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In the realm of health and life insurance, there’s a concept that can cause some confusion: elimination periods. In this post, we answer the question; what are elimination periods and explain how they can impact insurance coverage.

Understanding Elimination Periods

Elimination periods, also called waiting periods, are a common feature in both life and health insurance policies. They represent the duration of time that must pass after an approved event occurs before an insurance company pays a benefit. Although the specifics vary between life and health insurance coverage, the underlying purpose remains the same: to manage risk.

Life Insurance

Life insurance elimination periods typically come into play upon the policyholder’s death. This period serves as a buffer, ensuring that the policy has been in force for a specified duration before the death benefit is paid out to beneficiaries. Longer elimination periods may result in lower premiums. This usually results in a cost savings for policyholders. While shorter elimination periods provide quicker access to benefits, they may come with higher premiums.

Health Insurance

In health insurance, elimination periods are often associated with long-term care or disability coverage. Health Insurance waiting periods are similar those in life insurance. They require a waiting period before beneficiaries receive coverage. For example, in long-term care insurance, elimination periods determine when coverage for services like nursing home care or home healthcare begins. Disability insurance policies may have elimination periods that work in a similar fashion, they dictate when income replacement benefits are payable after a qualifying illness or injury.

Learn how ancillary sales can add important coverage options for your clients; watch our video

Understanding the Significance

The reason for elimination periods is to mitigate the risk for insurance companies. By imposing a waiting period, insurers can make certain that coverage is provided for more significant or long-term issues rather than minor, short-lived ailments. From the insured’s perspective, elimination periods can affect financial planning during times of illness or injury. In some instances, elimination periods can be covered by additional products, such as short-term care policies for beneficiaries waiting for long term care insurance to kick in.

The Impact on Coverage

Financial Preparedness

These wait times require individuals to have financial reserves or alternative sources of income to cover expenses. Understanding the length of the elimination period is crucial for financial planning.

Policy Customization

Many insurance policies offer flexibility in choosing elimination periods. Opting for a longer waiting period typically results in lower premiums, while shorter waiting periods come with higher premiums. Balancing these factors requires careful consideration based on individual circumstances.

Long-Term Care

In long-term care insurance, elimination periods range from a few days to several months. The length chosen affects when benefits become available for services such as nursing home care, home healthcare, or assisted living facilities. Adding a short-term care policy can provide coverage during the waiting period of a long-term care policy.

Disability Insurance

For disability insurance, elimination periods can vary widely depending on the policy. Individuals who pay higher premium amounts may have shorter waiting periods. This can minimize the financial impact of a disability.

Learn about protecting clients from coverage gaps

Making Informed Decisions

When selecting a health insurance policy, it’s essential to thoroughly understand the elimination period terms and their implications. Here are a few things to consider before choosing insurance coverage:

Assess Your Needs: Evaluate your financial situation, including savings, emergency funds, and potential sources of income during an illness or disability.

Understand Policy Options: Compare elimination periods offered by different insurance providers. Consider how each option aligns with your financial capabilities and risk tolerance.

Seek Professional Advice: Consult with insurance agents or financial advisors for personalized guidance based on specific circumstances and insurance needs.

Review Regularly: Life circumstances change, so periodically agents should review your insurance coverage to ensure it continues to meet evolving needs. Adjustments may be necessary as your financial situation, health status, or family dynamics change over time.

Agents who want to add these products, click here for online contract.

A professional insurance agent can help assess your needs, explain coverage options, and ensure that you make the best choice.

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If you are a licensed health agent, you should consider adding GTL Ancillary Products to your offerings. GTL offers several product choices in most states.

GTL Supplemental Health Products- click here and see what’s available

Learn the benefits of adding ancillary health products to your sales.

Here are some of the products that GTL offers to individuals:

Important; product availability varies by state. If you want to check what’s available in your area;

click here for GTL product state approval lists.

Hospital Indemnity

GTL offers Advantage Plus Elite Hospital Confinement Indemnity Insurance to help with the expenses associated with a stay in the hospital such as co-pays, deductibles and other out-of-pocket expenses not covered by a health insurance plan. Medical costs can quickly add up and beneficiaries can use the cash benefit any way they like.

Beneficiaries receive a cash benefit if they are confined to a hospital or receive any other covered care. The Advantage Plus Elite plan pays between $100 and $750 per day. The amount depends on the plan selected. Plans provide coverage for a period of either 3-10 or 15 days The benefit period resets when the beneficiary is out of the hospital for 60 days. There are also plan options that offer a 1-day benefit period with a $2,500 daily benefit amount.

Click here for Crowe online contract and add GTL to your products.

Already a Crowe agent and want to add GTL – Click here

Cancer Insurance

Precision Care Cancer Insurance helps policyholders who are diagnosed with cancer access advanced treatments that may not be covered by insurance. Precision Care lets policyholders access TGen’s world class Cancer Physicians and their cutting-edge genomic sequencing services. It also provides cash to pay for the services and the specialized cancer treatments. Learn more about Precision Care, just go to: outsmartmycancer.com.

If the beneficiary is diagnosed with cancer, TGen (the Transitional Genomics Research Institute) an affiliate of City of Hope nonprofit medical research institute receives a biopsy of the tumor, and the DNA is sequenced in TGen’s lab. Once this is done, doctors use the findings to suggest treatments that have been used to target the same mutations. For more information about TGen, visit www.tgen.org.

Cancer Heart Attack & Stroke Insurance

GTL also offers Cancer, Heart Attack and Stroke Insurance that provides beneficiaries a lump-sum benefit amount paid directly to them regardless of other health coverage they may have upon diagnosis of cancer or if they suffer either a heart attack or stroke. The amount of the benefit can range to as much as $50,000 for any of the covered diagnoses. The amount depends on the coverage chosen at the time of enrollment.

Short-Term Care Insurance

Recover Cash is short-term care insurance that GTL offers to provide coverage for several care options. Options include assisted living facilities, nursing homes, or in the enrollee’s home. Because there are gaps in health insurance coverage, Recover Cash provides a way to pay out-of-pocket expenses. Policyholders have access to TCARE’s Family Caregiver Concierge Services. This service provides support to caregivers to help prevent burnout. Policyholders receive this cash benefit directly and can use it any way they like.

GTL helps with both financial support and family caregiver support from TCARE. This helps the beneficiary and their family member through a difficult time.

Short-Term Home Health Care Insurance

Short-Term Home Health Care Insurance helps cover deductibles and co-pays for home health care services. The policy offers several riders to choose from as well as a Short-Term Home Health Care Aide Benefit and a Prescription Drug Benefit.

GTL’s Short-Term Home Health Care Insurance pays a daily benefit for many types of home health care services. Benefit amounts depend on the plan selected. There is a maximum benefit period of 360 days. A Licensed health care provider must certify the cognitive impairment or inability to perform at least two of the six activities of daily living (bathing, dressing, eating, continence, toileting or transferring) without substantial assistance.

Critical Illness Insurance

Critical Provider Plus is critical illness insurance that helps alleviate the financial hardships that come with a critical illness or accident. Coverage options range from $10,000 up to $100,000. The coverage pays up to two times for two separate critical illnesses. GTL issues policies to anyone from age 18 to 64. Lifetime maximum benefit amounts are between $25,000 and $250,000.

Please note: the information in this post is for use by licensed insurance agents only and is not intended for use by consumers. If you are looking for an agent to assist with the purchase of one of the GTL products, please contact our office either by email at teal@croweandassocites.com or by phone 203-796-5403.

As a health insurance agent, there are many useful ancillary products available to offer your clients. One of the best products to offer is cancer insurance. Because we all know someone who has faced this diagnosis, we understand the toll in can take on the patient as well as their family. Unfortunately, it often comes with significant financial burden as well as the other challenges it brings. While a patient is struggling to heal and recover, they do not need added stress that treatment costs or loss of income can cause.

In this post, we go over what cancer insurance is, how it works, and why it’s important to add it to your product offerings.

Understanding Cancer Insurance

Cancer insurance is a type of supplemental insurance. It is designed to provide coverage for the various expenses associated with cancer diagnosis and treatment. Although traditional health insurance policies cover some medical costs, cancer insurance provides financial protection and fills the gaps left by standard health plans.

Watch a video on the value of ancillary health products.

How does this coverage work

Normally, cancer insurance operates as a form of indemnity coverage. In other words, if the beneficiary is diagnosed with a covered cancer, they receive a lump-sum cash benefit directly from the insurer. The policy holder can use the benefit at their discretion to cover a variety of expenses related to their cancer treatment and recovery. Some expenses may include the following:

Medical Expenses

Cancer treatment often involves many medical procedures, including surgeries, chemotherapy, radiation therapy, and medication. Cancer insurance helps offset some costs associated with treatments, such as deductibles, copays, as well as out-of-pocket expenses.

Find out about UHC Advantage Guard Hospital indemnity and cancer plans

Experimental Treatments

In some cases, individuals may decide to try either experimental or alternative treatments not covered by traditional health insurance. Cancer insurance provides the flexibility for patients to pursue these options by offering a way to afford such treatments.

Non-Medical Expenses

There are many costs associated with cancer and some are not medical. In some cases, a patient may need to travel to receive the best care. There can also be costs incurred for home health care services, and maybe childcare expenses for parents undergoing treatment.

Learn about other coverage options like critical illness insurance, click here

Income Replacement

It is difficult for many individuals undergoing cancer treatment to maintain a steady income. They require time off for both treatment and recovery. That is why this insurance is a great way to provide a financial cushion to replace lost income during this period. This allows policyholders to focus on their health and not finances.

Why this coverage is a good option

Although there have been many advancements in medical science, a cancer diagnosis remains a life-altering event that can wreak havoc on one’s physical, emotional, and financial well-being. While health insurance provides coverage for some of the expenses, out-of-pocket costs associated with cancer treatments can be substantial. Cancer insurance bridges this gap, offering financial protection and peace of mind during a challenging time.

Find out about other ancillary health insurance products, click here.

Additionally, this product is available to individuals of all ages and health. This makes it an accessible option for anyone concerned about the potential financial strain of a cancer diagnosis. Unlike traditional health insurance, this product focuses specifically on the unique needs of cancer patients, providing coverage and support.

Agents, click here to join the team at Crowe!

Already a Crowe agent, click here to add ancillary products to your Crowe contract.

Cancer insurance offers a vital layer of protection to ensure individuals and families confronting this diagnosis can focus on what matters most: their health and well-being. By providing financial support for medical treatments, non-medical expenses, income replacement, and more, cancer insurance offers peace of mind.

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Health Insurance Open Enrollment 2018

Health Insurance Open Enrollment 2018 runs from November 1, 2017 through December 15, 2017.  This is an opportunity to make any desired changes to your existing health insurance plan. This could be changing plan options with the same company or looking a plans from other companies.  Those with an Exchange plan (obamacare) plan may want to look at other offerings in the exchange or possible outside of the exchange for 2018.  For exchanged and non exchange based plans, the insurance companies can not block enrollment due to health issues.  This is a guaranteed issue period on exchange and non-exchange type plans.  All changes during this time will take place on 1-1-18.

Benefit Changes and Rate Increases

Benefit changes and the inevitable rate increases for the plans also take place on 1-1-18.  The preliminary estimate shows that most companies will have increases of over 20% for 1-1-18. It is not yet know how the subsidy for those on Obamacare plans will be effected.  Usually, those receiving an income based subsidy are best staying on an exchange plan given they are getting help with the premium.  The monthly subsidy can be substantial if the insured persons income falls within the guidelines.  Although the plans will be increasing their premiums, it is hard to tell how much of that will be offset by the subsidy.

Health Insurance Open Enrollment 2018: Other options

Those that are not planning on being able to get a subsidy for 2018 may want to explore other options.  Non subsidized plan premiums are very expensive for someone age 50+ and the 20+ percent increase will only make that worse.  A non subsidized silver level plan for a 50 year old is currently about $640 a month.  After the increase that number will be around $768 a month.

Crowe and Associates has access to other non-exchange and non-subsidized plans for 2018 that have substantially lower premiums.  Call our office to learn more at 203-796-5403 or email Edward@croweandassociates.com

Our plan is a full major medical plan that waives the penalty for being uninsured. There are copays for services prior to paying any type of deductible.  Rates are the same for all ages and are as follows…

• Single -$548 month
• Parent and Children- $898 month
• Couple- $1,022 month
• Family- $1,298.00 month

Medigap Plans CT

Medigap plans Ct are also called Medicare supplement plans.   They provides coverage for these “gaps” in your Medicare coverage and can save you money.  Medigap plans are not Medicare Advantage plans rather, they provide coverage after Original Medicare A and B benefits pay.  As a result, it is important to note that Medigap plans will only cover services that are approved by Medicare. They will not help cover costs that Medicare does not allow/approve.

Access all Medigap plans CT (Medicare supplement plans) with this link.  Site will show you all plans and rates in CT.

Are you a broker looking to sell Medigap plans?  If so, click here to learn more about Medigap sales.

Medicare supplemental plans are offered by private insurance companies.  These plans help to pay the ‘gap’ between costs covered by original Medicare and your out of pocket costs.  Medigap plans are regulated by national and state governments and therefore benefits are generally the same, regardless of the insurance company.   For example, Plan A has the same benefits regardless of the company you purchase it from.  As a result, rates and value add benefits are the only difference from company to company.

Medigap plans do not cover medication expenses.  If you enroll in a Medigap plan, you should also consider a Medicare Part D (prescription drug) plan.  The rule is different for drugs under medicare part B. As a result, it is important to pick the right part D drug plan.  The pharmacy you like to use and the specific prescriptions you take make all the difference when selecting a drug plan.  Call our office to learn more or use the CMS drug plan finder tool. 

Want to learn more about the differences between a Medigap plan and a Medicare Advantage plan? Click here to learn about all your medicare options.

We are one of Connecticut’s leading Medicare brokerage firms.  Please call us at 203-796-5403 or email us at edward@croweandassociates.com if you have questions.  Better yet, we can set a time to sit face to face and discuss all of your options.  If you aren’t able to travel to our office, we will gladly come to you.

Low Cost Long Term Care Insurance

National Guardian Life (NGL) is now offering low cost long term care insurance.  NGL is offering a new long term care product with premiums up to 50% lower than other LTC companies.

Who should buy long term care insurance?

Long term care insurance provides services and benefits not covered by Medicare.  Unlike traditional health insurance long term care plans are designed to cover long term services and supports.  These typically include personal and custodial care.  Care can be give at home, a community organization or other facility.

Long-term care insurance policies reimburse policyholders a daily amount (up to a pre-selected limit) for services to assist them with activities of daily living such as bathing, dressing, or eating.  You can select a range of care options and benefits that allow you to get the services you need, where you need them.

The NGL Essential plan offers a lifetime benefit.

This benefit provides you with the comfort of knowing you are covered for life with no max benefit period.  Joint pricing offers a lower rate for couples applying together.  Step rated cost of living adjustment means that you will start with the lowest offered rate.  The reverse combo feature combines return of premium with or without a claims offset.  An optional surrender rider protects the premium you’ve already paid in to the policy.  In addition, if you never use the policy, your beneficiary will receive up to 80% of the amount you paid  into the policy.  This mimics a life combo policy.

Click here for a full product guide.

Crowe and Associates is a full service insurance brokerage.  We are also Medicare specialists.  Click here for a free confidential Medicare quote.  If you have questions regarding either medical or long term care insurance, please contact us for an appointment.  There is no fee for our services.   You can  reach us either via phone at 203-796-5403 Or,  you can email us at admin@CroweAndAssociates.com.

Medicare Supplemental Plan Rates

There are many various options when you decide to purchase a Medicare supplement plan. Medicare Supplemental Plan Rates are listed below. Coverage for Original Medicare, Part A and Part B, include monthly premiums, deductibles as well as co-insurances. There is no limit for out-of-pocket spending.  Long term care, dental and vision are not covered.  To stabilize and or limit some of the cost, many choose a Medicare Supplemental or Medigap Plan.  As you have most likely heard, Medicare enrollment can be complicated.  For your own piece of mind, we recommend speaking with an experienced, licensed health insurance agent.  A knowledgeable agent can help you  to choose the best option for YOU.

There are actually 10 Medicare Supplement Plan options available to you. Each plan has different, yet standardized, benefits and coverage. This means that no matter which insurer you buy from, the benefits of each plan will be the same.

However, while the plans are standardized across insurance companies, the Medigap costs can be vastly different. So even though you will ultimately be getting the same benefits, it pays to shop around to get the best rate.

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Do you have questions or concerns regarding your current Medicare plan? If you would like to learn more about future Medicare Advantage, Supplemental as well as Prescription Drug Plan options?   Please contact us either at 203-796-5403 or at admin@croweandassociates.com to discuss your Medicare options in detail.

Access Health Special Enrollment Period – April 1 – 30, 2015

Access Health CT has announced a special enrollment period from April 1 through April 30, 2015.  This special enrollment period is intended to allow both individuals and families the opportunity to enroll in coverage in 2015.   This is a chance for people who did not have health coverage in 2104 and are now subject to a federal tax penalty to get the coverage they need.

Although, individuals who do not qualify for an exemption from Access Health and went without health care coverage in 2014 will have to pay a penalty.  The penalty is $95 per adult or 1 percent of their income, whichever is greater.  This amount is added in when they file their taxes this year. Additinally, the tax penalty will increase to $325 per adult or 2% of income for the 2015 calendar year.

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Obama Care Income Limits for 2015

In this post we will explain the Obama Care Income Limits for 2015.  February 15th is the cut off to sign up for an Affordable Care Act plan (Obama Care).  In fact, after the 15th, only people with a valid special election can sign up for coverage.  Those with income below the allowable guidelines gain access to health insurance coverage at substantially lower cost than those with standard plans not affiliated with the exchange.  Those within the income limits can enjoy premium reductions of up to 90% .

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Obama Care  in Connecticut

The purpose of this post is to provide an understanding of Obama Care in Connecticut to help consumers make a better decision when they decide to enroll or not.    Our office is registered to advise the general population on which plan may be best for them and to process an enrollment in person or over the phone. Please review the list of bullet points below and call or email if you have any questions.

• Obama Care is run by Access Health in CT.  Prospective members sign up for the plan through the Access Health website.  Once you register, you can complete and submit an application.  Access Health then sends the insurance company that you chose during your application process the information is then sent to the insurance company that was chosen during the application process.  This will then prompt them to send out a monthly bill as well as ID cards.
• Subsidies are available to those within the income guidelines.  They are automatically applied to the premium and the bill received in the mail will be reduced by the amount of monthly subsidy being received.  Subsidy levels depend on the total annual income of the family and the number of family members.  They do NOT look at prior year income but look at current years income.  A person applying in 2014 is going to be provided or not provided a subsidy based on their 2014 income not prior years income.

• Subsidies levels are as follows:

• Single person under $45,960 adjusted gross is eligible for a subsidy.  A family of 4 under $94,200 is eligible for a subsidy.    For an example of the amount of subsidy provided we can use a 61 year old male.  At $47,00 annual income he is not eligible for subsidy and would pay $691 a month for a silver plan.  At $32,000 of income that same person would only pay $150.09 a month for the same silver plan.   A family of 4 making $96,000 a year would pay $1217.22 a month for a silver plan while a family of 4 making 52,000 a year would pay $217.00 a month for the same plan.
• Subsidies are only available by applying through Access Health
• Current companies offering plans are Anthem BCBS, Connecticare and Healthy Partners.  United and Harvard Pilgrim will  also be available in 2015
• Anyone can enroll in Obama Care but only those under the income level will get a subsidy

• The company sends a paper bill every month.

• The doctor networks are smaller than the normal networks.  We have found that the companies Obama networks have about 70% of the doctors that are in the companies normal networks.
• For those under the income guidelines, this is the lowest cost insurance they will be able to buy on an individual basis by a substantial amount.
• The benefits of the Obama Care plans are more comprehensive than the comparable plans out on the open market
• Obama Care will base your income on the total family income, even if the whole family does not enroll in the plan.

You can either call or email us with any questions or help enrolling.  We do not charge a fee for help with enrollments.  The insurance companies pay us directly.  The rates are the same with or without our assistance enrolling.   Office number is 203-796-5403 or email Edward@croweandassociates.com