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Posts Tagged ‘Medicare’

April 30th, 2009 by Hannah Waters

Whether you have two years until retirement or 30 years, you should still be thinking towards your future and preparing for retirement. With the downturn in the economy, people closer to retirement age are worried about whether or not they will have enough money to get through the rest of their life.

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Here are some things you need to do before you retire…

Increase Your Savings – As you near retirement age, you should increase the amount of money you put into savings each year. By increasing the money you put into savings each year, you are ensuring that you will be able to retire when you want to. Set a timeline for yourself and budget out how much you would like to put into savings each year. Although things like job loss interfere with your savings, be sure to stick to your budget schedule as much as possible.

Keep Money in your 401(k) – If you are younger and have not already done so, make sure you open a 401(k) as soon as possible! Having a 401(k) is a great way to put money away towards your retirement. One important factor to remember is NOT to take money out of your 401(k) before you need it. When you remove money you have to pay fees and taxes that are not worth it. Making sure to keep your money in your 401(k) will ensure that you will have a greater return on your money in the future.

Benefits – Figure out what will happen with your benefits when you retire. Although some companies help their employees once they retire, many are stopping this policy because it costs too much money for them to continue to support you. Find out whether or not your company will continue to help you out…if not, you need to make sure that you apply for Medicare. Medicare will help you with hospital insurance, medical insurance, and to help pay for prescription drugs. As you get older, you become more vulnerable to infections, colds, etc. and without medical insurance you may find yourself paying for some very hefty bills from the doctor.

Be Flexible – Try to be flexible with the time you are planning on retiring. Changing the age that you retire until a later date may really benefit you and allow you to save a little bit more money to help you in the future. Although you want to enjoy your time in retirement, many people take up a part-time job in order to supplement the money that they put into savings and make it last longer. This part time job can be something fun and something you have always wanted to do so that you do not really have to consider it a “job.”

Retirement is meant to be one of the best times of your life, but it can only work out that way if you have prepared yourself for the future along the way. Take initiative with your own life and start planning for retirement as early as possible.

Take your retirement IQ quiz to see where you stand and what you know!

— By Hannah Waters, Geezeo.com

Photo by: Kevin P.

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March 2nd, 2009 by Katie McCaskey

By Zach Anchors | MainStreet.com

Getting everything you deserve from your health insurance sometimes requires putting up a fight.

If you receive notice that a claim for healthcare expenses was denied, don’t just accept the decision. Healthcare providers frequently overturn claim denials. By following the steps below, you may be able to reverse your insurer’s denial and improve your own financial situation as a result.

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Investigate the denial: Start by figuring out why your claim was denied. Insurers usually provide a basic reason for their decision in the Explanation of Benefits (EOB) that accompanies their denial letters. You can get a full explanation by calling the customer service number on your insurance card.

Claim denials often stem from simple administrative errors, so there’s a chance a phone call will be all that’s needed to overturn a decision. Before you pick up the phone, gather relevant paperwork, including your EOB.

Once you’ve got a customer service agent on the line, find out whether your insurer deems your medical care not medically necessary or not covered by your plan. If you still believe your claim is legitimate after hearing your insurer’s explanation, get details about the appeal process, including potential timelines and required paperwork.

Be polite, but don’t hesitate to press for more details if the customer service agent simply repeats what you already knew or confuses you. Starting with this phone call, take careful notes on any communications with your insurer, including taking down the name and phone number of the person with whom you speak. This information could come in handy as the claims process progresses.

File an appeal: Now it’s time to make your case. You should have a document, labeled Evidence of Coverage or Summary Plan Description, that explains what your plan covers and what it doesn’t. (Many large insurers, like Aetna (Stock Quote: AET) and Humana (Stock Quote: HUM), post these documents online.) Read the document carefully, looking for any information that’s relevant to your situation. For example, if your insurer says you failed to get prior authorization for certain medical care you received, check your plan documents to make sure prior authorization really was required.

When you compile your appeal, use this information to show that your claim is legitimate. Along with your appeal, include records of any care you received that’s relevant to your claim.

If your insurer argues that your claim isn’t based on medical necessity, ask your doctor to write a letter explaining why it was medically necessary. You can also look for, and cite in your appeal, medical studies that support the necessity of the medical care you received. Likewise, if this care is covered by Medicare or another government-sponsored insurance program, mention that in your appeal.

Seek an external review: If your first appeal is denied, don’t get discouraged. Your plan may allow for another stage of internal review, likely administered by a panel of individuals who haven’t previously seen your case. This process may include a consultation with a physician and possibly your own testimony.

Once you’ve exhausted your plan’s internal review processes, it’s time to seek a higher authority. If you’re covered by an employer-sponsored plan, ask the human resources department whether the plan is self-funded. If so, your only recourse is the court system.

If the plan is not self-funded, determine whether your claim is eligible for review by your state’s department of insurance. (External-review procedures vary widely from state to state and a few states only review certain types of plans.) If so, ask the state to initiate an external review of your appeal. If you’re confident in your case, this process may be worth pursuing: Nearly half of the appeals that reach external review are successful, according to the Kaiser Family Foundation, which offers a comprehensive guide to navigating the appeal process.

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