Insuring You

Medicare

CMS requires all Medicare sales calls be recorded.

I do not offer every Medicare plan available in your area. Any information we provide is limited to those plans we do offer in your area. These include Aetna, Humana, Wellcare, Anthem, Amerigroup, BCBS of TN, Devoted, Clover and CIGNA. We offer Supplement plans, Advantage plans, Special Needs Advantage Plans, and Stand Alone PDP plans. Please contact State Health Insurance Programs (SHIPs) 1(877) 801-0044 or www.Medicare.gov or 1-800-MEDICARE to get information on all of your options.

Medicare Supplement

A policy that covers most of the out-of-pocket costs that Medicare does not cover. These are also called Medigap plans. These plans work with Medicare Parts A & B and any provider who accepts Medicare will accept a supplement plan. There is no network. If a Medicare beneficiary is not in a guarantee issue period, underwriting is required.

Medicare Supplement coverage chart: https://images.app.goo.gl/dZnesif2ee5yNQ7t5

Medicare Advantage Plan

Sometimes called Medicare Part C, Medicare Advantage plans are offered and administered by the insurance company according to Medicare guidelines. The coverage must be at least equal to Medicare benefits. Plans may include prescription drug coverage or may not include prescription drug coverage. Many plans offer additional benefits such as dental, vision and hearing. The plans may be HMO, POS, or PPO

Medicare Prescription Drug Plan

A plan offered by insurance companies according to Medicare guidelines. Prescription drug plans have a formulary, many have betting pricing at preferred pharmacies, and may require Prior Authorization or Step Therapy or quantity limits. Beneficiaries generally pay a monthly premium, an annual deductible, and per prescription co-pays. Prescription drug plans may be stand-alone call PDP or part of an Advantage Plan called MAPD.

There is an open enrollment period each year for Medicare Advantage and Prescription Drug Plans between October 15 and December 7.

There is no underwriting for Medicare Advantage or PDP plans.

Medicare Savings Plan

A type of Medicare Advantage plan that establishes an annual deductible. Medicare deposits a specified amount into the account annually based on the beneficiaries' enrollment date. Medicare Savings Accounts do not have networks, so you can see any provider that accepts Medicare. There is no underwriting. The money in your savings account rolls from year to year and is not taxed as long as used for qualified expenses.

Shopping For Medicare

Health Insurance for Individuals & Families

Insuring people who are between jobs, self-employed, retired early or their group coverage is not affordable.

On the Marketplace

Affordable Care Act Major Medical Insurance (commonly called Obamacare)

On the health insurance marketplace and possible tax credits

Applying for Major Medical Insurance on the Federal Marketplace with agent assistance is a great way to find the right coverage for you. My knowledge and service are free to the policyholder(s).

Those who are making less than 400% of the Federal Poverty Level may be eligible for tax credits to assist in paying the insurance premiums and may be eligible for assistance with the cost of care. If you earn more than the Federal Poverty Level, you can choose to apply off the marketplace instead of one the marketplace.

The Federal Marketplace is open between November 1 and December 15 each year for enrollment for January 1. There is no underwriting for an ACA plan.

Off the health insurance marketplace

Short Term Policy Major Medical

A policy for a specified period of time, sometimes called a catastrophic policy. There are a few questions for underwriting and for true short term policies if you answer yes, you are not eligible to enroll. Some newer options are available that offer more underwriting and will cause the policy to have higher rates, but will issue with some health concerns. The pre-existing conditions are NOT covered. Companies that offer short term policies for those not on Medicare include the following:

Indemnity Plans

Hospital Only:

A limited benefits plan that offers coverage for specific claims such as Emergency Room, Out Patient Surgery and Hospitalization. The plan specifies what will be paid for specific claims. The coverage is limited to the claims specified in the policy so it’s NOT Major Medical.

Cancer Plans and Other Diseases:

A limited benefits plan that pays for the coverage of cancer. Some policies may include coverage for other specific events such as heart attack or stroke. The policy identifies what type of disease is covered, and how the claims will be paid. Some are lump-sum payments for a diagnosis covered by the policy and some are reimbursement according to the policy guidelines.

Accident Plans

A plan that pays a lump sum designated by the policy when the insured has an accident requiring medical treatment, usually in the ER. These are frequently paired with short-term plans.

Prescription Drug Plan:

Policies that only cover medications prescribed by a doctor.

Medishare

Employer Sponsored Health Insurance

Paid by the employer with the employees portion of the monthly premium usually deducted pre-tax.

Health insurance ACA qualified Major Medical

May be HMO, PPO, or POS

May be HSA qualified

Health Insurance Level self-funded for eligible employers A plan administered by the insurance company or a third party where the company and the insurance share the cost of insurance.

Dental, vision, life – offered by some employers as benefits

Short term disability and Long term disability

Dental & Vision

PPO dental coverage --any dentist
DMO dental coverage for network provider only plans

Easy quoting and enrolling for individual dental and vision:

Humana dental and vision: https://www.humana.com/agent/health-insurance-Agents/AOALanding?SANID=1293542&isMarketpointAgent=false

Delta Dental and more: http://www.dentalforeveryone.com/default.aspx?id=90392-00000

UHC/Golden Rule: https://www.uhone.com/shop/#/census?brokerid=AA2435262

National General:
https://www.quotit.net/eproIFP/webPages/infoEntry/infoEntry_V2.asp?InsuranceTypeId=D&license_no=CBZZXQ