JustCare

Tag: Medicaid

  • It’s time to enroll in a health plan if you are under 65

    It’s time to enroll in a health plan if you are under 65

    Open enrollment in state health exchanges begins on November 15 and lasts through February 15.  You can enroll in a health plan or switch health plans even if you have costly health care needs.  Health plans cannot cancel your coverage if you need costly health care. Here are four things to keep in mind:
    1. Help with premiums: If your income is no more than four times the federal poverty level (between $11,670 and $46,680 for an individual or $23,850 and $95,400 for a family of four), you are eligible for help with the premiums.
    2.  Automatic reenrollment: If you have health insurance through an exchange and do nothing, you will be reenrolled in the same health plan.  But, if you’re smart, you’ll visit healthcare.gov to see whether there are any new plans in your area and what your current health plan is offering in terms of costs and benefits as compared to other health plans in your area.  Read these tips for choosing a health plan.
    3. Expanded Medicaid eligibility: If your income is at or below 138 percent of the federal poverty level ($16,105 for an individual and $32,913 for a family of four) in many states you are likely eligible for Medicaid
    4. Penalty if you go without health insurance: If you did not have insurance in 2014 or if you don’t have insurance in 2015, you will pay a penalty when you file your federal taxes.  In 2014, the penalty is $95 or 1% of your income, whichever is higher.  In 2015, the penalty is $395 or 2% of your income, whichever is higher.

    If you enroll after the 15th of the month, your coverage will not begin until a month and a half later.  If you enroll between the 1st and 15th of the month, your coverage will begin on the 1st of the following month. For more information, check out the Kaiser Family Foundation’s Consumer Guide.

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    Four tips for keeping your costs down in a private health plan or Medicare Advantage plan
    A crash course in five important health insurance terms

  • Three tips to plan for long-term care

    Three tips to plan for long-term care

    1. Protection: Because most of us will need long-term services and supports, it’s important to plan ahead for long-term care.  If your income is low, Medicaid will pick up the cost of a nursing home stay.  Depending upon the state you live in, you also might be able to spend down your income to qualify for Medicaid. If not, Medicare will at most only pick up the cost of a short-term stay in a skilled nursing facility depending on whether you meet the eligibility criteria.  Most people rely on family members and friends to provide long-term care at no or low-cost.
    2. Cost: If you cannot count on Medicaid or assistance from family and friends, you should plan ahead and set aside funds to pay for long-term care.  For more information on costs, this  AARP report shows that long-term care is unaffordable for many middle-income families. In 2013, an average nursing home stay cost $84,000 a year and the average cost of care in an assisted living facility was $42,000.
    3. Long-term care insurance: Before buying long-term care insurance, keep in mind that the premiums are likely to rise dramatically over time. And, the coverage you buy today may be inadequate when you need it since health care costs likely will rise more than the 5 percent inflation protection in some policies. If you’re thinking of buying insurance, find out what will trigger your getting benefits—e.g. inability to bathe or to dress—as well as when those benefits will begin, how much you will receive in benefits daily, how long you will receive benefits, and the maximum amount you will receive in benefits.

    For information on the costs and risks of buying a long-term care policy, read this article from Consumer Reports.

    Learn the full range of issues you need to consider before buying a long-term care policy from California Health Advocates, the consumer experts on long-term care here. You can also get answers to frequently asked questions.
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    Long-term care at a glance
  • Medicaid, Medicare and long-term care

    Medicaid, Medicare and long-term care

    Long-term care can cost a lot.  Medicare sometimes picks up a small piece of the cost.  Medicaid can cover a lot of the cost.  Paying out-of-pocket for long-term care tends to be extremely expensive. Here are some key facts on Medicaid, Medicare and long-term care:
    • Fact: Medicaid covers about two-thirds of all long-term care spending, about $131 billion in 2011.  87% of Medicaid spending on older adults is for long-term care.  One in three older adults with Medicaid receive long-term care through Medicaid.
    • Fact: 43% of people with Medicaid needing long-term care are under the age of 65.
    • Fact: Medicare does not cover long-term custodial care, nor does standard health insurance.  Medicare contributed 21% to long-term care in 2011, because it covers skilled nursing care and skilled therapy services for a limited time post-hospitalization.

    Here’s more from Just Care on aging in place and long-term care services and supports:


    Click here     to learn more about long-term services and supports from the Robert Wood Johnson Foundation and here to learn more about long-term care from JAMA.

    Photo Credit: RWJF
  • With Affordable Care Act, more Latinos insured

    With Affordable Care Act, more Latinos insured

    A new report from the Commonwealth Fund reveals that thanks to the Affordable Care Act, many more Latinos are insured.

    Overall, there has been a 13 point increase in the Latino population with health insurance since last year.  As of a few months ago, 23 percent of the Latino population is uninsured as compared with last year when 36 percent of the Latino population was uninsured.

    Young Latinos between the ages of 19 and 34 have seen the greatest drop—20 points–in their uninsured rate.  Between July and September 2013, 43 percent of the Latino population between 19 and 34 was uninsured.  Nine months later, between April and June 2014, 23 percent of the Latino young adult population was uninsured.

    States that have expanded Medicaid coverage have cut by half the percentage of uninsured Latinos from 35 percent to 17 percent.  States that have not expanded Medicaid coverage still have 33 percent of their Latino population uninsured.

    For decades, Latinos had the highest uninsured rate in America.

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    If you need health insurance, where you live could matter a lot 

  • If your income is low and you need health insurance, the state you live in matters

    If your income is low and you need health insurance, the state you live in matters

    A recent report by the Kaiser Family Foundation illustrates just how important it can be for people with low incomes who need health insurance to live in a state that has expanded eligibility for Medicaid. Thanks to the Affordable Care Act, 26 states and the District of Columbia now allow anyone with incomes up to 138 percent of the federal poverty level ($27,000 for a family of three) to enroll in Medicaid.  Before 2014, states had restricted Medicaid eligibility to different categories of individuals, primarily children, older adults, people with disabilities; adults without dependent children generally could not qualify for Medicaid.

    Twenty-four states have chosen not to expand eligibility for Medicaid. As a result, almost five million uninsured adults have too high an income to qualify for Medicaid, even though their income is below the federal poverty level, and too low an income to qualify for a subsidy in their state’s health insurance exchange.  For example, to qualify for Medicaid as an adult in Alabama, your income cannot be more than 16 percent of the federal poverty level, $3,221.  In Indiana and Missouri, your income cannot be more than 24 percent of FPL, about $4,600.

    To learn which states have not expanded eligibility for Medicaid, click here.

  • Americans are more satisfied with Medicare than with private insurance

    Americans are more satisfied with Medicare than with private insurance

    According to a new Gallup poll, people with government-provided health insurance, including people with Medicare and VA coverage, are more satisfied with their health care coverage than other Americans.  Almost four out of five people 65 and older are satisfied with their treatment by the health care system (79 percent of people with Medicare, Medicaid and VA coverage) as compared with about three out of five people between 18 and 45 (61-66 percent).
    More specifically, people without health insurance are the least satisfied with the health care system (36 percent). People with military or veterans coverage are the most satisfied (77 percent) and people with Medicare or Medicaid are the next most satisfied (76 percent).

    For this survey, Gallup was not able to separate out satisfaction rates for people newly insured in the health insurance exchanges.  They plan to do so in future polls as soon as practicable.

    The survey also does not speak to the reasons why people over 65 are more satisfied with the health care system than the rest of the population.  Joe Baker, president of the Medicare Rights Center, speculates it’s because Medicare and Medicaid coverage are easier to use than private insurance and in most cases provides better protection against financial risk.  “For sure, Congress can improve Medicare.  But, compared with the hassles of referrals and huge copays and deductibles with private insurance, Medicare is relatively simple.”

     

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