Enroll in an ACA compliant health insurance plan!

WHY?

• To ensure that you and your loved ones have coverage in 2020 that takes advantage of state and government reliefs and subsidies to which they are entitled.

All compliant coverage will protect you and your dependents from the extremes of medical and care costs.

WHEN?

• As soon as possible and definitely before DECEMBER 15^th (there are a few state extensions; check with your health insurance exchange)

For most of us OPEN ENROLLMENT (through an exchange (Federal, State or Private) is the only opportunity, time and place, to secure the tax relief, and cost-sharing reductions which make healthcare AFFORDABLE. Over 80% of US citizens receive tax relief.  Don’t miss out on the benefits to which you are entitled!

WHO?

YOU!

• If you are enrolling for the first time take advantage of the marketplace exchanges (for example TrueCoverage) to understand your options. 
• Exchanges are independent, unbiased and their services are free. Most importantly, your details are entirely confidential
• If you are planning to ‘rollover’ i.e. renew with the same insurer, take the opportunity to look at the alternatives.  Take a second opinion! It will be FREE but it may save you $THOUSANDS
  • Your circumstances have changed!  We all get older! You now know more about your recent medical costs, your prescription drug needs, future possible medical interventions
  • Your insurers (carriers) may have altered their terms, they may not have high star ratings for service.  Perhaps you can find coverage that is better administered or has a network more suited to your anticipated needs

HOW?

First off, go to HealthCare.gov for details of your state Health insurance exchange AND one or more private exchanges.

CHOOSE – make the calls

Be armed with the answers to their questions (they are very straightforward)

1. Your age?
2. Your location (Zipcode)? This will identify State variations in OPEN ENROLLMENT CLOSURE DATES and THE LOCAL SERVICE PROVIDER OPTIONS
3. Do you need an individual or family plan?

Have a note of the ages of your dependents

4. Do you use tobacco?

You cannot be refused a medical plan whatever your answer but it may affect your premium and possibly your co-insurance terms. (this varies from state to state)

Second, put some time aside for research.  Say 30 minutes to talk to your state exchange and ONE (at least) private exchange.

GIVE YOURSELF OPTIONS!

Finally, on most exchanges you can complete your enrollment ON-LINE or with the assistance of A QUALIFIED NAVIGATOR.

WHY DO I NEED A ‘QUALIFIED NAVIGATOR’?

Every family wants the Health insurance that best meets their needs. Each insurance company strives to offer them the coverage which best meets their expectations.

You are faced with millions of options.  Your NAVIGATOR can expertly point you in the right direction, help you to the decision that best suits you and your dependents’ needs.

Call us now

You don’t have much time left to enroll (open enrollment ends December 15^th) but for 2020 CMS (Centers for Medicare and Medicaid Services) has moved to make your choices better informed.

All Insurers (Carriers) are now required to display a ‘STAR RATING’ for any of their policies offered on Health insurance exchanges (Federal, State or private).

What does the STAR RATING tell us?

Like most five-star Quality Rating Systems the overall rating (5 stars is best) reflects the performance in key areas of the service being delivered.

In this case

1. Medical care
2. Member experience
3. Plan Administration

The Quality Rating System (QRS) will provide you with easily understood information to compare the quality and performance of comparable health care plans available on exchange websites.

1. MEDICAL CARE

• The medical care assessment is based on how well the health care providers in the plan’s network manage member’s healthcare. 
  • This includes providing regular screenings, vaccines, and other basic health services
  • Monitoring some conditions

2. MEMBER EXPERIENCE

• The member experience assessment is based on surveys of member satisfaction with:
  •  Their healthcare and doctors
• Ease of getting appointments and obtaining services

3. PLAN ADMINISTRATION

• This is a measure of how effectively a plan is run. The rating takes account of
  • Customer Service
  • Availability of necessary information appropriately presented
  • Network providers facilitating appropriate tests and treatment in a timely fashion

SUMMARY

The QRS (Quality Rating System) is a positive contribution to ensuring that enrollees have an independent tool for assessing the appropriateness and quality of qualifying the health plans available through the Health Insurance exchanges.

A star rating system may seem simplistic, but it is based on over 35 measurements of Medical Care, User satisfaction and Administrative excellence.  All plan ratings are calculated in the same way.

How does the STAR RATING work?

The choice of metal Bronze, Silver, Gold or Platinum is unchanged.  Your decision should be based on your expected healthcare needs in 2020.

Let’s assume you decide on a Silver Plan.  Your exchange (either in person or electronically) will offer you several plans from different insurers.  IT may be tempting to choose the least expensive premium between comparable offerings.

The QRS will allow you make your decision based on independent quality assessments.

You may still choose the cheapest plan but it will be a significantly better-informed decision!

Someone has to be last but don’t let it be you! Give yourself time to discuss your health insurance with experts. Learn how ACA (Obamacare) makes coverage for you and your dependents affordable.  In some cases, monthly premiums are entirely covered by tax relief.  The ten essential benefits and preventative services can effectively be yours FREE.

BUT BEWARE – these subsidies are only available if you shop through a health insurance exchange.  The services of the exchange (Federal, State or Private) are independent and free.  Their role is twofold.

1. To ensure that you have a competitive choice of plans to choose from and that they meet your needs
2. As brokers, the exchanges act on your behalf throughout the life of your policy

All exchanges are bound by the same rules of conduct, but in general private exchanges such as TrueCoverage offer greater flexibility and a wider range of options and ancillary services.

One thing that no one can alter is the CLOSING DATE for OPEN ENROLLMENT, DECEMBER 15^th (a few states have later closing dates e.g. NY, check with your exchange)

DO I HAVE CHOICES?

If you have not yet enrolled you can choose

• ROLL-OVER – Do the same as last year! It might be the right thing to do but you won’t know unless you satisfy yourself by looking for alternatives.
• LOOK AT THE CHANGES in your family (dependents) since last year.  Stop to think about the changes you anticipate in 2020, aging on, aging off.  Consult at least two exchanges! Compare their offerings.  Use the ‘worst case’ approach.  Don’t think “cheapest” think “best value”
• DO NOTHING – This should not be an option.  It is the highest risk.  You could be left facing enormous medical and care costs.  Unpaid medical and care bills are among the most common causes cited in US bankruptcies.
• RELY on short term insurance.  In some situations, it can be useful as a stop-gap measure but NEVER as a strategy for cutting the cost of health coverage and may not accept pre-existing conditions.
• WAIT for a special enrollment period (SEP) – DON’T! Special enrollment periods are personal opportunity windows.  They are designed to allow existing enrollees to modify their health coverage in response to major changes in their circumstances e.g. marriage, out of state relocation.

A common reason for not discussing health insurance with insurance is a concern for confidentiality, possibly about medical or financial details. Your personal information is used only as a basis for preparing health insurance proposals, estimates of premium tax relief and eligibility for cost-sharing subsidies (CSR).

NO personal information will be used for any other purpose and release to a third party will require your specific approval.