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Understanding Health Insurance: A Guide to Billing and Reimbursement
-By: Michelle A. Green, Joann C. Rowell
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The New Health Insurance Solution: How to Get Cheaper, Better Coverage Without a Traditional Employer Plan
-By: Paul Zane Pilzer
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Health Insurance
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A Guide to Health Insurance Billing
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Health Insurance Today: A Practical Approach
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Workbook to Accompany Understanding Health Insurance: A Guide to Billing and Reimbursement
-By: Susan A. Brisky, Ruth M. Burke
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California Health Insurance Agent Article

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This is a selection made from among articles on California Health Insurance Agent. For a permanent link to this article, or to bookmark it for future reading, click here.

Health Insurance and The Terminally Ill

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By its very nature, terminal illness is devastating for both the sick people and their families and friends. Unfortunately, the pressure of worrying about medical costs and trying to secure health insurance that addresses the needs of a terminally ill individual adds to the burden loved ones must endure during an already difficult time.

Depending on how a terminally ill person decides to spend his or her last days, the costs can be enormous. At the lower end of the spectrum, a terminally sick individual may want to refuse treatment, and die at home. While this is an option, a more popular choice is to seek aggressive treatment programs that will allow a terminally ill patient to extend the length of his or her life as comfortably as possible. Without adequate medical health insurance, this second option may not be financially available to everyone faced with making such a difficult decision.

Some relief is available through public health insurance plans such as Medicare and Medicaid, even in cases where hospice care is required. Hospice benefits can be provided by Medicare if the client is eligible for hospital insurance under Medicare Part A; the client’s doctor and the hospice director sign a declaration that the terminally ill person is expected to live less than six months; the hospice where you will receive care is a Medicare-approved facility; and the beneficiary signs away his or her regular Medicare coverage as it relates to his or her terminal condition in favor of hospice care. Conditions not related to the terminal illness are not affected by signing the statement.

Even with Medicare-provided hospice palliative care, terminally ill patients will still usually be responsible for their room and board costs but many other fees are paid under the Medicare plan. For example, a hospice Medicare beneficiary would not have to pay for: physicians’ visits and care; nursing care; equipment such as wheelchairs, walkers, or monitoring devices; standard hospital supplies such as catheters and bandages; pain killers and symptom-controlling medications; short-term respite or hospital care; homemaker/aide services; physical, occupational or speech therapy. Emotional or spiritual counseling may also be available to patients and their families.

If traditional health care insurance is not enough to cover the health-related expenses, looking to life insurance policies may provide additional financing options. Accelerated benefits (also called living benefits) and viatical settlements could be the answer to the financial woes of a terminally ill individual.

Accelerated or living benefits are life insurance monies paid to life insurance policyholders before they die. A few policies include accelerated benefit options, but if yours doesn’t, you can ask your insurance provider about adding the appropriate provisions to new or current policies. The amount of money available as early payment with accelerated benefits ranges according to what kind of policy you have. However, the amounts are typically between one quarter of the total policy. There are also limited circumstances under which living benefits will be awarded, and these also vary by policy. Speak to your provider to see what options are available to you.

Viatical settlements are funds you receive from selling your life insurance policy to a viatical settlement company. Life insurance policy holders who sell their benefits to a viatical settlement company will receive a lump sum payment equal to a percentage of the benefit that would be awarded if the policy holder had died.

Turning to accelerated benefits or viatical settlements does provide a good source of quick money to cover sudden or unanticipated costs, but don’t jump into either prospect without considering the long-term effects of what you are choosing to do. If your life insurance policy is a central part of your estate plans or is something to pass on to family members, using accelerated benefits or viatical settlements will have a big impact on your future financial situation.

Whatever you decide to do, it is important to make sure you are fully informed about your options and the possible consequences. Ask a lot of questions and don’t be satisfied until you get appropriate answers. Remember that policies offer many options so be certain to choose the best policy for your family. Most importantly, don’t sign anything until all of your questions and concerns have been addressed.


 



 

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