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 15th will take effect February 1st.
- 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.
Medicare Open Enrollment is happening NOW
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.
If you have a Medicare Supplement Plan, you are not obligated to make changes at this time. You can enroll in a Medicare Supplement at any time. Please note, if you are interested in making a change outside of your initial enrollment period, Medicare Supplement plans are subject to underwriting. This means you can be charged a higher rate or denied due to past medical history.
TIPS to Reducing your 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, that 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 Part B 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 different pharmacies charge for your drugs. You may see a difference that can save you some time in reaching the donut hole.
What you need to know about the Basics of MEDICARE
Part A is provided by Social Security and covers HOSPITALIZATION. The deductible is $1,484 and most people do not pay a monthly premium.
Part B is also provided by Social Security and covers DOCTOR VISITS at 80%. In 2021 the Part B premium increased to $148.50/month. Most people have the premium deducted from their Social Security. The deductible for Part B is $203 As a side note, Part B premium is based on income. If your income is greater than $85,000 for an individual or $170,000 for those that file a joint return, you will pay a higher premium.
*These figures have not been updated for 2022 yet and may be subject to change.*
WHAT DOES THIS MEAN??? If you have only original Medicare, you will pay 100% of your doctor visits and hospital visits until you reach your deductible. Once you meet the deductible (i.e. $203 for doctor visits) Medicare will start paying 80% of the bill. You are still responsible for the remaining 20%.
It is important to note that not all doctors accept Medicare. You will need to confirm with your doctor that they accept Medicare before making your appointment.
HOW TO FILL THE GAPS??? Many people purchase a Medicare Supplement plan to fill the gaps. The most common plan today is Plan G. These plans cover the Part A deductible and the Part B co-insurance (20%). Medicare Supplements are provided by private insurers (i.e. BCBS, United Healthcare/AARP, Mutual of Omaha, Aetna, etc.) and charge a monthly premium. The premium will vary by age, carrier, and zip code.
Another option is a Medicare Advantage Plan. These plans have a lower monthly premium, include prescription drugs, and are subject to the enrollment period noted above. Medicare Advantage Plans are set up as “pay as you go”. Meaning the monthly premium is less than a supplement/prescription drug plan, however you pay a co-pay for each of your services (i.e. $5 co-pay to see the primary care physician, $10 co-pay to see a specialist, etc.). These plans are offered by private insurers (i.e. Blue Cross Blue Shield, Human, United Healthcare/AARP, etc.)
WHAT ABOUT PRESCRIPTION DRUGS??? For those that are Medicare eligible, you are REQUIRED to purchase a prescription drug plan if you do not have credible coverage. Prescription drug plans are provided by private insurers (i.e. BCBS, Humana, United Healthcare/AARP, etc.), NOT Social Security. Many people think prescription drugs are included in Part A and Part B…they are NOT. If you choose not to purchase a plan, you will be penalized for each month that you do not have coverage. Once a drug plan is selected, the penalty will be added to the premium. Please note, the penalty is NEVER removed.
Prescription Drug plans are subject to an enrollment period. The enrollment period is NOW. If you qualify for a special election period (i.e. aging in to Medicare or losing credible coverage) you will be eligible for enrollment based on the date of your eligibility.
Prescription Drug plans have a monthly premium, co-pays are charged based on which Tier your drug falls in to, and some plans charge a deductible. It is important to review your drug list before switching carriers.
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.
6 Life Insurance Myths Debunked by Kelly
Myth #1: Life Insurance Costs Too Much
It is less than you think! Costs depend on a number of factors, including your health, age, tobacco use, and gender. As one example, a healthy 35-year-old male can expect to pay about $20 per month for $250,000 on a 30-year term.
Myth #2: I’m single and young, so I don’t need life insurance
Single people often forget that they need at least enough life insurance to cover the costs of debts, medical and funeral bills. If uninsured, you may leave behind unpaid expenses for your family. Don’t forget, the earlier you buy life insurance, the better because the premiums are based on age and your health is on your side!
Myth #3: My Term Life Insurance Coverage at Work Is Sufficient
This one comes up A LOT. You should know in most cases; coverage goes away if or when you leave the employer. This means if you quit, get fired, or RETIRE you will lose the coverage. Put that in perspective with the premium quoted in Myth #1 and you’ve just cost yourself significantly more in premium. Most people retire in their 60’s. That same estimate quoted in Myth #1 will now cost $105 per month for a 20-year term vs the 30-year term.
Also note, the amount of coverage is generally restricted to 1–2 times the salary, which in most cases wouldn’t be sufficient to meet the expenses of dependents in case of the unfortunate incident of death.
Myth #4: Only Breadwinners Need Life Insurance Coverage
The cost of replacing the services formerly provided by a deceased homemaker can be higher than you think. Insuring against the loss of a homemaker may make sense, especially when it comes to cleaning and daycare costs. Put into perspective some of the responsibilities of the homemaker…getting kids dressed, fed, off to school, back from school, off to extra-curricular activities, cleaning, homework, and dinner. Go to www.care.com for an estimate of these services. The average costs range from $15-$20 per hour, costing you $2,400 per month for a typical 8-hour day. Wouldn’t it be easier to buy a life insurance policy for $20 per month??
Myth #5: I Have Existing Health Issues. I Cannot Get Life Insurance.
There’s more to it! There are a number of other variables that insurers look at before offering coverage at certain rates for specific health problems. Although premiums may be slightly higher, most life insurance companies are willing to offer you coverage if you are suffering from conditions like diabetes, high cholesterol and arthritis. Past history of cancer; no problem. Depending on the stage and how many years in remission you can qualify for a standard rate! The point is, it doesn’t hurt to ask. Most carriers provide pre-screening which allows an agent to get an idea if the carrier will offer coverage and at what cost before submitting an actual policy.
Myth #6: It’s Only Good for Funerals & Inheritances
That’s just not true! An unfortunate stigma attached to life insurance is that of death. Traditionally, people bought life insurance for its death benefits, and these benefits are why many still do. But, life insurance offers several living benefits
- Cash value could be used to supplement retirement income
- Help pay for college tuition
- Benefits paid from life policies aren’t subject to tax.
- Immediate expenses such as medical bills, taxes, loans
- Payoff mortgage debt
- Payoff student loan debt
With more parents being listed as a co-signor for student loan debt, many people purchase a term life insurance to cover the debt for the length of the loan. This way, should the unexpected happen, the parent is not stuck holding the debt.
What to Expect for 2021
- Bright Health is a new provider that will offer plans via the Marketplace. Their network consists of Palos Medical Group and the Adventist network.
- NO penalty continues! This means you will not 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.
- Blue Cross Blue Shield and Cigna will continue to offer virtual visits. While Blue Cross Blue Shield only offers this service to their PPO plans, Cigna 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.
- Carriers continue to waive cost sharing and co-pays related to COVID 19 testing and treatment. You MUST select an in-network provider/facility.
- Northwestern Memorial will now accept plans from Cigna (Connect HMO). They will continue to accept Blue Cross Blue Shield (Blue Precision HMO and Blue Care Direct HMO).
- Out of pocket maximum will increase to $8,500 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 and now Humana 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.
How to Avoid Rate Increases
- Be prepared to discuss your household, estimated adjusted gross income for 2021. This will be used to determine if you 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 all 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 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.