SPECIAL REPORT:
Agencies available to help with plans
by Chris Wilson

Planning for how you'll need to be cared for as you grow older is something that is just as complex and unique as you are. And the best advice is to plan ahead and educate yourself.
Sifting through options and comparing HMOs, PPOs, Medicare, Medi-Cal, Medigap, and long-term care insurance options, is complex and confusing. This information can be best explained by a knowledgeable disinterested third party.
Getting the rundown on your options is as easy as calling the helpful staff at the Health Insurance Counseling and Advocacy Program of the Ventura County Area Agency on Aging. They understand the options, cost/benefit analysis breakdowns, terms of coverage, and the private vs. government-funded programs that are available to California seniors.
Factors that play into the mix are your age, your assets, amount of income, and your health condition at the time you need coverage.
The most important part of getting the most out of a long-term care dollar is taking the time to read, speak with a care counselor and understand your options.
It's Katherine Raley's job as HICAP manager to help people understand what their options are.
She makes concepts easy to understand, knows the nuts and bolts of how government-funded programs like Medicare and Medical. Everything health care related, from in-home nursing, to extended stay skilled nursing facilities comes at a price and it's going to be paid for in one of three ways - through an insurance program, by a government agency or directly out of your pocket.
Here are some simple definitions.
Private insurance can be purchased for long-term care through most insurance agents. Be sure to educate yourself about these plans before you speak with an agent, so you know what you're getting into. This is where HICAP comes in.
You will be assessed and assigned a monthly premium which will be determined by your age, health and policy needs. They come in dozens of styles. Raley says age 50 is a great time to start thinking about long-term health care insurance policies. Do some research. At age 50 premiums are likely to still be manageable. And, for example, people with assets exceeding $87,000 won't be able to qualify for certain government programs and should maybe consider private insurance options.
Medigap is private insurance that literally fills in the gap where your income or insurance policy doesn't.
If you are under the umbrella of a health maintenance organization, do you know what your deductibles are? How much prescription drug coverage you have? And if your HMO covers brand-name drugs or only generics?
As far as government programs are concerned, Medicare and Medi-Cal kick in when the money runs out, in almost all cases, to pick up the slack. You must meet certain income requirements to qualify, and services may lack the extra frills offered by private insurance.
HICAP in Ventura call: 477-7310.
HICAP at Help of Ojai: 646-5122 ask for Nita Whaley or Karen Kaminsky, for Volunteer Hospice at Help of Ojai ask for Susie Salguero.

© 2002 The Ojai Valley News

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