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Final Expense FAQ

  • What is Medicare?
    Medicare is the federal health insurance program for people who are 65 or older. It is also available for certain people younger than 65 with disabilities or people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD).
  • At what age can I qualify for Medicare?
    You can qualify for Medicare by age once you are 65 years or older. You will become eligible to enroll three months before your 65th birthday until three months after turning 65. This window is called the Initial Enrollment Period. You can apply for Original Medicare during this period if you are eligible. If you decide to delay your enrollment, you may face a late enrollment penalty whenever you decide to enroll for Medicare at a later time. However, you can avoid these late enrollment penalties as long you qualify and enroll during a Special Enrollment Period.
  • What are Medicare Supplements?
    Original Medicare, Part A and B, pays for many of your health-care services and supplies, but it doesn’t pay for everything. That’s why you may want to consider getting a Medicare Supplement plan, also called Medigap. Medigap plans supplement your Original Medicare benefits, which is why these policies are also called Medicare Supplement plans.
  • How do Medicare Supplement (Medigap) plans work with Medicare?
    Medigap plans supplement your Original Medicare benefits, which is why these policies are also called Medicare Supplement plans. You’ll need to be enrolled in Original Medicare to be eligible for Medigap coverage, and you’ll need to stay enrolled in Original Medicare for your hospital and medical coverage. Medicare Supplement plans aren’t meant to provide stand-alone benefits. Depending on the state that you live in, you may not be able to get Medicare Supplement coverage if you’re under 65 and have Medicare because of disability, end-stage renal disease, or amyotrophic lateral sclerosis. States aren’t required to offer Medigap coverage to beneficiaries under 65. If you’re under 65 and enrolled in Original Medicare, check with your state’s insurance department to find out if you’re eligible to enroll in a Medicare Supplement plan. Keep in mind that Medigap plans don’t include prescription drug coverage (Part D), so if you want help with your medication costs, you’ll need to enroll in a stand-alone Medicare Prescription Drug Plan. In addition, you can’t use your Medicare Supplement plan to pay for costs you may have with a Medicare Advantage plan. Medigap insurance can only be used to cover costs in Original Medicare. If you have Original Medicare and a Medicare Supplement plan, Original Medicare will pay first, and your Medigap policy will fill in the cost gaps. For example, suppose you have a $5,000 ambulance bill, and you have already met the yearly Medicare Part B deductible. Medicare Part B will pay 80% of your ambulance bill. If you have a Medicare Supplement plan that covers Part B copayments and coinsurance costs, then your Medigap policy would then pay the remaining 20% coinsurance of your $5,000 ambulance bill. Some Medicare Supplement plans may also cover the Part B deductible.
  • What types of coverage are not Medicare Supplement plans?
    As a Medicare beneficiary, you may also be enrolled in other types of coverage, either through the Medicare program or other sources, such as an employer. When you first sign up for Original Medicare, you’ll fill out a form called the Initial Enrollment Questionnaire and be asked whether you have other types of insurance. It’s important to include all other types of coverage you have in this questionnaire. Medicare uses this information when deciding who pays first when you receive health-care services. Below is a list of other types of insurance you may have. Please note that these types of coverage are different from Medicare Supplement plans: Medicare Advantage plans (like an HMO or PPO) Medicare Prescription Drug Plans (Part D) Medicaid Employer-or union-sponsored group coverage TRICARE Veterans' benefits Long-term Care insurance policies What benefits do Medicare Supplement plans cover? Currently, there are 10 standardized Medigap plans, each represented by a letter (A, B, C, D, F, G, K, L, M, N; there’s also a high-deductible version of Plan F). These plans are available in most states; Massachusetts, Minnesota, and Wisconsin each have their own different set of standardized Medicare Supplement plans. Coverage levels and premiums vary, but the benefits of each plan within a lettered category remain the same despite the insurance company or location. For example, Plan A benefits are the same in New Jersey as they are in Oregon. If a Medicare Supplement plan includes a certain benefit, this benefit is covered 100% unless otherwise specified.
  • What is Medicare Advantage?
    Medicare Part C is also known as a Medicare Advantage plan. As with SIMs, Advantage plans come from private providers. These plans include and replace Medicare Part A, B, and D coverage, with the exception of hospice care. Medicare pays the premiums for participants. Plans have a structure of health maintenance organization (HMO), preferred provider organization (PPO) plans, private fee-for-service (PFFS) plans and special needs plans (SNPs). The federal government forbids private insurers from selling Medigap policies to individuals enrolled in Medicare Advantage. To be eligible the individual must live in the plan’s service area, have Medicare Parts A and B, and not have an end-stage renal disease. These plans come from private providers who have government approval.
  • What are the types of Medicare Advantage plans?
    Health Maintenance Organization Plans HMO plans typically limit their coverage to in-network healthcare providers. This means there is a list of health providers to choose from, but you may cover all the out-of-pocket costs for the services if you choose to receive care out-of-network. These plans may also require you to select a primary care physician from one of their networks and get referrals when a specialist is needed. Preferred Provider Organization Plans PPO plans offer more flexibility than HMO plans but at a higher cost. Though each PPO plan has a list of in-network providers, you will typically have the option to get healthcare services from out-of-network providers. However, you will pay more for these services but will still get more coverage than you would with an HMO plan. Also, you don’t need a referral to go to a specialist, nor are you required to choose a primary care physician. Private Fee-For-Service Plans This type of Medicare Advantage plan allows you to keep or choose any healthcare provider as long as they accept the terms of your Medicare Advantage plan. You won’t be required to choose a primary care physician or get referrals to visit a specialist. However, this plan will decide how much they will pay for your services, as well as how much you will pay. Special Needs Plans Medicare Advantage Special Needs Plans are available to individuals with chronic health conditions and specific healthcare needs. These plans will cover everything that Original Medicare does, and they are required to provide prescription drug coverage. The three types of Special Needs Plans are: Chronic Condition Special Needs Plans. Institutional Special Needs plans. Dual Eligible Special Needs Plans.
  • What is ACA?
    The “Affordable Care Act” (ACA) is the name for the comprehensive health care reform law (passed in 2010) and its amendments. The law addresses health insurance coverage, health care costs, and preventive care.
  • What ACA rules apply?
    If you are subject to ACA rules, you are expected to meet the Individual Mandate each calendar year, or you will be subject to tax penalties when you file your Federal tax return.
  • What determines ACA eligibility?
    Under the Affordable Care Act (ACA), Medicaid coverage is extended to nearly all nonelderly adults with incomes at or below 138% of the federal poverty level (FPL) (about $23,556 for a family of three in 2022) in the 42 states (including DC) that opted to expand as of March 2023.
  • What is the summary of the ACA?
    ACA provides Californians with better health security by setting up modifications that expand coverage and lower health care costs. It also ensures more choice and enhances the quality of care for all. The law has created marketplaces, popularly known as exchanges, where consumers can compare plans in an easier format.
  • Who needs ACA reporting?
    Applicable large employers (ALEs) are required to report under the Affordable Care Act. ALEs have an average of 50 or more full-time employees, including full-time equivalent employees (FTEs), during the prior year.
  • What does life insurance cover?
    By paying a monthly premium or a lump sum to your insurer for life cover, you can safeguard your loved ones from financial hardship if you die or suffer from one of a list of illnesses. The money can be put towards funeral costs, payment of a mortgage, debts, or your family's living expenses.
  • Do I have to take a medical exam to get a life insurance policy?
    Yes, a medical exam is almost always part of the traditional life insurance underwriting process. There are a few no-medical exam life insurance policies out there, but they typically tout lower coverage amounts and higher prices than comparable policies subjected to the full underwriting process.
  • What’s an underwriter?
    An underwriter works for the insurance carrier and is basically tasked with figuring out how risky you are to ensure — or what classification you belong in. As we mentioned, they’ll look at your paramedical exam results, medical records and even your motor vehicle reports.
  • What’s a death benefit?
    The death benefit is how much the life insurance policy pays to your beneficiary, untaxed and in a single lump sum, should you die. That amount is considered the "face value" of the policy. Before you ask, "face value" is a fancy way of saying how much your policy is worth. And, just in case, your beneficiary is the person you designate to receive the death benefit.
  • What is term life insurance?
    Term life insurance is a policy that covers you for a fixed period of time. So, if you die during the term, your beneficiary gets the death benefit. Permanent life insurance, on the hand, covers you permanently. Your beneficiary is still entitled to the death benefit when you die, but there’s also a cash value component you can borrow against or partially cash out after a period of time.
  • How to cancel my CRM/DAILER Subscription?
    The flat fee recurring charge will continue until the customer cancels the CRM/DAILER Subscription. How to Cancel Your Subscription: Select the "Login/Signup" option on the top page Enter your email address. Consult your email for the login link to the Customer Portal. Choose "Cancel" and provide a reason for your termination. Your subscription will conclude at the end of the current billing cycle.
  • How can I become a BHB agent?
    Please fill out an agent application: https://www.bhbhub.com/agent-application
  • How can I sign up for Medicare/ACA/Final Expense Insurance?
    Please submit the "Insurance Enrollment" form at the bottom: https://www.bhbhub.com/insurance-products
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