FAQs:

Key Healthcare Enrollment Periods:

Medicare:

  • Annual Enrollment Period: October 15 - December 7. Medicare coverage starts January 1.

  • Medicare Advantage Open Enrollment: January 1 - March 31. (This is when you can drop your Medicare Advantage Plan and return to original Medicare. This does not apply to Part D plans.)

  • General Enrollment Period: January 1 - March 31. (This is when you can sign up if you missed initial Medicare enrollment.)

Affordable Care Act:

  • Open Enrollment Period: November 1 - December 15. ACA coverage starts January 1.

  • Special Enrollment Period: 60 day window after a qualifying life event like losing other coverage, getting married, having a baby, etc. Allows enrollment outside regular period.

Will There be a Reduction in Drug Costs?

Medicare:

Prescription drug plans typically update their formularies each year, which can impact costs. I work closely with clients during open enrollment to review any changes and ensure no surprises.

One important update for 2021 is that Medicare plans now offer capped insulin copays of no more than $35/month for patients with diabetes, which helps reduce costs.

Affordable Care Act:

The Inflation Reduction Act passed in 2022 includes provisions to lower some prescription drug costs for ACA marketplace plans as well:

  • Copays for insulin are capped at $35/month starting in 2023 for ACA marketplace plans.

  • Out-of-pocket costs for prescriptions are limited to $2,000/year starting in 2025 for ACA marketplace plans.

  • Vaccines recommended by ACIP, like flu shots, will be fully covered at no cost to the patient.

I'm happy to help evaluate both Medicare and ACA plan options to find affordable prescription drug coverage that fits your specific medications and health needs.

How do I get help with my Medicare Part A and B premiums?

Part A covers hospital stays and Part B covers doctor visits. Most people have to pay a monthly premium for Part B to get this coverage.

Some people qualify to get help paying their Part A and/or Part B premiums. This help is called a "premium subsidy”.

Who can get this help?

If you have limited income and resources, you may qualify for help. Exact income and resource limits depend on your situation.

How do you get this help?

You'll need to apply through your state Medicaid office or Social Security. We can help you understand requirements and guide you through the application process.

The takeaway: If paying your Part A or Part B premiums is a struggle, you may be eligible for financial assistance. Contact us today to discuss your situation. We're experts in Medicare premium help programs and happy to explain your options.

Should I sign up for Medicare Part B if I have VA Benefits? 

The short answer is yes - having Medicare Part B is important even with VA benefits.

Here's why: The VA only covers care at VA facilities. Part B covers you with any doctor that accepts Medicare, giving you more flexibility.

Part B may cover some costs the VA doesn't, like ambulance transportation.

If you ever decide not to use the VA, you'll have Part B as a backup. You may have to pay a penalty if you join after your initial enrollment period.

Part B works with VA care - it may cover a portion of copays the VA requires.

The bottom line is: Part B provides valuable coverage outside the VA system. We recommend protecting yourself and signing up for Part B.

Do I need help with my Medical Plan Choices?

Navigating health insurance can be confusing, especially with changes every year. If you're new to Medicare or the ACA or even reviewing your current coverage, rest assured we're here to guide you.

Our team of agents can explain your options in simple terms. We'll help you understand Medicare Supplements, Medicare Advantage, Part D drug plans, and The Affordable Care Act. You'll get personalized plan comparisons at no cost.

Turn a headache into peace of mind. Let us simplify your Medical Plan Choices so you can find coverage that fits your health needs and budget. With one call, you can save time, money, and frustration.

Have questions? Ready to review your plan?

Call us at 813-314-7575. We're here to maximize your Medical benefits and help you choose with confidence.