Birth
The first 30 days of life are covered under the Mom’s health insurance plan. Do not assume that this means the health insurance company “obviously knows a baby was born and will add that child to the plan”. It is the responsibility of the parents to do the proper paperwork to have the child added to the insurance plan within the first 30 days of life. If both parents are working and each have coverage through their employer, it may be necessary to compare benefits, plans, or how much of the premium you would be responsible for in determining which plan you wish to have Junior added to.
Childhood and adolescence
Children can be covered under the parents plan until they reach the age limitation to be a dependent on that particular plan. Most carriers will allow dependent children to be covered though the age of 19, or 23 if a full time student. Check with your specific carrier though, to be sure as this age limitation does vary from plan to plan. One company we work with will allow you to keep your child on the plan to age 26 as long as that child is enrolled as a full time college student or in an advanced degree program. This is certainly an advantageous way to minimize the health insurance expense for this child – even more so if you have other children still at home. The rate for family coverage is the same whether you have 1 child or 16 children. You do need to submit proper proof to the insurance company each semester that the child is enrolled as a full time student.
Post-high school or post college
Once you have ‘aged-off” your parents plan or have reached the maximum age limit to be covered under your parents plan, you had better think of something quickly! The first choice at this stage of your life is to be covered under the group health insurance plan your employer offers. If you have not yet found a job, or your employer does not offer health insurance, you had better find it somewhere. If you had been covered under a parents plan though their employer, you may have the right to continue your benefits for 36 months under the COBRA law if the insuring parent worked for a company with more than 20 employees. Check this option out first. If not, you should look into purchasing an individual plan. Do not overlook the importance of health insurance. This is often a time in life when there are plenty of other items that you would rather spend money on than health insurance. However, it is a necessity.
The adult years
First choice again, is to have coverage available through your employer. Group health insurance offers stronger coverage for less money than individual plans. If you are self employed, you may be eligible to set up a small group plan if you employ as few as one other person. Call us for more information on this option. If your employer does not offer coverage, or you are self employed and have no other employees, you should look to the individual health insurance market.
Age 65
Once you hit age 65 Medicare will be an option to the vast majority of people. If you are retired, or retiring soon, Medicare and a good Medicare supplement will be your best coverage scenario at this point. If you are still working, you may have group health insurance in lieu of, or in addition to Medicare. You really need to discuss your particular situation with a qualified professional. Electing to refuse Part B Medicare may be the appropriate decision for someone who has group health insurance coverage and is still actively employed, or could be the worst decision you ever made and cause you to suffer financial penalties down the road. Be sure you know exactly what you are doing with your health insurance coverage is you are working beyond age 65. We have explored this topic in much depth in previous columns, and will do so again in the near future.
Medicare supplements
Once you are retired, and no longer have benefits from a former employer, you will need a Medicare supplement to coincide with Medicare. Medicare was never intended to cover all of your medical expenses. Those of you who had been financially responsible for your own health insurance will quickly recognize that for $58.70 a month it is the best buy around for the coverage it offers. Shopping for a Medicare supplement became much easier when they were standardized in 1992. Plans available now are labeled with alphabet letters ranging from A (the most limited) to J (the most benefit rich). Premiums vary from company to company, but benefits do not.
Dental / vision
Dental &/or vision coverage may be a benefit to your group health insurance plan offered by an employer. If you have coverage on your own, you can still find dental & vision plans available, but the benefits tend to be very limited.
Long Term Care
We can not stress enough the importance of Long Term Care insurance. The younger you are when you purchase a plan, the less money you will spend over the course of your lifetime on premiums as premiums are based on age. It is hard to define just what the magical age is when you should investigate this coverage. It is medically underwritten so the healthier you are the better. Look at your family history, your parent’s longevity, and your personal desire to not spend every penny you have saved over your lifetime to cover the care you may need in your golden years.
Irene Card & Betsy Chandler share the responsibilities of running Medical Insurance Claims, Inc. a health insurance services company. If you have questions relative to this column or other related topics, we invite you to call (973) 492-2828, browse our past columns on our web site at www.micinsurance.com.
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