Southwest Florida's Health and Wellness Magazine Health and Wellness Articles
By Ulla-Undine Merritt (Dee) National Producer Number (NPN) 8853366
MARKETPLACE – Obama Care/Affordable Care Act – open enrollment IT’S NOT TO LATE. December 16th to January 16th will have February 1st, 2024, effective.
The website is HealthCare.gov, your local insurance agent can help you through the maze. The government also changes each year how much you can earn to receive subsidies to help lower your cost for insurance. Many people are not aware that they do not need to forgo having health insurance and there are affordable options for them. Insurance is not just about the price of the premium but particularly important the network of doctors, hospital, etc. that you can have access to. Be careful carriers that are selling in your area might not have a good network, so the price might be right but if your hospital and your doctors are not in their network that is a problem. So, always check the network! Understanding deductibles, out-of-pocket maximums, what applies to the deductible? Do I have to pay the deductible before the plan pays? This differs by each plan, Copays vs. coinsurance if you do not understand ask, become informed about what you are buying and how it works.
Individual/Family Health Insurance – Being young and healthy does not mean you do not need health insurance. Do you know anyone that knew when they were going to be diagnosed with cancer, or when they were going to have a heart attack or even a serious accident? I do not, it happens, and insurance is there to help you get the care you need and limit your financial exposure. What are your insurance options, and what is best for you? Employer Group Coverage, Individual Medically Underwritten Health Insurance, Medicaid, or the Government Marketplace Guaranteed Issue Health Insurance. There is a lot to know about the differences, as well as the cost. The monthly premium should not be your only consideration. You do not know what you do not know so ask the experts, which do know about all the plans and can help educate and guide you through the enrollment process. When it comes to medically underwritten plans, most of them you can enroll all year long, but you can also be denied based on medical underwriting. The cost is the same as going direct with the insurance carrier, so why would you not seek free professional help with an agent that sells all of the companies?
MEDICARE Open Enrollment Period January 1st- March 31st, effective the 1st of the following month. Medicare Advantage – Part C
If you change/enrolled in a Medicare Advantage Plan Part C if you are not happy with the one you have. You can make a 1 time change from one Advantage Plan to another, you can go back to Original Medicare and buy a standalone drug plan. I personally don’t feel you should have Original Medicare without a Medicare Supplement because your financial exposure is unlimited. Medicare Supplements are NOT guaranteed to accept you, there are a few exceptions. But in general, you need to pass medical underwriting. There are Medicare Supplements Letters A-N, each pays in conjunction with Original Medicare. There are a lot of companies and plans that you need to understand the plans and the differences in companies, it’s not just about the price today.
Most of the plans in your area have made many changes for 2024 and things you might not notice, especially important, are your doctors still in network, what tier are your medications and maybe the tier changed, copays, coinsurance. What extras are the plans offering? Maybe you need extra dental, vision, hearing aids. Many plans include some wonderful extra benefits, but it is also particularly important to know how to use the benefits and if they work for you. If the insurance company, you are with comes up with a better plan they will NOT switch you to it automatically. Your insurance agent should be making you aware of a better option. It is illegal for an insurance agent to call you regarding Medicare, do not talk to someone you have not given permission to call. Ask them for their National Producer number and report them to Medicare for an unsolicited call.
CMS has made many rules for 2024 Medicare season. If you want to enroll or review your plan over the phone, you need to agree to be recorded and Medicare requires us to keep the recording for 10 years. In person appointments do not have that requirement, but you need to sign a scope of appointment that authorizes us to talk to you about Medicare Advantage or a Drug Plan. It does not allow us to do anything but talk to you about these topics.
Many plans have decreased the cost of Insulin which will be a huge savings for so many in 2024. Part D after you, the plan and the pharmaceutical company paid $8,000 you no longer have a cost for your medications for the rest of the year.
When you turn 65 you are eligible for Medicare, once you have worked 40 quarters roughly 10 years there is no cost for Medicare Part “A”. Part A covers Hospitals, Skilled Nursing, Home Health & Hospice. Medicare Part B you can choose to take at 65 or you can hold off if you are still working and have credible coverage. If you do not have group health insurance that is considered qualified, and then you want it you would have a late enrollment penalty for each month you did not have Part B & Part D and that penalty will last for the rest of your life. Part B covers doctors, imaging, blood work, ambulance, durable medical equipment, etc. Part D is a Medicare Drug Plan and covers medications. During your initial enrollment period it is especially important to understand your options! Medicare Supplements/Medigap Plans are NOT guaranteed issue you may need to medically qualify. You can purchase a Medigap Plan during your 1st 6-month on Medicare Part B without medical underwriting. There are a lot of things you need to know. Again, work with an agent you can trust! Especially important: when you move you need to know your options. Can you keep the same plan? Do you need to make a change and what does that look like?
We offer Free Medicare Seminars in Lee & Collier County please e-mail info@logicalinsurance.com to register or call 239-362-0855 for dates. Medicare’s website is www.Medicare.gov.
Logical Insurance Solutions is a SWFL Insurance Broker that works with most of the carriers, we are happy to help you through the maze. This is what we do daily, it is second nature to us. We offer virtual seminars, one on one WebEx, phone and in person appointments.
To learn more about your options call to schedule an appointment contact: Logical Insurance Solutions for all your insurance needs, I am licensed in 36 states.
www.Logicalinsurance.com
info@Logicalinsurance.com
