Long-Term Disability Insurance: A Financial Lifesaver

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There are two different types of disability insurance: short-term and long-term. I have previously discussed short-term disability insurance, and in this article I’ll be discussing long-term disability coverage.

Many people receive long-term disability insurance from their employer, and the company may pay for part or all of it. Whether you have the option of receiving long-term disability from your employer or not, there are important factors to consider.

What is Long-Term Disability & Why Do You Need it?

Most individuals we meet with do not know the following: Assuming you are relatively healthy, the odds of you being disabled for an extended period of time (3 months+) are 3-4 times higher than the odds of dying before your normal life expectancy.

Long-term disability insurance picks up where short-term policies leave off, usually after a waiting period of 90 to 180 days. One should consider long-term disability insurance for the same reason they would consider short-term disability: If an individual cannot work, how are they going to replace that income?

There a few choices:
  • running up credit card debt;
  • tapping into savings; or
  • borrowing from an IRA or 401(k).

A much more cost-effective way to pay for expenses, especially for people with higher income, is to obtain a long-term disability plan.

A lot of the people who do have long-term disability insurance through the workplace do not know exactly what coverage they have. Most long-term disability policies offer the employee 60% of their gross salary with a monthly cap. That maximum amount per month may or may not cover the individual’s expenses.

Just as with short-term disability policies, premiums vary according to the monthly benefit and the specified waiting period. In addition, the underwriting is usually not done until there is a claim.

Employees who are interested in a long-term disability plan should take a look at their salary and lifestyle and crunch the numbers so they can make an educated decision as to whether the disability plan in the workplace will have enough benefit so they don’t have to dip into savings...etc. Will that amount be enough? We frequently find that clients have too much life insurance and not enough disability insurance.

If it won’t be enough, it would make sense for the individual to contact the appropriate insurance professional to consider an additional policy so that he or she doesn't put him or herself in a financial crisis, should disability for an extended period of time occur.

Disability Premiums are Paid with Post-Tax Dollars

One of the great advantages of both long-term and short-term disability insurance is that the premium is paid with your after-tax dollars. That means your disability benefits are not taxed. If you borrow from one of your savings plans—as opposed to getting long-term or short-term disability policy—and don’t pay it back according to your plan’s regulated amount of time, you may be subject to tax consequences.

Each and every one of our clients has unique circumstances, but our commitment to them is the same: We’re here to assist individuals with making educated decisions.

For a detailed, no-cost analysis of your situation, please contact me here.

Robert Remin
Licensed and Certified

What is Short-Term Disability and Why Do You Need it?

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If you get sick or injured, depending upon where you work, you may have access to short-term disability insurance benefits—either through your major medical insurance with your employer or through a supplemental benefits plan also through your employer.

The purpose of short-term disability is to replace your income until your long-term disability (if you have it) kicks in. Statistics show that most people are disabled for no longer than 3-6 months, and payments can begin from the onset of an accident and fairly soon after an illness. Even if you only miss a week or two of work, you may qualify for benefits for that time period—in addition to possibly being out longer.

Short-term disability is usually very affordable and some companies, such as the one I represent, allow you to receive up to $3,000 per month in benefits if you qualify with no underwriting. Short-term disability is paid for with post-tax dollars, so the benefits you receive are not taxed.

If you are not familiar with short-term disability, the best way to learn about your choices is to contact your HR department or benefits representative if you work for a medium-to-large company; or if you work for a smaller company, the CFO or CEO can contact me, so I can educate them about the advantages of short-term disability for their company and their employees. Several research reports show that offering short-term disability and other supplemental benefits creates improved employee loyalty and retention.

How to Determine How Much You Need per Month

The best way to determine the amount of short-term disability you might need is to calculate your monthly expenses and decide the amount of disability benefits you will need to cover those expenses. The purpose of this is to prevent credit card debt, selling assets, and/or borrowing against saving accounts—such as a 401k or IRA—to cover those expenses.

Short-term disability insurance is a great way to prevent unexpected financial stress should you become injured or ill. Once again, all the research and statistics show the odds of becoming disabled, even if only for a couple of weeks, far outweigh the odds of dying. Most people think the opposite and very often buy too much life insurance and not nearly enough disability insurance.

If you would like your current insurance program analyzed, please contact me today. There is no cost or obligation to receive an analysis of your current situation.

Contact me with questions or comments.

Robert Remin
Licensed and Certified

Solving the Medicare Puzzle  (Part 1)

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Finding the Medicare Coverage That Suits You Can Be a Daunting Process.

If you are turning 65, or are already a member of the Medicare Eligible market, you’ve more than likely spent a number of hours reviewing the Medicare system. During this research, I am fairly certain that you have wanted to:

Tear your hair out Throw your laptop, desktop or tablet against the wall in frustration Scream the harsh words racing through your mind at the people who wrote the Medicare rules and regulations.

The Four Parts of Medicare
  • Medicare Part A: hospital insurance that covers inpatient hospital care, skilled nursing facility, hospice, lab tests, surgery, and home health care.
  • Medicare Part B: medical insurance, with coverage that includes doctor and other health care providers' services, outpatient care, durable medical equipment, home health care, and some preventive services.
  • Medicare Part C: are the additional insurance plans sold by private companies.
  • Medicare Part D: is prescription drug coverage.
When you turn 65 and have met the work requirements, you automatically qualify for Part A and you can decide if you also want to enroll in Part B (some people qualify before age 65 based being disabled or certain illnesses). Part A has no cost and Part B has a 183.00 annual deductible, plus a monthly premium that’s based on income.

Seems simple enough. All you have to do is contact Social Security at the appropriate time (three months before or after you turn 65) register for Parts A and B, receive your red, white and blue card, present it when you require any type of medical services anywhere, and everything is taken care of.

Nope. Unfortunately, nothing is ever as simple as it seems when the government is involved. For instance, a person with Basic Part A and Part B without additional coverage has the following costs for 2018:

Part A out-of-pocket costs for hospital stay (2018)
  • Days 1-60: $1,340
  • Days 61-90: $335 coinsurance per day
  • Days 91 and beyond: $670 per day

Part B out-of-pocket costs for hospital stay (2018)
  • $183 deductible
  • Monthly premiums
  • 20% of all hospital costs
Unless you bought one of the FAAG (Facebook, Amazon, Apple, Google) stocks in its infancy, you are at catastrophic financial risk if you are part of Medicare with only Basic A and B coverage.
In order to cap your costs, you will need to add Part C and/or D prescription  plan to assist you.

So, you figure you can simply begin the research process to really understand all of your options. You start with the basic Medicare.gov guidebook. That’s an easy 136-page read!

Once you absorb all that information, which should only take anywhere between a couple weeks to a couple months, you can scour through all of the various plan options from the different carriers.

Seems easy enough, until you realize that here in the Metro-New York area there are probably several dozen plans per zip code, each with their own separate guides.

That means you will be attempting to decipher hundreds, if not thousands of pages about premium, co-insurance, deductible, PPO, HMO, PFFS, Cost Share, and prescription drug information. Then, you have to compare the pros and cons of each of these plans and how they fit into your budget and financial plan. If you can do this without becoming dazed and confused, kudos to you. Odds are high though that you will end up picking a plan that doesn’t match your situation for one reason or another.

For instance, Part C plans can change each year. Plus, the part D prescription drug part of a Part C plan  or  a separate part D prescription drug  plan can change during the year, which can cause a large increase in monthly cost to you.

The only way to be sure you are in the best matched plan for your needs is to have an independent agent with a complete understanding of all the various plans and with no ties to any particular carrier take a look at your coverage. Then, he or she can advise whether it makes sense to look at other options or remain in your current plan.

This article has been published in the Jewish Link (NY Metro),  The Five Towns Jewish Times, and Image Magazine. 

Robert Remin is an independent agent licensed and certified with all the Medicare carriers in the New York Metro area. As an unbiased resource, his only goal is to match you to the most appropriate plan. For any questions, or a cost free consultation, contact him at 914-629-1753 or email-robertremininsurance@gmail.com


Do You Understand Medicare Advantage, Medigap, and Supplement Plans? (Part 2)

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What you hear and see is not always what you get. Last week, two friends and I were discussing their Medicare coverage. Friend one told me she never pays anything when she goes to the doctor or hospital. Friend two said he pays all the time when he visits the doctor or hospital.

Which one has the most cost effective plan?

Most people automatically think it’s friend one. Actually, the answer depends on proper analysis of all your medical factors by a qualified professional independent agent.

First let's decipher the confusion about Medicare Advantage and Medicare Supplement, or as some call them Medigap Plans. Yes, that’s right. Medigap and Supplement plans are the same!

Most people call any additional plan to basic Medicare a Supplement Plan, which is not correct terminology. While private insurers sell Medicare Advantage and Supplement or Medigap Plans, each can have a number of differences that can impact your out-of-pocket costs.

Medicare Advantage Plans

The most appropriate way to understand the Medicare Advantage plans is to think of them as a pay as you go plan. Each time you visit your doctor or specialist, have a preventive or diagnostic test, or a hospital stay you make a payment.

The payments range from 0 to several hundred dollars depending upon the carrier and plan chosen, as each carrier has several Advantage plans in this area. Your cost will also depend on whether it's an office visit to a doctor (low cost) or a hospital stay (higher cost). The plan also might have a monthly premium, which is also carrier specific.

All Advantage plans have a MOOP, which is the Maximum Out-of-Pocket expense per plan year. The MOOP is also carrier specific.

Advantage plans use specific networks such as an HMO or PPO. Each carrier has their own network and some even have out of state coverage along with vision and dental coverage. In addition, your Part D prescription drug coverage is included in your Advantage plan.

Medicare Supplement or Medigap Plans

Medicare Supplement or Medigap plans are the ones with the letters assigned to them Think of them as a pay in advance plans.

You pay a monthly premium to the carrier. Then, depending upon which letter plan you have either most, if not all, of your costs are covered in advance. Therefore, when you see the doctor or go into the hospital there is no cost to you.

There is also is no MOOP with these plans though some do have a deductible. You can go to any doctor or hospital in the US that accepts Medicare and you are covered.

In addition, if you have a Supplement or Medigap plan, you will have to purchase a separate Part D prescription drug plan as well, creating an additional monthly premium.

One of the most important things to consider about Supplement or Medigap plans is that each letter plan is regulated but the government so they are  exactly the same in most states. However, there are large cost discrepancies from the carriers.

Finding the Most Appropriate Plan

For example, this week I have worked with clients and simply had them change carriers in order to save a significant amount of dollars for the exact same plan. Think of it this way. The supermarket you’ve been going to sells your favorite brand of coffee for 8.00 a bag. Then, a new supermarket opens and has the same bag for 4.00 all the time. Where are you getting your coffee?

Now that we made Advantage plans and Supplement plans as easy as buying coffee, how do you find the most suitable plan for you or your family member?

This depends on a number of factors, such as current health status, frequency of doctor visits, prescriptions drugs being taken, and carrier choices in your area.

This brings us back to my strong recommendation from last week’s article about how confusing and daunting trying to research all of this by yourself can be. Instead of stressing, call an independent agent licensed and certified with all the carriers who can help you sort through all the noise.

This article has been published in the Jewish Link (NY Metro), The Five Towns Jewish Times, and IMAGE Magazine. 

Robert Remin is an independent agent licensed and certified with all the Medicare carriers in the New York Metro area. As an unbiased resource, his only goal is to match you to the most appropriate plan. For any questions, or a cost free consultation, contact him at 914-629-1753 or robertremininsurance@gmail.com. Visit his website at http://www.robertremininsurance.com.  He is also available for speaking engagements.

More Medicare Guidance: Deciphering Part D-Prescription Drugs (Part 3)

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How do you get Part D?

If you are or about to be in the Medicare eligible market and will not continue receiving your health insurance from your job, you will need a Medicare Part D, also known as a Prescription Drug Plan.

As mentioned in my previous article, if you choose a Supplement or Medigap policy you will have to decide on the appropriate Part D plan. These plans have an additional monthly premium ranging from the low teens to about $100.00, depending on the carrier. More than likely, you will also have monthly drug costs depending on your coverage and health.

Many people assume that their Part D plan has to be from the same carrier that their Supplement/Medigap plan is from. However, this is not the case and most often, a plan from a different carrier is most appropriate.

Here comes the real fun part. Even if you are not taking any prescription drugs you still have to have a Part D drug plan when you become Medicare eligible. Otherwise you will pay a per month penalty when you finally do enroll in Part D. The monthly penalty is actually not that high (about .35 per month for 2018 or $4.20 for the year). However, if you go several years without Part D coverage you might be paying an additional monthly premium of $15.00 to $20.00 for no reason.

Keep in mind that there are some exceptions. For instance, if you have something called creditable coverage for drugs from work, or another source such as VA or Tricare, there is no Part D penalty when you enroll.

For those that choose an Advantage Plan instead of a Supplement or Medigap policy, Part D is automatically included whether the Advantage plan has a monthly premium or not.

How Are Drug Costs Determined

All prescription drugs are divided into what is called Formulary (a list of drugs, both brand and generic, by each carrier) and Tiers, numbered 1 through 5. Usually, the lower the Tier, the lower the cost.

However, here comes even more fun. Just to make it more complicated, every Carrier has their own Formulary and Tiers. So, a Tier 1 or 2 drug with Carrier A with a very low monthly cost could be a Tier 3 with Carrier B and cost several times more. Also, within the same Tiers, prices can vary immensely depending on the carrier. For example, I have seen one carriers' group drugs in Tiers 1 or 2 with zero cost for the year and another carrier have the same exact drugs cost $800 or $1000 for the year.

In addition, carriers can change the Tiers and costs of drugs during the plan year. This can cause a large increase or decrease in monthly and yearly drug expenditures for you.

Controlling or Capping Your Drug Costs

Some of you might have heard of something with Part D called the “Doughnut Hole” and Catastrophic Coverage for those that have several thousand of drug costs per year. Certain states, NY being one of them, have some very specific solutions for Doughnut Hole and Catastrophic Coverage. Please consult your Medicare adviser or state for details.

As with your Medicare part C plans, there is no magic formula to control or to cap drug costs. Proper research by an independent, unbiased resource is always my recommendation as they have the skill and expertise to offer you solutions for your unique situation.

This article has been published in the Jewish Link (NY Metro) and The Five Towns Jewish Times. 

Robert Remin is an independent agent licensed and certified with all the Medicare carriers in the New York Metro area. As an unbiased resource, his only goal is to match you to the most appropriate plan. For any questions, or a cost free consultation, contact him at 914-629-1753 or email-robertremininsurance@gmail.com  or through www.robertremininsurance.com. He is also available for speaking engagements at synagogues or other organizations to educate Medicare eligible populations. 

The Medicare Media Mania Annual Enrollment Period—AEP— Ends! (Part 4)

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It’s finally over. As you read this, the "media mania" and "fake news" that consisted of probably more advertising dollars spent this year and each year than all the Super Bowls combined to date has concluded. Did all that additional information put you into a frenzy to consider changing your Medicare plan by December 7th the deadline for most to do so. If it did, no worries as you are not alone.

This is the busiest time of the year in my industry, as we are working around the clock to assist those for whom making a change makes sense. However, many of the people I speak with are considering changes that are very often not necessary.

Reasons to Change Plans By Deadline

The following are the main reasons to consider changing plans:
  • Monthly Premium Plan and or Drug Costs Increase for following plan year,
  • benefits for certain services decrease or are eliminated,
  • one or more of your doctors no longer accept your plan,
  • your preferred hospital(s) will no longer accept your plan.  

All of the above apply to Medicare Advantage Plans only because Surprise, Surprise, Surprise, if you have a Supplement/Medigap plan you can change plans at any time.

Do not panic if you have an Advantage Plan and missed the Media Mania alleged Fake News  December 7th deadline as there are several other ways you can possibly change after the deadline such as your Medicare program will no longer be offered  the following year, your state has a pharmaceutical assistance program (New York Does), and several others for which I suggest you consult a knowledgeable independent agent to discuss your options.

Robert Remin is an independent agent licensed and certified with all the Medicare carriers in the New York Metro area. As an unbiased resource, his only goal is to match you to the most appropriate plan. For any questions, or a cost free consultation, contact him at 914-629- 1753 or email-robertremininsurance@gmail.com  or throughwww.robertremininsurance.com. He is also available for speaking engagements at synagogues or other organizations to educate Medicare eligible populations.


The Medicare Donut Hole aka Part D Coverage Gap and Catastrophic Coverage (Part 5)

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Whether you have an Advantage or Supplement/Medigap plan, your Part D Prescription Drugs are subject to reaching The Donut Hole and possibly the next step, which is called Catastrophic Coverage. These are out-of-pocket drug cost levels that, once you exceed them, you are eligible to receive discounts on your future drug costs.

What is the Donut Hole?

The best way to think of the Medicare Donut Hole is to think of it as your first stage to a possible maximum expense (called TROOP – True Out Of Pocket) for your prescription drugs each year.
In 2018, the Donut Hole kicks in when your Prescription Drugs have reached $3750.00 for the year based on their retail cost, not your copays. The good news is that if you reach the Donut Hole, you actually receive a discount on your prescription drugs, though the percentage discount depends on whether your drugs are Generic or Brand, so the specific savings may vary.

What is Catastrophic Coverage?

Once in the Donut Hole, you continue paying your share based on the discounts you receive and an additional percentage credit of the retail price of the drug you are taking until you hit the 2018 TROOP Cost of $5000.00. Once you exceed this limit, you are in the Catastrophic Coverage Phase, where your drugs cost no more than $8.35 per month.

These programs are designed to give a little bit of relief for Medicare patients who have high drug costs. But there are many other details to this program that won’t fit on this page.

The Simplified Recipe To Understanding The Donut Hole and Catastrophic Coverage

I’m not going to get into the nitty gritty of all these numbers because, as I’ve mentioned in my previous articles, all it does is confuse the Medicare Eligible Population even more. In fact, I know some people with MBAs who have studied the Medicare language only to end up more frustrated and confused then when they started.

Basically, if your drugs retail for about $313.00 per month in 2018 you will enter the Donut Hole. And, if they retail for about $702.00 per month, you will enter the Catastrophic Coverage Phase.
What you pay for your drugs each month depends on your carrier, as each has their own Drug Tiers and Formulary, like I wrote in last week’s article.

In order to save yourself time and frustration, your most appropriate choice is to work with an independent agent familiar with all of the plans available in you area. Only they know all of the options available, how these plans can fit into your overall financial plan, and your goals.

This article has been published in the Jewish Link (NY Metro) and The Five Towns Jewish Times.

Robert Remin is an independent agent licensed and certified with all the Medicare carriers in the New York Metro area. As an unbiased resource, his only goal is to match you to the most appropriate plan. For any questions, or a cost free consultation, contact him at 914-629-1753 or email-robertremininsurance@gmail.com or through www.robertremininsurance.com.