Southwest Florida's Health and Wellness Magazine Health and Wellness Articles
By Ulla-Undine Merritt (Dee) National Producer Number (NPN) 8853366
For some they will be for the better and for others for the worse. Looking back at the “Obama Care” Affordable Care Act, you may have received a tax credit (within 100%-400% of the poverty level) to help with your insurance premium and reduce the cost of your healthcare. This gave many people the opportunity to receive health insurance at no cost for extensive healthcare with a maximum out of pocket cost of $500 while others paid higher based on their financial situation. Great deal…$0 for insurance and $500 maximum all year for your healthcare no matter what potential health surprises the year brings!
I know many that that found themselves needing it and could not have afforded the care they needed without it. An unforeseen consequence of this is that many employers that had offered group health insurance in the past, stopped offering health insurance because their employees could do better if they did not offer health insurance due to part of the law that said you could not be eligible for group coverage to qualify.
Another area where things got sticky, is where the information people filled out in their application didn’t match their tax position at the end of the year and required some to be required to pay money back. Some people possibly didn’t think they would get caught or others may not have understood the law and filled out the information incorrect, stating that they made less money until they did their taxes found they owed money back. There is also the case where many didn’t think they qualified because they didn’t understand the law fully and did without it. I have even seen someone that made $1 too little, so they didn’t receive any subsidy and therefore, could not afford health insurance. The challenge is that you are projecting what you think your income will be. Potentially, you could work more hours, change jobs, get a raise, lose your job, or you’ve become sick and can’t work as much as before. These things can change your income.
There are many people that have always paid to have health insurance and now can’t afford it. They are hard working families that have a lot to lose if they get sick and aren’t in the financial situation to
absorb the high cost of health care without insurance. However, with the cost of health insurance at $40,000 under the Affordable Care Act, one family simply could not afford the cost of the insurance in the first place. I think we can all agree that this certainly is not affordable for most people. Thankfully, we were able to help this family and reduce their health plan cost to $7,600 for the year with a national carrier with great benefits.
You don’t know what you don’t know…so you should always work with a broker that represents many insurance companies and can explain the best of all options available to you. As a broker, it is our job to understand the products out there and even if we don’t represent a company, we can happily refer you to someone local to buy the coverage that works best for you. There are alternatives out there and you should never go without health insurance, so please feel free to contact us…we’re here to help!
Many employers are starting offer health insurance again to help their employees, the cost can be a lot less based on the age and number of employees. If your employer does not offer health insurance, you should talk to them and ask them to explore this option. The worst they can say is “no” and maybe it would help them out as well.
Some notes on MEDICARE…the 2018 Social Security cost of living increase this year was not much help, given the Part B cost for many went from $109 to $134 per month. Open enrollment ended December 31, 2017 for changing your Medicare Advantage and Part D (drug) plans. January 1st to February 14th is Medicare Disenrollment Period, this is when you can unenroll from a Medicare Advantage Plan, go back to original Medicare, or buy a Part D drug plan.
You can change or buy a Medicare Supplement all year long, but you must medically qualify! This is not always easy, and you should always wait to see if you qualify before buying a Part D as it will kick you out of your Advantage Plan. Why choose an original Medicare plan and a Medicare Supplement or not? Did you know that many Skilled Nursing or Assisted Living Facilities do not accept any other insurance except original Medicare? This is one major reason to pay for a supplement vs. an Advantage Plan, which manages your care through an insurance company.
Moving? There is a special election period if you are moving out of your plans service area. For example, if you moved from Collier County to Lee County, your plan might not be offered in your new county of residence. That doesn’t mean that you can’t see a doctor in your original county but it is just based on your residence. Now most plans are sold in neighboring counties but when moving from the east coast to west coast of Florida or from another state, the chances are you will need to change your insurance and the timing is VERY important. There are other special election periods that could allow you to make changes to your health insurance but those times are limited, so don’t delay asking an insurance broker about your options.
An annual review is very important, as laws, options, and cost can change. Too many times people assume they understand their coverage and all too often do so incorrectly. Don’t assume anything and take the opportunity to get any questions you might have answered by a qualified professional, as most initial consultations are at no charge.
To learn more, feel free to contact or schedule an appointment: Logical Insurance Solutions- Dee Merritt www.Logicalinsurance.com 239-362-0855 Dee@Logicalinsurance.com
