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Health Insurance Open Enrollment 2018

Health Insurance Open Enrollment 2018 runs from November 1, 2017 through December 15, 2017.  This is an opportunity to make any desired changes to your existing health insurance plan. This could be changing plan options with the same company or looking a plans from other companies.  Those with an Exchange plan (obamacare) plan may want to look at other offerings in the exchange or possible outside of the exchange for 2018.  For exchanged and non exchange based plans, the insurance companies can not block enrollment due to health issues.  This is a guaranteed issue period on exchange and non-exchange type plans.  All changes during this time will take place on 1-1-18.

Benefit Changes and Rate Increases

Benefit changes and the inevitable rate increases for the plans also take place on 1-1-18.  The preliminary estimate shows that most companies will have increases of over 20% for 1-1-18. It is not yet know how the subsidy for those on Obamacare plans will be effected.  Usually, those receiving an income based subsidy are best staying on an exchange plan given they are getting help with the premium.  The monthly subsidy can be substantial if the insured persons income falls within the guidelines.  Although the plans will be increasing their premiums, it is hard to tell how much of that will be offset by the subsidy.

Health Insurance Open Enrollment 2018: Other options

Those that are not planning on being able to get a subsidy for 2018 may want to explore other options.  Non subsidized plan premiums are very expensive for someone age 50+ and the 20+ percent increase will only make that worse.  A non subsidized silver level plan for a 50 year old is currently about $640 a month.  After the increase that number will be around $768 a month.

Crowe and Associates has access to other non-exchange and non-subsidized plans for 2018 that have substantially lower premiums.  Call our office to learn more at 203-796-5403 or email Edward@croweandassociates.com

Our plan is a full major medical plan that waives the penalty for being uninsured. There are copays for services prior to paying any type of deductible.  Rates are the same for all ages and are as follows…

• Single -$548 month
• Parent and Children- $898 month
• Couple- $1,022 month
• Family- $1,298.00 month

 What is an annuity

This is a more complicated question than one might realize. So what is an annuity?  The standard definition from the dictionary is listed below but it does not really help to answer the question.

Independent Medicare insurance agents

This post will help clients understand why it is important to work with independent medicare insurance agents.  Here at Crowe and Associates, we want our clients to feel confident about their insurance choices. We are happy to meet with anyone either in our office or at your home, if necessary.  Because every client is important to us, you can reach us by phone at (203)796-5403 or by email at edward@croweand associates.com anytime you have questions or concerns.

We DO NOT charge clients for our services. 

Independent Medicare insurance agents work with multiple insurance companies on a general contractor basis.  Independent agents do not work for any one specific company.  This arrangement gives clients more choices when they shop for Medicare plans.  This also helps to ensure that clients will receive the best offer available.  Unfortunately, not all independent insurance agents work with all of the companies.  It is important to ask your agent which companies they work with.  In general, they should be contracted to offer Anthem/Empire BCBS, United Healthcare Medicare Advantage and Medicare Supplement plans, Aenta Medicare, Wellcare, Connecticare, Emblem, Mutual of Omaha and First United American.  Crowe and Associates works with all of the mentioned carriers and a few others. There is never one insurance company with the best plan for everyone, therefore it is important to have access to all the major companies.

Crowe and Associates is an agency of Independent Medicare Insurance agents

Let the experienced professionals at Crowe & Associates help you understand the difference between Medicare Supplement and Medicare Advantage plans. We are here to make sure you get the coverage you need at a price you can afford.  We don’t want you to make the wrong health plan choice and get yourself into a mess that you could have avoided.   Let Crowe & Associates guide you through your Medicare enrollment and you can rest easy.

Medicare Advantage dis-enrollment period 2018

You are only eligible to enroll and dis-enroll in Medicare Advantage Plans at specific times of the year.  Therefore, some of you may want to know when the Medicare Advantage dis-enrollment period 2018 is.  The (MAPD) Medicare Advantage Dis-enrollment Period starts on January 1 and lasts until February 14 every year.  During this time, you can leave your MA plan and go back to Original Medicare.  You also have a chance to enroll in a Part D drug Plan, if you haven’t already done this.

During the Medicare Advantage Dis-enrollment Period 2018:

You can decide to leave a Medicare Advantage plan and go back to Original Medicare. The length of your enrollment does not matter.  Even If you have just joined the Medicare Advantage plan during the AEP (Annual Election Period).   You are able to change your mind and go back to original Medicare (Part A & Part B).  If you do decide to dis-enroll from your MA Plan, that goes into effect on the first day of the following month after you make your request.

Example:  if you dis-enroll from your plan on January 1, it won’t be in effect until February 1.

Be aware of  the date your Medicare Advantage dis-enrollment goes into effect. Some kinds of Medicare Advantage plans require you to use in-network providers in order to be covered. If you’re in a SNP (Special Needs Plan) or an (HMO) Health Maintenance Organization, you must only use doctors that are in the plan’s provider network until you are dis-enrolled. If you use out of network providers, your plan may not pay for the services you receive.

If you decide to dis-enroll during this period, you will be eligible to join a Medicare Prescription Drug Plan(PDP). This is true whether or not the Medicare Advantage plan you leave included drug coverage.  If you are enrolled in a Medicare Advantage Prescription Drug plan, you can just join a stand- alone Medicare prescription drug plan.  If you do this, you will be automatically dis-enrolled from your Medicare Advantage plan.  You could also just submit a dis-enrollment request to your plan.  As we stated earlier, when you join a Medicare prescription drug plan, your coverage starts the first day of the following month.

It would be wise to enroll in a PDP very close to the time you decide to dis-enroll from a MA plan.  This way you can avoid any lapse in drug coverage.   Original Medicare doesn’t come with prescription drug benefits. Additionally, Medicare Part D has a penalty if you go without creditable prescription drug coverage for over 63 days in a row. If you have other prescription drug coverage, it must be the equivalent of standard Medicare Part D prescription drug coverage.

You CANNOT use The Medicare Advantage Dis-enrollment Period 2018 to either join or to change plans.

The only thing you can do during the MADP is to dis-enroll from Medicare Advantage to go back to Original Medicare.  The Medicare Advantage Dis-enrollment Period is not the same thing as the Open Enrollment Period also known as the AEP.  The Open Enrollment Period is only to enroll in a Medicare Advantage Plan or a prescription Drug Plan, make plan changes or dis-enroll from a Medicare Advantage plan and go back to Original Medicare plans.

There is also a difference between the MADP and the Initial coverage election period.  The Initial coverage election period is the time that you are first eligible to enroll in a Medicare Advantage Plan.  There is no other time that you can change your Medicare Advantage plan unless you qualify for a special election period. In certain circumstances you can dis-enroll from your Medicare Advantage plan and switch to a different plan. For example; if you move out of the plan’s service area or if someone used deceptive marketing practices on you when you signed up for your plan.

Please contact us with any questions about this information.  You can reach us either at (203)796-5403 or at edward@croweandassociates.com.

Medicare Open Enrollment 2018

If you have questions about Medicare Open Enrollment 2018, you should read this.  The Open Enrollment Period (OEP) starts on October 15 each year and runs through December 7. This time is also referred to as the Annual Election Period.  This period of time is for Medicare clients to re-evaluate their coverage, check for changes and explore any new options that may meet their needs more efficiently.  You should speak with your broker and at that time he/she can help you compare your current plan against others on the market.   If you find a better health coverage option is available, you can make the desired changes.  Your new coverage will begin on January 1 of the following year (Jan.1, 2018)

For example:

If you have Medicare Parts A or B, you can either join or drop a Part D prescription drug plan.

If you already have a Part D prescription drug plan, you can change to a different Part D prescription drug plan.

You can also drop your Medicare Advantage Plan (also called Part C) and change back to Parts A & B (Original Medicare)

If you have a Medicare Advantage Plan, you can change to a new Medicare Advantage Plan.

Learn more about the difference between a Medicare Advantage plan and a Medicare Supplement plan

 Do I really need to re-evaluate my Medicare coverage during Open Enrollment?

Balance billing rules Medicaid

This blog Balance billing rules Medicaid will provide details on billing for those with Medicare and Medicaid.  It is also useful for those with Medicaid only. This information may help to prevent future out of pocket costs associated with health care.

Balance billing rules Medicaid and Medicare Advantage plans

A number of Medicaid eligible members also have a Medicare advantage plan.  Medicare advantage plans are co-pay based plans with a network of providers.  Those enrolled in Medicaid will not need to pay the co-pays on the Medicare advantage plan if the provider they see is participating with Medicaid. If the provider is not participating with Medicaid, they will have a co-pay for the services.  There are plans called Dual Eligible Medicare Advantage plans that work a bit differently.  If the provider participates with the Dual Advantage plan, the insured will not be responsible for a co-pay.  This is true even when you go to a doctor this not participating with Medicaid. This rule gives members access to doctors  who are not currently participating with Medicaid without a cost share.

Balance billing rules with Original Medicare and Medicaid

Those with Original Medicare A and B and Medicaid can go to any provider that participates with A and B.  If the provider does not participate with Medicaid, they are not allowed to bill the insured for the Medicare cost share.  Providers not with Medicaid do have the ability to refuse to see that member if they choose however.

Overall

Non Medicaid providers not being able to bill Medicare and Medicaid dual eligible members can be a positive in some situations.  This is because it allows members access to a wider range of providers.  Some providers will simply not be willing to see dual members any longer and as a result, this trend is increasing. Dual eligible plans help to expand access to providers and may have extra benefits such as dental and vision.  On the other hand, if the dual plan does not have a specific doctor in network, the member will not be able to see them.  They would be able to see that same provider if on Original Medicare only.

If you would like more information about Crowe and Associates, please visit our website at here.