Health Insurance – FACTS

By Ulla-Undine Merritt (Dee) National Producer Number (NPN) 8853366

Fact the Affordable Care Act (Obama Care) is still a big part of our current health insurance and I believe it will be for many years. President Trump has signed many documents that can change our health insurance system, but change doesn’t happen overnight.

So in 2018 you are required to have health insurance or you must pay a penalty for each month you did not have it. * Not having health insurance this year will cost you: The penalty is $695 per adult and $347.50 per child for a maximum of $2,085 per family, or 2.5 percent of the household income, whichever is greater. … If you owe a penalty, you’ll pay it when you file your income tax return. *(AARP)

In Lee & Collier County our options are very limited we have Florida Blue that sells health insurance both on and off the Market Place (Obama Care). The open enrollment period is normally from November 1-Dec15 for a January 1st effective date. Cigna also sells qualified full coverage health insurance plans, but not on the Market Place and they do not advertise this and have stopped working with insurance agents to reduce new policy holders. There are special election periods where you can still get on these plans but you must have a special reason such as loosing creditable coverage from your employer, moving out of the plans service area, marriage, etc. A major complaint for people that are purchasing this coverage is the cost. If you do not qualify for government subsidy due to your income, your income could be too high or even to low; Florida did not do with Medicaid expansion.

Many people have opted for alternatives such as Indemnity Health Insurance Plans or Short Term Plans. An indemnity plan pays a set amount for a service and may not have a contract with providers. As an example it might pay $50 for a doctor visit, but the cost may be $100 as a cash pay patient. So they have a set amount they pay regardless of the cost. A Short Term policy could be a PPO that has a provider network; it may have co-pays, deductibles and an out of pocket maximum that you could pay. So you know the maximum risk you could encounter during the term. Currently short term policies can only be sold for a maximum of 91 days, but you can add another 3-month at the time of purchase. So in a year you could have 4 plans. Both of these types require you to be healthy and they do not pay for preexisting conditions.

There seems to be a lot of confusion as to when you are eligible for Medicare. It is when you are 65, unless you are eligible due to a disability. It’s confusing because Social Security full retirement age is 66 right now for people born in 1953. If you are not on an employer group plan and you do not take Medicare when you are eligible and you decide to do so later you will be subject to a penalty. Your monthly Part B premium will go up

10% for each 12-month period you did not have it and it will last for the rest of your life that you are enrolled. Part D (drug plan) the penalty is 1% of the national average ($35.02 for 2018) for each month you did not have it and again once you take a drug plan the penalty will be added to your premium for the rest of your life that you enroll in a Part D Drug Plan. Low income Medicare eligible may not be required to pay the penalty but you must apply for low income subsidy.

Insurance can be very confusing and you should not do it alone as a professional. Did you know that in most cases insurance agents do NOT charge for their services? They are paid when you purchase a product from them. So please don’t pick a agents brain and then take their advice and do it yourself online. Work with a Broker that works with many companies and that will work with you each year to make sure that your needs are always meet. Research the agent that you are working with or ask your friends if they can recommend someone. Get to know the agent and you should always feel comfortable and never pressured. Most agents have your best interest at heart, but make sure they also have the knowledge.

LOGICAL INSURANCE
HDQ 2365 West First Street, Fort Myers, FL 33901
Ulla-Undine (DEE) Merritt – Broker –Logical Insurance Solutions USA, Inc.
To learn more or schedule an appointment contact: Logical Insurance Solutions USA, Inc. www.Logicalinsurance.com 239-362-0855
Local Agents – Marco Island, Naples, Bonita Springs,
Fort Myers, North Fort Myers