Posts tagged with "Obamacare"

Medicare and ObamaCare (Individual and Family) Annual Open Enrollment

Are you overwhelmed with the ads on TV about your health insurance plan options?  Is your table piling up with mail from every insurance company and agent?  The reason is, it’s Open Enrollment time for Medicare and Individual/Family (affectionately known as ObamaCare).  This is the period where you can switch plans or enroll into a new Part C (Medicare Advantage Plan) and Part D (Part D Plan) OR individual/family health insurance plan.  Here are the dates:

MEDICARE – October 15th – December 7th

INDIVIDUAL/FAMILY – CA, October 15th – January 15th (depending on your State – some are from Nov 1st – Dec 15th)

What to look for?  All plans seem to change something, especially the drug formulary (the list of medications they cover and which Tier they’re covered on). Look at your ANOC (Annual Notice of Change) booklet that you recently received (or call your Plan if you haven’t received it yet).  The first few pages will tell you what is changing in your Plan for the next year. There are also new Plans that are created each year and research needs to be done to see if there is another Plan that may offer you better benefits.   Many Medicare Advantage Plans offer extra benefits like chiropractic, acupuncture, vision, hearing, dental or gym memberships.  If you feel your Plan is good for you next year, there is nothing to do.  It will simply roll over.

Look for the ‘Star Ratings’ of the Medicare Plans also.  Medicare gives an overall rating of the Plan’s quality and performance for the types of services each plan offers.  For plans covering health services, this is an overall rating for the quality of many medical/health care services that fall into 4 and 5 different categories.  From my experience, there is a reason a Plan gets a low rating so BEWARE!                                         

Medicare uses a 5 Star Rating

This is also the time for those that are uninsurable (maybe in a nursing home or just diagnosed with cancer, etc.) to possibly obtain ‘guaranteed issue‘ into a MediGap supplement plan. If ANY benefit in your Medicare Advantage Plan increased by 15% or was eliminated, a window opens for you to go back to original Medicare (Part A & B) and obtain a MediGap Supplement (with NO insurable questions asked) and a stand alone Part D Plan (for drugs).   With this option, it gives you the choice to see ANY Provider that accepts Medicare, no referral needed!  It comes in handy if you want to go to a skilled nursing facility of your choice or have a surgery from a particular Surgeon.  

If your loved ones or neighbors are on Medicare, please help them.  Many times, they stay on the same Plan because they just don’t know who to turn to.  You can make a huge difference in their lives by having them to call us!

So what’s a person to do?  You can do your own research by going to Medicare.gov/Healthcare.gov OR reach out to an independent insurance broker/agent such as ourselves.  Imagine if you could put your head on your pillow tonight, knowing all this was behind you and you knew you made the right choice!  That’s what WE do for you!  We conduct a thorough search and will let you know if your Plan is right one or if you should look at other options.  The icing on the cake…there is no extra charge for our services!  How do we get paid?  If another Plan is better and we’re able to enroll you, we receive a commission from the insurance company.   If you’re on the best plan, we’ll let you know that too!  Make sure the person you are working with is REALLY independent and represents MANY companies.  We have come across many agents that are independent, however they are only Medicare certified with one or two companies :/   At Hoffman Insurance Resources, we are contracted with over 40 companies and Medicare certified with 13 carriers.  YOU’RE best interest is our interest, whether we get compensated or not.  If that wasn’t enough, we’re here for you AFTER we enroll your plan.  We’re your advocate and can help with everything from getting another ID card to helping with a bill you don’t understand.  Check out our Yelp and Google reviews.  Our clients are amazing and very giving  of their stories.  We’re sure one or two will resonate with your situation.  Your only assignment is to reach out to us early because it gets quite busy during the last week of Open Enrollment and our time is extremely limited.  Looking forward to hearing from you!

Hoffman Insurance Resources is an independent insurance brokerage agency specializing in Medicare and individual/family health plans.  We are contracted with over 40 companies, Covered CA certified and Medicare certified with 13 carriers.  Physically located in the Los Angeles area, we are also contracted in many states throughout the country.  We pride ourselves on doing what’s right for our clients (whether we make money or not), educating you, being your advocate after the sale and exceeding your expectations. We accept only the insurance company commissions so there are NO extra charges for our assistance and guidance.  From ObamaCare through MediCare…we truly Care!  Check out our reviews on Yelp and Google 🙂

Debbie@Go2HIR.com      323.455.4961      www.Go2HIR.com    https://www.facebook.com/hoffmaninsuranceresources

 

Highlights of the Senate Healthcare Bill

The Senate health bill resembles the House health bill with a couple of changes. I’m sure there will be tons more changes before this passes. Here are some of the highlights:
 
-Eliminates ObamaCare’s mandate that every American carry insurance.
 
-The Senate also backs away from some last minute House concessions that would have allowed states to opt out of several protections for those with pre-existing conditions, but insurers would not be allowed to charge higher premiums to those with pre-existing conditions.
 
-Subsidies will continue for 2 years although they are coming up with a new formula to determine who gets a subsidy and who much. Fewer middle class folks would get help because only those earning up to 350% of the poverty level would qualify, rather than the 400% threshold contained in Obamacare.
 
-Eliminates the ‘Enhanced’ plan benefits.
 
-Loosens requirements in Obamacare that health plans all cover a basic set of benefits like no limits on coverage.
 
-Phases out Medicaid’s expansion program and caps Medicaid (MediCal in CA) spending. It basically puts the entire Medicaid program on a budget, ending the open-ended entitlement that now exists.
 
-Repeals, retroactively to the beginning of 2016, the “employer mandate,” which requires large employers to offer health insurance to workers or be fined.
 
-Repeals the 3.8 percent tax on net investment income, to the start of 2017.
 
-Strips Medicaid funds from Planned Parenthood clinics for one year.
 
-Health plans that offer abortion services would not be eligible for the subsidies.
The bill is likely to come to the Senate floor next week. They’d like to get it done before the 4th of July recess.
 
The Senate has 52 seats and the bill would have to pass by 50 with Vice President Mike Pence breaking the tie.  They may have already lost one vote — Senator Rand Paul, Republican of Kentucky, has indicated that the bill is too liberal for him.
 
Resources:
http://www.latimes.com/politics/la-na-pol-senate-obamacare-20170622-story.html
https://www.washingtonpost.com/news/powerpost/paloma/the-health-202/2017/06/22/the-health-202-here-s-what-s-in-the-senate-health-care-bill/594aa367e9b69b2fb981dde9/?utm_term=.3064dd1601a4
http://www.cnn.com/2017/06/22/politics/senate-health-care-bill/index.html
https://www.nytimes.com/2017/06/22/us/politics/senate-health-care-bill.html

Aetna pulls out of the individual market in more states!

 

This just in from Aetna:  As a result of financial risk and an uncertain outlook for the Individual marketplace, Aetna (including Coventry)  has decided that we will no longer offer individual health products in the following states AR, AZ, CT, FL, GA, IL, KS, KY, LA, ME, MI, MO, NC, OH, PA, SC, TN, TX, UT, and WV for 2018.

What happens when there is no competition? You guessed it!  And we cannot afford anymore prices increases.  I just had another client drop his coverage because he cannot afford the premiums.  He’s 58 years old, makes $31,200/year, lives in a bare bones mobile home and because he worked hard and made a little more money last year, his premium double to over $200/month.  That’s for a Bronze, high deductible plan!

Dear elected officials.  Are you there?  Do you hear us?  HELP!!  We’re drowning!!

Here’s an idea!  Our government should put us all on the same plan our elected officials receive till they fix this mess!

On Covered CA and getting a subsidy on your health insurance? BE AWARE!

Opening your mail as you normally do and to your surprise, there’s a letter from Covered CA saying ‘Congratulations, you’re eligible for MediCal’!  Well, in all fairness, they don’t actually say ‘Congratulations’ but you get the gist.  This is what is transpiring right now as thousands of Californians that receive a subsidy, are getting pushed into MediCal because their income on their Covered CA account is $1 too low.  Yes, you read that correctly.  If you are $1 off, you too could lose your doctor!

Why?  The government released the 2017 Federal Poverty Limit Chart that gives guidance to which plans you are eligible for based on your MAGI (modified adjusted gross income) that you reported in Covered CA.  Why they don’t release this at year end, we’ll never know.  That would make too much sense!  For most people, your MAGI is Line 37 on your personal tax return.  If you receive social security and/or tax exempt interest, that’s added to your AGI to come up with your MAGI also.  If that figure is off by $1, instead of that amazing Silver 94 plan you’re enjoying, you could get that wonderful letter saying ‘Welcome to MediCal’.  Or if your MAGI is $1 to high, you could be pushed from the wonderful Silver 87 plan to the not so great Silver 73 plan (HUGE difference in benefits!).  It is vitally important that you check your Covered CA account, look at what income is reported to see if you are in danger and if so, get it changed asap!  I would even go so far as building a buffer for when it’s increased next year.

This mostly affects self employed people because you’re able to write off expenses from your income.  And the income in your Covered CA account is a guess-ti-mate anyway because how on earth are we supposed to predict the future?  I’m sure your tax person could find an extra dollar or two.  And if they can’t, we’ll get you to someone that can!  Are you making too much money?   Did you know that you could put money into an IRA or 401(k) and that would lower your MAGI?  And if you’re self employed, always make sure your tax pro is deducting your health insurance.

Here’s an idea!  Would you rather have someone deal with this for you and not have to pay them any extra?  It’s your lucky day!  While Covered CA really doesn’t advertise it very well on their website (not sure why), you can have an advocate on your side to take care of things like this and it doesn’t cost you ANYTHING extra!  You’re read that right, you won’t pay one extra dime to have us keep up with things like this AND MUCH MORE!   We accept just what the insurance companies pay us.  If you already have an agent and they aren’t pro-active like we are, while they may be really nice, it’s time to change agents!  Once we find out that Covered CA is utilizing the new chart, we review each account to see if they are in danger.  If Covered CA has to be called or your case needs to be appealed, we do that for you. We’re that breathe of fresh you’ve been looking for 🙂

Call or email us and we’ll walk you through how to easily add us as your advocate on your Covered CA account or your ‘off exchange’ health insurance plans.

Debbie Hoffman, Insurance Designs

323.455.4961

debbie@debbiehoffman.com