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Retire early: Can ordinary Americans find financial independence and stop work by 50?

What would it take to retire at 50 or 40, or even 30? It seems almost unrealistic to spill ink over when many Americans are already so behind on saving for retirement.

But there’s a movement growing in popularity, especially among younger adults, that preaches extreme saving, side hustles, long work hours and aggressive investing to achieve FIRE – financial independence/retire early – on an accelerated timeframe, often within 10 to 15 years.

But given the dismal statistics on Americans’ financial well-being, is FIRE only attainable for just higher-earning workers? After all, 40% of people can’t pay for a $400 emergency with cash on hand; only half have three months in emergency savings, and almost half carry credit card debt month to month.

What is FIRE?

While the “retire early” part typically turns heads, FIRE adherents focus more on financial independence, with the goal of building up enough in assets to pursue the kind of life they want as early as they can.

Many still work after achieving financial independence, but on their own terms without concern over how much money they make.

FIRE is as much a philosophy as a financial strategy.

“It was born out of dissatisfaction of the status quo of working in corporate America until you’re 60 or 70 years old and finally retiring and living a great life after that,” says Sam Dogen, founder of the blog Financial Samurai.

It also rejects American consumerism. Those seeking to “FIRE” learn to live on less by questioning the value of how they spend their money.

“Before, I succumbed to lifestyle creep. It’s baked in our society,” says Scott Rieckens, author of “Playing with Fire,” who has a forthcoming documentary on the movement. “But now I’m able to refocus my life and align my spending with my values.”

Can I FIRE?

Many of those who have popularized the FIRE movement did make around the median household income – when they first entered the workforce in their early 20s, supporting no one but themselves. After that, their income quickly escalated to several times the median.

For instance, the well-known Mr. Money Mustache – also known as Peter Adeney – started his first job in 1997 making $41,000.

But he and his then-wife ended up earning $195,000 when they reached financial independence at age 30 in 2005, according to an accounting on his blog.

Dogen started his FIRE journey with a $40,000 salary in 1999 in Manhattan and was pulling in more than $300,000 – with his wife – when he reached financial independence 13 years later.

Leif Dahleen, the author of the blog Physician on FIRE and an anesthesiologist by trade, was making about $400,000 when he realized he could retire early, but he’s keenly aware that accomplishing FIRE is a lot harder for those making the median income of $62,000.

“After taxes, they have a $50,000 budget. If you can live off half of that, you can achieve financial independence in 15 years,” he says. “But you have to give every dollar a job. You need to really want it and prioritize it over everything else.”

There are examples. For his book, Rieckens noted that he met several people pursuing FIRE on more middle-class incomes, including a family living on $70,000. Others point to Jillian Johnsrud of the blog Montana Money Adventures.

A real-life example

Johnsrud achieved financial independence in 13 years on a low-to-middle-class income and hampered by $50,000 in debt. She and her husband’s combined income started at $15,000 and went as high as $60,000 as they worked toward financial independence.

Johnsrud, who never completed college, worked a variety of retail and sales jobs, while her husband, who has a civil service degree, enlisted in the Army.

They saved big and small. When her husband was stationed in Washington, D.C., they took on a roommate, saving $800 a month for three years. “That’s $25,000 tax-free that we used to buy our first rental property,” she says.

When they finally bought their first house – in cash – they bought the cheapest one on the market at the time for $50,000 in Kalispell, Montana. Together on evenings and weekends for five years, they remediated its mold issues and renovated using YouTube as their guide.

They drove old cars such as a 1996 Honda Civic they had for 15 years. They ate bagged peanut butter and jelly sandwiches for lunch. They didn’t dine out. They still have “Rice and Bean Monday” and aim to eat less than $1 per pound. That keeps their monthly food bill for seven – they have five children now – at $700.

Overall, her family spends $26,000 to $29,000 a year. She doesn’t pretend the path to FIRE was easy, but she celebrated small victories along the way to stay focused.

“It’s an incredible feeling, especially that first $100,000,” she says. “Even if you don’t have financial independence yet, it’s still freedom. That’s three years of income.”

Back to reality

Johnsrud’s journey is inspiring, but is it easy to replicate?

“It’s an attractive idea to think you can power-pay yourself over five to 10 years and transition into that kind of lifestyle,” says Bruce McClary, the spokesman for the National Foundation for Credit Counseling. “The reality we see is there are so many woefully unprepared for retirement at any age, and they have so many financial obstacles.”

For the lowest-earning 40% of American households, it may be close to impossible. This group spends more annually than they earn and have little fat to cut from already frugal budgets.

“You can’t get around the math,“ Dogen says. "If your basic living expenses are $25,000 and you make that, then it doesn’t work.”

The middle 20% are better off, spending just under what they earn. They still would need to slash their annual budget of $48,000 by about half – like Johnsrud did– to make FIRE possible.

They must do this as they watch costs of the biggest budget busters – health care, education, housing and child care – continue to outpace wage gains, says Amy Traub, an associate director of policy and research at Demos, a public policy organization.

A lot of things need to go right for middle-class workers on their way to financial independence, she says.

“You can’t lose a job for a prolonged period of time. You can’t have a child get sick. You can’t help out a loved one financially,” Traub says. “You not only have to be very disciplined, but also very lucky.“

FIRE 101

Just like saving for regular retirement, it’s easier to start early when you have more time to build up money and assets and no children to support. It is also important to realize that your FIRE journey could take longer than others who had a leg-up with a higher-earning job. Here are the basic steps.

Save: FIRE adherents aim to put away a significant chunk of their income – at least half, often more. To do that, they slash their costs, typically aiming for the biggest expenses first – housing, food and transportation – and then moving onto smaller bills and more discretionary spending like the internet, cellphone and entertainment.

House-hacking is a common strategy, usually taking on roommates to defray shelter costs. FIRE followers avoid dining out and get creative on food costs. For instance, Dogen squirreled away free food his employer handed out when he was in his 20s. As for transportation, many rely on just one older, cheaper model. Others choose public transit or bicycle for commuting.

Earn: While they save, FIRE aspirants work to increase their income, either logging in overtime or taking on outside gig work such as freelance writing, consulting or driving for Uber or Lyft. Many of them blog about their journeys as another way to earn extra income.

Invest: They max out their 401(k)s and IRAs, which help lower their taxable income. Leftover money is poured into low-cost index funds. Others buy rental properties to create a passive income stream. The goal is to reach the 4% rule, or building up a large enough nest egg that you can safely withdraw 4% a year in retirement without touching the principal.

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How to Conquer the Fear of Financial Planning

As a fundamental part of our transformation to a wealth management firm, my company recently began to offer financial planning services. From numerous conversations with clients, we had learned that most acknowledge financial planning is important, but very few have done it in any meaningful capacity. Something had prevented them from doing it: the fear of unpleasant discovery, the shame of copping to one’s procrastination, the embarrassment of discussing taboo topics, or a combination of these and other reasons. Whatever the cause, their resistance to do it was palpable.

Most people who have done substantial financial planning did so principally in response to a crisis. They encountered something scary that required immediate attention. Perhaps a spouse had become gravely ill, and the couple had not yet done sufficient estate planning. Or maybe a single parent had learned that his teenager was accepted to a prestigious university, and the parent had no idea how to finance four very expensive years of education.

The reactive nature of people presents a fundamental challenge for the financial advisor/planner. A critical part of my job is to help clients untangle their web of concerns so that they can see them clearly in terms of their level of importance and urgency. This requires me to be very forward-thinking, looking not just at the present but also months, years, even decades down the road.

But what is an advisor to do when clients refuse to do any financial planning unless the work is viewed as both important and urgent? How do we encourage clients to abandon their myopic ways and adopt more long-term strategic thinking and behavior?

A Future ‘Crisis’ Today

Although I would never knowingly manufacture a crisis for clients, I do see the benefit in identifying one or two key elements of a client’s life to reframe as an inevitable financial challenge as a “problem” to be solved by financial planning. Too often clients with young children put off a conversation about financing higher education because the matter seems too far in the future. It’s not considered a problem; affording diapers and day care is. That short-sighted thinking is a mistake. New parents need the cold, hard facts about education costs so that they will address the problem and become early adopters of a workable solution: a very long runway of intentional saving, investment, patience, and faith (in the power of compounding).

Simple Savings

Clients and prospects alike are often skeptical of the monetary benefit of financial planning. One way to overcome their doubt is to perform a simple cost-cutting exercise. A short conversation about an individual’s spending habits may reveal obvious opportunities to cut expenses, “low-hanging fruit” savings that can be diverted to financing something the individual has long desired — perhaps a modest vacation or luxury item. If a skeptic receives a tangible reward for a relatively painless modification in spending behavior, she may be more likely to entertain a review of her comprehensive financial picture.

A Gift to Loved Ones

I like to tell clients that they should view financial planning as a gift to loved ones. Why? Clients will act much more quickly when financial planning is presented in the context of the financial health and stability of dependents and other loved ones. Sharing my own experiences has also helped tremendously. I will often cite my father’s passing and my cancer diagnosis, spinning those narratives in such a way to include the perspectives of my mother and wife so that clients understand that my planning decisions were never made in a vacuum — they were specifically structured to benefit my loved ones, not just me. A message of care is sure to resonate with clients and get them thinking more proactively about financial planning.

The Future Is Brighter

Perhaps the most difficult clients to win over are the carefree ones, those who love to live in the moment. These clients tend to be spendthrifts, and their loose spending behavior only makes their need for financial planning that much greater. The good news is these clients are often idealists, and advisors can use their optimism to argue the merits of financial planning. Bigger and better is just around the corner … if these clients will incorporate a little planning, delayed consumption, and simple risk management into their everyday lives.

The goal is to do this as seamlessly and non-obtrusively as possible. These clients won’t bite if they think their adventurous lives will be disrupted by a written document. Advisors/planners can utilize simple, “behind-the-scenes” financial tools like automated retirement contributions, cash-back credit cards, and insurance policy reward provisions that, over the long term, will return great value to clients even though they may not be fully aware of the accruing benefits.

As financial advisors, we need to encourage clients to address important issues before they become urgent. Re-framing topics as solvable problems, presenting easy cost-cutting wins, addressing the needs of loved ones, and adjusting our methods to suit challenging personality types can be powerful techniques to move reluctant clients in a more prosperous direction.

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Individual Health Shrinkage Drives Up Uninsured Rate: CBO Data

That coverage enrollment category is the only one that showed a big enrollment drop between 2016 and 2018, according to a ThinkAdvisor analysis of new health insurance coverage data for people under age 65 from the Congressional Budget Office (CBO).

The decline in the number of unsubsidized individual major medical insureds pushed the number of uninsured people up 5% between 2016 and 2018, to 28.9 million.

The CBO is an arm of Congress that helps Congress analyze the effects of policy choices on federal spending. It prepared the new health insurance enrollment report to show Congress the data and logic that will be included in new health insurance policy impact analyses.

The CBO found that the total number of U.S. residents increased by about 1 million between 2016 and 2016, to 284.7 million.

The number of people under age 65 with Medicaid, Children’s Health Insurance Plan coverage, subsidized Affordable Care Act exchange plan coverage, the ACA Basic Health Program or Medicare coverage crept up to 86.9 million in 2018, from 86.6 million in 2016.

Employers increased the number of people they covered by 2.2 million, to 159.7 million.

The number of people with subsidized ACA exchange plan coverage increased to 8.4 million, from 8.3 mllion.

But the number of people with unsubsidized ACA exchange plan coverage fell to 1.3 million, from 1.6 million, and the number with individual off-exchange coverage fell to 4.9 million, from 7.4 million.

Employer health plans and subsidized health programs absorbed the 1 million new U.S. residents under 65, and they seem to have absorbed about 1.4 million of the people who had unsubsidized individual major medical coverage in 2016.

But about 1.4 million of the people who had unsubsidized coverage in 2016 slid into the uninsured column in 2018.

The list of reasons for the shift could include the rising cost of unsubsidized coverage, and insurers’ decisions to withdraw from the individual market in part or all of the country.

Another reason could be because of how the CBO defines individual health insurance.

CBO includes only major medical insurance that meets ACA minimum essential coverage standards in that definition. It excludes people who belong to health care cost sharing ministries. It also excludes people who are using products such as short-term health insurance as alternatives to major medical coverage.

The Alliance of Health Care Sharing Ministries estimates, for example, that its member organizations an affiliates now reach about 968,662 people. A comparable enrollment figure for 2016 was not immediately available.

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Checking on Social Security Estimates Is a Good Idea, but Many People Don’t Do It

Checking your official Social Security statement is important to make sure your future retirement benefits reflect what you’ve earned over your working life. Yet a new report suggests that many Americans aren’t doing that.

In recent years, the Social Security Administration has greatly curtailed the number of statements it mails, encouraging workers to check the information online instead.

But fewer than half the 39 million people registered for electronic “my Social Security” accounts as of Sept. 30 had checked their earnings statements in the previous 12 months, according to a recent audit report from the agency’s inspector general.

Linda Sherry, director of national priorities for Consumer Action, an advocacy group, said the findings suggested that the shift to digital statements had left many people without “meaningful access” to their earnings history and that the government was falling short of its obligation under the Social Security Act to keep workers informed.

That’s a problem, she said, because the statements are a crucial retirement planning tool for many Americans. She said she would prefer that the agency gave people the option of receiving paper statements periodically, as it did in the past, rather than force them online.

The administration’s policy on mailing statements has varied over time.

Two decades ago, most workers 25 or older received a paper statement each year around their birthday. The document provides a summary of annual earnings. It also shows the size of the check to expect each month in retirement, and how the amount may vary depending on what year the recipient decides to stop working.

Under current policy, adopted in 2017, the administration automatically mails statements only to people over age 60 who aren’t yet getting benefits and who haven’t set up digital accounts. (Paper statements are still available to anyone on request, by submitting a special form. More than 139,000 people got statements that way in the 2018 fiscal year, the report said.)

The move away from mailing statements has saved the government money, the report noted. Last fiscal year, the agency spent less than $8 million to print and mail statements, down from $65 million eight years earlier.

The agency mailed just under 15 million statements last fiscal year, which ended on Sept. 30, the report said. When that total is combined with the number of people who checked their statements online, it appears that fewer than 35 million people saw their earnings statements.

Back in the 2010 fiscal year, the agency automatically mailed out 155 million statements, the report noted.

“That’s a huge discrepancy,” Ms. Sherry said.

Asked whether the report raised concerns, a spokesman for the Social Security Administration, Darren Lutz, said in an email that the shift to online statements was rooted in tighter agency budgets, along with an increasing preference by the public for doing business online. Currently, he said, 42 million people have “instant” access to statements through their online accounts.

The agency encourages everyone to create an online account, Mr. Lutz said, and suggests that people review their statements annually to verify that earnings posted are correct, to make sure their benefit estimates are accurate.

There’s also a reason besides retirement planning to review your Social Security statements: to check for signs of identity theft. Doing so is good “identity hygiene,” like checking your credit reports, said Charity Lacey, a spokeswoman for the Identity Theft Resource Center.

If, for instance, your reported earnings are much higher than your own records, it may be a red flag that someone is fraudulently using your Social Security number, said Paul Stephens, director of policy and advocacy with the nonprofit group Privacy Rights Clearinghouse.

Here are some questions and answers about checking your Social Security statement:

How do I create a “my Social Security” account?

You can register on the Social Security Administration website. You’ll be asked to enter your Social Security number and birth date, and you’ll also be asked a series of questions — similar to those asked when you check your credit report online — to help confirm your identity. Then you’ll receive a code by either email or text, which you enter online to complete the process. If, for some reason, you can’t set up the account online, you can visit a Social Security office. After you establish an account, you’ll get an annual email reminder to log on and review your statement.

If you have a security freeze on your credit report to help ward off fraud, you must lift it temporarily to set up your online Social Security account. Specifically, you’ll need to thaw the freeze at Equifax, the company the administration currently uses to help verify users’ identities.

If I can get paper statements, why should I get an online Social Security account?

Creating a digital account is a good idea, if only to prevent someone else from fraudulently creating one first and using it to steal benefit payments in the future, said Mike Litt, consumer campaign director with the United States Public Interest Research Groups. Given the number of security breaches in recent years, it’s possible someone may be able to illegally obtain your sensitive personal information, like your Social Security number, and use it to set up an account in your name.

Mr. Litt said it was wise to establish an account and then check it periodically for anything that looked suspicious. “You should sign up for your online Social Security account,” he said, “before fraudsters try to claim it and redirect your benefits to their bank account.”

Mr. Litt also recommends adding optional extra security, like getting a code sent in a letter via the mail. If you prefer, you can also block all electronic access to your account.

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Before Deciding on a College, Look Closely at the Financial Aid Letter

High school students opening their college financial aid offers may be excited to see that they have received an “award.” After all, it sounds like a prize, but “award” has its own meaning in the student aid world.

An award could be a grant or scholarship. It could also include a loan that must be repaid, with interest, or work-study aid that requires a student to first land a job to earn the money.

“Celebrate,” said Laura Keane, the chief policy officer at uAspire, a nonprofit group that aims to help students afford college with less debt. “Then, decide.”

Industry jargon and arcane terminology can make it challenging for students to figure out just how much money they are being offered by each college, and how much more they’ll need to come up with to pay for their college education, student advocates say.

Colleges and universities are not required to use similar terminology or formats when sending out financial aid packages to accepted students. Schools are not even required to include specific financial details, like the full cost of attending, in their offers.

“There is no standardization,” said Rachel Fishman, deputy director for research with the education policy program at New America, a think tank that recently teamed with uAspire to analyze financial aid offers sent by hundreds of colleges.

Their 2018 study identified, for example, 136 different terms used to describe a single type of federal student loan — including two dozen labels that did not actually include the word “loan.”

In some cases, Ms. Fishman said, the word was lost because software used to list the loans simply cut off words that did not fit. Other colleges used abbreviations of the sometimes cumbersome titles of federal student loan programs.

The hodgepodge can leave students baffled and struggling to compare offers from different colleges, said Lindsay Ahlman, a senior policy analyst with the Institute for College Access and Success, a nonprofit group that analyzed a smaller sample of student aid letters and came to a similar conclusion.

The Education Department recently renamed the form and is testing a revision, but use of the form remains optional.

This week, however, the department issued guidelines urging colleges to avoid using terms like “award” when notifying students of financial aid packages.

Rather, the department said, they should use terms like “college aid offer” or “college financing,” which better reflect that offers may include loans, as well as aid that does not need to be repaid.

“Loans,” the department said, “are not awards.”

The guidelines also recommend that aid offers should list “gift aid” like grants and scholarships separately from loans. The letters should also include the total cost of attending a school — not just tuition and fees, but also costs like housing, meals, books, supplies and travel — as well as the “net” cost to the student, after deducting grants and scholarships.

When evaluating an aid package, Ms. Keane said, students should calculate the “all in” cost of attendance, if it is not cited in the offer document.

Psychologically, scholarships can be exciting and make students feel wanted, Ms. Keane said, but students need to consider the full picture. Think of scholarships as “coupons,” she said, and consider the percentage of the total cost that such aid will cover. If you get a $10,000 scholarship but need to cover costs of $20,000, that’s like a half-off coupon — not bad. But if you need to cover $60,000, “that’s not the same coupon,” she said.

Here are some questions and answers about evaluating financial aid offers:

What if I don’t understand the terms of my financial aid offer?

Students and families can find definitions of many financial aid terms on the Education Department’s website. The Institute for College Access and Success offers a tip sheet for decoding aid offers, and helps define common terms.

Still unclear? Call the financial aid office at the college making the offer for clarification. “Make sure you find the information you need,” Ms. Keane said. Many schools require deposits by May 1, so the clock is ticking.

Are there any online tools that can help me compare financial aid offers?

The Consumer Financial Protection Bureau offers a tool on its website, as does the College Board.

The Hechinger Report, a website that specializes in reporting on education, recently began offering a “decoder” tool that lets users upload a copy of their financial aid letters.

Will colleges be required to use standardized financial aid offers anytime soon?

Legislation was filed in March in the Senate that would compel colleges to use a standard format. The measure, called the Understanding the True Cost of College Act, had been introduced several times before — first in 2012 — but failed to gain traction. This year, however, advocates say they are more hopeful that the bill may advance, because it has bipartisan support and offers a relatively straightforward fix to a vexing problem.

Do you want to know more about what is chip then please contact us and send your queries regarding this.

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2 New Ways To Get Smarter About Medicare

Shopping for a Medicare policy and even just understanding what Medicare covers can be maddeningly difficult. But the new United Income Medicare Advice free personalized shopping service and the new free What’s Covered mobile app from Medicare itself could help make things easier. That app, sadly, has some serious limitations, though.

Making smart choices can mean saving serious money for people 65 and older, the age for the program’s beneficiaries.

“Out-of-pocket medical expenses for Americans over 65 average $4,300 a year,” according to a recent study by the Center for Retirement Research, said Elizabeth Kelly, senior vice president of operations at United Income, which is a financial services firm for boomers. “So it’s incredibly important to make the right choices. Unfortunately, the Medicare program is incredibly complex.”

Worse, if you don’t enroll in Medicare on time, you can get socked with steep financial penalties. That means higher costs for the rest of your life.

Here’s a look at each of the two new tools:

The United Income Service to Find the Right Medicare Coverage

First, the Medicare service released yesterday by United Income, a financial services firm geared to boomers: After spending about five to 10 minutes answering a few questions online about your health care preferences and needs, you then get United Income’s suggestions for coverage that’s most appropriate. To get there, the company reviews more than 300 options.

United Income won’t, however, recommend a particular health insurer’s Medicare Advantage or Medigap policy. “We wanted to provide Medicare advice that’s part of a financial plan,” says Andrew Vincent, United Income senior vice president of product.

The first thing United Income determines is whether a user is eligible for the program or if Medicare is the best choice. “If you have access to retiree coverage through the military or a union, that may be a better option than Medicare,” Vincent notes.

Then, the service gets into trade-offs. Things like lower premiums versus the breadth of doctor networks and the need for pre-approvals for treatment.

Next, you’re asked to estimate your health expenses and your tax filing status.

United Income then tells you which types of Medicare and supplemental Medicare plans would be most suitable, why, and an estimate of your monthly premium. (United Income doesn’t have premium figures for Medigap policies yet, though.)

The Medicare ‘What’s Covered’ App

Medicare’s What’s Covered app, available on Apple’s App Store and on Google Play, came out in late January. It has one goal: to tell you whether Medicare Part A or Part B (treatment in hospitals and doctors offices) would cover your medical test or service, as well as basic cost information. The app is part of the government’s eMedicare initiative for computers, phones and tablets.

You don’t need to be a Medicare beneficiary to download or use the app.

“We’ve seen over the last couple of years an increase in mobile usage,” says Jon Booth, web and new media director for the Centers for Medicare and Medicaid services, ”so we thought the What’s Covered app would be a good opportunity to address what people are looking for on the Medicare.gov site.”

And, Booth added, “the app makes the information available to users if they’re offline or have spotty internet coverage in a doctor’s office. You can browse through it without needing an online connection at that minute.”

Put another way, the information in the What’s Covered app is the same as what you’ll find on the government’s Medicare.gov, just more accessible.

A Work in Progress

The What’s Covered app can be quite helpful, but it’s a work in progress.

For one thing, your search for what’s covered may turn up nothing because you didn’t enter the word or phrase Medicare is looking for. I found that when I tried out the app and typed in “heart scan” and got no results. A recent Kaiser Health News story  had a similar search problem.

“We recommend to users if the term you enter is not returning results, look at the A to Z list we provide of all items and services at the bottom of the screen,” says Booth. “We encourage using the most generic term you can. If you had searched ‘scan,’ you would have seen what’s covered for diagnostic, non-laboratory tests.”

The staffers behind What’s Covered, Booth says, are constantly updating and improving the app’s search results based on user experiences.

It’s also worth remembering that What’s Covered won’t help you learn whether a treatment or procedure is covered by Medicare Advantage plans, because their coverage differs so much.

“This is primarily targeted to people with original Medicare and maybe Medicare Part D (the prescription drug plan) and their caregivers,” says Booth. “That’s a substantial number of users.”

Do you want to know more about the health insurance harrisburg then please contact us and send your queries regarding this.

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Marriage and Medicare Eligibility

Medicare can be confusing for any new beneficiary- and it is not uncommon for someone to assume that Medicare will be just like their Employee Health Plan was. As you may well know, an Employee Health Plan can include one or more family members, and all those members are working towards one deductible and one maximum out of pocket expense. You can choose the  Blue Cross Medicare advantage plan for yourself and for your loved one, as it very beneficial for you  and your family to be safe.

Can I sign up for Medicare at the same time as my spouse?

Medicare eligibility is an individual process because your Initial Enrollment Period (IEP) is tied to your birthday. You have a seven-month window around your 65th birthday in which you can sign up for Medicare, it begins the three months before your 65th birthday, includes your birth month, and extends the three months past your birth month. Depending on age and IEP, one of you may be able to sign up before the other.

Even if your birthdays happen to overlap and you share a sign up window, you may select the same type of plan, but you cannot enroll in the same plan. When it comes to Medicare, plans are individualized, there is no family plan.

Does Medicare Cover Younger Spouses?

Medicare does not cover younger spouses, unless they have a disability and have been receiving Social Security Disability Benefits for 24 months or until they turn age 65. There are a few options for your younger spouse to maintain health insurance, especially if they do not have their own job-based insurance:

1) You can continue working until your younger spouse meets Medicare requirements, and delay your Part B enrollment

2) You can enroll your spouse in your retiree insurance (if eligible), possibly delaying Part B

3) Your younger spouse can gain employment that offers job-based insurance

4) Your spouse can get a quote for an individual health plan

Should I enroll in the same type of Medicare Plan as my Spouse?

The reality is that some spouses may be better served by enrolling in different Medicare plans because of their diverse needs. There is a good chance you both are not seeing the same doctors, or taking the same medications, or have been diagnosed with the same medical conditions. In this case some plans or Supplements may offer benefits that would be a better fit for one spouse over another because of their individual needs and costs.

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Diabetes and Medicare Coverage

Diabetes is a serious disease, that when diagnosed in older adults, has been linked to higher mortality, reduced functional status, and increased risk of institutionalization. Older adults with diabetes are also at substantial risk for both acute and chronic micro vascular and cardiovascular complications of the disease.

Diabetes occurs and is diagnosed in patients when their blood glucose, also called blood sugar, is too high and difficult to manage and keep within normal range. There is some good news though, Type 2 Diabetes, the most common form of the disease to develop in older adults, can be prevented or even delayed with some healthy lifestyle changes. One in three Americans is at risk for developing type 2 diabetes, which can lead to complications like kidney disease, blindness, and amputations.

If you have diabetes, Medicare covers many of your supplies, including insulin, test strips, monitors, lancets and control solutions. In some cases, Medicare Part B also covers therapeutic shoes if you have diabetic foot complications. You pay 20% of the Medicare-approved amount for these supplies.

Many Medicare beneficiaries may not know that Original Medicare also covers diabetes self-management training to help you learn how to better manage your diabetes. These training’s teach you how to monitor your blood sugar, control your diet, exercise, and manage your prescription medications. If you have been diagnosed with Diabetes, talk to your doctor about how this training can help you stay healthy and avoid serious complications.

Knowing your risk is the first step. Many people with diabetes don’t know that they have it, but Medicare covers screening tests so you can find out if you do. If you are having health problems and suspect that you may be suffering from an illness like this, take control of your health- call and speak with your doctor today about which screening tests, supplies, and training may help you stay healthy.

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Choosing a Health Insurance Plan

Time is typically limited to choose the best health insurance plan for your family, but rushing and picking the wrong one can be costly. You should make sure to considered the important points when choosing your health insurance plan. First you should go to your marketplace and view your plan options side by side. Decide which type of plan is best for you and your family. Eliminate plans that exclude your doctor or any local doctors in the provider network. Determine whether you want more health coverage and higher premiums, or lower premiums and higher-out-of-pocket costs. While selecting the business health insurance, you will need to spend some time understanding the options available to you through your company.

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Ways to Choose a Health Insurance Policy

A health insurance policy is a type of insurance that offers coverage for the medical and surgical expenses incurred by the policyholder when he/she is hospitalised during the policy period. An insurance broker or intermediary can help you better understand your coverage needs and buy a policy that matches them. There are some important factors to bear in mind when choosing a policy like your current doctor being in the network for a particular insurer and making sure the options you choose in the policy are right for your health needs. Chip health insurance pa is a right option, if you are looking for a plan that meets your needs and your budget.

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Tips from a vision benefits pro: Leverage vision coverage to impact your highest medical cost drivers

A growing trend in employee benefits is the integration of health and vision benefit plans. It’s called Integrated Health Care. It’s a “big data” benefit strategy that enhances a client’s clinical health and wellness program with vision data for early detection and management of health conditions.

Tip 5: Integration of medical and vision clinical data

To give you an example of what this looks like in action: Consumers are more likely to go for a vision exam than their annual physical. And there are at least seven high-risk health conditions that can be detected through a simple eye exam. So picture Joe, who has been avoiding his annual physical. He knows he needs to lose weight and take better care of his health, but he hasn’t made any progress since his last physical and doesn’t want to hear the same “lecture” from his doctor again. However, Joe makes it a point to visit to his eye doctor each year, because he needs his annual supply of contact lenses. If Joe’s eye doctor finds evidence of disease like diabetes or cardiovascular issues, Joe’s insurance carrier will receive notice of the diagnosis when his vision claim is submitted. That claim can trigger proactive outreach to help Joe get the extra support he needs to manage his health.

My company has been tracking employer actions regarding Integrated Health Care for the past six years and publishing a bi-annual Integrated Health Care Report. Some eye-opening findings in the latest report:

Every single one of the top 25 utilized drugs have vision and/or dental side effects.1 That’s why collaboration between health and vision providers is vital.

As of 2018, 69% of employers with 100+ employees were actively integrating their vision and health plans.2

More than 80% of employers with 100+ employees say they have to offer more integrated health care in order to compete for talent in a low-unemployment job market.2

If you aren’t integrating your benefits, you’re being left behind.

Many employers don’t realize their vision plan can be leveraged to help impact their highest health cost drivers like diabetes, cardiovascular and cancer spend. Earlier detection means earlier treatment, and earlier treatment could mean lower medical costs.

So look for a carrier that provides integrated medical and vision plans. And when you look at the time and money that your organization spends on a vision benefit plan, don’t think of it as just coverage for the eyes. It’s actually a cost-free way to enhance your existing clinical, health and wellness programs. It’s a classic “getting more for your money” scenario.

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Breaking Down Bundled Payments: Cancer Treatment

You don’t need us to tell you: Cancer costs keep rising. In 2017, more than $147 billion was spent on cancer care in the United States, according to the National Cancer Institute. Businesses and their employees are paying a large portion of that cost.

“Nowhere in health care are employers facing a greater challenge to provide quality care at a reasonable cost than in cancer treatment and support,” Michael Thompson, president and CEO of the National Alliance of Healthcare Purchaser Coalitions, said in a press release earlier this year.

Bundled payments represent one value-based approach to taking on that challenge. Here’s what you need to know about the promise they’re showing.

What Are Bundled Payments?

With bundled payments, insurers pay a lump sum for the entire episode of care instead of each individual service. Providers can share in any savings, but if costs exceed the budget, there may be a financial penalty. Providers may also face penalties for failing to meet quality goals.

Episode-based payments are most commonly used for joint replacements, urinary tract infections and other conditions that have clearly defined guidelines or clinical pathways.

So far, so good. But cancer? Cancer isn’t like a hip replacement.

Indeed, cancer treatment is quite different in several respects. For one, “cancer” isn’t one thing. It requires, so to speak, specific terms of engagement depending on the varying “specific genetics and molecular pathways of different types of cancer,” according to the Journal of Clinical Pathways.

What constitutes an “episode”? It could be the duration of chemotherapy or a set amount of time — or something else. Because providers are incentivized to work with other providers across the continuum of care, the model supports care coordination, something particularly crucial for cancer patients.

A Case Study: Medicare’s Oncology Care Model

Various programs — many of which are still pilots — are underway to find the most efficient way to make bundled payments work in oncology.

In fact, the Centers for Medicare and Medicaid Services (CMS) is in the midst of its five-year Oncology Care Model, a pilot that that includes 76 practices and 10 payers. Participating practices receive monthly care management fees and are eligible for bonus payments if they lower overall Medicare spending and meet certain quality goals. It is focused on an episode of care, namely chemotherapy and related care during a six-month period.

Physicians receive a monthly payment of $160 and are evaluated every six months against a benchmark for bonus payments. It includes some flexibility; for instance, benchmarks can be adjusted when patients need newer, more expensive medications.

The goal, which the pilot appears to be on track for meeting, provides incentives for physician offices to improve care coordination and reduce the total cost of care episodes for chemotherapy.

The Patient Journey

But much of the time, cancer care isn’t just about the latest chemotherapy; it’s about keeping the patient healthy during a long life. Bundled payments include a more integrated approach to care.

One pilot that demonstrated the feasibility of the approach involved head and neck cancers. A major private insurer paid MD Anderson Cancer Center an annual lump sum for all the care provided during the course of the year: surgery, radiation, chemo, palliative care and so on. The patients received only one bill — which is, if you think about it, remarkable.

The Oncology Care Model also focuses on that journey. It requires participating practices to focus on, according to CMS:

“Improving care coordination, symptom management, palliative care, and end of life care.

“Recognizing depression and distress in cancer patients.

“Addressing financial toxicity.

“Improving communication with patients and other providers.”

Bundled payments can help integrate care, from the medical therapy itself to psychosocial support and palliative care, as well as any other related specialty care. In some cases, it could even include benefits coordination and ongoing management, which means healthier, less stressed patients and a faster return to their lives and their work.

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