Frequently Asked Questions

When it comes to long term care or Medicare planning, asking questions is essential.
Information will help you make better decisions when considering your options - Kirk Matenaer

01

Our Services
FAQ’s

How do you choose the insurance carriers you work with?

We are insurance brokers and not connected with any specific carrier. We look for companies that are leaders in the industry and those that are bringing innovative solutions to the marketplace. We study a company’s track record, longevity in the industry and ratings history. Because we are involved on a day to day basis helping our clients with claims, we are in a good position to evaluate a carrier’s claims processing procedures and level of responsiveness.

How are you paid?

We receive commissions from insurance carriers only when a long term care, life, annuity or Medicare Supplement policy is put into effect. We do not charge for initial consultations for long term care planning, for policy reviews or claims servicing.

How do you protect client confidentiality?

We do not disclose any nonpublic personal information obtained in the course of our practice except as required by law. Permitted disclosures include, for instance, providing information to our team members, and in limited situations to unrelated third parties who need that information to assist us in providing services to you. In all such situations, we stress the confidential nature of information being shared. In order to guard your nonpublic personal information, we maintain physical, electronic and procedural safeguards that comply with our professional standards.

Are you open to working together on a plan with my already existing advisors?

Absolutely. In fact a majority of our business is generated from referrals given by other professionals. It’s not uncommon for us to meet with a client in their attorney’s, financial advisors, or accountant’s office.

I see that you’re based out of South Carolina, are you able to provide your services in any other states?

Yes. We have clients throughout the entire country as we are licensed to do business in every state.

Where do you hold most of your meetings?

Most of our clients prefer to meet us in our office. However, we tend to meet many people at their homes or even a neutral place such as a coffee shop etc… For non-residents we conduct business through tele-conference and e-mail.

02

Long-Term Care
FAQ’s

When is long-term care needed?

Long-term care is needed when you are not able to complete personal care or other daily activities on your own. This is most often the result of a chronic illness or disability. In some cases, the illness or disability may be the result of a cognitive impairment which includes memory loss, confusion, or disorientation. This can be the result of conditions such as Alzheimer’s disease.

Does Medicare cover long-term care?

Medicare does not pay the largest part of long-term care services or personal care—such as help with bathing, or for supervision often called custodial. Medicare will pay for services in a skilled nursing facility up to 100 days if:

  • you have had a recent prior hospital stay of at least three days;
  • you are admitted to a Medicare-certified nursing facility within 30 days of your prior hospital stay; and
  • you need skilled care, such as skilled nursing services, physical therapy, or other types of therapy.

Is it true that Obama-care will pay for long-term care?

No. The Affordable Care Act authorized the creation of the CLASS Program a national, voluntary insurance program. Due to the October 14, 2011, announcement by HHS Secretary Sebelius that implementation of the CLASS Program has been suspended; the CLASS Program is not available.

What are my odds of needing some form of long-term care in my life?

There is a good chance you will need some long-term care services if you live beyond the age of 65. Almost 70% of people over 65 need long-term care.

03

Long-Term Insurance
Questions

Can long term care insurance cover home care?

Some older policies – issued in the early 90’s – pay only for care in facilities. Policies issued today are “comprehensive” which means that they reimburse the policyholder for care received at home, in an assisted living facility or in a skilled nursing facility.

Who decides when I can use my long term care policy?

Benefit triggers” for a long term care policy are based on 1) cognitive impairment or 2) activities of daily living. The insurance company will obtain medical records from your physician and in many cases order an independent assessment to determine benefit eligibility.

What is the best age to get long term care insurance?

According to industry data, the average age of long term care insurance applicants is 58 although applications are accepted up to age 79 (some hybrid policies can be written up to age 90). The younger you are the lower the cost of coverage and the more likely your health will enable you to qualify.

How much coverage is the right amount?

There is no “one size fits all” solution so this is something to discuss with your Long Term Care Specialist. Some of the factors to consider include:

  • Costs for care where you live or expect to be in the future
  • Your age and the future cost of care
  • How much you can pay for care out of pocket using recurring income like pensions, social security etc.

Are there less underwriting requirements with the newer type policies that combine with annuities or life insurance?

In some cases – yes. It depends on the carrier and type of plan. Some combination policies require no underwriting at all while others may have what’s called a simplified underwriting process. And with some carriers the underwriting is the same with combination policies as it is with traditional policies.

04

Medicare
Questions

When I turn 65 am I automatically enrolled in Medicare?

NO – unless you are already receiving Social Security you must contact Social to enroll.

Am I subject to penalties if I don’t enroll in Medicare when I turn 65?

NO – not if you or your spouse are still employed and covered under an employer’s group coverage.

Who pays my health care expenses after age 65 if I am still working and covered under a group plan?

If your employer has 19 or fewer employees, Medicare will be the primary insurer. If the employer has 20 or more employees, the group plan is primary.

When I leave my group coverage must I sign up immediately for Medicare?

No – there is a “Special Enrollment Period” of 8 months that begins the month after employment ends or the group health plan coverage terminates – whichever happens first – during which you can enroll in Medicare without penalty.

If I am 65 and have an 18-month COBRA benefit, can I wait to enroll in Medicare?

NO – You have only the “Special Enrollment Period” as described above and if you miss this, you must wait for the next open enrollment (January 1 – March 31) with your coverage not beginning until July 1 of that year. In addition you will be subject to a penalty of up to 10% added to your Part B premium for the rest of your life.

I am married, but have never worked. Am I eligible for Medicare when I reach 65?

YES – if your spouse has paid into Medicare for the required time, you qualify under a spousal benefit.

I am younger than 65 and collecting Social Security. Am I eligible for Medicare?

NO – you would not be eligible for Medicare unless you are disabled.

When I turn 65 and want to continue to work, can my employer force me off their group plan?

No – this would be considered age discrimination but it could make sense to compare the group coverage with the combination of Medicare and private Medicare Supplement insurance.