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How to Talk about Long-Term Care Insurance with Clients

How to Talk about Long-Term Care Insurance with Clients

A large part of your job is advising clients to take action in their best interests. While there are certainly many rewarding financial client planning meetings, there will always be a few uncomfortable ones. Talking to your clients about long-term care insurance and, ultimately, death, is one of those meetings that no one wants to have, but are crucial for your clients in order to enjoy the autumn of their life.

Long-term care isn’t always needed, but the conversation around it is. Simply put, you need to bring up this subject if they don’t. You’re aware that it is in their best interest, you know that it has to be discussed, and it’s clear to you that their finances and lifestyle will be impacted if the dialogue doesn’t take place before it’s too late.  

How to start the conversation


While approaching the conversation is difficult, you can always reassure them that many people don’t need long-term care and those that do don’t necessarily stay in it for the rest of their lives or for a long-period of time.  It has to be made clear, however, that if they do need it and do not have a plan in place to pay, they will be sacrificing their financial security and quality of life.

This shouldn’t be just a passing conversation either, it should be a thoughtful, in-depth discussion of all the aspects surrounding long-term care. These are some questions you need to answer during these meetings:

  • What happens if they need long-term care?
  • Who will take care of what if they are admitted?
  • What happens if a client dies while in long-term care?
  • How do they plan on paying for it?

Questions like these may make you shift in your seat, but everyone is better off clearing the air and having the conversation. Try to think of a way to ease the atmosphere before or during these conversations. Think about providing food or drinks during the meeting or have the conversation outside on a pleasant day. Get creative with a way to lighten the mood around a somber topic. If nothing else, put yourself in a frame of mind that allows you to confidently approach the topic and deliver what your clients expect and need.

It also helps to have solutions in place within your practice, such as HALO, that allow you to have data points that can provide a dose of reality to the conversation.

Focus on the outcomes

Nick Dragan, a financial advisor with Mass Mutual, believes that education and technology go hand-in-hand to create the experience that clients now demand from their advisors.

The days of just selling products are over. It’s all about the counsel you provide – including education on a wide variety of topics such as LTCI. Technology and financial planning solutions become tools we use to provide the right advice that is quantitative, objective, and opens up the conversation of where things fit into their plan.


There may be more rewarding aspects to your job than having these conversations, but they are a necessary part of building a strong relationship with your clients. Not every client will be difficult and some might have no problem discussing it at all. Explain thoroughly why the conversation is necessary and why it is in their best interest and both parties will be satisfied with the outcome.

Top Five Long-Term Care Insurance Issues for Advisors

Top Five Long-Term Care Insurance Issues for Advisors

The greatest unknown facing financial advisors and retirees alike is just how long retirement will last. A close second is how much care your clients will need in their final years. While most people expect to have some care as clients age, the world of long-term care insurance planning is quite a bit different. We’ve assembled five issues that are on the minds of advisors when it comes to LTCI.


1. Long-Term Care (LTC) is becoming unaffordable.

Over the past decade, every type of health insurance has risen, but none so much as LTC policies. Certain states have different rules dictating premium increases, but in some places, increases have been over 100% in a single year. Astronomical increases like these make planning for long term care difficult as predicting them is akin to fortune telling. Tom Riekse, from LTCI Partners, LLC, agrees that this is a big challenge:

“[LTCI is] more expensive now, so most providers and clients approach it as part of a life insurance rider. We are trying to position it as education rather than a hard sell for affluent clients due to the costs.”

2. New Policies On The Market

As with any product, the market is full of choices. The question is, which policy is right for your clients? This can be a difficult decision, especially if made uninformed. There are several factors that go into deciding what type of policy to buy and all need to be considered carefully. Consult your clients before wading into the world of LTC policies to make sure you have a clear vision of what policies they would want.


3. Do Your Clients Have Enough Money?

If your clients don’t opt to have an LTC policy, they may consider paying out of pocket. This is most likely an unaffordable option for all but the wealthiest of your clients. There is the option of paying for a traditional and more affordable LTC policy, though these policies seem to be diminishing in popularity and don’t cover much outside of just the care. New “hybrid” whole-life policies seem to be taking their place but are anywhere from two or three times more expensive. Work with your clients to figure out what they can afford both now and into the future.

4. The Clients Themselves

Often, clients will be in denial about LTC. Some will say they won’t use it or will be reliant on Medicaid in the event that they do need extra funds to get them through. Needless to say, planning by denial isn’t really planning. Though it may be a hard topic to broach with your clients, push for them to consider LTC as a real possibility and work with them to purchase insurance or set money aside in the event that they need extended care.

5. Risk Assessment

Health, lifestyle, and genetics are all major factors in assessing clients risk later in life. This can be one of the trickiest aspects of planning for the need for LTC. Having an honest conversation around their level of risk and how to prepare for it, as it pertains to LTC, is important in securing financial security in their later days. HALO by Genivity can help with this process and provide customized, reliable data points for you to get the conversation started.

How Medicare Impacts Financial Planning

How Medicare Impacts Financial Planning

Planning for retirement requires planning for many scenarios and options. One element to consider is Medicare. In a survey by Forbes, 30 percent of Americans believed that home health care expenses were less than $417 monthly when in reality, the cost is closer to $4,000 a month, or $45,000 annually. To put this into perspective, a 65-year-old in 2016 expected to need approximately $270,000 in savings to cover at least 90 percent of their health care costs in retirement. While this may seem like a cost that will be impossible to cover, Medicare can be very useful in this case.

Apply for Medicare

Medicare is a federal program for U.S. citizens and legal residents of five years. Individuals who are over 65 years of age can apply to this program. Individuals who are under 65 years of age can also apply if they receive disability benefits from Social Security, are members of the Railroad Retirement Board, or who have medical conditions such as Amyotrophic Lateral Sclerosis (ALS) or End-Stage Renal Disease (ESRD).

To apply for Medicare, you have a seven month period. You have three months prior to turning 65 and three months after turning 65. You may also apply during the general enrollment period from January 1 through March 31. If you are accepted, coverage will begin July 1.

To re-apply for Medicare, make sure to do so before your policy expires. If you are uninsured for a 12-month period and re-apply for Medicare part B, you will be charged a 10 percent increase in your premium. In other words, if you re-apply five years later, you will witness a 50 percent increase in your monthly premiums.

For more guidelines, read more at Medicare.gov.

Medicare Part A

Medicare part A is also known as hospital insurance. This insurance covers inpatient care such as those in hospitals, skilled nursing care, or hospice services. This service does not typically require a monthly premium. However, this will depend on your circumstances. If you receive part A, it is very likely that Medicare part B will also be required.

Medicare Part B

This insurance is also called medical insurance and covers medical care that is necessary in outpatient settings such as doctor’s offices. It also covers ambulance fees and durable medical equipment such as wheelchairs. It is aimed at diagnosing, treating, and preventing healthcare conditions. A part of the preventative services includes lab testing and the influenza vaccine. This insurance policy requires a monthly premium, which in 2017 was approximately $134 a month. However, if you also receive Social Security benefits, this premium is deducted from your income.

Medicare Part C

Part C is also called Medicare Advantage. Private insurance companies run your insurance policy and determine the amount of money you will receive to cover your health expenses monthly, regardless of whether it meets the cost of your services. In other words, your policy can determine you will only receive $200 a month for your health care, even if your health care is $500 a month. To apply for this insurance, you will need to be enrolled in part A and part C. You get several options, however. Your policy can be a Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), or a Medical Savings Account (MSA).

Medicare Part D

Medicare part D covers prescription drugs and also have a monthly premium like part B. However, there is a limited amount of money given to you for your prescription drugs. For example, in 2017 the limit was $3,700. If you reach that limit, you are required to cover the cost of your medication. If you have name-brand prescriptions, you are required to pay at most 40 percent of the plan’s cost. If you have generic prescriptions, you are required to pay 51 percent of the cost. However, it is important to note the coverage gap is expected to be phased out by 2020.

Retirement is a difficult topic to discuss when there are so many factors. However, with a basic understanding of how Medicare can help you with retirement, we hope this has given you a starting point. Medicare is important in maintaining your health in your older years. Your financial advisors can assist you in determining how Medicare fits into a retirement plan, which can ease your transition into retirement. Talk to your financial advisor today to determine which Medicare parts apply to you.

Genivity is here to help. We place emphasis on helping advisors with goal-based financial planning that incorporates health wealth factors to provide personalized reporting. Your health will greatly impact how you plan for retirement, and it is important you get that information in an easy to read manner! If you are interested in understanding how your health influences your retirement, ask your advisor for an assessment with Genivity’s HALO.

What you Need to Have on Hand to Enroll for Health Insurance

What you Need to Have on Hand to Enroll for Health Insurance

What You Need to Enroll Health Insurance 960x650 If you’re gearing up to enroll for health insurance coverage for next year, you may be wondering what steps you need to take, what information you need to have on hand and if there’s any prep to do before dialing in to a marketplace. With Open Enrollment beginning November 15, 2014 and stretching through February 15, 2015, here’s your guide to the documents and information necessary for purchasing a plan. 1. An overview of the Marketplace. Are you totally confused on what the Marketplace even is and how it works? Read up on the basics here before you get started. You can also purchase a health insurance plan directly through insurers or private exchanges. 2. Your desired plan. Even if you currently have health care coverage through healthcare.gov, you can change your plan for 2015. While the insurance plans are set to “default” to roll your current coverage into next year automatically, there is still plenty of time for you to change your current plan. All of the available options and plans will be made available on the marketplace in early November. 3. A healthcare.gov account. Before you are able to get down to the actual business of choosing and paying for a plan, you will need to log on to here and create an account to enroll. 4. Social security numbers. Time to dig out all of the kids’ social security numbers–just be sure to stash them in a safe place to avoid any identify theft. You will need the social security number for all members of the family you will be enrolling. 5. Most recent tax return. While you don’t have to wait for your 2014 taxes to be done, you will have to be as accurate as possible when reporting your estimated household income for 2015 when applying or renewing your insurance coverage. Taking a look at your household income last year can help you gauge how much you expect your income to change in 2015. 6. Employer information and income statements. For every wage-earner in the household, the government requires information on their employer along with income information, preferably from pay stubs or a W-2 form. 7. Immigration documentation. If you are a legal immigrant, you will need one of these immigration documents to enroll. 8. Current health insurance information. If you currently have health care coverage, you will need the notices from your current insurance provider, including policy ID numbers for all members who are enrolled. 9. Employer coverage form. Before you can apply for marketplace coverage, you need to fill out this employer coverage form to see what type of employer-based insurance you may be eligible for. You don’t have to accept any of the employer-based insurances, but you do have to fill out this form before doing anything else. 10. An employer contact. To properly fill out the employer coverage form in #9, you will need to know who handles the insurance coverage and information at your employer, or your partner’s employer. Set up a time to speak with them with the form in hand, or find out if you can email your questions to them directly. 11. A number for help. If you run into trouble along the application process or simply have a question that you can’t find an answer to online, you can call The Marketplace Help Number at 1-800-318-2596. 12. A timely reminder. If you want convenient email reminders or texts to your phone when it’s time to apply and for updates along the way, sign up with your information here. Give yourself plenty of time if it’s your first time applying for coverage. You can be fined if you do not have health insurance coverage. If you are in doubt or have put off enrolling in a plan, today’s the day to take a healthy — and legal! – – step forward for you and your family.
Do I Need Life Insurance?

Do I Need Life Insurance?

There are a few reasons why life insurance is a hard topic to bully yourself into considering. First, thinking about future money is difficult. Insurance-related vocabulary words tend to nudge the majority of us into a deep sleep.  Also, it’s hard to conceptualize the inevitable sequence of financial events that will occur after your demise — not just the funeral expenses, but also the unpaid student loan debt, the effect of your lost wages and, of course, the other inevitability: taxes. A way to force yourself through this thought experiment without your eyes glazing over is to consider the ultimate goal of life insurance: To provide income to your dependents in your absence. This single goal helps to define who needs life insurance and at what stage of life, as well as how much is needed.

Assess your life insurance needs by walking through these easy life stages.

Taking on debt The first form of debt that you will likely accumulate in life is student loan debt. If you are coming out of a degree program with a considerable amount of debt, you need to know that this debt will not just disappear. If you would like to avoid transferring your student loan burden to your family upon your untimely demise, consider a life insurance policy that covers the amount of your loans. Getting married If you are graduating from the single life and combining your financial affairs with another human, you need to consider how your death will affect your spouse. Will your spouse be dependent on your income in order to make ends meet? If so, you may want to consider life insurance to help your spouse manage expenses for the initial few years after your death or to potentially help your spouse go to back to school. Buying a house Consider a life insurance policy to cover your fixed-rate mortgage in order to help your family stay in your house in the event of your death.  This type of security can give them time to grieve and plan for the future. Having kids Adding to the family means adding to the pool of people who will be financially affected by your death. Consider a life insurance policy that would help your family manage until your children turn 18, and even help them pay for college. If there are people in your household who may not become independent at age 18, perhaps for reasons of mental or physical impairment, take this into account as well. Also weigh the possibility of aging parents needing to join the household. Planning for retirement If your kids are out of the house and your debt is paid off, do you still need a life insurance policy? Consider how many years you have until retirement, when a spouse would begin receiving support from social security. Also consider retirement goals and whether your spouse would be able to manage 20 to 30 years into retirement on your present savings.

If you’ve now identified yourself as someone in need of life insurance, what kind should you get?

According to the Insurance Information Institute, it’s important to know that there are two types and they differ significantly. Term life insurance is valuable if you have identified a specific period of time when you will need coverage, after which point you may not. Premiums tend to be lower. Permanent life insurance comes in four different varieties. Premiums tend to be higher but they can be beneficial because they can be used as a savings account and can be fixed (so they will not increase if you fall ill). In order to evaluate further after this primer, visit LifeHappens.org, a non-profit organization that provides calculators for your specific life insurance needs.
Next steps to take after an insurance claim is denied

Next steps to take after an insurance claim is denied

Medical Claim Denied 900x675 Whether attending a routine appointment or undergoing emergency surgery, many of us rely on health insurance to cover the bill. There are times, however, when insurance claims are denied, often for reasons unclear. According to the American Medical Association there are tens of millions of such denials each year. As it turns out then, having your claim rejected isn’t that unusual and there are steps you can take if your insurers decide not to pay out. The first thing to do after receiving a letter of denial is to check the details of your policy, particularly the small print. Your denial letter should include what’s called an ‘Explanation of Benefits,’ which tells you what your insurer paid and what they didn’t, typically with a reason why your claim was rejected. It’s important to check the insurer’s reasoning against the details of your policy. If there is a discrepancy, the next step is to call your health care provider’s billing office. Explain that the details in your denial letter do not match your policy. At this stage you should also check that your claim was coded correctly as in some cases denials are caused simply by the wrong claim code being used. If this is the case, ask the billing office to resubmit your claim using the correct code. If after speaking to the billing office you are still unsatisfied with your insurer’s decision, you can submit an internal appeal. This involves either filling out a form supplied by your insurer or sending a letter to your insurer outlining your argument along with any required evidence. Reasons for disputing your denial might include the use of an out-of-network provider (one not covered by your policy) because that provider is the only one in your area offering the services you require. Other reasons might refer to a specific prescription drug you have used or a certain part of your treatment for which your insurer requires further evidence. Bear in mind, you’ll need to send your appeal within 180 days of the denial. For services you have not yet received, your insurer has 30 days to respond to your claim while for services you have already received your insurer has 60 days. In the case of a medical emergency, insurers may respond within a few days. For more details on the process involved in appeal, have a look at the government’s Health Insurance Marketplace website. If your internal appeal is refused, you also have the right to request an external review. In some states, external reviews are conducted by independent review organizations while others will be overseen by the federal Department of Health and Human Services. Often, details on how to request an external review are included in your Explanation of Benefits, which is included with your denial letter. If not, contact your state’s insurance commissioner’s office. If your insurer is still refusing to pay out, and you feel strongly that your denial is unjustified, you can contact an attorney. Of course, taking legal action might not be worth the hassle for smaller claims and often the most prudent approach is to look for another insurer. Not all insurers are the same and some are more generous than others. When looking elsewhere, be sure to cross-check policy details and if in doubt, call up the insurer to clarify the cover on offer. Whether your claim is eventually paid or denied, you can always negotiate your portion of the medical bill, both with the insurer and the hospital billing department.  Many people don’t realize that medical bills are negotiable and prices for the same procedure vary wildly from doctor to doctor within the geographic region.  You can often get large bills down to a more reasonable rate but it is best to act quickly and arm yourself with the details of your procedure and your medical history to make your case.  If this sounds too intimidating, on’t be afraid to seek out the help of a medical billing advocate, a professional who can help you navigate the medical billing system.