Andrew Rosner Law and Insurance

Tune in to 93.5 FM January 28, 2019 at 7:30 PM  to listen to Long Island Elder Law Estate Planning Asset Protection Lawyer Andrew Rosner talk about Elder Law, Wills, Trusts, Estates, and the Andrew Rosner Long Island Asset Protection Estate Plan.

 

• A Massachusetts urologist was reprimanded by state regulators after he removed a kidney from the wrong Albert Hubbard.

Details

• The Worcester Telegram reported that Ankur M. Parikh, MD admitted the error.
• Parikh interpreted the CT scan of another patient with the same name.
• Both men had CT scans of their abdomen and pelvis on the same day.
• One Albert Hubbard saw Parikh for blood in his urine, and the urologist pulled up a CT scan for "Albert Hubbard" that showed a large tumor.
• Unfortunately, the scan was for the other Albert Hubbard.
• The mistake was found after a pathologist found the removed kidney to be healthy.
• The state said Parikh made 3 mistakes:
  • failing to verify the patient's date of birth before viewing his scan;
  • failing to review the CT scan the day of surgery;
  • electing to remove the kidney even though it wasn't as heavy as would be expected with a tumor.
• Parikh did attempt to log in to UMass Memorial's medical records system the day of surgery but was unable to because of a firewall problem.
• The Hubbard whose kidney was removed is suing Parikh and his medical group, among others.

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Alot of people wonder about the differences between Medicare supplement Plan F and Plan N:
 What does plan F cover vs. plan N?
 Which one is the more popular Medicare supplement plan ?
 Does Medigap Plan N cost less?
Before we compare Medicare supplement plans, we need to review a little about Medicare:
Medicare is a federal health insurance program that pays most of the health care costs for people who are 65 or older. It will also pay for health care for some people under age 65 who have disabilities.
Original Medicare has two parts, A and B. Part A covers Inpatient care in hospitals, skilled nursing facility care, some home care, and hospice care. Part B covers doctor services, outpatient care, some home care, durable medical equipment and some preventive services. Not all costs are covered, though.
You will usually be responsible for copays, coinsurance and deductibles (your out-of-pocket expenses).
How do Medicare Supplement Plans Work?
A Medicare Supplement policy (or plan) is private insurance that helps pay for those out-of-pocket expenses.
It is one of two options available to you to pay for some or all of these costs. The other option is called Medicare Advantage (Medicare Part C)
There are ten standardized Medigap plans.
They are denoted by the letters A through N. Because these plans are offered by private insurance companies, the cost and availability of each lettered plan may differ, but not the benefits. In other words, all companies that offer, say Plan F, must offer the same standardized benefits for their Plan F.
With a Medicare supplement policy (“Medigap”) you can go to any doctor, anywhere in the United States, as long as that doctor accepts Medicare. The companies that offer these policies are allowed to charge whatever they want for the coverage. So premiums will vary among companies. They are also allowed to determine their own underwriting criteria for enrollment.
You should know, though, that all companies must enroll you on a guaranteed basis, also known as Medicare Supplement Open Enrollment, when you turn 65.
Plan F vs. Plan N Benefits
Plan F
Plan F covers 100% of your out-of-pocket expenses (copayments, coinsurance and deductibles).
Plan F also covers 80% of foreign travel emergency expenses with a $250 deductible and $50,000 lifetime maximum.
Plan N
Plan N covers as much as Plan F covers except for:
 The Medicare Part B deductible
 Medicare Part B excess charges
 Doctor Visit and Emergency Room Copays
Part B deductible
The Part B deductible for 2019 is $185. You are responsible for this yearly amount whenever you begin to receive any Part B services with Plan N.
Part B Excess Charges
Plan B excess charges are not permitted in New York, so this is a reason N plans may be more attractive in New York than F plans.
Doctor Visit and Emergency Room Copays
Under a Plan N, you may also have to pay up to $20 copay per office visit, and a $50 copay per emergency room visit. The $50 is waived if you are admitted to any hospital, and the emergency room visit is covered as a Medicare Part A expense.
The main point for you here is that in a plan N, your out-of-pocket costs would be the same as Plan F, except for having to pay the annual $183 Part B deductible, and doctor visit and emergency room copays.
Plan N makes a lot of sense for a lot of people in New York.
It is also wise to consider whether a Medicare Advantage Plan works better for you than a supplement. More than 90% of people in Medicare Advantage Plans are happy with their plans. Medicare Advantage Plans are growing rapidly in popularity. People are switching out of supplement plans and into Medicare Advantage Plans, because they save money, get better benefits, and get comparable insurance coverage.
Today, December 7, 2018, is the last day to switch out of a supplement plan into a Medicare Advantage Plan during the annual enrollment period for 2019. For many people, this is your last chance until 2020 to make the switch.
There are Medicare Advantage Plans for 2019 with no monthly premium, no medical deductible, free preventative care, lower drug costs than Part D plans you would buy if you had a supplement, free visits to your primary care doctor, telemedicine, silver sneakers, and reasonable co-pays. Also, you can go to any doctor in the USA who accepts Medicare, and you don't need referrals, just like in a supplement plan
Now that Medicare Advantage Plans give you the same freedom to see any doctor as you have with a supplement plan, with no monthly premiums or deductibles, free preventative care, free visits to your primary care provider, and other benefits, many people are switching to Medicare Advantage Plans,
If you want to enroll in a Medicare Advantage Plan today, call me at (516) 228-1050.

The time to plan for long term care is now. I am offering a life insurance policy with a long term care rider with among the lowest rates in the market, guaranteed not to increase. The policy ensures professional care, easing the emotional, physical, and financial toll that providing care has on loved ones. It maximizes the monthly benefit, up to $50,000 per month. We handle the paperwork, alleviating the family or advisor of billing responsibilities. Reimbursement benefits are tax free. Let's talk to see if this policy is right for you. In addition to insurance solutions, I also offer legal solutions for long term care planning. Call me at 516 228 1050 for a free consultation.

At a meeting of The Pulse Center for Patient Safety and Advocacy, on Monday, November 12, 2018, at 6:00 PM, at the Imperial Diner in Freeport, I will be speaking about "The Anatomy of a Medical Malpractice Verdict". Please join us for dinner, a great talk, great conversation, and bring your questions!

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I proudly offer the following types of business insurance: Business Owners, General Liability, Workers Compensation, Property, Commercial Auto, Business Interruption, Errors and Omissions, and much, much more!  Every year I review your policies to make sure you are provided with the VERY BEST insurance coverage you require.  You'll ALWAYS know if there are better options for you and your business protection.  

Does your homeowners' insurance policy have a high, 5% hurricane deductible? Policies from well-known companies do. That means you have to pay out of pocket a $25,000 hurricane loss on a $500,000 policy. For a quote on a homeowners' policy with a low hurricane deductible, call me at 516 228 1050.

The Centers for Medicare and Medicaid Services announced April 27, in a memo, rules changes that could turn the Medicare Advantage program into a major provider of long-term care benefits.
The Medicare Advantage program gives private insurers a chance to provide an alternative to traditional Medicare coverage. CMS requires the issuers in the program to comply with strict benefits package rules. In the past, CMS has not let issuers use a “supplemental benefits” coverage option to cover services such as adult day care services.
A CMS official said in the April 27 memo that, starting with the 2019 plan year, CMS will let a Medicare Advantage plan issuer address the “social determinants of health” by covering almost any form of long-term care other than nursing home care. A plan issuer will be able to cover adult day care, and almost any form of home support other than meal delivery.

Long Term Care Planning
What are the risks and costs of long term care?
Risks and costs of needing long term care.
If you’re 65 today in the United States, there’s a 70% chance you’re going to need some kind of long-term care during your life, according to the U.S. Department of Health and Human Services.
And that care — whether it’s at your home, an adult day care center, a nursing home or an assisted-living facility — is expensive.
Nursing home in NYC or Long Island; $18.000 per month, or $216,000 per year.
Staying home is cheaper, but not cheap. In 2015, he average daily cost for a home health aide in New York was $205.  That would come to $75,000 per year.
And those costs are increasing.
Are there Problems with Relying on Medicare and Medicaid?
I am Medicare Certified, I know Medicare,  and I can help you enroll in the right Medicare Insurance Plan.  Medicare will help pay for a short stay in a skilled nursing facility, hospice care or home health care under certain limited medical conditions, but that’s it.  It will not pay for long term care.
With Medicaid, you need to qualify.  There are asset and income tests that may require you to divest yourself of assets to qualify in the first place.  If you do qualify, you lose a lot of choice about the type of care you’re going to get. And your medical costs will chase you. If you have equity in a home, your estate will get those bills after you die.
Relying on Medicaid to cover your care can be financially devastating, especially if you have a surviving spouse, who will be left with greatly depleted resources.
What is Traditional Long Term Care Insurance?
With traditional long-term care insurance,  you pay a set premium that typically goes up as you age, until it hits a specified maximum. To receive benefits, the buyer must need assistance with at least two of six “activities of daily living”: bathing, dressing, continence, eating, toileting and “transferring,” such as moving from a wheelchair to a bed. Like most forms of insurance, if you don’t use the benefit, you lose it; the insurance company keeps your money. And long-term care insurance is both expensive (costs have spiked over the years) and difficult to find. Fewer and fewer insurers are issuing policies, and in some states, it is simply unavailable.
Other Insurance possibilities
The insurance industry is offering alternatives, including “living benefits” products that combine life insurance with long-term care. They allow you to accelerate your policy’s benefits to get much-needed money if you suffer a terminal, chronic or critical illness. If you don’t need care, the money goes to your heirs or your estate when you die via the life insurance death benefit.
A similar solution is asset-based long-term care insurance. Instead of paying premiums, you deposit a lump sum of money with the insurance company. If at some point you require care, the insurer will pay you benefits based on how much you deposited and how old you were when you purchased the policy, the earlier you start the more benefits you get for your dollar. If you ever decide you don’t want the policy, you have options for getting your money back. And if you die without needing care, there is still a death benefit for your heirs.
There are also annuities with long-term care benefits.
Some work much like the asset-based life insurance policies: You put in a lump-sum deposit and you’ll receive some interest on that. Then, if you need long-term care, a multiplier is applied to the cash you put in. For example, if you put in $100,000 and you need long-term care, that amount increases to $300,000 to put toward long term care expenses.
Another annuity option offers an income rider. You put in a certain amount of money and the company will, depending on your age and when you want to start taking distributions, guarantee a certain rate of income. But if you need long-term care, that income is doubled. So, if you had an annuity that guaranteed $40,000 annually in income, it would double to $80,000. It may not cover all your expenses, but it certainly will help.
Long-term care planning is something a lot of people ignore. They hope they won’t get sick, or that they won’t need it.  Unfortunately, the statistics say that the majority of people will need some sort of care assistance, and planning for that is important.
For help with long term care planning, call me at 516 228 1050

 

Disability Insurance
What is the risk of disability? 
Two of the biggest myths about disability are that it doesn’t happen to younger people and it’s largely the result of work-related accidents.  Here’s the reality:
•  Just over 1 in 4 of today’s 20 year-olds will   become disabled before they retire.
•  90% of all disabilities are caused by illness,   while only 10% are the result of accidents. 
•  Close to 95% of disabling accidents and  illnesses are not work-related.
How do you  protect yourself against the financial impact of becoming too sick or injured to work and protecting what you’ve worked so hard to build: your lifestyle, your future, and your income?.
Alternatives don’t work
Disabilities can cost millions in lost income and added expenses. There are alternatives for supplementing income, however, most alternatives are short-term, unreliable and inflexible. Consider these points:
What’s wrong with relying on personal savings?
Personal Savings – Disability can be devastating to your family’s finances.  If you saved five percent of your income each year, a six-month disability could wipe out ten years of savings.  Considering the average long-term disability claim duration is 31.6 months, it’s critical to explore realistic options for replacing income during an extended period of disability.
What’s wrong with relying on social security?
Social Security – Many claim applications are denied due to the stringent requirements. After all appeals, only about half of claims are ultimately approved. Even then, the average monthly benefit paid, which may be subject to federal income tax, is barely above the poverty line at $1,130.5
What’s wrong with relying on Group Long-Term Disability (GLTD) insurance?
 – Group LTD is a good foundation, however, the need to supplement Group LTD is an important consideration, here’s why:
• Group LTD does not cover bonus income or   retirement contributions.
• Benefits are generally taxed since coverage   is employer-paid, significantly minimizing   actual benefits received.
Group coverage is not individually-owned    (can’t be customized, can’t take it with you   if you leave and can be cancelled at any time   by employer).
• Benefit limitations placed on group can leave   higher paid individuals under protected.
What are the advantages of a private disability insurance policy?

• DI helps keep income strong so your savings,   your lifestyle and your future plans can remain   on track.
• Individual DI coverage is based on your    income, not that of a collective group or   Social Security level.
• Individual DI policies can cover base salary,   bonuses and retirement contributions.
• Also, if you pay the premiums yourself,    benefits are not subject to taxes.
• Most individual DI policies come with fixed   premiums and non-cancellable coverage.
• Individually-owned DI is portable; if you change   jobs or careers you can take your coverage   with you.


When will the insurance company regard me as totally disabled? The core of any disability income policy, the definition of Total Disability, outlines what constitutes being totally disabled.  Different companies use different definitions.  Some policies pay benefits if you’re unable to perform the duties of your own occupation, even if you are at work in another occupation. Others pay only if you’re unable to perform the duties of your own occupation and you’re not working in any other occupation. Still others pay only if you cannot work in any occupation for which you are reasonably qualified.
How much coverage am I eligible for? Generally up to about 60% of net salary or business income.  Factors include your current salary and any other coverage you have (either applied for or in force).
Questions to Ask When Considering
When do benefits start? A policy’s Elimination Period is the length of time that must elapse following the onset of disability before benefits become payable. A common elimination period is 90-days; however, choices are available. You elect your policy’s Elimination Period when you purchase your policy.
How long will benefits last? Typically, disability benefits are payable monthly for a maximum of two years, five years, ten years or to age 65 or 67. Few companies offer benefits payable beyond these periods. Your policy’s Benefit Period is determined when you purchase your policy. If you are younger and just beginning to save for retirement, then you may want to consider an extended benefit option; if you are older and have substantial retirement savings, you may not need a benefit that extends beyond age 65 or 67.
Can my policy be changed or cancelled, or my premiums raised? If you pay for something, then you should own it. A good policy cannot be changed or canceled, even if your health or financial situation changes. It should also guarantee that your premiums will remain fixed until age 65 or 67, as long as you continue to pay them on time.
What if I want to change my coverage? Look for policies that allow you to increase coverage to keep pace with the cost of living or increases in your income. Some offer optional riders that allow automatic or optional increases every year. Insurers sometimes add restrictions to benefit increases if applicants have reached a certain age—say 55 or 60. So it’s best to ask early.
What if I change jobs or careers? One advantage of owning your own DI coverage is that it’s portable. You pay for it, so you own it and you can take it with you if you leave your employer—or if you go into a completely new field or line of work.
What if I’m only partially disabled? A good policy will pay benefits if you do not qualify for total disability benefits but because of sickness or injury your income has been reduced, or you can only work part-time. Look for a policy that does this even if you don’t become totally disabled first. This benefit provision may be referred to as a partial or residual disability benefit, and it may be included in the base contract or attached as an optional rider.
To trigger such a benefit provision, the disability need not be “total,” but may require a loss of time, duties, income specified as percentage of your pre-disability earnings, or any combination thereof. The richest policies have the fewest requirements to receive such partial disability benefits, pay the highest percentage of your total disability benefit, and do so for the longest period of time.
Is there protection for my business in the event I become disabled? If you own or share ownership of a business or professional practice, you might also consider protecting that investment for the long-term. •  Overhead Expense insurance provides reimbursement for the ongoing expenses of operating your business or practice if you are too sick or injured to work. • Business Reducing Term insurance offers protection for financial obligations that require periodic payments expiring at a given time, such as business loans, professional practice loans and salary contracts or contract performance guarantees. • Disability Buy-Out insurance reimburses the owners or partners of a business or professional practice in the event they need to buy out a disabled owner’s financial interest in the company.

 

Under the prior tax law, all casualty losses were eligible for a deduction on your taxes.  Under the new tax law, only casualty losses that occur in Federally declared disaster areas are eligible for the deduction.  Accordingly, having proper coverage for casualty losses is essential.  Your insurance policies may not cover you for all losses you may suffer.  Many policies exclude certain types  of perils from coverage. Call Andrew Rosner for a free review of all your insurance coverage, to make sure your assets are properly protected.