HEALTH INSURANCE FOR EVERYONE
About Your Agent
As an independent health insurance agent, I focus on providing health insurance options which includes Medicare options for senior citizens, health insurance options for families and individuals as well as dental insurance.
I am appointed with many insurance companies which allows me to offer unbiased, expert advice to make sure that my clients have choices in the type and level of coverage to fit their individual needs. I am also certified to offer Covered California options as well as dental insurance.
My mission is to provide my clients with peace of mind, to help navigate the complex world of healthcare insurance with respect to their needs, providing the best customer service possible and becoming a community resource.
You’re eligible for Medicare if you are 65 or older, a U.S. citizen or permanent resident, and if Medicare taxes were taken out of your or your spouse’s income for at least 10 years. If you’re under 65, you may still qualify for Medicare if you have a disability or permanent kidney failure or ALS (Amyotrophic Lateral Sclerosis also known as Lou Gehrig’s disease).
Learn more about Medicare here
MEDICARE PART A & B
You are automatically enrolled in Medicare hospital insurance (Part A) when you apply for Social Security benefits – usually upon reaching 65 years of age. Part A covers inpatient care in a hospital or a limited stay in a skilled nursing facility. Part A is premium-free if you have worked 40 quarters (or 10 years). Part B covers physician and outpatient hospital services such as doctor’s and lab appointments. The premium you pay for Part B is deducted from your Social Security benefits.
Medicare pays for many healthcare services and supplies, but it doesn’t cover all of your healthcare costs. For example, you pay a deductible for each hospital stay and coinsurance anytime you use the services of a physician or surgeon. In addition, drug coverage is limited. Because Medicare rarely pays the full cost of healthcare services, you may want to consider a Medicare Advantage or a Medicare Supplement or Medigap insurance policy.
MEDICARE PLAN OPTIONS
Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are Medicare-approved plans offered by private companies that contract with Medicare to provide you with all your Part A and Part B benefits. Medicare Advantage Plans include HMOs, PPOs, PFFS Plans, Special Needs Plans, and Medicare MSA Plans. If you’re enrolled in a Medicare Advantage Plan, Medicare services are covered through the plan and not under Original Medicare. In many cases, you’ll need to use healthcare providers in the plan’s network. Most Medicare Advantage Plans offer Part D or prescription drug coverage, as well as extra benefits such as vision, hearing, and dental benefits.
A Medicare Supplement or Medigap insurance policy helps cover the costs that are left unpaid after Medicare Parts A and B pay their portion of your healthcare expenses. Unlike a Medicare Advantage plan, a Medicare Supplement policy is purchased in addition to your Medicare Parts A and B benefits. Medicare Supplement or Medigap Policies are standardized into plans labeled “A” through “N”, each with its own set of benefits that are sold by private insurance companies. While the costs of these policies may vary, individual insurance companies must provide the same standardized benefits. To purchase a policy, you must be enrolled in Medicare Part A and Part B. In addition to paying the monthly Medicare Part B premium to Medicare, you will have to pay an additional premium to the insurance company providing your coverage.
MEDICARE PART D
Medicare Part D is drug coverage that helps pay for prescription drugs. It’s optional and offered to everyone with Medicare. If you decide not to get it when you’re first eligible, and you don’t have other creditable prescription drug coverage (from an employer or union), you’ll likely pay a late enrollment penalty if you join a plan later. Generally, you’ll pay this penalty for as long as you have Medicare drug coverage. To get Medicare drug coverage, you must join a Medicare-approved plan that offers drug coverage. Each plan can vary in cost and specific drugs covered.
Open Enrollment Period (OEP)
Open enrollment period is an annual time frame that anybody can enroll into a health insurance plan. California’s open enrollment occurs from November through January. During this time it is possible to enroll into a new plan, renew a plan or make changes to an existing plan . The plans that are selected during the open enrollment period do not start until the first of the next year. This means if somebody applies for a plan in November or December the plan will not start until January of the next year. During this time period it is not necessary to have a specific life change or life event to qualify to enroll into a health insurance plan.
Open enrollment is a very important time because it allows people to apply , re-enroll and review what their health insurance options are for the coming year. Every year the health plans benefits, monthly costs and doctors networks change. These changes can affect the cost and type of coverage that may be right for you from year to year. This is why it is necessary to review your healthcare options during open enrollment; so that your benefits match your needs and your budget.
Special Enrollment Period (SEP)
Special Enrollment Period is a time period that is unique to a person’s life events. This special enrollment period happens when a life change occurs and their existing health insurance coverage is lost. This could be because of a birth, marriage, loss of work insurance, moved or similar events.When these changes happen it is possible to enroll into a health plan for 60 days following the date that the loss of coverage happened. During the Special Enrollment Period you can choose a health insurance plan, make changes to your existing health insurance plan or renew an existing health plan with your new information. SEP’s do not have a specific time, rather they are initiated when you have a life change.
Cancellation Of Covered California Plan
Covered California plans are specifically designed to either permanent coverage or temporary coverage. Any Covered California plan may be terminated at any time throughout the year. But if you cancel a plan voluntarily and then later try to re-enroll; you may not be able to re-apply unless you have a qualifying life event for Special enrollment. In this way Covered California can be used as permanent or Temporary insurance coverage.