• Connect

    Link to my Kelly-burke-social-facebook Page
    Link to my Kelly-burke-social-linkedin Page
    Link to my Kelly-burke-social-twitter Page
  • Get A Quote

    Stay informed with the latest news.

    Your Guide to Medicare 2020-Open Enrollment.

    Posted: October 28, 2019

    It’s time for Medicare Fall Open Enrollment.  Knowing how to navigate coverage options and understanding what changes are in store for Medicare in 2020 will help you make the most informed decisions during Fall Open Enrollment.

    During this time, you can make changes to your prescription drug plan, enroll in a plan, change your Medicare Advantage Plan, or enroll in a Medicare Advantage Plan.

    WHO IS ELIGIBLE FOR MEDICARE?  People that are 65 or older or those that have been disabled and collecting social security disability for 24 months.


    What to Expect in 2020

    • Plan F will no longer be offered to newly eligible enrollees.  If you have a Plan F currently, your plan will remain the same.  If you became eligible for Medicare before January 1, 2020 you will still be able to enroll in Plan F.
       
    • Humana had made a change to their prescription drug plan.  Those on the Humana Walmart Plan have been re-mapped to the Humana Premier RX plan.  Humana is offering a less expensive option, but we MUST make sure your drugs are covered in the new plan.  If you want to discuss your options, please have your list of drugs available.
       
    • The Part D (prescription drug) deductible has increased to $435.  Many carriers offer plan with $0 deductible for drugs in Tier 1 or Tier 2.
       
    • Donut Hole: The initial limit has increased to $4,020. 
    • United Healthcare/AARP and Blue Cross Blue Shield have little to no changes to their plans for 2020.  If you are happy with your plan, the plan will automatically renew. 

    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 maximum out of pocket and confirm that your doctors accept the plan before switching.  This will protect you in the event of a “bad” year.
    • Consider switching the type of Supplemental Plan you are in currently (i.e. Plan G is often less expensive than a Plan F).  I will caution, changing your plan may require you to pay for services that you have not paid for in the past.  For example, a Plan N will charge the $185 deductible and $20 co-pay for doctors’ visits. 
    • 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 are taking).  
       
    • Consider switching pharmacies.  First, watch to 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. 
       

    This is an extremely busy time for me. I suggest scheduling early as my schedule will fill up.  Contact me at 708-444-0050 or kelly@kellyburkeinsurance.com.

    Please include your availability (i.e. mornings, afternoons, or evenings) and the type of appointment you are requesting (face to face or conference call). 

    2019 Open Enrollment. Important Details You Need to Know.

    Posted: November 26, 2018

     

    During this time, individual policy holders can enroll in a health plan or make changes to their existing plan. *If you obtain health insurance from your employer, you are likely to have a different Open Enrollment period.*

     

    What to Expect in 2019

     

    • The penalty has been removed! This means you will no longer receive a penalty for not having coverage or for obtaining a plan that does not provide the 8 coverages required by the  Affordable Care Act.
    • Short term medical plans will now offer coverage for the full year. These plans do not provide coverage for pre-existing conditions, maternity, or wellness visits. However, these plans are a fraction of the cost of plans offered through the Marketplace and they all have a PPO network.
    • BCBS will continue to offer virtual visits for PPO plans only.  Policy holders can call or chat online with a nurse practitioner to obtain a diagnosis and prescription for medication.
    • Group plans are still an option for small employers. Blue Cross Blue Shield does 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.

    How to Avoid Rate Increases

     

    • Be prepared to discuss your household, estimated adjusted gross income for 2019.  This will be used to determine if you qualify for assistance.
    • Those without pre-existing conditions should consider a short term medical plan.  The premium is much lower and all plans offer a PPO network.  Wellness visits are not included with these plans.
    • 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 based on a diagnosis of a critical illness (cancer, heart attack, or stroke) and in the event of an accident (slip, fall, and break an ankle) the plan will pay you a certain dollar amount.  The purpose is to use the funds to pay towards the unexpected hospital or urgent care visit.
    • Review ALL of your insurance policies. I specialize in personal lines insurance, which includes auto, home, and Medicare. As a broker, I have access to multiple carriers which allows me the opportunity to find the best plan based on your needs.  I’ve saved people thousands by reviewing rates with multiple carriers.

    NOTE:  This is an extremely busy time for me.  I suggest scheduling early as my schedule will fill up.  Call 708 444-0050 or email, kelly@kellyburkeinsurance.comfor an appointment.  Please include your availability (i.e. mornings, afternoons, or evenings) and the type of appointment you are requesting (face to face or conference call).

    Trump’s Executive Order Defined

    Posted: October 26, 2017
     

    On October 12th, President Trump signed an Executive Order, forcing changes to be made toward some of the rules of small business health insurance plans, short-term health insurance policies, and cost-sharing reduction payments (aka subsidies). 

     

     What does the Executive Order mean

    • Broader rules for AHP’s (Association Health Plans), allowing small businesses to purchase plans across state lines.  By joining an AHP, small employers within the same line of business could purchase plans collectively. 
    • Increase the policy period on short-term plans from 3 months to 12 months with the option to renew.  These plans are not required to follow the rules of the ACA mandate (i.e. they do NOT provide coverage for pre-existing conditions)
    • Cost-sharing reduction payments (aka subsidies) will no longer be funded by the government.  Insurers are required by law to offer assistance to low-income individuals.  Customers who are currently receiving assistance through the Marketplace will likely see little change.
    • Rates have not been released and likely will not be released until November 1st.  This means renewals will not be available until November 1st. 

    How to Avoid Rate Increases:

    • Be prepared to discuss your household, estimated adjusted gross income for 2018.  This will be used to determine if you qualify for assistance.
    • Those without pre-existing conditions should consider temporary insurance.  The premium is much lower and all plans offer a PPO network.  Wellness visits are not included with these plans.
    • 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 based on a diagnosis of a critical illness (cancer, heart attack, or stroke) and in the event of an accident (slip, fall, and break an ankle) the plan will pay you a certain dollar amount.  The purpose is to use the funds to pay towards the unexpected hospital or urgent care visit.
    • Review ALL of your insurance policies.  As a broker I have access to multiple carriers which allows me the opportunity to find the best plan based on your needs.  I’ve saved people thousands by reviewing rates with multiple carriers.  Personal lines insurance (auto, home, life, and health) is my area of expertise!

    Healthcare Open Enrollment What You NEED to Know

    Posted: November 9, 2016

    Open Enrollment started November 1st and will last until January 31st, and only affects those that are required to purchase their own insurance.  

     

    Here is what you can expect…

     

    • If you need a policy with a 1/1/17 effective date, you must enroll by December 15th.  This includes anyone with a plan with Aetna/Coventry, Harken Health, United Healthcare, and Land of Lincoln.
    • The remaining carriers offering plans are Blue Cross Blue Shield, Health Alliance, Ambetter, and Cigna.  Carriers and plan options vary by county. 
    • If you are happy with your plan it will automatically renew.  I will warn that rates have increased and it may be worth it to review your options.  Please Note: Subsidies (assistance provided by the government) have also increased in an attempt to offset the premium difference.
    • Blue Cross has announced that doctors in the NorthShore University Health System NorthShore Medical Group and Northwestern Medicine are accepting the Blue Cross Blue Precision HMO plan.  Call 847.570.4202 to find out if your Northshore doctor accepts the Blue Precision HMO and 312.926.8400 to find out if your Northwestern doctor accepts the Blue Precision HMO.
    • Group insurance is competitive again.  This may be an option to consider for small employers.  The larger PPO network is still available for group insurance.
    • Out of Pocket Maximums have increased from $6850 to $7150 (the out of pocket max varies per plan.  The maximum allowed on ANY plan is $7150).
    • Blue Cross Blue Shield has introduced a new plan with a smaller network to help offset the increase to premiums.  
    • As a reminder, assistance is provided by the government to those who qualify.  The assistance is based on household size (number of people reported on your tax return) and the household’s adjusted gross income for 2017.  Your adjusted gross income is located on line 37 of your 1040.  If you are self-employed, this is the number AFTER your write-offs.

     

    Please contact me at 708.444.0050 or kelly@kellyburkeinsurance.com to schedule a time to review your plan options.  

     

    open-enrollment

     

     

     

     

    Blue Cross Blue Shield Announces MAJOR Network Changes

    Posted: September 29, 2015

    Open Enrollment this year will be November 1st-January 31st.  During this time, Blue Cross Blue Shield has already announced major network changes.  The biggest being the elimination of their broad PPO network.  Those with a plan in this network will receive a letter and or phone call from BCBS stating that their policy will expire 12/31.  You will need to pick a new plan by 12/15 to ensure there is no gap in coverage. 

     

    Those with the Blue Choice, the HMO network, or on an employer plan will NOT be affected by this change. 

     

    BCBS has also announced that there will not be a cap on out of network charges, making it extremely important to stay in your plans network.  What this means is that a service that costs $10,000 at an out of network facility will cost you $10,000.  Nothing will be applied towards your deductible.

    Questions
    Questions

    Feel free to email or call me with any questions or comments about my services or if you have any insurance related inquires.

    Contact
    Contact

    Phone: 708.444.0050
    Email: kelly@kellyburkeinsurance.com

    Availability
    Availability

    Monday - Friday: 10am - 5pm
    Evening and weekends
    available upon request