Affordable Care Act options in Missouri and Kansas

October 3rd, 2018

Individual health insurance options have become quite limited and are administered thru the Marketplace.   We are able to assist you on the application process with the following companies….

Missouri 

Ambetter, Centene, Cigna, and Medica

Kansas

Medica, and Ambetter

 

You may be able to lower your monthly premiums for health insurance through the Advance Premium Tax Credit. These credits may be applied directly to your monthly premium or can be used at the end of the year when you are filing your taxes. The amount of savings depends on family size and your modified adjusted gross income (MAGI). MAGI is generally the household’s adjusted gross income plus any tax exempt Social Security, interest, and any other sources of income. The MAGI will be calculated for you during the Marketplace application process. The amounts below can be used as a general guide and are based on 2019 numbers….

Family of four

< 133%                       < $33,383
133 – 138%                $33,383 – $34,638
138 – 150%                $34,638 – $37,650
150 – 200%               $37,650 – $50,200
200 – 250%               $50,200 – $62,750
250 – 300%               $62,750 – $75,300
300 – 400%               $75,300 – $100,400
> 400%                       $100,400

Individual

< 133%                         < $16,146
133 – 138%                  $16,146 – $16,753
138 – 150%                  $16,753 – $18,210
150 – 200%                 $18,210 – $24,280
200 – 250%                 $24,280 – $30,350
250 – 300%                 $30,350 – $36,420
300 – 400%                 $36,420 – $48,560
> 400%                          $48,560

Short term health insurance

October 3rd, 2018

A short term health insurance plan can be a very good alternative to the individual health insurance plans offered thru the Affordable Care Act.   In 2019, the penalty of not having creditable coverage is being eliminated.  Furthermore,  the short term coverage periods are being extended to have continuous coverage for up to 36 months.  In most cases, the short term plans have a larger number of providers/facilities that are in-network which gives the consumer more flexibility.  The only downside to these plans is that pre-existing health conditions are not covered.

Medicare Supplemental Basics

October 3rd, 2018

As one becomes eligible for Medicare, get ready to be bombarded with information and options.  It is very easy to become confused and there is a good chance that the plan you choose will not work as you thought.  Basically, there are two categories of Medicare supplemental coverage…traditional (AKA Medigap, Tie-In, Supplement) and Medicare Advantage (AKA MA, MAPD, Part C).

Traditional plans work with your Medicare parts A & B.  Medicare is the primary and the supplement is secondary.  They work together to pay either all or a portion of the claim dependent upon which plan you choose.  The supplement options that are available are plans A, B, C, D, F, G, K, L, M, and N.  Under this scenario, these plans basically cover medical claims only and you will need to have a separate prescription plan (AKA part D) for your medications that are taken on a regular basis.

Medicare Advantage plans work differently than traditional plans.   In this scenario, Medicare is not part of the claim process.  A private insurer is solely responsible for your coverage.  The plans available are HMO, PPO, PFFS, and SNP.  In most cases,  these plans provide both medical and prescription coverage under a single plan.

If a separate prescription plan is needed, the best way to determine the plan that is right for you is by looking up your prescriptions on each company’s formulary.  There is not a one size fits all, because each plan has different premiums, co-pays, and formularies.

Enrollment into one of these plans are dependent upon your status…there are several periods where changes can be made to your current plan (which is set by CMS).  These are IEP, SEP, AEP, ICEP, OEPI, and MADP.

Again, as you can see, it is easy to become overwhelmed as to what choice to make.  We are experts in explaining the different options and can help you feel comfortable with your decision.

Ancillary insurance

October 2nd, 2018

With the rising costs of health insurance, one way to decrease premiums is to raise your deductible.  However, that increases your out of pocket cost when you have a claim.  Having an plan that will reduce your out of pocket can give you a little more peace of mind.  Examples of plans are…

Hospital indemnity insurance-will pay a specified per day amount (200-1000 per day) during a stay at the hospital.

Cancer policy-will pay a lump sum on a first diagnosis cancer ($5000-$20,000), that you can use for unexpected costs.