Why can't I buy Health Insurance anytime I want? View the Article Here

Why can’t I buy Health Insurance anytime I want?

We received a call today from someone looking to buy health insurance right now.  They had individual health insurance and let it cancel for nonpayment several months ago.  Here is why they cannot sign up for health insurance now. The Affordable Care Act established enrollment times when someone can sign up for health insurance.  (Annual Open Enrollment and Special Enrollment Periods) Since we are not in Annual Open Enrollment, you must have a Special Enrollment Period qualifying event.  Letting existing...

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We received a call today from someone looking to buy health insurance right now.  They had individual health insurance and let it cancel for nonpayment several months ago.  Here is why they cannot sign up for health insurance now.

  • The Affordable Care Act established enrollment times when someone can sign up for health insurance.  (Annual Open Enrollment and Special Enrollment Periods)
  • Since we are not in Annual Open Enrollment, you must have a Special Enrollment Period qualifying event.  Letting existing insurance cancel for nonpayment is not a qualifying event for a Special Enrollment Period.

Unless they qualify for a Special Enrollment Period, they are unable to buy ACA compliant health insurance for the remainder of the year.

 

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PREMERA CUTS TIES WITH PROVIDENCE – WHAT THAT MEANS FOR YOU

Premera Blue Cross recently announced a major change coming in its in-network providers. Will you be affected? Read about the change and what you can do. Change is brewing, and it comes in the form of Premera Blue Cross. As of January 1, 2017, Premera Blue Cross will no longer support Providence Health & Services as in-network providers. As the Northwest’s largest insurance provider, Premera’s move is significant: thousands will inevitably be affected. Providence comprises significant healthcare across the Northwest,...

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Premera Blue Cross recently announced a major change coming in its in-network providers. Will you be affected? Read about the change and what you can do.

Change is brewing, and it comes in the form of Premera Blue Cross.

As of January 1, 2017, Premera Blue Cross will no longer support Providence Health & Services as in-network providers. As the Northwest’s largest insurance provider, Premera’s move is significant: thousands will inevitably be affected. Providence comprises significant healthcare across the Northwest, including Providence Health and Services, Swedish Health Services, Pacific Medical Centers and Kadlec Regional Medical Center. In fact, since Providence took over Swedish in 2012, Providence has grown into the Northwest’s third-largest medical provider.

So, what’s next? Right now, nothing. While Providence is indeed large, it is only the third-largest healthcare provider in the region. Some of the many award-winning options, Evergreen, UW Medicine, and Virginia Mason, offer a robust range of services at in-network prices. Plus, Virginia Mason is the official healthcare provider of the Seahawks – what more do you need?

You have a few months to soak it in. Come November, you’ll be able to compare and review the updated Premera Blue Cross network; you can also take the opportunity to review competing health insurance providers and their networks. Most importantly, you have the entire Open Enrollment period (November 1, 2016 through January 31, 2017) to weigh your options and decide the best health insurance for you, your family or business.

Will it still be a happy new year? Absolutely. You’ll greet 2017 prepared with either a new health insurance plan or a new plan for in-network providers.

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Prescriptions are Not for Medication Only

Prescriptions are no longer limited to medication – in today’s ever-changing insurance world, you may need a prescription for a service, too. It’s a journey I just experienced myself: One round of Capture the Flag and my daughter now needs a physical therapist. The answer? Despite being on a PPO medical plan, the insurance carrier wants a “plan of care” in place, plus a prescription written for that plan. Thus, we need a prescription – not a referral. No longer...

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Prescriptions are no longer limited to medication – in today’s ever-changing insurance world, you may need a prescription for a service, too.

It’s a journey I just experienced myself: One round of Capture the Flag and my daughter now needs a physical therapist. The answer? Despite being on a PPO medical plan, the insurance carrier wants a “plan of care” in place, plus a prescription written for that plan. Thus, we need a prescription – not a referral.

No longer a simple PT appointment to soothe an ankle, we first had to set up a routine doctor appointment. The doctor prescribed PT, and we sought a PT provider in-plan. Was it a challenge? Maybe at first.

The majority of prescriptions you’ll continue to receive will of course be medication – pills, shots, injections and more. However, treatment and extended care plans are now being routed in the prescription process. The requirement and term may have changed, but the medical support you’ll find is as solid as ever.

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Health Insurance Reform

Watch a video about the basics of the Affordable Health Care Act

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Critical Illness – How are you prepared to live?

After having a conversation with a colleague this past week – where we dove in to the necessity of critical illness insurance – for most of us, we know this kind of insurance as cancer, accident, heart attack, hospital income, and even disability insurance – we debated how far the market has evolved – and then the poor joke of “heaven help us – we lived”. Just how we are surviving/living is the issue. I deal with many clients who are going on the...

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After having a conversation with a colleague this past week – where we dove in to the necessity of critical illness insurance – for most of us, we know this kind of insurance as cancer, accident, heart attack, hospital income, and even disability insurance – we debated how far the market has evolved – and then the poor joke of “heaven help us – we lived”.

Just how we are surviving/living is the issue.

I deal with many clients who are going on the thought that they have very generous friends and family to fall back on for money and time when they are struck with a critical illness – If you are one of these unprepared individuals, I invite you to have the conversation with your friends/family and let them know what you expect of them.  I think you will be surprised by the outcome.

Here is what I have to say:   Most of us do not have the financial/time resources to give you.  We will be your friend/family to love and emotionally support you – but please treat us with respect and be responsible and allow us this benefit and the opportunity to be the kind of friend/family you will emotionally need.  Take care of yourself, first.

 

 

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Health Insurance for children open enrollment begins in WA State

March 15th to April 30th is open enrollment for children in the individual and family health insurance market.  During this time you can add children to your health plan, buy them their own health plan, or switch health plans.   Now is the time to make your changes.  For more info on this, please visit the WA State Insurance Commissioners website www.insurance.wa.gov   or give a local agent an opportunity to help you.

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March 15th to April 30th is open enrollment for children in the individual and family health insurance market.  During this time you can add children to your health plan, buy them their own health plan, or switch health plans.   Now is the time to make your changes.  For more info on this, please visit the WA State Insurance Commissioners website www.insurance.wa.gov   or give a local agent an opportunity to help you.

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How do I choose a health insurance policy?

When it comes to Health Insurance, I think we have all known someone who was confused and frustrated and decided to “just pick something” and hope it works out.  The world of health insurance lends itself to this, but it doesn’t have to.  Here are some basic rules to help you get started when choosing the right health insurance plan: Make a list of your doctors Make a list of your prescriptions Make a list of the services you cannot...

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When it comes to Health Insurance, I think we have all known someone who was confused and frustrated and decided to “just pick something” and hope it works out.  The world of health insurance lends itself to this, but it doesn’t have to.  Here are some basic rules to help you get started when choosing the right health insurance plan:

  • Make a list of your doctors
  • Make a list of your prescriptions
  • Make a list of the services you cannot live without (maternity, Rx, etc)
  • Does everyone that will be on your health plan need the same services (does one person need Rx, while another does not?)  Most of us do not realize that we do not need to insure everyone on the same health plan.
  • Check the health plan’s doctor network to make sure your doctors are in network/out of network.
  • Check the health plan’s pharmacy formulary to confirm if your Rx is listed for coverage and what pharmacies or mail order can you use.
  • Check the health plan’s deductible – keep in mind if it is an individual or family deductible.  Will the deductible be higher depending on where your receive the care (in network/out of network).
  • Check the health plan’s maximium co-insurance – keep in mind if it is an individual or family c0-insurance maximum.  Will the co-insurance amount be higher depending on where you receive the care (in network/out of network)
  • Check the health plan’s co-payments and how many doctor visits are covered before you have to satisfy the deductible.
  • Discuss with the health plan if you will have a pre-existing wait period applied to any health conditions you have when switching plans and/or health insurance carriers.
  • Read the health plan limitations and exclusions.

Remember health insurance is not designed to cover everything and this is a basic list to help you get started in the process of choosing a plan.  We recommend you call an agent – there are plenty of good ones out there waiting to help you.

 

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Change your kids health insurance during open enrollment time – Happening right now!

It’s Open Enrollment Time!  In Washington State, beginning on 9/15/11 and ending on 10/31/2011, you can buy or change health insurance for kids under 19 in the private, individual health insurance market. It’s a big deal.   Right now you have choice for your kids health insurance.  The insurance carriers can’t deny them insurance or apply a pre-existing insurance clause to them because of medical history.  Basically, there are no health questions asked, they will accept your children for health insurance when you complete an application and...

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It’s Open Enrollment Time!  In Washington State, beginning on 9/15/11 and ending on 10/31/2011, you can buy or change health insurance for kids under 19 in the private, individual health insurance market.

It’s a big deal.  

Right now you have choice for your kids health insurance.  The insurance carriers can’t deny them insurance or apply a pre-existing insurance clause to them because of medical history.  Basically, there are no health questions asked, they will accept your children for health insurance when you complete an application and meet other requirements such as living in their coverage area, among others.

Why some of my customers are considering changing:

  • Their reasons for purchasing the plan they currently have, changed.
  • The current insurance company took an annual rate increase, and they can’t afford to stay on the plan they have.
  • They are ready to buy a policy for their children.
  • They want to move their children to their own plan, off of the family plan they have been on.
  • They have discovered that it is less expensive to move them off of their employer group plan and have them purchase a plan in the individual market.

Whatever the reason, now is the time to do your research and see if a move is beneficial to your family.  Talk to a local agent who can help you figure out if you really should change your coverage.

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Why do I need Life Insurance?

It is the only insurance you are guaranteed to use.    Imagine your spouse/parents/partners/children receiving an envelope when you die.  Does the envelope contain the life insurance death benefit that is going to help them get through the entire process of dealing with your death and all of the financial responsibilities you created?   Or instead, without life insurance,  is the envelope empty?   Where do they begin?  Life Insurance will provide them with the primary financial tool to begin...

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It is the only insurance you are guaranteed to use.    Imagine your spouse/parents/partners/children receiving an envelope when you die.  Does the envelope contain the life insurance death benefit that is going to help them get through the entire process of dealing with your death and all of the financial responsibilities you created?   Or instead, without life insurance,  is the envelope empty?   Where do they begin?  Life Insurance will provide them with the primary financial tool to begin to try and  maintain their lifestyles.

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Are the eligibility requirements for group health insurance changing?

Yes!  October 1, 2010, in Washington State, one of the biggest criteria to qualify for a group health insurance plan changes from a minimum of two individuals to one.   This change is incredibly positive and you have to ask yourself:   How often does this happen in the health insurance arena!   For an individual business owner, like myself, this is a tremendous option and one that has me very happy.  I will now be able to move from an individual...

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Yes!  October 1, 2010, in Washington State, one of the biggest criteria to qualify for a group health insurance plan changes from a minimum of two individuals to one.   This change is incredibly positive and you have to ask yourself:   How often does this happen in the health insurance arena!   For an individual business owner, like myself, this is a tremendous option and one that has me very happy.  I will now be able to move from an individual and family plan, which for those of us who have had to stay with this option, are relegated to high deductibles and limited coverage.    I can now purchase a group policy which will have richer benefits, lower deductible choices and prescription coverage.   My premiums will be higher, but we actually get something for the dollars spent.

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