Tips to Reducing your Medicare/Health Insurance Premium

Posted: November 27, 2021

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REMINDER: Medicare Open Enrollment ends December 7th and Health Insurance Open Enrollment ends January 15^th.

TIPS to Reducing your Medicare Premium…

*Consider a Medicare Advantage Plan.  If you are already in one, you may want to consider another carrier.  Be sure to pick a plan with a low maximum out of pocket and confirm that your doctors accept the plan before switching.

*Consider switching the type of Supplemental Plan you are in currently (i.e. Plan N is less expensive than a Plan G).  I will caution, that changing your plan may require you to pay for services that you have not paid for in the past. 

*Consider switching carriers for your Supplemental Plan.  Plan coverages are the same regardless of who the carrier is.   Please note, you may be medically underwritten which means the new carrier can charge a higher rate or deny you based on your medical history.

*Review your drug lists with other carriers.  Medicare.gov is a great source for reviewing rates with other carriers.  Simply plug in your drug information, select your pharmacy, and review the different plans available (based on the drugs you have been prescribed).

*Consider switching pharmacies.  First, make sure your pharmacy is still in the Preferred Network with your prescription drug plan.  Second, find out what the different pharmacies charge for your drugs.  You may see a difference that can save you some time in reaching the donut hole.

TIPS to Reducing your Health Insurance Premium…

*Be prepared to discuss your household, estimated adjusted gross income for 2022.  This will be used to determine if you qualify for assistance.   Thanks to the American Rescue Plan, the threshold has increased.  Some families making $250,000 per year can qualify for assistance!

*Those without pre-existing conditions should consider a short-term medical plan.  These plans do not provide coverage for pre-existing conditions, maternity, and limited wellness visits. However, these plans are a fraction of the cost of plans offered through the Marketplace and they have a PPO network.

*If you are going to opt to self-insure, protect yourself with an accident or critical illness plan.  The plan works separate from health insurance and pays you in the event of an accident (slip, fall, and break an ankle) as well as a diagnosis of a critical illness (cancer, heart attack, or stroke).  The purpose is to use the funds to pay towards the unexpected treatment.

Consider splitting your household.  If one of you need to be on a plan that covers pre-existing conditions the other can look into the short term medical plan.  You can also split plans through the Marketplace. 

Health Insurance Open Enrollment

Posted: November 26, 2021

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During this time, individual policy holders can enroll in a health plan or make changes to their existing plan.

What to Expect in 2022

• Open Enrollment has been extended to January 15th! Please note, changes made AFTER December 15^th will take effect February 1^st.

• NEW CARRIERS: Molina Healthcare, Oscar Health Plan, and United Healthcare will offer plans for 2022.  Blue Cross Blue Shield continues to be the only carrier offering a PPO network.

• OFF EXCHANGE Plans: While the network is the same on exchange or off exchange, Blue Cross Blue Shield, Bright Health, and Cigna will offer off exchange plans.  This means if you do not qualify for assistance you do not have to go through the Marketplace.  Blue Cross Blue Shield is the only carrier offering a PPO network.

• NO penalty continues! This means you will not receive a penalty for not having coverage or for obtaining a plan that does meet the minimum standards of the Affordable Care Act.
   
   
• Blue Cross Blue Shield, Bright Health, Cigna, and United Healthcare will offer virtual visits.  While Blue Cross Blue Shield only offers this service with their PPO network, Cigna, Bright Health, and United Healthcare will offer the same service on all of their plans. Policy holders can call or chat online with a nurse practitioner to obtain a diagnosis and prescription for medication.

• Out of pocket maximum will increase to $8,700 per person.  You can offset this by purchasing an accident or critical illness rider.  The rider starts at $25 per month and provides coverage to you in the event of an accident or diagnosis of a critical illness (heart attack, cancer, or stroke). 

• Group plans are still an option for small employers. Blue Cross Blue Shield continues to offer relaxed guidelines during this time to allow for a 1-person group. The employer must have at least 2 full time employees that are not husband and wife.  The employees can be 1099’d.

• Carriers are offering Visa gift cards for participating in their rewards program.  Some are offering up to $500!  Rewards are given for signing up for an account online, obtaining an annual physical, signing up for text message reminders, selecting a primary care physician, etc.

• Cigna is offering plans tailored to those with asthma, COPD, and diabetes.  This means lower drug costs, $0 cost for labs, pulmonary rehab, and supplies (including certain brands of insulin pumps)

I am now license in Florida!!  Insurance Counts can service plans in Illinois, Indiana, Wisconsin, Texas, and Florida.