Desert Health News - March-April 2024

. YOUR FINANCIAL HEALTH By Michele T. Sarna, CFP ® , AIF ® What Will Your Garden Grow? Planning for the future and growing a garden are quite similar. When we set out to grow a garden, we need a plan to determine the desired results. Do we want to harvest the garden to feed the family? Contribute to a community? Use it to accent what we already have available to us? Or plant a specific flower like tulips? The same thought process goes for investing. Are we relying on the investments for financial security through our golden years? Paying for college? Or supplementing an income such as a pension or family inheritance. Planting the seeds. Once we know what type of garden it will be, we need to prepare the soil before planting the seeds. The soil of a garden is the basis for success and needs proper preparation and irrigation. To properly invest for our desired goals, a financial plan should be implemented to prepare the roadmap, define those goals and decide the timeline needed to determine the types of investments (asset allocation) used. Depending on the desired goals, a garden may be planted in sections to produce different outcomes throughout the year. Knowing what season is right for planting those vegetables, fruit, herbs or flowers will aid in the success of your garden. Much like one must consider timing and diversification of investments to meet desired financial goals. Maintaining the garden. Throughout the process, you may need to add more fertilizer or treat the soil to ensure its nutrients are enough to sustain the term of the harvest. Likewise in planning, reviewing the goals and adjusting expectations and timelines will reap a successful outcome. One also needs to be prepared for the unexpected. In gardening, an irrigation issue that causes flooding, extreme weather, or a lack of water will disrupt the growth and success of the garden. In that case, a new crop may need to be planted or suspended until the next season. In financial planning, an emergency or situation could derail the success of the plan. Although proper planning includes safeguards like an emergency fund, some circumstances may deplete the fund or may be too big to be diminished by the savings; therefore, the goals need to be adjusted and the timeline for the success of those goals extended. Whether it be a garden or future goals, a well thought out plan with the ability to pivot as needed will bear the fruits of your success. Michele Sarna is a certified financial planner™ with Beacon Pointe Advisors and can be reached at (760) 932.0930 or msarna@beaconpointe.com . www.DesertHealthNews.com March/April 2024 Financial Health The Valley ' s Leading Resource for Health and Wellness 18 www.millermehr.com We are a team of innovative consultants serving the Greater Coachella Valley. We help relieve the burden and mystery of accounting and taxes. Our industry expertise includes accounting, tax planning, and accounting systems setup and training for high-net-worth individuals, businesses in health care, transportation, restaurant, retail, real estate, non-profits and more. Using Cloud based technology streamlined for businesses and individuals, we will help you to: • Strategize to minimize your income taxes • Get out from under piles of paperwork, clean up your books, and get back to growing your business • Banish any stress over payroll, billing and tax preparation • Setup computerized accounting systems and software applications • Always know and understand how your business is performing • Make better decisions by having access to reliable financial information and guidance Trusted Specialists for Businesses and Individuals Proudly serving a number of Desert Health clients (760) 779-8946 74-710 CA-111 #102 • Palm Desert info@millermehr.com • ww.MillerMehr.com Steven J. Miller, CPA, Partner Helena M. Mehr, Partner www.beaconpointe.com Where will your future take you? 73-833 El Paseo Drive, Suite 102 Palm Desert, CA 92260 beaconpointe.com Michele T. Sarna, CFP ® , AIF ® Managing Director, Partner Phone 760.932.0930 msarna@beaconpointe.com Provided as information only and should not be considered investment, tax, or legal advice or a recommendation to buy or sell any type of investments. Asset Allocation, portfolio diversification, and risk strategies cannot assure or guarantee better performance and cannot eliminate the risk of investment losses. Form ADV contains important information about Beacon Pointe Advisors, LLC, and may be viewed at: www.adviserinfo.sec.gov. Build strength and security through understanding your financial picture–where you are, where you want to go, and how to get there. Let us help you through your financial journey with comprehensive financial planning. Provided as information only and should not be considered investment, tax, or legal advice or a recommendation to buy or sell any type of investments. Asset Allocation, portfolio diversification, and risk strategies cannot assure or guarantee better performance and cannot eliminate the risk of investment losses. Form ADV contains important information about Beacon Pointe Advisors, LLC, and may be viewed at: adviserinfo.sec.gov. Think of your financial strategy as seeds to harvest for a bountiful future. Most of us are enrolled in some type of managed care health plan. Managed care means you agree to allow a private insurance group or physicians group manage your access to health care. From the insurer’s point of view, these are cost containment measures, and they can be frustrating to deal with if they are unexpected or delaying your care. What type of plan do I want? Managed care comes in three most common plan types: HMO, PPO and Part D drug plans. Almost all plans for those under the age of 65 are PPO or HMO. If you are in a Medicare Advantage plan, it is an HMO or PPO, and if you have Original Medicare plus a supplement, you might also have a Part D drug plan. It can get complicated, so we can all benefit from learning how to navigate the managed care process. Do I need pre-authorizations? In all plan types mentioned, the insurer has the right to request prior authorization for any procedure. With an HMO, authorization for a referral to care from anyone other than your primary care provider is required. This prior authorization allows the insurer to control the cost by confirming that the procedure is deemed necessary by their guidelines and priced within their contract parameters. For example, having physical therapy after an injury might be limited to only a few sessions until your doctor requests further treatment. Knowing this can help you get ahead of the delay by simply communicating the need for further sessions well in advance. Is my doctor in their network? The provider network is another managed care tool with which you must work. Both HMO and PPO plans have a network of contracted providers. These health care professionals and facilities have signed a contract agreeing to the payment terms of the insurer. However, you do have the right to request treatment out of network. In a PPO plan, this can be arranged directly with the provider if they agree to accept your insurer’s reimbursement rate and bill you the balance. In an HMO, your primary care provider is responsible for finding the referral, and if it is out of network, it will not cost you more, but it may delay care, and the referral will be on a case-by-case basis. So, seeing that care provider once does not mean you will always have access to them. On drug plans, prior authorization and quantity limits are imposed on many medications, especially controlled substances and expensive brand name drugs. Authorizations are specific to the exact dosage prescribed as well, so if your doctor changes your dosage, you may have to request authorization all over again. We see this a lot with Ozempic and other GLP1 meds, where the normal course is to raise dosage as treatment progresses. Does theplancovermymedications? Drugplans are required tocover onemedication in each class of drugs. If your medication is not covered, you can request a formulary exception. This requires the prescribing physician to certify that the covered drug is “contra-indicated” in this patient, meaning it either does not work for you or causes a side effect. In this case, the drug plan is required to cover the same class medication at the agreed cost of the drug that is on their formulary. This can save you thousands of dollars over the course of treatment. Being prepared for these cost containment practices can help you avoid surprises and frustration in dealing with any medical treatment or drug therapy. Randy Foulds of FouldsHealth InsuranceAgency is an independent broker andMedicare specialist in La Quinta (license #0G69218) and can be reached at (760) 346.6565. This is provided for informational purposes only and is not intended to substitute for professional advice. Managing Your Managed Care By Randy Foulds