Southwest Florida's Health and Wellness Magazine Health and Wellness Articles
By Ulla-Undine Merritt (Dee) National Producer Number (NPN) 8853366
Medicare Annual Election Period ends December 7th, 2018 for a January 1st, 2019 effective date. This applies to Medicare Advantage Plans and Part D Drug Plans. These plans now have a new Open Enrollment Period which starts January 1st to March 31, 2019 this gives you “ONE” chance to make a change if you were not happy with your choice that you made for 2019. Example I choose a plan and thought my doctor was in network and he isn’t, you can make a 1 time change to a different Medicare Advantage Plan. Or another example you may want to go back to Original Medicare and a Part D Drug plan, someone may want to do this if they could qualify for a Medicare Supplement. Medicare Supplements do NOT have an enrollment period you can apply for them anytime, BUT you must Medically Qualify if you don’t have a special enrollment period. Don’t call an 8xx call a local licensed insurance broker that works with all of the carriers to assist you. There are a lot of choices and making the wrong one can hurt you and you may get stuck with a bad decision.
Individuals/Families have Open Enrollment that ends December 15, 2018 for January 1st, 2019. This applies ONLY to ACA (Affordable Care Act complaint plans) these are plans that accept people with pre-existing medical conditions and they are not charged more for having them, people that may qualify for subsidy to help pay for their medical insurance and possibly reduce the cost of their medical care. The only Insurance Carrier that is compliant is Florida Blue in Lee & Collier County. In order to get subsidy, you need to apply through the Market Place.
Lower price options are available for people that have few to no pre-existing conditions outside of the ACA. In 2018 the plans were not as good as they will be in 2019. You can enroll into these plans all year long and they are good up to 360 days. Many are like your old Major Medical Plans, you pay for the services until you reach your deductible and some then also have that that is the maximum you can pay. Example: Lee County 35-year-old male with a $2,500 deductible/out of pocket maximum cost $130.89 a month (lower of you pay in full for the year) this is a PPO with no referral required and good in many states, the least expensive plan on the Market Place cost $421.99 with a $7,900 deductible/out of pocket maximum. This is an HMO where referrals are required and not valid out of the area unless it is an emergency. Preventive services are covered at no cost, maternity is available, dental for children, there are benefits that are not offered on the other plan. So, you can see you do have choices and you should work with a broker that can assist you. Remember a Florida Blue
Agent can only talk about Florida Blue as they are not allowed based on their contract to discuss other carrier options. You need to educate yourself on the differences and decide on the plan that will work best for you.
Employer Group Plans are becoming very popular again as the cost of insurance continues to go up and the economy improves. The completion for employees and retaining good employees is making more and more companies rethink offering Employer Health Benefits. There are excellent options in Lee & Collier County, if your employer is not offering insurance currently you may ask them to look into it. Your better options apply to 10 or more employees applying, but there are also good plans for less employees.
Most insurance companies are offering incentives for you to live a healthy life. Examples are getting your annual exam, flue shots, eating the right things and exercise to name a few. You can normally find this when you log into your online sight and see if they are offering and wellness benefits. Many companies are offering discounts & even free gym memberships.
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 agent’s 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.
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