My Seasons

Dual Special Needs Plans
Dual Special Needs Plans

Most of my friends know that I’m a veritable insurance mall. I handle Medicare, dual Medicaid/Medicare plans (D-SNPs), and both traditional, supplemental and Medicare Advantage plans. I also offer Marketplace (Obamacare/ACA), as well as private and specialty health plans. And if that wasn’t enough, my core business – when we’re not in a Medicare or Marketplace open season – is life insurance. I represent numerous life insurance carriers and plans so that I can match individual needs with the plan that fits best.

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It’s January 10th. As I post this, there are only six days left of open season for the Marketplace. If you are under 65 and have significant preconditions and don’t have a very high annual income, the Marketplace may be the best match for you. You can probably avoid premiums. Just be aware that having no monthly premiums to pay does not mean you get free healthcare. And think about it. If you have preconditions, that will likely matter a lot. Always check to see what your annual deductibles will be. And count up your most likely copays and costshare. Most “free” healthcare plans only pay 70-80% and that’s only after a huge annual deductible is out of the way. Don’t get me wrong. A lot of thes out-of-pocket expenses may be subsidized, as well. But then maybe not. I’m here to help my clients figure that sort of thing out and direct them to the plans that will save them the most money.

As you might imagine, my goal is to help as many people as possible. To do that, I’ve got to manage my time super well. I’m happy to educate people, but I also like to make sure they’ve followed my advice. If I don’t have the best plans for your needs, I’ll let you know. I don’t mind that at all. What gets me down is when people end a conversation saying they want to shop around some more, and then I find out they’ve chosen a plan that will cost them more.

Life in the nursing home. Who is there to love them? Who becomes family when family leaves them?
Who becomes family when family is gone?

One thing that is particularly difficult for me emotionally is helping the seriously sick and poor with their health insurance. They are often incapable of providing the paperwork needed to prove they qualify for Medicaid or Low Income Subsidies (LIS). I will literally go the extra mile to help people who don’t know how to help themselves, sometimes driving far out of town. If a person needs Medicaid, their friends should know it. We need to be one human family and look out for one another. Managing bills when you’ve had a stroke and live alone can be near impossible. Imagine if you were alone and growing old. Who would help you? Be that friend. Step up. Let each person do what they do best. Make sure your friend has help. Bring them to your local Health and Human Services office and help them get them enrolled in Medicaid. Help them with their bills. They need you. Then once they are enrolled, they need people like me, to set them up with D-SNPs.


Qualifying for Medicaid triggers a special enrollment period for a D-SNP. That means I can help your friend outside of the normal enrollment periods most any time of year. I can work over the phone or face to face. Usually, the only limitation is that you will need to schedule at least 48 hours ahead of time using a Scope of Appointment form to schedule me once you’ve helped them enroll in Medicaid.


I’m sure you know your friend will also need legal representation if they can’t answer questions for themselves. Sometimes a non-family member can obtain a temporary power of attorney to help make insurance decisions on their behalf. Medical Power of Attorney, Living Wills and Advance Directives are related and sometimes critical to obtain to help people when they need it most. That said, I’m not an attorney and this is not legal advice. Downloadable forms can be obtained for free online for these purposes and you can personalize them. Then you would need to get your friend to sign them in front of a notary, but I would strongly suggest you consult with a local attorney before doing anything.

The seasons of our lives change. In the fall, I go into full Medicare mode. In the winter, I do both health and life. In spring and summer I focus on life insurance. And throughout the year I think about how I can help as many people as possible, especially those most incapable of helping themselves. Please help me help your friends. Understand that I can’t speak with you about their medical conditions or about any possible health plans without a scope of appointment that is properly authorized. And that means you may have to obtain a Power of Attorney so you can act on their behalf. If you are helping them gather the information they will need to apply for Medicaid, you will likely need a POA for that too.

  • Participating sales agencies represent Medicare Advantage [HMO, PPO, PFFS, and PDP] organizations that are contracted with Medicare. Enrollment depends on the plan’s contract renewal. 
  • I do not offer every plan available in your area. Currently I represent 6 organizations in Tallahassee which offer 42 plans and other organizations with numerous but not all plans in six total states, including Florida, Georgia, Texas, Arizona, California and Virginia.

What is Holistic Insurance?

You are problably aware by now that as an independent insurance consultant, I am like a virtual insurance mall. While I don’t have contracts with every carrier, I am licensed in multiple states to produce not just Medicare of every type, but also Obamacare for those under 65 and private insurance, as well. And I have more options for life insurance than most other agents too – more carriers, more products, more variety, sorting from among 95 top rated carriers based on your personal qualifications.

But do Insurance Malls offer shopping assistants?

The problem with the insurance mall concept is that it suggests casual browsing. If you treat shopping for insurance casually, then you are taking the wrong approach. You should be diligent and make a good decision. Good decisions can save you thousands of dollars. Bad decisions can cost you tens of thousands of dollars. All this affects those you love.

Also, in a mall, there is no consultant to guide you through a mass of complex options so that you can make the right decision about something you could need immediately and just don’t know it yet. What you need is an experienced coach. As I see it, my job is to encourage you to take the world of insurance seriously. There is nothing that affects your pocket book more dramatically than lack of adequate health or life insurance when you or your family needs it.

Being Over-Insured

You could have an accident tomorrow. You, or a loved one could have a stroke. Bad things happen to seemingly healthy people all the time and you never know when. I don’t have to tell you this or you wouldn’t be here reading about it. But don’t let such facts frighten you into buying more insurance than you need. You are buying too much insurance if you are unlikely to be able to make the premium payments. That part is obvious. But you are also buying too much insurance if the odds of you ever needing it are exceedingly poor, or if the same insurance would be included in another type of policy. You don’t want overlap. Third, you may be paying too much and probably are, plain and simple. Why pay more money for less insurance? Usually, the problem is being under-insured, of course, and then finding this out too late. Many, for instance, rely on their employer’s insurance, or their VA benefits, only to discover that their coverage has limitations. I strongly advise that you take the time to have me review your policies.

What To Expect From Me?

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I take a holistic and realistic approach as I help you shop for insurance. I leave my teaching to my blog. I assume you don’t have unlimited time to research this. So I will simply explain why one product is better suited for you than another and give you a recommendation based on your personal needs and qualifications. My goal is to get you set-up with an insurance plan effortlessly and without delay once we’ve identified the right products you need and searched for the best price. As always, insurance is highly regulated.

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On the health side, there are only certain times of the year you can make changes. I’ll let you know when those are. For Medicare, you will need to complete a Scope of Appointment form to even talk to me about specific plans and there will be a 48 hour minimum delay before the appointment. That’s the law. For Marketplace products (Obamacare, AKA ACA), you’ll need to grant me permission to contact you.

Of course, I won’t contact anyone who hasn’t asked for help anyway. Same for life. If I call you, it is because you asked me to. I only ask that you keep your appointments and have the documents you will need on hand.

What Documents Do You Need?

In almost every case, you can expect simplified underwriting and instant approvals. The carriers I choose generally don’t require medical appointments. Instead they utilize information from the Medical Information Bureau (MIB) under HIPAA.


  1. Drivers License or proof of identity
  2. List of Medications insured takes, dosages, how long taken
  3. Names, Addresses, Phone Numbers of all proposed insured and their beneficiaries.
  4. A good email address of the policy owner.
  5. Policy owner’s social security number.
  6. Bank Routing Number and Account Number to draw premiums from


  1. Same as for Life (see above) except list of meds and beneficiary info aren’t needed
  2. Medicare card if applicable
  3. Name and address of Primary Care Physician if you have a preference
  4. Name and address of any specialists you want to keep
  5. Current Policy Info. (Carrier names, plan details)
  6. List of drugs you want to see the prices of. (You don’t have to volunteer any medical information when applying for Obamacare or Medicare but it is often helpful when comparing plans)

What is Private Health Insurance?

In general, you will save money with private insurance and get the same or greater benefits if you qualify. On the downside, with private insurance you won’t get tax credits and cost sharing help from the ACA state or federally facilitated marketplace and you may not qualify if you have pre-existing conditions. On the positive side, you don’t have to pay for other people’s pre-existing conditions or subsidize their healthcare costs and this saves all of the members money. Generally, it is best suited for those who earn too much to qualify for significant tax credits in the marketplace and who don’t have significant pre-existing health conditions. Not everyone qualifies.

Most ancillary plans are also private. Ancillary plans cover serious conditions like cancer, heart attack and stroke on the one hand, and dental, hearing and vision, on the other. Many plans also offer network discounts and other benefits for things such as lab work, imaging and genetic analysis. Most private plans include medical appointments and counseling online or over the phone with little or no extra cost. Some private plans also specialize in short term medical and in-home care, which is not covered by traditional plans.

What is a Holistic Approach?

A holistic approach to life and health insurance looks at goals and budgets. It analyzes gaps in coverage and counts the cost of filling them and the risk of not filling them. Many people are surprised when they find they have been paying huge premiums only to encounter budget busting deductibles that prevent plans from paying the first benefit when a health crisis comes along. A holistic approach is educational. It is not enough to be insured. A person should know what is not insured and what risks they are taking and what the consequences of being under-insured can be. An independent insurance agent is your friend and guide. It is their job to keep you informed and adequately and appropriately insured. Many plans also offer incentives and benefits for going to the gym or for planning a healthy diet and for going in for regular check ups. An ounce of prevention is worth a pound of cure. Some plans also offer over the counter drug benefits, allowing you to purchase vitamins and other non-prescription drugs. As your guide, it is my job to help you weigh out these options. Sometimes a traditional plan saves you more money than a plan with lots of perks. If I can get you to fully understand what the trade offs are without overwhelming you with too much information, I’ve done my job well.

A holistic approach also considers your whole family. It helps you plan long term and considers your final expenses and legacy. On account of marketing regulations in the health insurance business, I generally start a discussion about life insurance first. I am not permitted by law to cross-sell life insurance to my Medicare clients. But my aim in producing life insurance is to help families keep homes, protect inheritances and build savings. Instruments like Indexed Universal Life insurance policies build wealth that can be transferred to loved ones at death without inheritance tax and free from creditors. Annuities and IULs can both be indexed to S&P etc. for more earnings than banks, yet guarantee against loss. Some offer living benefits. This means that if a chronic or terminal illness occurs, a life insurance policy can cover what a health insurance policy doesn’t. Life and health insurance are related through living and accelerated benefits. So, typically a conversation about life insurance will lead to a conversation about health insurance and savings plans.

Ultimately then, I’m simply your insurance guy. I don’t offer everything. Who does? No property and casualty insurance here, for instance. But I can offer group health and life, or individual and family health and life, as well. I’m very versatile. And if you’ve got a 401K, I can even show you how to convert it into an annuity that won’t be subject to market losses. Very cool. Like I said, I’m a virtual insurance mall. Just don’t be so casual. And don’t be too proud to ask for a guide. Everyone needs help. And very few people understand what being under-insured actually means.


  • Participating sales agencies represent Medicare Advantage [HMO, PPO, PFFS, and PDP] organizations that are contracted with Medicare. Enrollment depends on the plan’s contract renewal. 
  • I do not offer every plan available in your area. Currently I represent 6 organizations in Tallahassee which offer 42 Medicare plans and other organizations with numerous but not all plans in six total states, including Florida, Georgia, Texas, Arizona, California and Virginia.