this expense out of pocket, unless you have Plan F or G.
  • The cost of travel from a foreign country to the United States, if you have a medical emergency.

Please note that, like Plan F, Plan G only covers Medicare-approved expenses. If you incur bills for services or items that original Medicare does not help to pay, you will have to shoulder these costs yourself.

Original Medicare (Medicare Parts A and B) does not pay for things like routine eye exams, eyeglasses, routine dental care, dentures, routine hearing exams, hearing aids, prescription drugs (Medicare Part D can cover these), homeopathic treatments like acupuncture and acupressure and several other types of health-related goods and services. Read a policy carefully to know exactly what it covers, before you get locked into the plan for a year.

Every state makes its own regulations. Be sure to talk with an elder law attorney near you to find out how your state might differ from the general law of this article.

References:

Boomer Benefits. “Medicare Plan G – Part G” (accessed October 24, 2019) https://boomerbenefits.com/medicare-supplemental-insurance/medicare-supplement-plans/medicare-plan-g/

 

What Does Medicare Plan F Cover?
What Does Medicare Plan F Cover?

What Does Medicare Plan F Cover?

What Does Medicare Plan F Cover?

Today is the fourth part in my Medicare series. Previously we covered Medicare A & B, C and D in three different blog posts. We will not cover Part E because new enrollment has closed. Plan E is not open to new enrollees but if you had the plan prior to 2010 you may keep it. Therefore, to start today’s post What Does Medicare Plan F Cover?

Although you might not have heard about it by this name, there is a Medicare Plan F. “Original” Medicare, also called Parts A and B, covers hospitalization and many outpatient healthcare costs. Part C is the official term for Medicare Advantage, which is the services of Parts A and B, but through an HMO or PPO-type of private health insurance.

Medicare Part D helps to pay some of the costs of prescription drugs. There is no longer a Part E of Medicare. With so many options already with Parts A, B, C, and D, some people might wonder why we need a Plan F. What does Medicare Plan F cover?  Part F in simple terms covers co-pays for doctor’s visits.

Many people in the insurance industry call Plan F the “Cadillac” coverage of Medicare supplement options. Another term for Plan F is “Medigap” coverage. As long as Medicare would cover the item, Medigap Part F will pay for it.

How Medigap Coverage Works

Medigap coverage means you pay nothing for healthcare services that original Medicare covers. You will have two cards – your Medicare card and your Medigap supplemental policy card. When you receive medical services, you present both cards to the service provider. Medicare will pay its portion, and Medigap will pay the rest.

What Medigap Does Not Cover

Medigap does not pay for things that original Medicare does not cover, unless your plan contains specific terms to the contrary. Neither original Medicare (Parts A and B) nor Medigap cover these things:

  • Vision care and eyeglasses
  • Routine dental services and dentures
  • Routine hearing examinations and hearing aids
  • Homeopathic treatments, like acupuncture and acupressure
  • Surgery that is not medically necessary
  • Prescription drugs (Part D is a separate plan)
  • Foot care, unless the treatment is for a medical condition
  • Help with daily living tasks, like grooming and eating

When Medicare denies a claim, Medigap will not pay any portion of the cost of the item or service. Medigap only kicks in after Medicare pays its part.

Things That Medigap Covers

Here are some examples of things that Medigap covers:

  • Your annual deductible for Medicare Parts A and B
  • Your copays (usually 20 percent of the hospital, doctor, or another medical bill)
  • An extra 365 days of hospital coverage after you use up your Medicare hospitalization benefits
  • Blood transfusions, up to three pints
  • Coinsurance for Part A hospice care
  • Coinsurance for a skilled nursing facility
  • Some doctors charge the patient 15 percent more than the Medicare reimbursement rate. If you go to one of these doctors, you have to pay this “excess charge,” unless you have Medigap coverage. Medigap pays the 15 percent excess charge for you.
  • Emergency foreign travel for medical reasons, up to $50,000. Medicare does not cover any of this expense because Medicare only pays for healthcare services inside the United States, but a Medigap policy will pay 100 percent of this cost.
  • A portion of some of the expenses of emergency healthcare services in a foreign country, up to the individual policy’s limits.

Medigap policy premiums and benefits can vary widely from one company to another. You should read the details carefully and compare multiple policies.

Medigap Part F is going away for new enrollees starting January 1, 2020. If you have it already or are otherwise eligible you can keep your medigap but in an effort to prevent people from going to the doctor for a sniffle Part F is being closed to new enrollees.

Your state’s laws might differ from the general law of this article. You might want to talk to elder law attorney Frank Bruno, Jr. to discuss.

References:

Boomer Benefits. “What Does Part F Cover?” (accessed October 24, 2019) https://boomerbenefits.com/faq/what-does-plan-f-cover/