Caregivers: Get Ready for Health Insurance Open Enrollment

Senior caregivers — especially CNAs and Home Health Aides, are certainly considered members of the healthcare industry. Ironically, many don’t have adequate health insurance. If you are a Certified Nursing Aide or other professional caregiver and work through a quality senior home care agency or nursing home, chances are you have some medical insurance coverage through your employer. However, if you work as an independent contractor, come 2014, you will need to enroll in a health insurance plan per the Affordable Care Act.

If this affects you, our friends at have recently released answers to frequently asked questions regarding health insurance open enrollment for 2014.

Open Enrollment for 2014 Health Plans: Frequently Asked Questions

When is the new open enrollment period?

The first-ever open enrollment period for individual and family health insurance plans under the Affordable Care Act begins October 1, 2013 and continues through March 31, 2014. Open enrollment periods in succeeding years will be shorter than this one-time six-month period.

What is an open enrollment period?

The Affordable Care Act’s open enrollment period is when individuals and families can purchase health insurance plans that meet the requirements of the health reform law. Coverage under these new plans will begin no earlier than January 1, 2014. New health plans will provide coverage for essential health benefits defined by the ACA. Consumers who qualify will be able to apply for government subsidies and enroll without fear of being denied for pre-existing medical conditions.

Who needs to apply for coverage during open enrollment?

The new open enrollment period is for individuals and families who do not have employer-sponsored major medical health insurance meeting the requirements of the Affordable Care Act. If you already have employer-based major medical health benefits, you do not necessarily need to enroll in a new plan during the open enrollment period, but rather through your employer’s own open enrollment period for group coverage. If your share of your employer-sponsored health insurance monthly premium is deemed too costly under the law, you may choose to opt out of that plan and purchase a qualified health plan with subsidy assistance, depending on your income level.

Will I be required to purchase a health insurance plan during this period?

If you are currently uninsured and wish to enroll in a health reform-compliant plan for 2014, you will need to enroll during this open enrollment period. If you don’t purchase a health reform-compliant plan, you may be subject to a tax penalty and it may be difficult to find and qualify for health insurance later in the year. If you are currently enrolled in an individually purchased health insurance plan, you may be able to retain your current coverage into 2014. Ask your health insurance company for more details.

What happens if I don’t purchase during the open enrollment period?

Outside of open enrollment, your ability to apply for health insurance may vary from state to state. It may be limited to the occurrence of a qualifying event, such as the loss of a job, a marriage or divorce, a move, or the birth of a child. 

What if I miss open enrollment and don’t have a qualifying event?

You may be able to purchase a health plan that is not in compliance with the health reform law, like a short-term health insurance plan. However, these plans may not meet the standards of the Affordable Care Act and you may be subject to a tax penalty on your 2014 federal tax return.

If you need to shop for affordable insurance, we’ve made it easy for you to compare the rates of healthcare insurance providers.

Caregivers, let us know — how do you feel about mandatory healthcare insurance and the Affordable Care Act? Are you covered through your Senior Home Care Agency?

Supreme Court Upholds Affordable Care Act

Obama Care, or the Affordable Care Act healthcare law has been upheld by the Supreme Court of the United States.  The controversy around the healthcare law was the requirement for all Americans to have access to health insurance and be required to have health insurance.  Right now, it is very difficult for small businesses to access affordable health insurance plans as most health insurance companies only want to insure large corporations with 75% participation by workers.  This has meant senior home care agencies have not been able to provide health insurance for senior caregivers............which has always seemd a bit odd - for someone to be paid to take care of a senior but yet not be provided with health insurance benefits for themselves.

In addition, all American seniors do receive health insurance via Medicare or Medicaid at age 65.  A geriatric doctor once said to me:  "if only all of these seniors had health insurance their entire lives, the costs of providing health care at 65 and above would be much less."  He said you have no idea how many seniors have never had health insurance prior to Medicare or Medicaid.

At the same time, those of us who are individually insured may pay as much as $350 per month with a $5,000 deductible.  This is how it works for those working for small businesses or self-employed.

Senior caregivers should have access to affordable health care - the only option should not be an emergency room.  Certainly provisions will be tossed onto the truck and off the truck as we iron out a better healthcare system in the U.S.A. which includes preventive healthcare.

You may read all about the Supreme Court's decision on this live blog.  It will be exciting to see American health insurance companies roll out preventive health care plans that reward people for trying to live healthy lifestyles and to have the security of knowing everyone has access to health care - not just seniors at age 65.

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Caregiver Health Insurance

As Congress debates the healthcare overhaul legislation, Caregiverlist decided to find out if professional caregivers receive healthcare benefits, as oftentimes companies require caregivers to be full-time employees to qualify.

The results?  Only 26% of Caregivers said "Yes, as a professionally employed senior caregiver, I receive healthcare benefits."

Another 18% of Caregivers said the do not participate in their company health benefit program because the co-pay is too much.

Caregiverlist Survey:
Professionally Employed Caregivers Receiving Health Insurance as a Benefit:  26%
Professionally Employed Caregivers Not Participating in the Company Health Insurance Because it is Too Costly:  18%

However, those Americans who do not have insurance, are not turned away from emergency rooms for care, even if they are unable to pay.

According to Northwestern Memorial Hospital's annual report (Northwestern is located in downtown Chicago, Illinois and is a leading university research hospital), in 2008, $28.6 million was spent on providing "charity care" to these individuals who did not have insurance and could not pay for care.  Another $110.3 million was for the additional costs of unreimbursed Medicare and Medicaid patient care.

Because healthcare is not available to everyone - even co-pays can be too expensive for small businesses and individuals because they do not enjoy the benefit of having risk spread out over a large number of people - health care costs are higher for those who do pay and insurance costs are higher.

Many Americans only receive health insurance for the first time in they go onto Medicare insurance, which everyone receives at age 65.

One wonders what would happen if preventive care were part of our system.  In addition, as the baby boomer population numbers 77+ million people, many more senior caregivers will be needed.  It would be nice to know that individuals who must quit their jobs to care for a relative and caregivers working for small businesses will have access to affordable health insurance.  As we try to find the best ways to provide care for seniors, Caregiverlist hopes we can also pave the way to provide care for the senior caregivers through affordable health insurance benefits. , ,

Healthcare Legislation Update: Senior Caregivers Will Have Health Insurance

Many senior caregivers who work part-time or who work for smaller senior care companies do not have health care benefits.  However, the health care legislation which recently passed the House of Representatives and now is up for consideration by the Senate, would provide a program where all employees would receive health care.

Impact to Caregiving Employees of the Recently passed health care bill in the House of Representatives:

  • Employers will be required to cover all of their employees for health insurance
  • Employers will be required to pay 72% of the single premiums and 65% of the family premiums
  • Low-income employees will receive subsidies to purchase coverage
  • There will be no pre-existing condition clauses
  • The insurance rate difference between young and old employees will be less (rating bands will be shrunk)
  • Costs projected to be $1.2 trillion dollars (paid for via savings to Medicare and taxes on the wealthy)

The Senate debate continues, with most negotiations happening behind closed doors.  The Senate vote is expected after Thanksgiving or possibly in 2010.  The proposed health care changes would not take effect until 2013.

Find out about current caregiver employment benefits and training programs on Caregiverlist's Career Center.


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Better Healthcare for Caregivers

Ironically, senior caregivers, as the people on the front lines of providing the daily care needs, very often do not have robust health care insurance through their employers.  Caregiving can be physically and emotionally draining, much more so than many other careers.  Senior care corporations have the same challenges as other small businesses in the U.S. - difficulty providing for benefits for employees who make less than six figures a year and difficulty qualifying for group plans because of high turnover in employees and a high number of part-time employees (caregiver turnover is a necessary part of caregiving as senior clients get better or pass away).  At the same time, a little preventative care would go a very long way in helping caregivers manage a healthy lifestyle. Stress turns to distress when it is not handled positively and results in physical, mental and emotional health issues.  As stress comes with the territory of caregiving, effective health insurance to assist with combating stress should always be provided to caregivers.

Following are some of the health effects of stress on the body.   As caregivers for seniors are assisting with end-of-life issues, along with the daily activities of living, it is important they are able to effectively manage the stresses that come with caregiving.
  • Disturbed Sleep (sleeping too much or too little)
  • Difficulty Concentrating
  • Appetite changes (eating too much or losing appetite)
  • Overacting to situations (easily angered or irritated)
  • Need to be alone (isolation)
  • Constant negativity
  • Moodiness and hypersensitivity
  • Loss of confidence
  • High blood pressure
  • Headaches
  • Breathing problems (anxious or can't catch breath)
  • Unmotivated and feeling tired constantly
  • Muscle tension and pain (the kink in your neck that doesn't go away)
Studies show that the combination of one or more of the health effects of stress can lead to diseases such as substance abuse, heart problems, strokes, hypertension, ulcers, depression, skin problems, severe weight gain or weight loss, to name just a few.

As the need for senior caregivers continues to grow along with the aging population, it is important our country considers the health care needs of all workers.  The New York Times/CBS news poll indicates wide support for a government run health care program.  Americans said they would be willing to pay higher taxes for a universal health plan.  It seems to make sense that the health care industry should be a fan of this new plan which would help them support their frontline caregivers better.

Starbuck's founder, Howard Schultz, experienced the challenges of living without health insurance along with the economic hardships that come with it, as his father did not have a job providing health insurance.  He went down a very long and winding road to be able to provide health care coverage to Starbuck's employees and this continues to be a benefit he believes in, even when the shareholders protest because of the costs.

Let us know what your health care benefits are as a caregiver - post your comments and join the conversation. 
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