As the 2023 Medicare Annual Enrollment Period (AEP) comes to a close (December 7th), I’ll be shifting my focus from Medicare to Marketplace and Group Health Plans from now through January 15th. Tis the season. If you happen to find out you don’t like a Medicare Advantage plan that you just got on, an adjustment to your Medicare Advantage plan, either from one to another, or back to traditional Medicare may be made January 1st through March 31st.
If health insurance confuses you, here is a quick summary. There are three basic types:
Medicare: Generally those 65 years old or more who qualify for social security or social security disability. Also those with ALS and End Stage Renal disease. To set up an appointment to get onto or switch Medicare plans near Tallahassee, call 850-270-2642. Elsewhere, dial 833-485-0194.
Marketplace: Generally the Marketplace is for adults 21 and up who don’t qualify for Medicare and don’t have Group Health Insurance. The Health Insurance Marketplace is also referred to as Obamacare and ACA, which stands for the Affordable Care Act. The ACA Marketplace is designed for those with low income and/or pre-existing conditions. Others not on Medicare should probably try Private Insurance to save money. Under 65 and don’t qualify for Medicare? Compare Marketplace plans here.
Private Insurance: Private Insurance is generally the best option for those who don’t qualify for Medicare and who don’t have Group Health, who have to pay too much for Obamacare because they earn too much and also don’t have pre-existing conditions. Paying too much for Obamacare? To schedule a consultation, dial 850-270-2642.
Outside the Buckets
In addition to the main categories above, there are certain special situations.
SNPs: If you’re on Medicare and also close to or below the federal poverty line, you may qualify for extra help, either through a Low Income Subsidy program (LIS), or state Medicaid. If you are both on Medaid and Medicare, then you qualify for a Dual Special Needs Program (DSNP). If you need free healthcare, DSNPs are one way to get it. There are also other types of SNPs, such as Institutional and Chronic Illness SNPs. If you qualify for an SNP of any type, there will typically be a Special Enrollment Period corresponding to it, which you should ask me about. If you know of someone going into or coming out of an institution such as a nursing or rehab facility, direct them to a licensed agent like me to see whether an adjustment to their plan makes sense.
Specialty Plans: There are some types of plans you can enroll in all year long. They don’t have enrollment periods. As an example, insurance for cancer, heart attack and stroke, for short term home health care, for long term care, for dental, vision and hearing, for health matching accounts and life insurance policies mostly don’t have enrollment periods. You can ask me about this type of insurance any time of year. I’ll help you compare plans and options you qualify for. Call 850-270-2642.
Specializing in Hard Cases
I have noticed that the people who need insurance the most are commonly the people who are least able to afford it and unable to help themselves. This saddens me because I like to fix things for people. Very poor people, the elderly and the infirm can be hard to help. Many don’t have the same level of digital access. I have to meet with people several times and not everyone is capable of understanding everything that is at stake. It isn’t profitable to serve hard cases. It takes more time. Policies that require premiums often get canceled for non-payment and insufficient funds. People often make poor decisions.
My goal in the coming years will be to create an agency that specializes in handling hard cases and simplifying the complex for those in need. No one should be left behind. I hope to build an army of highly educated specialists for this purpose. If you would like to take part, I will be happy to train you. You have my number.