Elder Law Newsletters
Some of the most important features of a long-term care insurance policy are the provisions relating to gatekeepers. Gatekeepers are the individuals who decide extremely important issues, such as whether a person is eligible to buy coverage and whether a policyholder's placement in long-term care is warranted.
Some Medicare enrollees choose to receive their services through private fee-for-service plans offered by private insurance companies. Although these plans differ from the Original Medicare Plan, enrollees are still part of the Medicare system. This article discusses how private fee-for-service plans work, what costs are involved for enrollees, and what services are covered.
There are many items that Original Medicare will not cover under either Part A hospitalization coverage or Part B medical insurance. These include routine care, such as annual medical checkups, eye examinations and corrective wear, dental work, and most immunizations. Items that are not medically reasonable or necessary are also excluded. Examples of these items include cosmetic surgery, private nurses, and personal conveniences. In addition to items that are not covered, Medicare beneficiaries must pay coinsurance, copayments, and deductibles, all of which increase their out-of-pocket costs and create a market for supplemental health insurance.
Due to divorce, teenage pregnancy, and many other factors, relatives, especially grandparents, are increasingly called upon to take care of children. Whether a formal, legal relationship or an informal one, this is known as kinship care.
In the insurance business, rebating is a practice whereby something of value is given to sell the policy that is not provided for in the policy itself. An example of rebating is when the prospective insurance buyer receives a refund of all or part of the commission for the insurance sale. Rebates can be made in the form of cash, gifts, services, payment of premiums, employment, or almost any other thing of value.