Individual Medical Benefits

 

Confused by what the new Health Care Reform means to you and/or your family?  We can help you navigate through and find the insurance you need at a price you can afford.  There are many options and we can guide you through the process.

 

EVERYONE is required to have medical coverage and children under the age of 18 must also be covered under a pediatric dental policy. As an individual you are able to purchase insurance through a private insurer and are not required to use the Federal Exchange.  The Exchange would be used for those individuals who, based on income and employment, may qualify for premium tax credits.   

There is now an “open enrollment” period for making application, however, some individuals are able to acquire coverage outside of the “open enrollment” time frame.  All pre-existing conditions are covered and your monthly rates are based on age, home zip code and if you are a smoker. 

​​
 

Medicare

Medicare is a great benefit and pays for most but not all of your health care needs.   We are here to help you understand and navigate the Medicare options to get you the benefits and coverage you need which include enrolling in Medicare, Medicare Supplements and the Medicare Part D prescription plan.  Being informed will make the selection choices simple and give you peace of mind.

​

Changes you can make during Medicare Open Enrollment:
 

• You can switch from Original Medicare to Medicare Advantage or vice versa

• You can switch from one Medicare Advantage plan to another or from one Medicare Part D prescription plan to another.  

• Changes are effective January 1, 2021

 

Medicare Facts
Medicare is a Health Insurance Program for:

 

• People age 65 or older

• People under age 65 with certain disabilities, and

• People of all ages with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a kidney transplant).
   

Medicare Has:

Part A Hospital Insurance - Medicare Part A (Hospital Insurance) helps cover inpatient care in hospitals, skilled nursing facilities (not custodial or long-term care).

Part B Medical Insurance - Most people pay a monthly premium for Part B. Medicare Part B (Medical Insurance) helps cover doctors' services and outpatient care.

Prescription Drug Coverage - Private companies provide the Medicare Part D coverage. Beneficiaries choose the drug plan and pay a monthly premium. 
 

Your Initial Enrollment in Medicare is Time Sensitive:|
 

1. The Initial Enrollment Period (IEP) is your first chance to enroll in Medicare. It’s the three months before your 65th birthday month, the month of your birthday, and the three months after your birthday month.

2. If you are eligible for Medicare due to disability, your IEP is based on your disability date.

3. Late enrollment penalties may be incurred for missing certain enrollment periods for Part B, prescription drug coverage and Medicare supplement insurance.

 

Contact Medicare @ www.medicare.gov or 1-800-772-1213.