November 2018 Updates
November 2018 Update
Open Enrollment 2018
Hello Friends,
I hope everyone is adjusting to the time change well. Open enrollment for pretty much everyone in the country is in full force: Group, Medicare and Individual health insurance. This is the busiest time of year for us so please be patient, we are trying to be as efficient as possible with the increased volume of people we are serving. This email goes out to all of my clients so even though we may have already spoken or taken care of you, we want to make sure we don’t miss anyone and provide updates and value to our readers.
As always thank you for allowing us to be Your insurance Advocates.
Medicare
December 7th is the deadline to make changes to your prescription drug plan and Medicare Advantage plans. Most of you do not have to re-enroll, but we check in to make sure you are in the best situation for your unique individual needs. Please know that we are always here to assist with any questions you may have. Click here to schedule an appointment
Non-Medicare coverage
There are a few different options available to protect yourself from catastrophic losses in 2019 in regards to healthcare. Your options are determined by your health status (i.e pre-existing health conditions.), your adjusted gross income for 2019, your appetite for risk, and your willingness to change doctors.
Group Insurance- If you have at least one full time employee on payroll or a partner that is receiving a K1 distribution from working at your company you may be eligible for a small group health plan. There are fees associated with the setup of the structure and the insurance is not cheap, but it gives the most flexibility with doctor and hospital choices, coverage for medications and the most stable health insurance in our current market. If you would like to discuss this please schedule an appointment.
Short term (non-compliant coverage)- Rules have been relaxed and you can buy catastrophic coverage with large PPO networks for a quarter of the cost of individual marketplace coverage. The plans do not cover any pre-existing conditions, you have to go through underwriting and preventative care is not paid for with your premiums. It works more like car insurance where you have to pay for routine maintenance on your own. What it does do is give you up to 2 million dollars in protection in a hospital and outpatient care, provides access to some of the best doctors and hospitals in the country and chooses higher limits of exposure, (up to $25k a year per person.) This will allow you to save on premium and gives you the choice to self-insure for the little things.
Click Here for Short Term Quotes
Affordable Care Act (aka Obamacare)- Metro Atlanta will have 3 choices, Kaiser, Anthem Blue Cross Blue Shield of Ga and Ambetter, in 2019.
Click Here to See Compliant Quotes
Kaiser Permanente- HMO where you get all of your medical services from Kaiser Drs and facilities unless a true medical emergency. It is the highest rated health plan in GA. In my experience people either really love or really hate KP. It is managed care and you don’t get much choice. If you go this route, you will be paying more than the other carriers and have less choice in your healthcare decisions.
Anthem BCBSGA Guided Pathway- BCBGSA pulled out of the market for 2018 and is making a big entrance back into the market for 2019. They are the cheapest in the market. There are some caveats though. It is a very skinny Guided Access HMO network, so you will need a primary care physician referral to go to any specialist to have coverage. They have a deal with Northside hospital so most surgeries will be run through the Northside system.
Ambetter - Ambetter by Peach State is the second lowest cost health plan in GA. Being the cheapest last year we had a large number of people enroll with them, and overall my clients have been happy. There will always be complaints with health insurance companies but they have been fairly easy to work with and have paid some major claims. They are not guided access, so you do not need a referral for a specialist and they do pay for some prescriptions written by non-network doctors. This is important for some people, especially with pre-existing conditions, that want to keep their doctors and just pay cash. If this is your philosophy I recommend Ambetter.
In regards to ACA compliant plans, you can go two ways either direct to a carrier or through the exchanges. You go through the exchanges to get subsidies (i.e. tax credits) based on estimated income for 2019. Here is a link to the income limits based on household size. I know this is a lot to digest, but the more you know before our chat the more we can focus on your individual needs.
Things to have ready for telephone appointment
Estimated income for 2019
Pre-existing health conditions including medications, surgeries had or scheduled in the last 5 years.
Height and weight of every applicant.
A list of doctors you really want to keep.
Please feel free to forward this to anyone you think would need our help. We are ready to assist as many people as possible and will be working late until the evening making sure everyone that needs help will be taken care of. As always, I appreciate your continued business. Our team is ready to serve you, your friends and family this season and we look forward to being Your Insurance Advocates.