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.

Author: jamescarvin

Licensed insurance agent W965746. National Producer #20666979. Presidential candidate 2016. Inventor. Entrepreneur. Philosopher. James has two grown children, cares for the disabled, and blogs in his spare time when he's not on the road helping families optimize their awesomeness.