IT TOOK MONEY to resolve my recent health issue—on the surface, a lot of money. But figuring out what it really cost is difficult. Actually, I found it impossible.
Still, being a health benefits nerd, I couldn’t resist looking at the claims processed by Medicare and my Medigap insurance. Trying to understand billed charges, allowable charges and the resulting payments is daunting. I’m guessing most patients wouldn’t even try. Why should they?
My surgery was in the outpatient department but required an overnight stay.
I BECAME INVOLVED with employer health benefits in 1962. Back then, my job was to screen medical claims before sending them to the claims’ administrator for processing.
In the decades that followed, I designed, negotiated and managed health plans for a company with 15,000 employees and 4,000 retirees. My job was twofold: to make sure the health benefits were working correctly and to manage costs. The first goal was relatively easy. The second was nearly impossible.
RETIREMENT COMES with many risks, but the scariest I’ve witnessed is dementia. It’s estimated that more than six million Americans are living with Alzheimer’s, and they account for just 60% to 80% of all dementia cases.
Other types include vascular dementia, frontotemporal dementia, Parkinson’s disease dementia and Lewy body dementia. Drug side effects, brain injury, depression and alcoholism can create dementia symptoms, too. The symptoms may get better when those conditions are treated.
Whatever the cause,
WHEN PLANNING OUR early retirement, I realized that getting and paying for health insurance for my wife and me would be our biggest financial challenge.
Before 2010’s Affordable Care Act (ACA) took effect in 2014, we talked to an insurance agent who gathered our medical histories and submitted them to insurers for consideration. Despite two major surgeries, I was deemed insurable. My wife, due to a congenital condition that had never caused a problem but might,
IS IT JUST ME OR HAS dealing with health insurance companies become more confusing and frustrating? Trying to figure out who to speak to feels like that classic Abbott and Costello comedy routine, “Who’s on first?”
My wife retired last July. For the previous four years, we’d used her employer-provided medical benefits and now we needed to shop for coverage. Under my old employer’s pension plan, pension-eligible employees like me—who retired prior to beginning Medicare—were eligible to sign up for one of the company’s medical plans.
THERE ARE TWO THINGS that Americans loathe paying: taxes and health care costs. When those two come together, watch out.
That brings us to IRMAA, short for income-related monthly adjustment amount, the steeper Medicare premiums paid by retirees with high incomes. Those who pay IRMAA are often livid about the extra cost.
I looked up my Social Security records. Over my working career, I paid $98,062 in Medicare taxes and my employer paid $97,735,
MY IN-LAWS AND MY mother all moved into continuing care retirement communities after giving up their homes. My in-laws were not yet 70 when they moved in and my mother was age 75. They lived in two different communities about a 45-minute drive from one another.
Both communities provided excellent care, but had differing levels of service and had different ways of being paid. I’ve garnered further insights as a volunteer board member for a third continuing care retirement community (CCRC),
AT FIRST GLANCE, personal finance might appear to have nothing in common with the world of personal fitness. I’d argue otherwise.
Perhaps the clearest parallel is between the gains from diligent investing in low-cost index funds and the gains from proper diet and exercise. Both are hardly noticeable at first and, as a result, there’s a temptation to stray. But if we continue the process of saving and investing—or eating correctly and exercising—we can see tremendous gains over time.
HERE’S A SOBERING statistic: It’s estimated that 50% to 60% of 65-year-olds will require long-term care at some point in their lives. This is defined as assistance with activities of daily living—things like taking a bath, dressing oneself, and maintaining bowel and bladder continence. How’s that for something to look forward to?
Such care isn’t cheap. By some estimates, the average 65-year-old can expect to incur $138,000 in long-term-care (LTC) expenses, with half of that cost borne by families.
DESPITE WHAT’S SHOWN on TV medical shows, cardiopulmonary resuscitation (CPR) can be a traumatic procedure that has a low likelihood of success. Even if successful in immediately restarting the heart, the fact that it was necessary doesn’t bode well for long-term survival.
Some injuries or illnesses happen so suddenly that there’s little time to consider options. But for many, old age creeps up slowly or a serious illness drags on and worsens. This is the point where it’s helpful to have not just a living will and a health care power of attorney,
IF YOU FIND YOURSELF with a loved one in hospital who can’t make medical decisions, it can be overwhelming, intimidating and emotionally charged. Decisions are needed and each family member is conflicted: What would I want? What would the patient want? What do I want for the patient? The result can be sharp family disagreements.
Death, the prospect of death or even thinking about death is so loaded with emotion that it can hinder our willingness to prepare.
LIVING A HEALTHY lifestyle is one of the most important aspects of a happy retirement. It is, alas, also one of the most difficult goals for many of us to achieve. A 2005 Boston College Center for Retirement Research study concluded that health was the second most important factor in determining the happiness of retirees—and those with poor health “experience dramatically lower levels of well-being.”
I stopped working fulltime on March 31, 2017. My health,
I HAVE BUT ONE New Year’s resolution: I’ll be working on a habit that promises to lower my risk of cancer, boost my immune system and decrease the odds that I’ll succumb to Alzheimer’s disease. This activity has a host of other health benefits: lower blood sugar levels, reducing the risk of cardiovascular disease and aiding weight loss. It has also been shown to improve mood, memory and creativity.
What is this wonder drug and how much will it cost me?
I QUIT MY JOB last year and then found I needed medical care. My old employer was required to offer me health insurance—but it was expensive. Luckily, I found a loophole that allowed me to obtain the coverage I wanted at a bargain price. I got the treatment I needed, and saved almost $1,000.
First, a bit of background. More than half of the U.S. adult population gets health insurance through their employer. Indeed,
I HATE TO BE WRONG. I’ve written before about the technique I’ve developed for evaluating health insurance. My wife and I have used it over the years to decide which plan to select. I’ve shared it with friends and colleagues, and many have found it useful in gaining insight into their own health insurance options. I still think it’s a valid and valuable method.
But our recent experience, after switching health insurance mid-year, made me realize it was missing one important variable—the length of time you’ll be in the plan.