Mary the Medicare Lady Blog

Top 10 Ways to Retire Happy

Thu, 16 Apr 2026 14:42:26 GMT

For many people, retirement is something they look forward to for decades. It represents freedom from the daily grind, more time with family, and the opportunity to finally enjoy hobbies, travel, and personal interests. Yet many retirees discover that happiness in retirement doesn’t happen automatically. It requires planning, balance, and a willingness to adapt to a new phase of life.

The good news is that research and real-life experience show that happy retirees tend to share several common habits. Whether you are approaching retirement or already enjoying it, these strategies can help you make the most of your retirement years.

1) Take Care of Your Health

Your health becomes one of your most valuable assets in retirement. When you feel well physically, you have the energy to travel, spend time with loved ones, and enjoy your hobbies.

Simple habits can make a big difference. Regular exercise, even something as basic as walking each day, can improve heart health, strength, and balance. Eating nutritious foods, staying hydrated, and getting regular checkups are also important.

Preventive care and early treatment can help you stay active longer and avoid serious health problems down the road. Preventive care includes not only regular visits and screenings with your doctor, but also checkups for your eyes, ears, and teeth.

2) Stay Socially Connected

One of the biggest challenges retirees face is loneliness. When a career ends, the daily interactions with coworkers and clients often disappear as well.

Maintaining social connections is extremely important for both mental and emotional health. Spending time with family, meeting friends for lunch or coffee, participating in church activities, joining clubs, or volunteering in the community can help retirees stay connected and engaged.

For those who may not have family or friends living nearby, companionship can still come in many forms. Some retirees build friendships through hobby groups, community centers, or volunteer work. Others find meaningful companionship in a different way, through pets.

Pets can provide daily interaction, routine, and emotional comfort. Studies have shown that pet ownership can reduce stress, lower blood pressure, and even help combat feelings of loneliness.

Walking a dog or visiting a local dog park can also create opportunities to meet new people. Simply petting a purring cat on your lap can bring joy to your day.

Staying connected, to people or even a beloved pet, can make a tremendous difference in overall happiness during retirement.

3) Find a New Sense of Purpose

For many people, work provided structure, identity, and a feeling that they were contributing to something meaningful. When retirement begins, that sense of purpose can sometimes feel lost.

Happy retirees often replace that sense of purpose with new activities. Volunteering, mentoring younger people, serving on community boards, helping with charitable organizations, or even working part-time can create a renewed sense of fulfillment.

Having something meaningful to look forward to each day can dramatically improve overall happiness.

4) Keep Learning and Growing

Retirement is the perfect time to explore interests that you may not have had time for earlier in life. Learning new things keeps the mind sharp and makes life more interesting.

Some retirees take classes at local community colleges or senior centers. Others learn new hobbies such as painting, gardening, photography, or playing a musical instrument. Traveling and exploring new cultures can also be a great way to keep learning.

Keeping the brain engaged helps maintain cognitive health and adds excitement to everyday life.

5) Maintain Financial Confidence

Money itself doesn’t guarantee happiness, but financial stress can certainly reduce it. Having a clear understanding of your retirement income, expenses, and healthcare costs can provide peace of mind.

A solid retirement plan often includes Social Security, retirement savings, and strategies for handling healthcare costs such as Medicare premiums, prescriptions, and long-term care needs.

When retirees feel confident about their finances, they are much more likely to relax and enjoy the lifestyle they worked so hard to achieve.

6) Create a Flexible Daily Routine

One of the greatest joys of retirement is freedom. However, having absolutely no structure can sometimes lead to boredom or a lack of motivation.

Many happy retirees develop a flexible routine. They may exercise in the morning, volunteer a few days a week, meet friends regularly, or dedicate time to hobbies and projects.

A routine helps maintain a sense of productivity while still allowing the freedom that retirement provides.

7) Focus on Experiences Rather Than Possessions

Studies consistently show that experiences tend to bring more lasting happiness than material possessions. Traveling, spending time with grandchildren, attending events, or exploring new places often create memories that last a lifetime.

Retirement offers the opportunity to focus on these meaningful experiences. Even small adventures like day trips, nature walks, or attending local events can bring a lot of joy.

8) Simplify Your Life

Many retirees discover that simplifying their lives reduces stress and increases happiness. This might involve downsizing to a smaller home, reducing unnecessary expenses, or decluttering belongings accumulated over many years.

Simplification can free up time, money, and energy to focus on the things that truly matter—relationships, health, and meaningful activities.

9) Maintain a Positive Mindset

A positive outlook can make a tremendous difference in how retirement feels. Aging naturally brings changes but focusing on gratitude and the opportunities retirement provides can help maintain happiness.

Many retirees practice gratitude by appreciating the extra time they have with loved ones or the freedom to enjoy activities they once had to postpone.

Staying optimistic and adaptable helps people navigate life’s changes with resilience.

10) Plan for Healthcare and Future Needs

Healthcare can become one of the biggest concerns during retirement. Planning ahead for medical expenses, prescription drugs, and potential care needs can relieve a great deal of anxiety.

Understanding Medicare coverage, supplemental insurance options, and long-term care options can help retirees avoid unexpected financial surprises later in life.

When healthcare planning is in place, retirees often feel more confident about their future.

A Final Thought on a Happy Retirement

Retirement should be one of the most rewarding chapters of life. It’s a time to enjoy the freedom you worked so hard to achieve, spend meaningful time with the people (or pets) you love, and pursue the interests that bring you joy.

But a happy retirement doesn’t happen by accident. It comes from thoughtful planning, maintaining good health, nurturing relationships, and making informed decisions about your financial and healthcare future.

Understanding your retirement benefits, managing healthcare costs, and protecting the assets you’ve built over a lifetime can give you the confidence to truly enjoy these years.

When retirees feel informed and prepared, they are far more likely to relax and focus on what really matters—living well, staying active, and making the most of every day.

Non-Medical Home Care Plans: Paying for In-Home Help

Sat, 07 Mar 2026 06:00:00 GMT

Why Non-Medical Home Health Care Coverage Matters More Than You Think

Most people picture home health care as something that only follows a hospital stay or major medical event. In reality, many care needs begin quietly—without hospitalization, without surgery, and without warning. A fall that limits mobility, early cognitive decline, or difficulty managing daily tasks can quickly turn everyday life into a challenge.

Non-medical home health care insurance is designed to step in during these moments. It provides support when someone suffers a cognitive impairment or can no longer perform two of the six activities of daily living (ADLs)—and importantly, benefits can begin without requiring a hospital stay.

When Care Is Needed, but Not “Medical”

Non-medical home health care focuses on assistance with daily living rather than medical treatment. This type of care helps people remain safe and independent at home when they are no longer able to manage routine activities on their own.

These needs often arise gradually. Someone may struggle with bathing, dressing, or moving safely around the home. Others may experience memory loss or cognitive changes that make it difficult to manage medications, prepare meals, or handle basic household tasks. While these situations may not require hospitalization, they absolutely require care.

Without coverage in place, families are often left with limited options: paying out of pocket for help, relying heavily on unpaid family caregivers, or considering institutional care sooner than they would like.

Understanding Activities of Daily Living (ADLs)

Most non-medical home health care policies use activities of daily living as a trigger for benefits. The six commonly recognized ADLs include:

Bathing
Dressing
Eating
Transferring (moving in and out of bed or chairs)
Toileting
Continence

When an individual is unable to perform two or more of these activities without assistance, benefits may become available. This structure recognizes that meaningful care needs exist well before someone becomes severely ill or hospitalized.

In addition to ADLs, cognitive impairment—such as memory loss, confusion, or diminished judgment—will also qualify someone for benefits, even if they are physically capable of performing daily tasks.

No Hospital Stay Required

One of the most important features of non-medical home health care coverage is that benefits do not depend on a hospital stay. This reflects how care needs actually develop in real life.

Cognitive decline, balance issues, or loss of strength often occur gradually. Waiting for a hospital admission before coverage begins leaves many people without help when they need it most. Non-medical home health policies recognize that early support can prevent accidents, reduce stress, and help individuals remain safely at home longer.

How Non-Medical Home Health Benefits Are Used

Benefits from these policies are typically paid directly to the policyholder. This flexibility allows individuals and families to arrange care that fits their unique situation.

Benefits may be used for services such as:

Assistance with personal care, including bathing and dressing
Help with meal preparation and light housekeeping
Supervision and support for individuals with cognitive impairment
Companionship and safety monitoring
Support that allows family caregivers to take needed breaks

Because the care is non-medical, it focuses on quality of life, safety, and independence rather than clinical treatment.

The Impact on Families

When non-medical care needs arise, family members often step in by default. Spouses, adult children, and relatives may find themselves providing daily assistance while juggling work, finances, and their own health.

Over time, this can lead to caregiver burnout, lost income, and emotional strain. Having coverage in place helps relieve some of this pressure by making professional care more accessible and affordable. Even a few hours of paid help each day can make a significant difference for both the individual receiving care and their family.

Affordable Protection for Real-Life Needs

Non-medical home health care policies are typically more affordable than traditional long-term care insurance and often involve simplified underwriting. Many plans require only a few health questions and no medical exams, making coverage accessible to a wider range of people.

Because these policies focus on short-term or limited-duration benefits, they are designed to provide meaningful support without a long-term financial commitment. For many individuals, this makes non-medical home health coverage a practical and realistic planning option. An 81 year old woman can get a plan that will give her home health benefits of $50/day plus a $3500 lump sum caregiver benefit for $73.49/month.

Preserving Independence and Dignity

Most people want to remain in their homes for as long as possible. Non-medical home health care coverage supports that goal by providing help early—before a crisis forces difficult decisions.

By addressing care needs related to cognitive decline or difficulty with daily activities, these policies help individuals maintain dignity, comfort, and control over their daily lives. Early support can also reduce the likelihood of falls, accidents, and unnecessary institutional care.

Planning Ahead Makes All the Difference

The time to think about non-medical home health care is before it’s needed. Once cognitive impairment or functional limitations arise, options become more limited.

Non-medical home health insurance is not meant to replace comprehensive long-term care planning, but it can play a valuable role in filling the gap between medical insurance and out-of-pocket caregiving costs. It provides peace of mind knowing that help can be available when daily tasks become difficult—without requiring a hospital stay or major medical event.

A Thoughtful Next Step

If you’re under the age of 85 and staying independent at home matters to you—or if you’re concerned about how cognitive decline or loss of daily function could affect your family—it may be worth learning more about non-medical home health care coverage.

A short conversation with an independent, knowledgeable advisor can help you understand how these policies work and whether they fit into your overall planning. Exploring your options now can help ensure that support is available when everyday tasks are no longer so simple.

For families in Nebraska who are beginning to explore care options, working with a trusted, local provider can make all the difference. AmanaCare is a faith-based, non-medical home care provider serving communities across Nebraska, helping individuals remain safely at home while receiving compassionate, personalized support. Our team walks alongside families to help them understand their options and build a care plan that fits their unique situation.Learn more at: www.amana-care.com

Frequently Asked Questions:

What is non-medical home health care?

Non-medical home care provides assistance with everyday activities such as bathing, dressing, meal preparation, light housekeeping, transportation, and companionship. These services help seniors remain safely in their homes while maintaining independence.

Does Medicare pay for non-medical home care?

No. Medicare generally only covers short-term skilled medical care at home, such as nursing or physical therapy. It does not pay for long-term assistance with daily living activities like bathing, cooking, or housekeeping.

What services are included in non-medical home care?

Non-medical home care services often include personal care, medication reminders, meal preparation, transportation to appointments, light housekeeping, and companionship.

Who typically needs non-medical home care?

Seniors who want to remain independent at home but need help with daily tasks often benefit from non-medical home care. It can also support individuals recovering from illness or those whose family caregivers need additional help.

How can seniors pay for non-medical home care?

Seniors often pay for non-medical home care through personal savings, long-term care insurance, Medicaid (for those who qualify), or specialized insurance plans designed to help cover in-home assistance.

Is non-medical home care the same as home health care?

No. Home health care involves medical services provided by licensed professionals such as nurses or therapists. Non-medical home care focuses on daily living assistance and personal support.

Hospital Indemnity Plans Fill Coverage Gaps

Mon, 29 Dec 2025 16:40:54 GMT

Hospital Indemnity Plans: The Quiet Safety Net Filling America’s Growing Coverage Gaps

As healthcare costs continue to rise and insurance plans shift more financial responsibility onto patients, a once-overlooked product is stepping back into the spotlight: hospital indemnity insurance. Long regarded as a supplemental add-on rather than a core piece of coverage, these plans are increasingly being used by both seniors and those under age 65 who are looking for predictable protection from unpredictable hospital bills.

Hospital indemnity plans—sometimes called “fixed indemnity” or “hospital cash” plans—provide a simple promise: if you are hospitalized, the insurer pays you a set amount of cash. Unlike major medical insurance, which reimburses healthcare providers directly, hospital indemnity plans pay the policyholder. The benefit can then be used for anything—medical bills, transportation, lost income, childcare, or even household expenses that pile up when illness disrupts daily life. This flexibility is one reason the product is finding renewed popularity.

A Response to Rising Out-of-Pocket Costs

Deductibles and coinsurance requirements have grown at a pace many Americans find hard to manage. Meanwhile, many Medicare Advantage plans, while offering robust benefits, still impose copays on hospital stays. For individuals living on fixed incomes—or families trying to maintain financial stability—these unforeseen costs can quickly lead to debt.

Straightforward Structure, Flexible Use

The simplicity of hospital indemnity plans is part of their appeal. Policyholders often know exactly what they will receive if certain conditions are met. A three-day hospital stay means three days of benefits. A trip to the emergency room may be eligible for a separate payment. Because compensation is based on a fixed schedule rather than actual charges, there is no complicated billing process or worry about whether the claim will be deemed medically necessary by an insurer.

Consumers increasingly appreciate this predictability. Indemnity payments can be used for many of these expenses, making them distinct from traditional health insurance, which only applies to medical costs.

Partnership With Major Medical Plans

Hospital indemnity insurance is not meant to replace comprehensive health coverage. Instead, it works as a complement, especially for those with high-deductible health plans (HDHPs), employer plans, or Medicare Advantage plans. Brokers have specialized quoting tools that can help “fill the gaps” left by your insurance.

For example, a Medicare Advantage enrollee might face a daily hospital copay of $500 for the first five days of an inpatient stay. A hospital indemnity plan may offer a daily benefit of $500, effectively neutralizing the out-of-pocket exposure. Some plans can also cover ambulance services or observation stays—often areas where costs catch patients off guard.

Younger adults, too, are purchasing indemnity plans to offset the steep deductibles that come with many marketplace and employer-sponsored health plans. A serious illness or accident early in the year can force them to meet the full deductible before insurance pays. A supplemental plan can soften that financial blow.

Affordability is a Key Reason for the Popularity of Hospital Indemnity Plans

Independent insurance brokers note a surge in demand, especially during the Medicare Annual Election Period. As consumers compare plan options, many discover they are comfortable with their Medicare Advantage $0 or low monthly premiums, but uneasy with potential hospitalization charges. Hospital indemnity coverage has become a practical, affordable add-on.

Most plans cost significantly less per month than major medical insurance, often ranging anywhere from $30 to $60 depending on age and benefit level. For many households, that cost feels manageable compared to the risk of an unexpected $3,000 hospital bill.

Hospital Indemnity plans can be purchased any time of the year and do not have any special election periods.

Guaranteed Issue

One of the lesser-known advantages of hospital indemnity plans is the availability of guaranteed-issue plans, which require no medical underwriting. Several carriers allow applicants to enroll without answering health questions, and many offer guaranteed-issue eligibility up to age 79. This makes the plans accessible to older adults, individuals with chronic conditions, and consumers who may not qualify for other forms of supplemental insurance. For those who have been declined for life or health products before, guaranteed-issue hospital indemnity plans provide a rare opportunity to secure meaningful financial protection.

Limitations and Misconceptions

Despite their benefits, hospital indemnity plans are sometimes misunderstood. They do not cover routine medical care, doctor visits, or prescription drugs. They also do not act as substitutes for major medical insurance—something that regulators emphasize regularly. These plans pay fixed amounts, not actual costs, which means a large bill could still leave a policyholder financially strained.

Consumers are encouraged to read the fine print carefully. Some plans impose waiting periods on pre-existing conditions.

A Growing Role in America’s Healthcare Landscape

As the healthcare system evolves, so do the tools consumers use to navigate it. Hospital indemnity plans have become a key part of the supplemental insurance landscape, offering simple, predictable benefits at a time when medical cost-sharing grows increasingly complex. Their straightforward structure makes them appealing across demographics—from younger families enrolled in high-deductible plans to seniors who want added protection alongside Medicare Advantage.

Not connected with or endorsed by the U.S. government or the federal Medicare program. Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. See www.hiattagency.com or contact licensed independent agent mary [at] hiattagency [dot] com or call or text 402 672 9449 for more information.

Changes to 2026 Medicare Advantage Plans and Access to Drug Plans

Mon, 29 Dec 2025 16:37:07 GMT

Independent Insurance Agents spend countless hours preparing for the Annual Election Period to help their clients. They attend carrier rollouts and learn about the new plans changes for the year ahead. Agents are not allowed to charge for their services; they work for free and then earn a commission when helping Medicare beneficiaries enroll in plans. Considering the time and investment independent agents make in their business, they don’t earn high commissions on their valuable work for seniors.

Independent Agents are dealing with unprecedented changes trying to help their clients with Drug plan reviews or Medicare Advantage plan reviews. Almost all Drug Plans have gone non-commissionable, and effective Nov 9^th, a major Drug plan has removed its plans from all quoting platforms except Medicare.gov. This has severely crippled agents’ ability to help their clients, some agents have quit helping even their Medicare Supplement clients with Drug plan reviews.

Some Medicare Advantage plans have gone non-commissionable in 2026. They filed their plans with CMS - Center for Medicare and Medicaid Services as if they were going to be paying commissions on them and then pulled the commissions. They essentially are saying that they do not want more business. This has made it very difficult for independent agents to help their clients. It’s sort of like tip toeing through landmines difficult.

There are not enough SHIP agents to help all the non-technical savvy seniors who need help with their plans. If you want to help agents help you, please see the contact information at the end of this article and request that Nebraska follow other states that are issuing cease and desist orders and raising awareness for these unfair trade practices.

Stand Alone Prescription Drug Plan Important Changes

Premiums and formularies change. If you don’t review your drug plan between Oct 15-Dec 7^th, you won’t get another chance until the next Annual Election Period.

Drugs expected to have lower pricing in 2026:

Eliquis, Xarelto, Januvia, Jardiance, Farxiga, Enbrel, Stelara, Imbruvica.

Entresto - there’s a generic available for this now, called sacubitril/valsartan, but as of this writing not all drug formularies have it loaded into their systems.

Fiasp and NovoLog: Insulin will still be at the $35 copay, IF the Drug or Medicare Advantage plan has it on their formulary.

The maximum allowable Part D deductible will be $615, up from $590 in 2025. However, some Part D plans will have lower deductibles or none. This is where having a knowledgeable agent can help you get the right plan based on what your annual expenses would be for both your premiums and the costs of your prescriptions. You could possibly get on a Drug plan or Medicare Advantage plan that caps your Drug maximum out of pocket at far less than the $2100 if you get on the right plan.

Prescription Payment Plan: In case you missed it last year, Medicare enrollees in Part D prescription plans and Medicare Advantage plans with prescription coverage have the option to pay out-of-pocket costs in monthly installments rather than all at once at a pharmacy. This means a $2,100 bill in January becomes a $175-a-month payment through the Medicare Prescription Payment Plan.

If you were already in the payment plan, you’ll be reenrolled automatically unless you opt out or change to a new Part D or Medicare Advantage plan. If you do change plans and want to continue a payment plan, just contact your new drug plan. It’s best to do this before you fill your first prescriptions on the new plan. Neither your pharmacy nor your agent can help you with this, you must call the number on your card.

Medicare Advantage Plan Important Changes

Some Medicare Advantage plans have left the market. If your plan has left the market, you will be without insurance coverage in 2026 unless you pick a new plan. When a Medicare Advantage plan leaves the market, you have 2 options: Pick a new Medicare Advantage plan, or you will have guaranteed issue into a Medicare supplement plan and then you can pair it with a Drug plan, and Dental and Vision plans if desired.

2026 NE Plan/Contract Terminations (all counties)

SmartFit HMO-POS (H7149-009)

Value Plus HMO-POS (H7149-008)

Enhanced Select PPO (1608-082)

Service Area Reductions:

Signature HMO-POS (H7149-001): 6 COUNTIES EXITED- Burt, Cuming, Dodge, Otoe, Jefferson & Washington

Signature PPO (H1608-012): 6 COUNTIES EXITED Burt, Dixon, Holt, Otoe, Saunders & Washington

Signature Extra PPO (1608-038): 6 COUNTIES EXITED: Burt, Dixon, Holt, Otoe, Saunders & Washington

There is an HMO-POS Medicare Advantage plan that is now requiring a referral to see specialists. Even if those specialists are in network and you’re already seeing them. Again, review with your local independent agent, or check your Annual Notice of Change carefully.

A Medicare Advantage plan has expanded into the Omaha metro starting in 2026. It is a PPO plan, and CHI is its first major network. This Medicare Advantage company is a privately owned company that historically has had star ratings at or above the industry average. (CMS uses a 5-star quality rating system.)

Grocery and Utility benefit for DSNP- Dual Special Needs Clients

Per CMS, Medicare Advantage plans are no longer able to offer Grocery and Utility benefit to DSNP- Dual Special Needs Clients UNLESS the beneficiary has one of the SSBCI Conditions -Supplemental Special Benefits for Chronically Ill. Please work with your agent to make sure you still qualify.

Many Medicare Advantage Plans have eliminated or reduced the non-Medicare ancillary benefits.

Remember that if you’re on a Medicare Advantage plan already, and you missed important changes to your plan, you have an Open Enrollment Period from Jan 1^st through March 31^st to make a one-time plan change effective the first of the following month. Medicare Advantage beneficiaries with qualifying Chronic Conditions can make changes any time of the year.

Medigap- Medicare Supplement Plan Changes

Please remember that you can shop for a Medigap plan any time of the year, but in Nebraska, underwriting questions will be asked unless you’re Guaranteed Issue – turning 65, leaving a qualified group health plan, or your Medicare Advantage plan exits the market. Some beneficiaries might have to consider a Plan N, High Deductible G, or Innovative G to keep premium costs down.

Part B

Nothing has been officially announced yet, but speculation is that the Part B premium will rise from $185 to $206.50. With that, the Part B deductible is likely to rise. And of course IRMAA (Income Related Monthly Adjustment Amount for high income earners)

Protecting Choice Through Independent Guidance-How You can help

The Idaho Department of Insurance (DOI) issued emergency cease-and-desist orders to at least two major carriers. These insurers are accused of deliberately limiting access to MA applications (both online and paper) and withholding or eliminating broker commissions for new enrollments even though those commissions were built into approved premium rates. At the time of this writing, several other states have followed Idaho’s lead.

Medicare exists to ensure older adults and people with disabilities can access health care without undue financial hardship. When distribution changes make coverage harder to compare or remove the people who help seniors make informed choices, the program’s promise erodes. Seniors shouldn’t have to become health policy experts to secure the care and medications they need. Restoring transparent choices and reliable counseling isn’t just a market nicety — it’s a matter of equity and dignity.

If you believe in fair trade for your Medicare options, please write or call the Nebraska Department of Insurance at 1526 K St Suite 200, Lincoln, NE 68508 or call (402) 471-2201. Tell them Mary the Medicare Lady sent you.

Best Insurance Broker in Papillion!

Thu, 09 Oct 2025 12:33:10 GMT

Honored to Be Named Best Insurance Broker in Papillion by BusinessRate!

I’m truly grateful to share that I’ve been recognized as the Best Insurance Broker in Papillion by BusinessRate — an award determined by recent, verified client reviews.BusinessRate’s award process uses relative comparisons: Ensuring local, small-town businesses aren’t compared to big-city chains. Their rankings focus on recency, reliability, and real local impact — ensuring that the recognition truly reflects the experiences clients have today. This honor wouldn’t be possible without my amazing clients who continue to place their trust in me. Your feedback, referrals, and support inspire me every day to provide honest guidance and exceptional service. I’ll keep doing what I love — helping people navigate Medicare options with clarity and confidence, and finding coverage that fits their needs and budget. Thank you for your continued trust!

#BestInPapillion #InsuranceBroker #MedicareAdvisor #ClientTrust #LocalRecognition #Gratitude #BusinessRate

Why Work with an Independent Agent for Medicare

Wed, 01 Oct 2025 12:46:13 GMT

Reasons to Work with a Local, Independent Licensed Agent for Medicare

It’s that time of year again—the Medicare Annual Election Period. Between the commercials, mailings, and endless chatter on social media, it can all feel overwhelming. The good news? You don’t have to figure it out alone.

Here are some reasons why so many people love working with a local, independent licensed agent:

Independent & Unbiased Advice

Independent agents work for you—not the insurance companies.
There is no fee for their services, and your cost is the same whether you use an agent or not.
Commissions are generally the same across plans, and some plans (like certain prescription drug plans) pay no commission at all—yet if you have a dedicated agent for your Medicare supplement they may still help you enroll in a drug plan if it’s the right fit.
Tax dollars are not used to run an independent agent’s office.

Trained & Certified

Agents must first earn a state Life & Health Insurance license before they even navigate towards Medicare.
They complete regular Continuing Education and Ethics training to keep that license active.
Each year, agents must pass a national Medicare exam (such as AHIP or NABIP)
Each year they spend additional hours certifying with each carrier they represent.
They attend ongoing trainings, webinars, and local meetings to stay on top of plan changes.

Local Expertise & Advocacy

Independent agents know the plans in your local market and have direct contacts with carrier representatives—so they can advocate for you if issues come up.
They’ll alert you to important changes in your plan. For Example: last year a carrier dropped dental coverage beyond cleanings and exams—clients without an agent didn’t realize that until they were at the Dentist’s office facing big bills.
They’ll screen for financial assistance qualifications and direct you to proper organizations.
They’re members of your local community and support Chambers of Commerce and other civic organizations.

Annual Medicare Reviews

Each year, your agent reviews your prescriptions, doctors, health needs, and budget to make sure you’re still on the best plan.
You’ll talk to the same agent every year—someone who knows you personally and understands your medical and financial history.

Enrollment Beyond Medicare Plans

Agents can enroll you in the Medicare Supplement/Medigap, Medicare Drug, or Medicare Advantage plans that you want, and also help you protect any gaps with:

Dental, Vision, and Hearing plans
Hospital Indemnity coverage
And more—depending on your needs

Protection & Professionalism

Agents carry Errors & Omissions insurance to protect both you and themselves.
They use specialized software to compare plan pricing, rate history, and loss ratios so you can make an informed choice.
They know about the yearly changes from CMS (Center for Medicaid and Medicare Services) and how to navigate them.
They’re members of Professional Organizations and Facebook groups and help support and educate each other.

Convenience & Personal Service

Schedule appointments in person, by phone, or over Zoom—whatever works best for you.
Agents can even speak with your doctor or dentist’s office on your behalf if issues arise.
They’ll remind you to use the ancillary benefits your plan includes.
They keep track of when it’s time for you to review all of your coverages, not just Medicare.

Finding the Right Agent

There are plenty of experienced, independent agents in your area—you just need to find the one that feels like the best fit.

Tip: When choosing an agent, make sure they show you their computer screen and can provide an estimate of your annual prescription costs on different plans. This feature isn’t always available on public quoting sites, but good agents have the tools to do it.

The Bottom Line

Medicare is complex, but you don’t have to navigate it alone. A local, independent licensed agent can make sure you’re informed, protected, and confident in your coverage not only at the Annual Election Period, but throughout the year.

If you’d like a free review of your Medicare options, reach out to a local independent agent this Annual Election Period. You’ll be glad you did.

Mary Hiatt is a Retirement & Insurance Advisor and President of Mary the Medicare Lady (A non-government entity.) She is Certified in Long Term Care Programs, Policies, & Partnerships and Annuities. She offers Educational Workshops on Medicare, Long Term Care and more at no charge. She helps retirees convert their 401Ks and IRA’s into guaranteed income streams as well as helping clients get Medicaid with eligible spend-down plans and Funeral Expense Trusts. Not connected with or endorsed by the U.S. government or the federal Medicare program. Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. See www.hiattagency.com or contact licensed independent agent mary [at] hiattagency [dot] com or call or text 402 672 9449 for more information.

Shop Medicare Supplement / Medigap Plans in Omaha Nebraska area

Mon, 01 Sep 2025 05:00:00 GMT

Did you know that you can shop for a Medicare Supplement/Medigap policy any time of the year and possibly get a better price?

You might be thinking, “But my policy with XYZ company has paid for everything and I’ve never had a problem.” Yes, and that’s exactly how ALL Medigap policies work!

Medigap policies are standardized and must follow federal and state laws designed to protect you. These plans are named by letters, such as F, G or N. All plans with the same letter offer the same basic benefits, no matter which company you buy the policy from. The only difference is price.

For example, when you have a Medigap Plan G, your claim goes to Medicare, Medicare determines if it’s a covered service and what they’ll pay. Medicare pays 80% of the approved amount, and your Medigap plan pays 20%, after you’ve paid your $257 annual deductible. That’s it. The insurance company doesn’t decide what’s covered, Medicare does.

The cost of Medigap policies can vary widely depending on the insurance company, the plan, and where you live. So, should you just choose the cheapest option? Not necessarily.

When shopping for a Medigap policy, work with an experienced and independent agent to consider the company’s

-number of years they’ve offered this plan in your state

-number of lives on this plan

-history of price increases

-loss ratio. The minimum required loss ratio for Medicare Supplement is 65%, but you’ll see most companies in the 75-95% range.

Guaranteed Issue

In some cases, an insurance company must sell you a Medigap, even if you have health issues. You’re guaranteed the right to buy a Medigap policy when:

- you’re in your Medigap Open Enrollment Period (Turning 65)

- you’re Medicare eligible and you’ve lost group health coverage

- if your Medicare Advantage plan leaves the market

- if you qualified for Medicare Advantage “Trial Right” and wish to return to Original Medicare

If you buy a Medigap policy when you have a guaranteed issue right, the insurance company must cover all your pre-existing health conditions without a waiting period.

Switching Medigap Policies

Outside of these periods, you can still apply to change Medigap policies, but you’ll go through underwriting and could be denied based on your health history. So why do people switch? Usually, to save money.

A common misconception is that people think they got a price increase because they used their plan. Price hikes are typically due to rising costs and aging policyholders in the company’s risk pool.

The Leading Medigap Plans and their differences According to KFF.org*

Plan F has the second largest share of Medigap enrollment, covering 36% of Medigap policyholders. Plan F can no longer be sold to new beneficiaries who turned 65 on or after January 1, 2020 due to a change in law (Plan C also is no longer available as of that date because it also covered the Part B deductible)

In 2025, the Part B deductible is $257. Most folks on Plan F are going to be paying far more than $257 annually in premiums to avoid paying that deductible. So, if you think you can pass underwriting, it’s a good idea to see if you can save money with Plan G or Plan N. “But my policy with XYZ company has paid for everything and I’ve never had a problem.” Yes, and that’s exactly how ALL Medigap policies work! (Have you heard this somewhere before?) The only difference is price.

Plan G is the most popular Medigap policy, accounting for 39% of all policyholders, Plan G is the most comprehensive policy available to new policyholders, covering the Part A deductible and all cost sharing for Part A and B covered services, but not the Part B deductible.

Plan N has the third largest share of Medigap enrollment, but at a much smaller percentage, only 10%. Plan N is similar to Plan G, except that there are Part B copayments for some office visits and some emergency room visits, and it does not cover Part B excess charges.

If the amount a doctor or other health care provider is legally permitted to charge is higher than the Medicare approved amount, the difference is called the excess charge. The excess charges are currently capped at $20 for a doctor visit and $50 for a visit to the emergency room. Certain services may result in higher out-of-pocket costs. Plan N would also be subject to excess charges from providers who do not accept Medicare. This means you may face an additional charge of up to 15% more than the Medicare-approved charge. Depending on what part of the country you live in, Oncologists, Endocrinologists, Pain Management Docs, Ophthalmologists, Psychotherapists, and Physical Therapy are all providers that tend to charge the extra 15%, which can be many thousands of dollars annually.

Another Option: Innovative Plan G

A popular alternative for those who want to keep their lifetime of premium increases in check is the Innovative Plan G. This plan is currently offered by only one company. It acts like a High-Deductible Plan G the first 3 calendar years with lower premiums and then converts to a Plan G at the 1^st of the 3^rd calendar year. But all future price increases are based on that lower rate. As an added safety measure, the Deductible Discount Rider can be removed from the policy at any time prior to the deductible elimination date. (Effective the 1^st of the following month.) At that time the benefits will be that of Plan G at the current Plan G premium.

Thinking of Shopping for a New Policy?

It’s smart to check prices if:

-You’re on a Plan F and in good health

-Your current insurer has had large price increases

-You want to avoid being in a closed risk pool

Just keep in mind that underwriting applies unless you qualify for guaranteed issue. The carrier will run a prescription drug and health data check before approving your application. You can view sample health questions at www.hiattagency.com

A Word of Caution

Recently, two companies, Ace and Allstate, announced that they are exiting the Medigap market. If you’re already with either of them, you can keep your policy, but your risk pool is now closed. This could mean higher rate increases down the road.

*Author’s Note: None of my clients are on either of those plans because I had concerns with these companies being too new to the Medigap market. I recommend waiting until a carrier has at least 5 years of experience offering Medigap in your state.

*https://www.kff.org/medicare/issue-brief/key-facts-about-medigap-enrollment-and-premiums-for-medicare-beneficiaries/

What's in the One Big Beautiful Bill?

Fri, 01 Aug 2025 14:07:34 GMT

The One Big Beautiful Bill Act

OBBBA has passed. What’s in it?

It’s difficult to find non-partisan interpretations of what’s in this bill. It’s difficult to see the misinformation that has been floating around that Medicare and Social Security are ending. Medicare and Social Security are NOT ending. However, Medicaid WILL have stricter requirements.

This is a summary of various articles that touch on issues that affect senior citizens. Some of you are working while others are retired, some own businesses, some are high net worth while others are on Medicaid, some have started collecting Social Security, and others are waiting to start collecting.

For those still working

Medicare Part A

Prior to this Bill, if someone was participating in a Health Savings Account and continued to contribute to it past Age 65, they would get a penalty. Now they will be able to continue to contribute to their HAS without penalty. See https://www.kiplinger.com/retirement/medicare/changes-to-medicare-in-the-one-big-beautiful-bill-act.

No tax on overtime or tips

The deduction for tips is limited to $25,000 per year, while the deduction for overtime is limited to $12,500 per year ($25,000 if a joint return is filed). Additionally, both deductions are phased out for workers with modified adjusted gross income more than $150,000 ($300,000 for a joint return.) See https://www.theemployerreport.com/2025/07/senate-passes-no-tax-on-tips-and-overtime-provisions/

For Business Owners

The Section 199A deduction for small businesses is expanded; and incentives are reinstated, such as 100% immediate expensing for machinery, equipment and R&D expenses and allowing full expensing for new factories (to encourage domestic manufacturing).

Social Security

According to the 7/3/25 Press release by Social Security: The bill ensures that nearly 90% of Social Security beneficiaries will no longer pay federal income taxes on their benefits, providing meaningful and immediate relief to seniors who have spent a lifetime contributing to our nation's economy. See https://www.ssa.gov/news/press/releases/2025/?utm_content=pressrelease&utm_medium=email&utm_source=govdelivery#2025-07-03

However, you are still going to see taxes come out of your Social Security check unless of course you request that they no longer take taxes out. According to AARP, the targeted tax relief for older adults will come in the form of a $6,000 “bonus” deduction that could offset federal taxes on Social Security benefits for some.

The full deduction is available to taxpayers age 65 and older with a modified gross adjusted income (MAGI) of up to $75,000 for an individual filer and $150,000 for a couple filing jointly. (Each spouse can take the deduction, for a total of $12,000, if both are 65-plus.)

The deduction is reduced for higher earners, up to $175,000 for a single filer and $250,000 for a couple. Above those thresholds, you don’t qualify.

You can claim this new deduction even if you otherwise itemize deductions on your tax return. If you don’t, you can add it to the existing standard deduction, which is already higher for taxpayers 65 and older. But you’ll be able to do so only for the next four years — the bonus deduction is set to expire in 2029. See

https://www.aarp.org/government-elections/budget-bill-older-americans.html

Medicaid

This bill eliminates benefits for an estimated 1.4 million undocumented immigrants. See https://www.whitehouse.gov/articles/2025/06/50-wins-in-the-one-big-beautiful-bill/

To be eligible for Medicaid, there will be new “community engagement requirements” of at least 80 hours per month of work, education or service for able-bodied adults without dependents. One source says the new requirements would begin on Dec. 31, 2026. Another source says the new requirement would not kick in until Jan. 1, 2029. People would also have to verify their eligibility for the program twice a year, rather than just once.

The resulting cut in Federal funding over 10 years is estimated to total $700 billion. See

https://www.pbs.org/newshour/politics/house-republicans-narrowly-passed-trumps-big-beautiful-bill-heres-what-in-it and https://apnews.com/article/big-beautiful-bill-trump-tax-cuts-medicaid-00ce1ff8a7b7fea7a894d38398748c6b

Supplemental Nutrition Assistance Program (SNAP) (Food Stamps)

Starting in fiscal 2028, States would shoulder 5% of benefit costs, and 75% of the administrative costs. Currently, states pay none of the benefit and half of the administration costs.

This bill expands the work requirements to receive food aid. Under current law, able-bodied adults without dependents must fulfill work requirements until they are 54, and that would change to age 64. (Also, some parents are currently exempt from work requirements until their children are 18; that would change so only those caring for a dependent child under the age of 7 are exempt.)

The resulting cut in Federal funding over 10 years is estimated to total $267 billion. See https://apnews.com/article/big-beautiful-bill-trump-tax-cuts-medicaid-00ce1ff8a7b7fea7a894d38398748c6b

Other Tax provisions

The Tax Cuts and Jobs Act that was passed in 2017 was scheduled to sunset at the end of 2025. This has been permanently extended and maintains the current top income tax rate of 37%.

See https://taxfoundation.org/research/all/federal/big-beautiful-bill-house-gop-tax-plan/

Increase in the Standard deduction threshold. In addition to the $6,000 increase for seniors, there’s a $1000 increase for individuals and $2000 increase for married filing jointly.

Auto loans for U.S. made vehicles allows for a tax deduction of up to $10,000 in interest, this expires in 2029.

The State and Local Tax (Salt) Deduction was raised from $10,000 to $40,000; and an increased estate tax exemption from $13.99 million to $15 million for individuals and from $27.98 to $30 million for those married filing jointly.

Depending on your financial situation, everyone will interpret the changes that are coming differently. Stay healthy, stay strong, and stay informed from reliable sources on the subjects that matter the most to you. And remember that you don’t have to do this alone, reach out to trusted partners and experts in your areas of concern.

The links to the sources for this article will be live on the blog page at www.hiattagency.com

This summary is provided for general informational purposes only and is not all-inclusive of the nearly 1,000 page bill. Please talk with your Accountant and Financial Advisor for more details. The information was obtained from sources considered reliable but not guaranteed to be accurate.

Mary Hiatt is a Retirement & Insurance Advisor and President of Mary the Medicare Lady (A

non-government entity.) She is Certified in Long Term Care Programs, Policies, & Partnerships and Annuities. She offers Educational Workshops on Medicare, Long Term Care and more at no charge. She offers eligible spend-down plans and works with reputable estate planning Attorneys to help her clients get Medicaid. Not connected with or endorsed by the U.S. government or the federal Medicare program. Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. See www.hiattagency.com or contact licensed independent agent mary [at] hiattagency [dot] com or call or text 402 672 9449 for more information.

Medicare Does Not Cover Long Term Care Part 5

Thu, 03 Jul 2025 11:42:30 GMT

This Article is the 5^th and Final in a Series on “Medicare Does Not Cover Long-Term Care after 100 Days”

The last article focused on ways to qualify for Medicaid to pay for Long Term Care (LTC).

At the opposite end of the spectrum are those who can afford to self-pay for their LTC with income, savings, and/or investments. In addition, they may be able to afford to purchase traditional LTC insurance via monthly premiums or roll over investments to a plan to help protect them if they’re not sure if they have enough to pay for their longevity and they want to avoid Medicaid at all costs.

This article focuses on the majority who fall between the extremes of poor and affluent. Those who have a modest amount of personal assets worth preserving but not enough to pay for long-term care services out of pocket. They can rollover some investments or afford the monthly premiums to buy a policy providing moderate coverage but not a full-bodied product with unlimited lifetime benefits. They are not averse to applying for Medicaid if necessary, especially if they can preserve some if not all of their personal assets in the process.

A smart approach to use for those who are not able to fully fund their LTC are Partnership Programs. The program’s goal is to encourage consumers to purchase affordable long-term care insurance (LTCI) policies and to shift financial responsibility to Insurers and reduce the burden on state Medicaid programs. Partnership-qualified LTC policies generally have limited lifetime maximums; $100,000 to $300,000 is typical. In a partnership plan, the LTC policy helps with the self-pay requirements of most LTC facilities. Long Term Care facilities typically require anywhere from 12 to 36 months of self-pay before they will accept Medicaid as payment. It can also make sense to match the policy’s total benefits to the amount of assets the insured wants to pass on to heirs.

The key benefit is the applicant can keep assets equal to the policy’s paid benefits. These assets are exempt from Medicaid estate recovery upon the insured’s death.

If the insured requires long-term care services, the LTC policy pays out its benefits. Then, if the insured continues to need care after the policy’s benefits are exhausted (or the cost of his or her care exceeds the policy’s benefit level), he or she can apply for Medicaid. However, the standard asset limit that the state Medicaid program would otherwise impose does not apply to the owner of an LTC partnership policy.

For example, if someone has a $150,000 LTC partnership policy they can retain personal assets of $150,000. Those assets would be protected against Medicaid’s spend-down requirement. Only assets are protected; most of the income of the person receiving care still gets paid toward care.

For those who are concerned about the “use it or lose it” aspect of traditional LTC Insurance, here are 2 popular options:

Hybrid Annuities

For many, a hybrid annuity may be a suitable option for LTC funding. Hybrid annuities are fixed single premium deferred annuities with long-term care insurance riders. These products are designed to provide a means to cover the cost of LTC insurance and to generate LTC benefits if that need arises; and to accumulate funds on a tax-deferred basis for any future purpose, if LTC is not needed.

For example, an individual who deposited $100,000 in a hybrid annuity that grew by the time an LTC claim occurred would have $300,000 to $450,000 of long-term care coverage, depending on the multiple. Other product designs provide for an LTC fund equal to some multiple of the original premium deposit.

If long-term care is needed, the benefit is funded first through monthly payouts of the annuity’s cash value. If the cash value is depleted and care is still needed, then at that point, the LTC rider becomes operative and will continue to pay the same monthly amount for an extended period, such as 25 or 50 months.

If long-term care is not needed, the hybrid annuity operates like any other deferred annuity. The owner can continue the contract as long as he or she wishes, earning tax-deferred interest, withdraw the contract’s values and pay taxes on the earnings, or annuitize the contract, meaning to go ahead and convert the lump sum into a stream of payments.

Having the option to use the contract’s funds for other than long-term care is one of the primary advantages of a hybrid annuity. It overcomes the concern many consumers have about purchasing a stand-alone LTC insurance policy: that long-term care will not be needed and that premiums paid for such coverage would be “wasted.”

Hybrid annuities are typically issued with a waiting period (such as two years from the time the product is purchased) before benefits will be paid, as well as an elimination period (such as 90 days) once an LTC claim is filed. Many hybrid annuities also offer optional inflation protection provisions.

Hybrid Life Insurance with LTC Benefit

Life insurance policies can include a long-term care benefit, either as part of the policy or as a rider. These “hybrid” policies provide for an advance on the policy’s death benefit, payable tax-free, to cover long-term care costs while the insured is living. If the insured is certified as needing long-term care (i.e., he or she cannot perform two of the six specified activities of daily living), the benefit can be paid as a drawdown on the death benefit. The LTC benefit is typically defined as a percentage of the death benefit, paid monthly. For example, a $100,000 life policy might provide for a monthly long-term care benefit of 3 percent. Accordingly, this policy would pay $3,000 a month, up to 33.3 months, at which point the benefit would be exhausted. Any portion of the death benefit not paid out for long-term care would be payable as a death benefit to the insured’s beneficiaries at the insured’s death.

In summary, 70 percent of individuals over 65 will require some type of long-term care during their lifetimes. An LTC policy improves your chances of receiving care in the home verses having to go into a facility. If the time comes when you have to go into a facility, it is very difficult to find quality facilities that have open beds accepting Medicaid. Most facilities require at least some period of self-pay before they will accept Medicaid as payment. A hybrid policy funded with a lump sum now can exponentially increase the coverage you receive in the future and avoids the “use it or lose it” concern of traditional LTC insurance. Aging is inevitable. But facing it unprepared doesn’t have to be.

Mary Hiatt is a Retirement & Insurance Advisor and President of Mary the Medicare Lady (A non-government entity.) She is Certified in Long Term Care Programs, Policies, & Partnerships and Annuities. She offers Educational Workshops on Medicare, Long Term Care and more at no charge. She offers eligible spend-down plans and works with reputable estate planning Attorneys to help her clients get Medicaid. Not connected with or endorsed by the U.S. government or the federal Medicare program. Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. See www.hiattagency.com or contact licensed independent agent mary [at] hiattagency [dot] com or call or text 402 672 9449 for more information.

Medicare Does Not Cover Long Term Care Part 4

Fri, 06 Jun 2025 16:20:28 GMT

This Article is 4^th in a Series on “Medicare does not cover Long-Term Care after 100 Days”

Medicaid is the nation’s largest public payer of long-term care.

Eligibility for Medicaid Long-Term Care

Medicaid requirements are established by each state. Most recipients of Medicaid long-term care assistance come from the low-income aged, blind, and disabled group of eligible beneficiaries.

Those who apply to Medicaid for payment of Long-Term Care services must generally meet three criteria. They must:

Belong to a Medicaid-eligible group (categorically needy or medically needy.)
Have a medical or functional need—inability to perform activities of daily living (ADLs.) Those who are able to receive care in the home may also qualify. Medicaid case management agencies evaluate individuals to determine if their medical or functional needs require long-term care services.
Have income and assets at or below specified levels. If the individual exceeds these limits, they must “spend down” their resources to qualify.

Medicaid Income Requirements

First, let’s define Community Spouse: this is the spouse of a Medicaid recipient who remains in the home, they’re not the one applying for financial assistance. The sole income of the community spouse does NOT have to be counted as being spent on the recipient’s care. Also, if the community spouse has a low monthly income, it is possible for the community spouse to receive an allowance from the income of the Medicaid-recipient spouse.

Once individuals become eligible for Medicaid long-term care, they’ll have to direct almost all their available income toward the cost of their care. Medicaid covers the balance. Each recipient is permitted to retain only a nominal amount, such as $50 or $80 each month, for personal use. Those who receive Long Term Care services in their home are given a higher income allowance to allow them to maintain their home.

When determining Medicaid eligibility, an individual’s income is categorized as countable or not countable. Examples of income counted in determining Medicaid eligibility include wages, interest & dividends, social security benefits, veteran’s benefits, pensions. Remember that any income the community spouse receives in his or her own name—Social Security, pension, or dividend income, for example—may be retained fully by the community spouse and will NOT be counted.

Income not counted towards eligibility includes temporary aid to needy families, supplemental security income (SSI), food stamps, Low Income Home Energy Assistance Program benefits, foster care payments, certain housing or utility subsidies.

In some states, residents whose countable incomes exceed the state’s income limit may still qualify for Medicaid payment of nursing home costs if they establish a Miller Trust, which is designed specifically for this purpose. The amount of the applicant’s income that exceeds the Medicaid limit is assigned as payable to the trust. In turn, the trust pays out monthly to the nursing home facility.

Medicaid Asset/Resource Requirements

Just like income eligibility, an applicant’s assets are either countable or non-countable.

Countable Assets include cash, checking and savings accounts, certificates of deposit and money market accounts, stocks, mutual funds, bonds, and other investment holdings, IRAs, Keoghs, and other retirement funds, and nonresident property. In most states, the cash value of any policies with face values (generally) over $1,500 will be counted toward the asset limit.

If the value of total countable assets exceeds the Medicaid eligibility limit, the applicant must spend down these assets to the limit before Medicaid assistance is available. Certain allowances are made for married couples that enable a community spouse to retain countable assets up to a certain limit.

Noncountable Assets include the primary residence as long as the equity value in the home is less than (generally) $500,000. The exempt value of the primary residence is unlimited if the applicant has certain family members living there, such as: a spouse, a child under age 21, a blind or permanently disabled child. Also excluded are one automobile of any value if it is used by a household member, and household and personal items, burial plots and the purchase or prepayment of various items and details of burial.

Spending down is the process of depleting private or personal resources to become eligible for Medicaid. Many people enter a nursing home or obtain Long Term Care services by initially paying the costs out of pocket, and then they apply for Medicaid once they’ve depleted their resources to the point of meeting eligibility requirements.

Spending down does not have to be limited to spending on costs of care or care needs; an individual could spend down by acquiring noncountable assets, for example. Mary the Medicare Lady has helped clients become Medicaid eligible with Dental, Vision, Hospital Indemnity and Cancer plans, and Irrevocable Funeral Expense Trusts. These can be up to $6507 per person in Nebraska and can be purchased for yourself, your spouse, children, siblings, parents, and stepchildren.

Look-Back and Penalty Periods and Transfers of Assets

If, during the 60 months before applying for Medicaid, an improper transfer of property was made, it could result in a penalty period. The penalty period is the waiting period—the period during which Medicaid will not pay for care. It begins when the individual enters a nursing home and otherwise meets Medicaid’s eligibility requirements.

If an asset is improperly transferred, Medicaid will still count the transferred asset. When such transfers are added to other countable assets, and the total exceeds the maximum level allowed for Medicaid qualification, the result will be a period of ineligibility—in other words, a waiting period—before Medicaid coverage begins.

Certain transfers are allowed and will not be penalized. These include transfers to a spouse, to a third party for the benefit of the spouse, and to disabled individuals.

Medicaid Estate Recovery

The fact that property or assets are exempt or noncountable for purposes of determining Medicaid Long Term Care eligibility does not necessarily protect them in the future. For any noncountable property held by the Medicaid recipient at his or her death, Medicaid reserves the right to take from the estate the amount it paid for nursing home or skilled facility care. This is done through a process called estate recovery.

The state may claim a portion of personal property owned jointly. Recovery of assets from an estate may be made after the death of an unmarried Medicaid recipient or the surviving spouse, when the Medicaid recipient has no surviving child under age 21, or who is blind or totally disabled. In cases where asset recovery from an estate would create undue hardship, the right to immediate recovery may be waived by the state.

Mary Hiatt is a Retirement & Insurance Advisor and President of Mary the Medicare Lady (A non-government entity.) She is Certified in Long Term Care Programs, Policies, & Partnerships and Annuities. She offers Educational Workshops on Medicare, Long Term Care and more at no charge. She works with reputable estate planning Attorneys to help her clients get Medicaid. Not connected with or endorsed by the U.S. government or the federal Medicare program. Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. See www.hiattagency.com or contact licensed independent agent mary [at] hiattagency [dot] com or call or text 402 672 9449 for more information.