Special Enrollment Period
LOSS OF COVERAGE
– Termination of group coverage
– Reduction of hours to part-time status
– Loss of employer contribution
– COBRA ending
Don’t wait until it’s too late to get your individual health coverage for 2017. Open Enrollment for Individual Health Insurance ends on January 31st. If you haven’t enrolled in a plan by this date, you may be stuck with your current coverage or no coverage for the remainder of the year unless you have a qualifying life event. Schedule an appointment with a licensed benefits counselor or start shopping today to make sure you are covered.
Coinsurance is your share of the costs of a covered healthcare service calculated as a percent (for example, 20 percent) of the allowed amount for the service. You pay coinsurance plus any deductibles you still owe for a covered health service.
A premium is the amount of money charged by an insurance company for coverage. The cost of premiums may be determined by several factors, including age, geographic area, tobacco use, and number of dependents.
Life happens, and when it does, it is very likely that your Health Insurance coverage may need to change. When you encounter a Qualifying Life Event (QLE) that impacts your insurance needs, it is important to know that you can take advantage of a special enrollment period – since most people are unaware that they may enroll outside of Open Enrollment.
Medicare is the federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease. It is divided into Parts A, B, C and D. The different parts are organized to help cover specific needs.
Part A is Hospital Insurance that is provided through the Federal Government. It provides coverage for inpatient hospital stays, skilled nursing facility care, and hospice care.
Part B is Medical Insurance that is provided through the Federal Government. It helps cover doctor’s visits and outpatient care. Also, it provides coverage for some preventative services, occupational therapy, physical therapy and home health.
Medicare Advantage (MA) & Medicare Advantage Drug Coverage (MAPD) is provided through Health Insurance Companies. This covers everything Part A & B cover, and often things like wellness and fitness memberships. MAPDs also include prescription drug coverage.
Medicare Prescription Drug Plan (PDP) is provided through insurance companies and other private companies. This is optional – however, if you wait until after you are originally eligible then you may have to pay a penalty.
Together, Hospital Part A Insurance and Medical Part B Insurance, make up original Medicare which is provided through the Federal Government for those eligible. It provides coverage for most of the care you may need, but not all of it.
Medicare does not cover long-term care, most dental care, eye exams related to prescription glasses, dentures, cosmetic surgery, acupuncture and hearing aids. In some cases, even if a service or item is covered, you generally have to pay your deductible, coinsurance and copayments.
Medicare Supplement, or Medigap, plans are sold by private insurance companies to help with the balance of Medicare-approved services after original Medicare has paid.
Medigap Important Dates
• You have 6 months from when you turn 65, or enroll in Medicare Part B, to take advantage of guaranteed issue.
• You can apply any time during the year, but Medical Underwriting may be required.
Note: You must be enrolled in Parts A & B to be eligible.
What Types Of Medicare Supplement Plans Are Offered?
These plans are standardized, but they offer a variety of coverage options. You are not required to use a specific provider network to receive care. Currently, there are 10 standardized Medigap plans, each represented by a letter (A, B, C, D, F, G, K, L, M, N; there’s also a high-deductible Plan F). These are sold in most states and the benefits of each plan within a lettered category remain the same, however premiums will vary.
So how does it work? Medigap lets Medicare pay its share of the Medicare-approved amounts for covered health care costs. Then, the Medigap policy pays its share. This typically includes the copayments, coinsurance and deductibles.
Before you apply for Medicare Supplement plans, it is important to consider a number of things. First, in order to get a Medicare Supplement plan, you must have Medicare Part A and Part B. Second, the cost of premiums, deductibles, coinsurance, and copayments should help you decide which plan is best for you. Third, make sure you pick and research your preferred doctors and hospitals ahead of time – do they accept Medicare assignment?
Ready to apply? Click to request a quote.
Did you know that one in four Americans over 65 have no teeth? That being said, a healthy smile can be an impressive asset! Your teeth vary in shape and size depending on where they are in your mouth. These differences allow them to do many different jobs. They help us talk, pronounce different sounds clearly and give our faces their shape! Because they are so important, it makes sense to give your teeth the best care possible. For most of us, thorough daily oral hygiene lays the foundation for a healthy smile. Just a simple routine of brushing and flossing, in addition to regular dental checkups, can be enough in most cases to help prevent tooth decay, gum disease, and bad breath.
Follow these tips to hold onto your smile!
Floss, then brush.
We have heard this our whole lives, but not many of us do it. If you floss before brushing, you remove food that is trapped in tight spots – which are major “bacteria growth” zones. Place your brush at a slight angle toward the gums when brushing along the gum line. Use a gentle touch—it doesn’t take much pressure to remove the plaque from your teeth, and a vigorous scrubbing could irritate your gums. Concentrate on cleaning all the surfaces of the teeth. To help prevent tooth decay, use a fluoride-containing toothpaste.
Good eating habits.
Many people think that having a high level of sugar in your diet is the most common reason for tooth decay. This is not true – it is how often you have sugar in your diet, not the amount. It takes up to an hour for your mouth to cancel out the acid caused by eating and drinking sugar. Give your teeth a cleanse by munching on crunchy vegetables or fruits at the end of a meal, this serves as a type of mini tooth-brushing session. The hard flesh acts as a cleanser and the chewing motion stimulates saliva production. Replace your afternoon soda with tea – tea leaves contain the tooth protector fluoride. Studies show that green tea drinkers have a lower incidence of advanced gum disease. As an added bonus, researchers believe that the catechin in green tea is more effective than mints at combating bad breath.
Take your vitamins.
Vitamin C, Calcium, Vitamin D and Omega-3 are vital for maintaining and repairing gum tissue. Everything from tooth sensitivity to receding gums can often be attributed to Vitamin C deficiency. Calcium is crucial for strong teeth and healthy bones. Vitamin D helps maximize calcium absorption. Omega-3 or fish oil supplements can help gum tissue heal.
Watch your medicine intake.
Medicine, both prescription and over-the-counter, can often cause decreased saliva production. This is dangerous because saliva serves as a protective barrier against gum and tooth decay. When on medicine, be sure to take frequent sips of water or chew sugar-free gum to help relieve dry mouth. If this doesn’t do the trick, consult your dentist!
Regular dental check-ups.
Only a dentist can truly assess the health of your gums. It is important to keep up with cleanings and regular six-month checkups. Gum disease is a serious infection that can lead to tooth loss and compromised health if left untreated. These are some of the warning signs that should prompt you to see a dentist:
Everyone needs dental care. Schedule your check up today!
Don’t have dental insurance? Start shopping for coverage today!
For many, insurance policies seem complex and hard to understand. You know you need insurance, but what you may not understand is what your insurance policy covers, and how to budget your yearly medical costs so they don’t negatively impact your finances. Deductibles are one area of health insurance that people often overlook.