No matter what your politics, the Affordable Care Act will fundamentally change how we buy and pay for healthcare. Whether you have Medicare or are in that gray area between retirement and Medicare, one thing is certain. To be able to afford your healthcare you will pay more out of pocket. Is there any way to prepare so you can age with quality and not in crisis? Yes, but it takes some planning and determination.
This may sound obvious but the truth is that most of the healthcare costs in this country are tied up in chronic disease management. We have become addicted to the healthcare system and they like it that way. Guess what? Most of these chronic conditions are preventable. It’s called self-responsibility. The skyrocketing costs of treating these diseases ultimately impacts your health care premium.
It says something when WalMart starts to enter the primary care market and when urgent care centers and CVS clinics become the choice of young people for primary care. These setting are efficient, quick and the least expensive option for care.
The healthcare exchanges will offer multiple options for insurance. All will have tradeoffs. The lower the premium, the higher the deductible, the lower the choices. Figure out what you can afford and also make sure you are comfortable with the providers available under the plan.
To offset the high deductible costs, sock money away in an Health Savings Account (HSA) particularly when you are still working. That nest egg will serve you well in the future.
When you do roll around to become eligible for Medicare and assuming it is still around, consider a Medicare Advantage plan. Typically these will be more comprehensive, least costly and they will provide the type of medical management you need to avoid what I wrote in #1!
The elephant in the room of Obamacare is the financing of long term care. Hint: there is no financing mechanism save Medicaid. You have some choice especially if you start younger. Consider a long-term care insurance policy or converting a life insurance policy to a long term care benefit. Consult your financial advisor.
The sandwich generation, that group that is caring for aging parents and still raising or caring for children, is shifting. As the boomers’ parents pass on, so to is the baton to Gen X’ers, who now are beginning to absorb the brunt of the caregiving crisis. Ultimately this burden (or opportunity depending on your viewpoint) has a cost, both financially and health wise. And keep in mind it will impact how you prepare for retirement. So think about these issues sooner.
Recent statistics show that the number of unpaid caregivers, typically family members, will dwindle over the next 20 years. In 2010, the caregiver support ratio was more than 7 potential caregivers for every person in the high-risk years of 80-plus. By 2030, the ratio is projected to decline sharply to 4 to 1; and it is expected to further fall to less than 3 to 1 in 2050. That means you will probably have to pay for some home health care and custodial care.
There are cottage industries springing up that can advocate for your healthcare. Geriatric care managers can help coordinate. Patient advocates can be your champion when in a hospital. And there are companies that will scrutinize bills and challenge providers on costs. They take a percentage of the recovered money but could be well worth it.
This gets back to our first “do” and that it exercise responsibility for your health. People are becoming more and more dependent on the healthcare system believing there will always be another pill, implant, procedure or prosthesis to save them. This serves no one, jacks up costs and increases the likelihood of your needing more acute care in the future.
Heathcare could bankrupt this country as it has millions of Americans. There is still no real assurance that you can avoid a catastrophe if something unexpected happens. But if you do the best to prepare, you can at least make decisions from an educated viewpoint and not in a crisis mindset. The preparation you do before to prepare for aging and the decisions you make with a rational mind when something happens will not just save you money but could save your life.
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