Life & Health
Are You Adequately Covered?
The US is currently in the midst of a major health care crisis. Health care costs in the U.S. average $7,538 per person per year. As medical care and treatments increase, so do accessibility and affordability of the coverage.
Research indicates that having health insurance is closely tied with the quality and timeliness of care. A recent Harvard Medical School study demonstrated that people without health insurance had a 40% higher risk of death, compared with those who had some form of health coverage.
According to the Centers for Disease Control and Prevention:
- Over 136 million people visit a hospital Emergency Room each year. This number translates into 45.1 visits per 100 people in the United States, which is about half of the population.
- Once a patient visits an Emergency Room, 17.1 million are actually admitted, with 2.2 million of those going to a Critical Care Unit of the hospital.
- Once admitted to the hospital, patients stay an average of 4.5 days, which costs around $17,500. This excludes the additional costs of surgeries, physician fees, any lab work, medications, etc.
- More than 60% of all bankruptcy filings in the US in 2007-08 were caused by illness and the cost of medical bills. The vast majority of those declaring bankruptcy were highly educated, middle-class families who owned their own homes. Almost 75% had health insurance, but the families were not adequately insured against a major accident or extended illness.
It is estimated that more than 25 million Americans with insurance are currently under-insured. Our team at David A. Crotts & Associates can help you navigate the complex world of health insurance offerings so that you have adequate coverage when you need it. Contact us now for more information.
If Full Health Insurance Isn’t an Option: Limited Medical Coverage & Affordability Hospital Indemnity plans are an affordable choice for those without Major Medical Insurance, or for those who wish to supplement their Major Medical policy or Medicare Advantage plan’s high deductibles and out of pocket costs.
Why Do You Need Life Insurance?
There are many reasons, but to begin consider these questions:
- Can your family maintain their current standard of living, without your income?
- Do you own your own home?
- Who will be responsible for paying for your final expense costs?
Life Insurance comes in many forms – from Term Life, which can protect your family from possible financial hardship, to Whole Life policies with set premiums and guaranteed payouts. The best way to decide what is right for you is to meet one-on-one with a licensed David A Crotts & Associates agent.
The most straightforward of protection, Term Life Insurance offers coverage for a set number of years, generally ranging from 10 years to 30 years. These policies are most often used to cover a financial obligation such as paying off a mortgage or assuring a college education for surviving children.
Term Life can also be used to cover end of life expenses, such as burial and funeral costs; and can be used to pay off debt so that survivors are not burdened.
Term Life Insurance is easy to understand, very affordable and is a practical solution for protecting loved ones from possible financial hardships that an unexpected loss could create. You choose the length of the coverage term (10, 20 or 30 years for example), and the amount, which can be anywhere from a few thousand up to a million or more dollars.
Whole Life is a permanent solution to life insurance and offers policy holders financial security for the length of their lifetime. Whole Life pays a set amount to your beneficiaries upon your death.
Whole Life Insurance is normally Guaranteed Renewable, and builds a cash value which may be borrowed upon. Many Whole Life policies also have the additional benefit of favorable tax benefits.
Meet with a David A Crotts & Associates Life Insurance Professional and learn about the benefits of owning a Whole Life Insurance Policy.
Dental and Vision: A Happy Smile and Clear Vision
Everyone knows how important it is to have Health Insurance, but what about Dental and Vision coverage?
Studies have shown that dental health is directly linked to overall wellness and disease prevention, yet most Health Insurance plans do not include comprehensive dental coverage. What does this mean? It means that routine visits to your dentist are often skipped, leading to the likelihood of more costly and invasive tooth and gum problems down the road. According to the American Dental Education Association, every $1 spent on preventive dental care can save you $8 to $50 in future expenses.
Dental coverage can help you pay for checkups, cleanings, fillings, extractions and in some cases, even restorative care such as crowns and bridges. David A Crotts & Associates offers a variety of Dental plans that are affordable, flexible and convenient and can provide coverage for your entire family
Practicing good eye health and proper eye care are both key to preserving your vision. Supplemental Vision plans make this easy, giving you access to a nationwide network of Doctors and Optometrists. In addition to yearly eye exams, our plans offer coverage for glasses, contact lenses and even discounted Lasik surgery.
Long Term Care
Protect Your Family’s Financial Future
Long-term care helps pay for personal care services when you are no longer able to care for yourself or perform everyday activities without assistance. Circumstances for long-term care can include a disability, physical illness or cognitive impairment, such as Alzheimer’s disease.
According to the U.S. Department of Labor, the greatest uninsured risk Americans face today is Long-Term Care.
- Almost 70% of people who live to age 65 will need about 3 years of care in a long-term or assisted living facility.
- The average cost of living in a nursing home is about $80,000 per year.
- The average cost of an assisted living facility is about $40,000 per year.
Long-term care is not intended to improve your medical condition, but it will help maintain your current lifestyle. These services are available at a nursing home, assisted living facility, an adult daycare, hospice care center, Alzheimer’s facility, or even in a personal residence. Home care coverage options include a companion, care-giver, therapist, housekeeper or private duty nurse.
Many Americans assume that Medicare will pay for their long-term care expenses, when in fact it does not. Medicare may pay for a portion of skilled nursing and rehabilitative care needs, but only if a series of strict requirements are met, and only for a limited time period. In addition, Medicare does not pay for expenses incurred from intermediate, custodial, or Alzheimer’s care.
Purchasing a long-term care policy provides you with:
- Peace Of Mind.
- Asset Protection
- Less Burden On Family Members.
- Increase Access To Quality Care.
- Freedom Of Choice.
The average life expectancy of Americans living today is about 75 years. As we live longer, it is more likely that we will need long-term health care services. Long-term care insurance can help protect your familys’ assets against the high cost of extended personal care needs.
Goes To Work For You When You Can’t Work
Typically, people have insurance for their homes, cars and other valuable assets. However, people most often overlook protecting their ability to generate income.
Disability is an unpredictable event, and one that is often not planned for. Here are some sobering statistics:
- Almost 50% of all home foreclosures are the result of a disability.
- A 30-year-old man has a 1-in-5 chance of suffering a long-term disability before his planned retirement.
- A 30-year-old woman has a 1-in-3 chance of suffering a long-term disability before her planned retirement.
- Roughly 50% of people who suffer disabilities lasting longer than six months remain disabled after five years.
- About 1-in-7 employees will be disabled for five years or more before retirement.
Disability insurance, both short-term and long-term can provide much-needed benefits in the case of loss wages due to illness or injury. Disability insurance protects your most valuable financial asset- your earning potential. Having disability insurance guarantees an essential foundation of security for your financial future.
Disability insurance helps support financial obligations and maintains your standard of living. It can help cover expenses for household needs, such as utilities, groceries, and mortgage payments. It can also cover additional items, such as car payment and school tuition. Disability insurance helps provide financial security until you can begin working again.
At David A. Crotts & Associates, we have the information that you need to help you decide the right options for you and your family.
Final Expense Plans
Peace of Mind for Life’s Final Expenses
Today’s funeral costs are skyrocketing with the average funeral now reaching over $10,000. A Final Expense policy offers peace of mind during a difficult time, and assures that your final wishes will be carried out properly, without added financial stress on your family.
Why should you consider a Final Expense Plan?
- Final Expense plans are renewable for life, regardless of changes in your health.
- Final Expense plans are much more affordable than most traditional Life Insurance policies
- Final Expense plans do NOT require a medical exam
- It takes on average, 90 days, for a traditional Life Insurance Plan to pay benefits. With Final Expense plans, you may receive the payout in as little as 24 hours after the death of a loved one.
- Final Expense plans, as a division of Whole Life Insurance, are permanent insurance and maintain a cash value.
- Final Expense plans may be purchased to supplement already existing Life Insurance, or may be used as stand-alone policies.
Rest assured that you are not leaving your family with the undue burden of end of life expenses, and ask a David A Crotts & Associates Life Insurance Professional about Final Expense plans today.
A Medicare Advantage Plan is a health plan offered by a private insurance company that works directly with Medicare to provide you with all their traditional Part A and Part B benefits.
Medicare Advantage Plans Include:
- Preferred Provider Organizations (PPO)
- Health Maintenance Organizations (HMO)
- Medicare Medical Saving Account Plans (MSA)
- Private Fee-For-Service (PFFS)
- Special Needs Plans (SNP)
Things to consider when selecting a Medicare Advantage Plan.
- You’re still in the Original Medicare Program and have all Medicare right and protections.
- You still get complete Part A and Part B coverage through the plan.
- You are only enrolled in a plan for 1 year and you can only join a plan at certain times during the year.
- You can join a Medicare Advantage Plan even if you have a pre-existing condition. The only exception is End-stage Renal Disease (ESRD).
- You must follow plan rules. If you go to a doctor, other health care provider, facility, or supplier that doesn’t belong to the plan’s network, your services may not be covered, or your cost may be higher. You should always verify coverage with your plan before you receive any service or schedule an appointment with a referred specialist to make sure they are covered by the plan’s network.
- A number of Medicare Advantage plans are all inclusive plans meaning, they also include prescription drug coverage. To ensure it is the right plan for you always review the drug formulary.
- If you join a clinical research study, some costs may be covered by your plan. Contact the plan administrators for more information.
- Medicare Advantage Plans can’t charge more than Original Medicare for certain services like chemotherapy, dialysis, or skilled nursing facility care.
- Medicare Advantage Plans also offer an annual cap on how much you pay for Part A and Part B services during the year. This annual maximum out-of-pocket amount can be different between advantage plans. You should consider this when choosing a plan.
- If the plan decides to stop participating in Medicare, you will have to join another Medicare Health Plan or return to Original Medicare.
*Source: Medicare.GOV, A Federal Government Website Managed By the Centers For Medicare & Medicaid Services
Medicare is a complex program and as a result many of senior citizens need answers. While there are no “one size fits all” answers, the team at David A. Crotts & Associates has a large network of carriers, and we will partner with you to recommend broad coverage at a reasonable premium.
Less than 60% of Medical Costs Are Actually Covered by Medicare
One of the great benefits that Americans receive as they mature is Original Medicare. However, Americans who qualify are surprised to discover that all medical costs are not covered under the government-sponsored plan. In fact, Original Medicare covers less than 60% of medical expenses. With all the deductibles, co-pays and exclusions, many seniors are left with burdensome medical expenses and are wondering what their options are to help cover these additional costs.
A Medigap or Medicare Supplement private insurance policy provides coverage for those medical expenses either partially covered or not covered at all by Medicare. All plans are standardized by the government. However, while the benefits are the same from one company to the next, there are still many options to choose from, and premiums and extra costs may vary significantly. It is important to be well-versed in those options before sitting down to make a decision.
At David A. Crotts & Associates, we represent many of the strongest Medicare Supplement carriers in the industry. Our team will help you explore the options available. Contact us today for more information.
Medicare Supplement Insurance (Medigap) Plans
|Medicare Part A coinsurance and hospital costs (up to an additional 365 days after Medicare benefits are used)||100%||100%||100%||100%||100%||100%||100%||100%||100%||100%|
|Medicare Part B coinsurance or copayment||100%||100%||100%||100%||100%||100%||50%||75%||100%||100%|
|Blood (first 3 pints)||100%||100%||100%||100%||100%||100%||50%||75%||100%||100%|
|Part A hospice care coinsurance or copayment||100%||100%||100%||100%||100%||100%||50%||75%||100%||100%|
|Skilled nursing facility care coinsurance||100%||100%||100%||100%||50%||75%||100%||100%|
|Medicare Part A deductible||100%||100%||100%||100%||100%||50%||75%||50%||100%|
|Medicare Part B deductible||100%||100%|
|Medicare Part B excess charges||100%||100%|
|Foreign travel emergency (up to plan limits)||80%||80%||80%||80%||80%||80%|
|Out-of-pocket limit in 2020|
* Plans F and G also offer a high-deductible plan in some states. With this option, you must pay for Medicare-covered costs (coinsurance, copayments, and deductibles) up to the deductible amount of $2,340 in 2020 before your policy pays anything. (You can’t buy Plans C and F if you were newly eligible for Medicare on or after January 1, 2020. See previous page for more information.)
** Plan N pays 100% of the Part B coinsurance. You must pay a copayment of up to $20
for some office visits and up to a $50 copayment for emergency room visits that don’t
result in an inpatient admission.
Medicare Part D
Medicare Part D, also known as Medicare Prescription Drug Plan, is an optional insurance coverage that helps seniors pay for prescription drugs. Anyone enrolled in Medicare Part A or Part B is eligible to enroll, regardless of income. There are no physical exams required and applicants cannot be declined due to medical history or history of prescription drugs.
Medicare Part D can be purchased as a stand-alone plan, known as a PDP (Prescription Drug Plan) or as part of an MA-PD (Medicare Advantage Prescription Drug). While plans may vary, there are several mandatory standards set by the federal government.
Medicare can be a daunting program, but at David A. Crotts & Associates, we can assist in guiding you through all the details and help you decide which plans are best for you.
Security In Times Of Need
Critical Illness plans can offer a lump sum cash payment to the insured upon diagnosis of specific critical illnesses, such as heart attack, stroke, cancer or end stage renal failure.
The cash benefit is paid directly to the policyholder, to be used as they choose, and can help offset expenses such as:
- Loss of income
- In home care
- Travel expenses
Not intended to replace Major Medical Insurance, Critical Illness plans are a compliment to your traditional healthcare policy. With each American facing the real possibility of some type of critical illness, it is more important than ever to be properly protected.
Preparing For Your Future Today Means Less Worry Tomorrow
According to the American Cancer Society, almost 1 in 2 men, and 1 in 3 women will get a cancer diagnosis during their lifetime.
Most Americans assume that their Major Medical Insurance will provide enough coverage, but the fact is that cancer patients and their families incur many additional costs that are not covered under a standard Major Medical policy. A specified Cancer Plan provides immediate cash benefits that will protect individuals and their families from unexpected financial costs, including:
- Travel and lodging expenses for out of town treatments and consultations
- In-home care
- Loss of income
- Special dietary needs
- Experimental treatments
A Cancer Plan is a much-needed compliment to your traditional Health Policy – providing peace of mind should you encounter the unthinkable. Don’t worry about unknowns of tomorrow by getting them properly covered today!
Affordable Care Act
In March of 2010, the Affordable Care Act (ACA) passed into law. This sweeping legislation represents the most significant overhaul of the U.S. Healthcare system in generations. The law was enacted with the purpose of increasing quality and affordability of healthcare insurance and reducing the number of uninsured Americans. As of April 2014, over 8 million Americans have signed up for coverage under the ACA.
Key features of the Affordable Care Act include:
- No one can be denied health insurance due to pre-existing health conditions
- No exclusions can be placed on health insurance policies – limiting or denying coverage of pre-existing conditions
- No one can be charged more for health insurance because of their health status or gender
- There are no lifetime limits on coverage, and an insurance company cannot drop you when you get sick
- Approved preventative services such as annual mammograms and wellness checks are covered with no out of pocket costs
- Cost assistance is available for low to moderate income families to reduce monthly premiums and make health insurance more affordable
- All policies must meet the minimum essential benefits standard and offer coverage for the following expenses: outpatient care, emergency room care, mental health, addiction treatment, maternity care, prescription drug coverage, and dental and vision care for children under 19.
David A. Crotts & Associates has certified agents available to answer your questions regarding the Affordable Care Act and to assist you in choosing a plan for you and your family.