Showing posts with label John Moran. Show all posts
Showing posts with label John Moran. Show all posts

Sunday, October 20, 2013

Health Care Premium Tax Credits-money for health care



Authored by John Moran, CPA, cpacaregivercentral.blogspot.com, 720.635.3180

Tax  Credits – Reducing your Health insurance with tax incentives
Tax credits are not new having been a part of tax law for 50 years or more.   A tax credit is a dollar for dollar reduction of your tax liability (as opposed to a tax deduction which reduces your income in arriving at taxable income, the amount upon which the tax rate is applied and tax computed).  Using tax credits to pay for health insurance is new, and has not been part of any earlier tax law.

Fast forward – Year 2014 (but take action now by visiting the Marketplace Health care exchange)…
The health care insurance marketplace (the “Exchange”) includes a new feature – using income tax rules to pay part of your monthly insurance premiums.  Therefore, the insurance company premiums posted to the exchange are merely the starting point in computing your true cost.  Income tax credits (which differ significantly from income tax deductions) can now be used to reduce the posted insurance premium cost.  

Let’s go through an example:
Peter, Mary and their two children have an annual income of $52,988 which translates to approximately 2.25 times the federal poverty line income level.  At this income level, the family is expected to contribute 7.18 %  of their income to the cost of health care insurance, or $3,802. Let’s further assume the premiums for health care for a benchmark (I’ll define benchmark later) family plan are $15,000.  Peter and Mary are entitled to an $11,198 premium tax credit.  The premium tax credit is the difference between $15,000 total family cost and $3,802, their expected contribution.
Current tax law will allow Peter & Mary to request an advance on their premium tax credit and send the tax credit to the insurance company thereby reducing their monthly cash outlay for health insurance. Alternatively, Peter & Mary can pay the regular premium due each month and claim the credit on their individual tax return filed for each year.  Either way will be allowed.

Bronze, Silver, Gold, and Platinum Insurance plans
Health care exchange coverage and related premium cost will have four levels. At the lowest exchange coverage level, bronze, the insurance company will pay 60 percent of your medical costs.  At the highest exchange coverage level, platinum, the insurance company will pay 90 percent of your medical costs. Understanding the coverage levels is key to understanding the change imposed on the health insurance market.  It is not possible to self-insure or avoid insurance for small dollar health care costs. Instead an insurance provider will be involved in some form of reimbursement for every dollar of health care cost incurred.  Most home insurance, vehicle insurance, and other personal insurance creates certain deductibles thereby avoiding “trading dollars” with an insurance company and incurring unnecessary administrative costs of processing claims.  The Affordable Care Act contains no provisions for initial deductibles, and potentially burdens the claims handling process with extra costs.  The extra costs, in turn, must be reflected in the premiums charged by the insurance companies.

Benchmark plan
A benchmark plan is the second lowest silver plan available to each member of a tax household. Please note it is possible not all family members in a tax household reside in the same geographic location. Students in college are members of one tax household even though they may reside most of the year in a distant city (out of state student, for example).  The cost of a silver plan for the student would be added to the parent’s plan in arriving at the tax household benchmark plan cost.

Medicare
Medicare coverage is not affected by the premium tax credits, nor by most provisions of the Affordable Care Act (“Obamacare”).   There are some rulemaking changes, most notably in the reduction of the Part D drug plan donut hole (a topic for another article), and increased accountability by Medicare Advantage plan providers to make sure the premiums they receive are used, in fact, for medical care.

Employer plan participants
The health care insurance premium tax credits do not apply, for the most part, to those who work for employers with 50 or more employees.  These large companies typically have plans available which cover 60 % of the cost of medical care.  Employees who are charged more than 8 % of their household income for medical plan benefits can opt out of their employer plan, purchase a policy on the exchange, and then use premium tax credits. The premium tax credits are available until household income exceeds 4 times the federal poverty level.  The year 2013 federal poverty levels are approx. $11,500 for a one person household, and $23,500 for a four person household.

In Colorado the Connect for Health.org web site is http://connectforhealthco.com http://connectforhealthco.com/

Saturday, December 22, 2012

Senior Health - Telemedicine is HERE.

American Well - Press Releases

The Villages, Fla. and Boston, Mass., June 22, 2012 — American Well™ today announced a partnership with USF Health at the University of South Florida to increase access to quality primary and specialty care to the residents of The Villages, the country’s largest Over-55 residential community in the United States. This marks the first time American Well’s industry-leading Online Care telehealth platform will be specifically targeted toward a senior population.

Online Care is a web-based software platform that allows consumers and healthcare providers to have immediate, live and clinically meaningful online visits through video, secure text chat and/or phone.

USF Health will deploy Online Care in support of its patient-centered healthcare system, developed in partnership with The Villages, which provides easy access to quality healthcare to residents. The goal is to utilize Online Care to reduce hospital admissions, readmission rates and pharmacy costs, while maintaining Medicare beneficiaries in their homes rather than long-term care settings.

Through Online Care, retirees will have immediate access to primary care from the comfort of their homes. In addition, USF Health physicians will use Online Care to consult with outside specialists to deliver comprehensive care, including post- operative care, diabetes care, cardiovascular health, dermatology, mental health and urology.

Wednesday, December 19, 2012

Tips for Difficult Family Conversations

Tips for Difficult Family Conversations

Tips for Difficult Family Conversations

December 12, 2012 by Amy Goyer
 
In the course of caring for our aging loved ones many family members must have difficult conversations around decisions and changes — whether they be about driving, living situations, health care, financial or care and support issues. Here are some tips for approaching these conversations:
  • Talk early and often. The more you’ve discussed and planned for the future, the easier it will be when it is time to make decisions.
  • Do your homework first. Observe your loved one’s situation, identify areas of concern, talk with other family members, then research the options for support and care for them.
  • Start by expressing your love and concern. Be clear that your thoughts and actions are motivated by your love and your desire to help them be as independent as possible for as long as possible. Be sincere; family members will see through a snow job right away. It’s not about buttering them up for the fall, it’s about honest, caring, clear communication.
  • Your role is to provide support for them, not take over their lives and be a “parent” to your parents. If you communicate from this vantage point they will feel less threatened. Don’t make this a power play. Talk about ways you can support their independence, even if it means making some changes.
  • Use “I” statements. Any time you start a sentence with “you” be aware of how your loved one will react. “You need to …” or “You just have to …” will put people off. Instead, try “I am concerned about …” or “I want to help you …”
  • Ask them to say how they think they are doing. Don’t just dive in with your opinions, ask for theirs as well. If they say everything is fine as is, express your own concerns. Ask about specifics if it’s hard to get the conversation going, for example:
    • Do they ever think about the future and how to plan for a time when they may need more support?
    • Are they ever worried about taking care of the house and yard?
    • Do they ever feel unsafe, isolated or uncomfortable being alone?
    • What would they like to do more of?
    • Would a bit of help with a few things ease their stress?
  • Validate their feelings. Change is hard, and the “unknown” is the biggest fear for all of us of any age. It’s normal to want to avoid change, so tell them you understand their reluctance, fears or even anger and you want to help make change easier for them. Sometimes they just need acknowledgment that this is hard stuff to deal with.
  • Involve the right people in the conversation. Include trusted family members or, if needed, an objective third party to facilitate the conversation. If your parents always take your brother’s advice, be sure he’s there. If they trust their doctor, financial adviser or lawyer, then arrange for an appointment and go along.
  • Try an indirect approach. As a more casual conversation starter, talk about a friend dealing with his/her parents or an article you read, or seeing a television show on the subject.
  • Offer specifics and alternatives. Especially if you want them to give something up, have some resources and options lined up already so they know there will be a replacement or alternative available.
For more on the fantastic NBC Nightly News series on caregiving and the sandwich generation, watch these segments and additional exclusively online video (which you can view immediately after the segments – keep your browser open and they will start automatically) and articles:
  1. Caregiver Stress
  2. Critical Family Conversations
  3. Multigenerational living
Follow Amy on Twitter @amygoyer and Facebook AmyGoyer1

Saturday, January 14, 2012

Medicare - Resources and Benefits for Caregivers

Ask Medicare - www.medicare.gov/caregivers/,  this resource provides information, tools and materials to assist the caregiver and their loved ones in making informed healthcare decisions. The website provides a sign-up for an e newsletter emailed bi-monthly. The newsletter provides information on important dates such as open enrollment, changes in programs, and other available resources.


Eldercare locator - www.eldercare.gov/ is a public service of the US Administration on Aging and is the first step to finding resources for older adults in any US community.


Meals on Wheels - www.mowaa.org/Page.aspx?pid=183 This organization is the oldest and largest organization in the US representing those who provide meal services ot people in need. MOWAA works toward the social, physical, nutritional, and economic betterment of vulnerable Americans. 


Medicaid - www.cms.hhs.gov/MedicardGenInfo/   If you can't afford to pay for medical care right now, Medicaid can make it possible for you to get the care that your need so that you can get healthy and stay healthy. 


See my website at www.moranlong.com 

Sunday, December 26, 2010

My Medicare.gov [Information repository] - Organization Tool for Caregivers

A valuable tool for those assisting elders requiring care is the www.MyMedicare.gov web site. The site helps you organize doctors, medicines, and medical history. We must be sensitive to privacy but having this information in one convenient site enables more efficient care. The website is available 24/7. Also, it is possible to search for various medical and related non-medical service providers.  The information requires a user name and password (created at web site account application). A caregiver can identify themselves as a caregiver, thus fully disclosing their relationship to the patient receiving Medicare assistance when applying for a web site account. The following tasks can be completed on the site:



  • Track health care claims
  • Order a duplicate Medicare Summary Notice ("MSN") or replacement Medicare card.
  • Check Part B (Medical provider insurance coverage) deductible status.
  • View eligibility information.
  • Track the preventive services available (probably a bigger issue in the future).
  • Find information about hie or her Medicare health or prescription drug plan, or search for a new one.
  • Keep his or her Medicare information in one convenient place.
  • Sign up to get the "Medicare & You" handbook electronically.
If you have further questions about the MyMedicare web site call 1-800-MEDICARE.