The Sandwich Generation: Planning for Your Family’s Future

Anyone experiencing the struggle of simultaneously caring for children and aging parents is part of the sandwich generation. Although generation is part of the phrase, it does not refer to people born at a specific time. Typically, these “sandwich” family caregivers will be in the thirty to forty-year-old age range and balancing duties to provide for their families and provide care duties for both children and parents.

Trends that Lead to an Increase of the Sandwich Generation

The rise in the numbers in the sandwich generation is a byproduct of influential trends. Two obvious and long-term trends are women who opt to give birth later in life and the increasing numbers of the senior US population. The third influence is the COVID-19 pandemic. Fear of placing aging parents into long-term care facilities where thousands have perished due to the coronavirus prompts many families to care for their elder loved ones in their homes or their parents’ homes nearby. Additionally, many in the sandwich generation continue to work remotely to balance income needs with care for their children and aging adult loved ones.

If this scenario reads familiar, you are not alone. You are most likely experiencing significant anxiety and stress as you juggle, in some cases, limited in-person schooling and activities for your children, career and increased financial expectations, family dynamics, and daily caregiver duties. Though this is a challenging time in your life, it does not have to be as impossible as it may seem. There are steps to take to help you provide the best outcomes possible in your sandwich generation endeavor.

How the Sandwich Generation Can Plan for Their Family’s Future

Start with a simple first step by reprioritizing “daily.” Suppose there seems an overwhelming number of tasks to accomplish in a day; prioritize between urgent and non-urgent categories to triage what needs addressing first. Also, make time for self-care to avoid caregiver burnout. Focusing on basics like nutritious meals, adequate sleep, and exercise will serve you and your loved ones well. Know your rights at your workplace. Programs like the Family Medical Leave Act (FMLA) offer job security to those taking a leave of absence for family medical reasons. While it is not a paid benefit, you will maintain access to your health insurance benefits for up to twelve weeks of time off. If you haven’t, explore working remotely to put you in the same physical location as those you care for in your home. And, of course, share your feelings about your burdens and get extra help when you need it. Talking things through with family members can better manage everyone’s expectations. There are also forums and community resources that can put you in touch with others in the sandwich generation, where you can share information and offload burdens.

Make an honest evaluation of your available resources before determining a course of action. Are your parents able to pay for their care on their own, even within your own home? Do they carry long-term care insurance or whole life insurance policies with living benefits? Do you have other family members willing to contribute financially, or is a public assistance option viable?

Talk things through with your parents about their preferences and abilities to pay. Include any siblings you may have and figure out who can help provide care and whose home provides the best solution. If external help is a must, research local resource possibilities and at what cost. Most importantly, consult an elder law attorney to ensure all relevant legal document requirements are at hand if a sudden financial or medical decision presents itself.

While your parents are a huge responsibility, it is crucial not to overlook the needs of your retirement that will protect your children’s lifestyle and future. College funds need to be a priority, as is a 401(k) plan if your place of employment offers one. Consider the purchase of a term or whole life insurance policy to protect your family’s future in the event a tragedy befalls you and your ability to care for your family. Start an emergency fund right away, as life is unpredictable. This fund can help cover incidental costs, unexpected medical bills, and a long-term hospital stay. Unexpected costs can throw your budget out of whack so try to be prepared ahead of time with some emergency cash on hand.

If your sandwich generation status continues for a long time, re-evaluate your finances periodically. Goals will change, and updating your estate plan and possibly your parents’ plan too may help you stay on track to meet your nuclear family’s long-term goals. You may need to renovate your home as your parents age for both their comfort and safety.

Money management and estate planning are critical elements to creating a mutually beneficial living experience as part of the sandwich generation. While this may not be the easiest time of your life with the multitude of demands placed upon you, it is survivable, indeed a situation where you can all thrive with adequate planning. Contact our Ruston, LA office by calling (318) 255-1760 for assistance in structuring your plan.

What Happens When Your Doctor Leaves Your Health Plan?

A doctor’s visit for most people is an important event. Often, you must explain your ailment quickly and succinctly, trust that your doctor has your best interests at heart and will keep your confidentiality; and make yourself vulnerable and talk about health issues that may be uncomfortable. Having a good relationship with your doctor can alleviate all these issues and can even increase the quality of your healthcare. So, you have a good relationship with a doctor you like, and you find out he is no longer in your health insurance network. Now what?

First, let’s examine why doctors leave health insurance networks. Usually, doctors leave health insurance networks for normal reasons such as retirement or if they move geographic locations. They are professionals, after all, and just as you probably have had to move to a new job, they do the same. Sometimes, there are other more technical reasons, such as if the doctor is unhappy with how the health insurance network conducts business. You’ll most likely be warned ahead of time if your doctor is leaving your network so you have time to plan, however, your doctor and your health insurance provider are not legally obligated to inform you if he is no longer covered. Unfortunately, huge surprise medical bills are all too common and these can leave you financially crippled for years. This is why it is so important when you reach your open enrollment dates each year that you call your doctor’s office and ensure your doctor is still covered under your plan.

So, what do you do if your doctor leaves your network? You may have continuity of care protection, which enables you to retain the same level of care from your doctor, for the same copays and fees, temporarily. If you are a senior who participates in a Medicare Advantage plan, you have the option to leave your health care network if your doctor does and if the network change is “considered significant based on the [effect] or potential to affect current plan enrollees” according to the Centers for Medicare and Medicaid Services guidebook. If you are currently covered under a private plan and are considering switching, it is prudent to call your doctor’s office and ensure they are covered under the new plan you are considering.

What if you can’t switch plans? Often, doctors will allow you to pay cash for your visits. You may be able to negotiate a reasonable cash price with your doctor because they won’t have to bill your insurance, which would save them time and administrative costs. If your doctor’s cash price is relatively expensive, it may still be worth it to you to maintain continuity of care.

If the previous options are out of the question for you, the next best thing to do is just to ask your doctor if they have any referrals. After all, your doctor will know your situation best and how to provide the best care and may know someone else who will be a good fit for you.

Having a doctor you like and trust can be such a relief and it’s always an unfortunate circumstance when your health insurance network no longer covers that doctor. Fortunately, there are ways you can plan for this and methods to make a smooth transition to a new doctor. If you need assistance in this process or have questions about anything you have read, please reach out to our office. Please contact our Ruston, LA office by calling us at (318) 255-1760 or schedule an appointment to discuss how we can help with your long-term care needs.


What To Know About Telehealth Coverage

Many health systems and hospitals have been coping with many unprecedented challenges during the coronavirus pandemic of 2020. There has been a need to increase and safeguard healthcare staff as well as non-COVID-19 patients, testing and treating infected patients, expanding critical care unit capacity, procuring personal protective equipment (PPE), and canceling non-emergency patient procedures. The American Hospital Association estimates that healthcare systems are losing an average of 50.7 billion dollars a month. This financial crisis is jeopardizing the telehealth industry as insurance groups seek to lower rates for virtual appointments. Without payment parity equivalent to an in-person appointment, many health care systems will be unable to continue telehealth services.

COVID-19 has brought telehealth from a niche service to a common practice in less than a year. The assurance of physical distance, preservation of PPE, and limiting infection spread has been invaluable. Yet, despite the advantages telehealth provides, insurance coverage, prescribing, and technology access remain limiting factors. The federal government created the Coronavirus Aid, Relief and Economic Security Act (CARES Act) to address these concerns, removing many barriers to promoting telehealth expansion. The Centers for Medicare and Medicaid (CMS) created a toolkit to encourage state Medicaid agencies to adopts CARES Act standards, and many private insurers followed suit. Still, telehealth’s subsequent explosive increase in patients became unprofitable. The resulting financial strain on the healthcare system and insurers may force telehealth provision limitations, although the public health crisis remains.

Early in 2020, the use of telehealth saw an increase from 13,000 to 1.7 million Medicare recipient visits per week. During the height of the national lockdown, between mid-March to mid-June, the number of Medicare recipients receiving telehealth care was more than nine million. Meanwhile, private insurers, mimicking the CARES Act policy changes, saw telehealth claims increasing upward of 4,000 percent from 2019. The CARES Act intended to last until the public health emergency was over. With the advent of this flu season and the possibility of a second wave of coronavirus, there is a call for telehealth’s expansion to become permanent.

However, many private insurers are changing their telehealth coverage policies for non-COVID-19 issues due to financial losses. United Healthcare will no longer waive co-pays and other fees for non-COVID related appointments. Other insurers like Anthem BlueCross BlueShield will extend coverage through the end of 2020; however, only the first two telehealth sessions will be free for the consumer. Telehealth billing standardization remains elusive as each private insurance plan, and many state-funded Medicaid plans have varying rules and dates for what telehealth treatments have coverage. Some patients are paying more, while others are paying less. Costs are confusing, and patients may be delaying healthcare to avoid a surprisingly expensive bill.

America’s Health Insurance Plans (AHIP) is a trade and political advocacy association of health insurance companies with certifications for Medicare Advantage and other CMS governed health plans. Working with public and private sectors, AHIP implements solutions to lower out-of-pocket costs, which can be a barrier for people seeking telehealth medical care. AHIP’s website lists many insurance providers and general information about their coverage, often addressing telehealth. If you or a loved one requires telehealth coverage, it is the optimal time to review your health care coverage for 2021 as the insurance industry is in its annual enrollment program.

Diminishing coverage for telehealth visits will continue to impact Americans this fall and beyond. Patients are paying more while health care practices are earning less, and the risk of infections increases. Health insurers seem to be driving patients back to the in-person appointment model. Telehealth is truly innovative and protective during the coronavirus pandemic, but its continuation will suffer unless it can also become profitable.

If you have questions or would like to discuss your own planning needs, please don’t hesitate to reach out. We would be honored to help. Please contact our Ruston, LA office by calling us at (318) 255-1760 or schedule an appointment to discuss how we can help with your long-term care needs.