Why Shop Outside of the Marketplace for Coverage?
There are a few good reasons to shop around for quotes outside of the marketplace. Let’s cover those now:
You don’t make enough for cost assistance (more than $46,680 as an individual or $95,400 as a family of 4). Cost assistance is only available on the marketplace, but if you don’t make enough for cost assistance the marketplace simply access as a plan comparison and enrollment tool of marketplace plans.
You want access to a wider array of plans. Since not every plan in your region will be sold on the marketplace you’ll need to shop outside of the marketplace to get access to every plan in your region. There is no one provider or broker who will have every health plan in your region. You’ll need to shop around to see what is out there.
Will I Pay More For a Health Plan Outside of the Marketplace?
Without taking cost assistance into account, you’ll never pay more for a specific plan in a specific region regardless of how you shop. Prices are tightly regulated and prices of plans cannot be changed based on factors like commissions. In fact broker and agent commissions are paid for directly by the insurer out of a pool. If you go direct to an insurer, the insurer just keeps the commission.
The only things that affect the price of your health plan are: what plan you get, your location, your age, your family size, your income (if you are eligible for cost assistance subsidies), and factors like employer contributions. Your health or where you shop won’t affect the price of a specific plan.
FACT: You’ll never pay more for the same plan in the same region, before cost assistance, regardless of where you get it from.
Should I Shop for Health Quotes Outside of the Marketplace?
The more money you make, the more viable shopping outside the marketplace becomes. If you just barely qualify for cost assistance you may want to understand all of your options, chances are you’ll still pick a marketplace plan as even the most expensive subsidized plan is substantially cheaper than an unsubsidized one. That being said, healthcare costs go beyond premiums, the more medical services you plan to use in a year the more sense it will make for you to shop around and see all of your options. You’ll never be locked into a plan until you enroll, and under the ACA switching plans is pretty painless if done during open enrollment. Once open enrollment is over you’ll be locked into your plan until the next open enrollment period.
As a rule of thumb, the more cost assistance you are eligible for, the less sense it makes to shop anywhere except your state’s Health Insurance Marketplace.
How to get drug coverage
Medicare offers prescription drug coverage to everyone with Medicare. If you decide not to join a Medicare Prescription Drug Plan (Part D) when you're first eligible, or if you decide not to join a Medicare Advantage Plan (Part C) (like an HMO or PPO) or other Medicare health plan that offers Medicare prescription drug coverage, you'll likely pay a late enrollment penalty unless you have other creditable prescription drug coverage, or you get Extra Help.
To get Medicare drug coverage, you must join a plan run by an insurance company or other private company approved by Medicare. Each plan can vary in cost and drugs covered.
Types of Drug Coverage
Medicare Prescription Drug Plan (Part D). These plans (sometimes called "PDPs") add drug coverage to Original Medicare, some Medicare Cost Plans, some Medicare Private Fee-for-Service (PFFS) Plans, and Medicare Medical Savings Account (MSA) Plans.
Medicare Advantage Plan (Part C) (like an HMO or PPO) or other Medicare health plan that offers Medicare prescription drug coverage. You get all of your Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) coverage, and prescription drug coverage (Part D), through these plans. Medicare Advantage Plans with prescription drug coverage are sometimes called “MA-PDs.” You must have Part A and Part B to join a Medicare Advantage Plan.
When you join a Medicare drug plan, you'll give your Medicare number and the date your Part A and/or Part B coverage started. This information is on your Medicare card.
Joining a Medicare drug plan may affect your Medicare Advantage Plan
If your Medicare Advantage Plan (Part C) includes prescription drug coverage and you join a Medicare Prescription Drug Plan (Part D), you'll be disenrolled from your Medicare Advantage Plan and returned to Original Medicare.
Dental & Vision Coverage
We work with multiple carriers to offer the very best dental & vision plans on the market today. Some plans offer routine preventative while some offer much more with comprehensive benefits included.
Dental & Vision Coverage
We work with multiple carriers to offer the very best dental & vision plans on the market today. Some plans offer routine preventative while some offer much more with comprehensive benefits included. Call today to have a broker assist you in finding the dental or vision plan that fits your needs and your budget.
What's Medicare Supplement Insurance (Medigap)?
A Medicare Supplement Insurance (Medigap) policy, sold by private companies, can help pay some of the health care costs that Original Medicare doesn't cover, like copayments, coinsurance, and deductibles. Some Medigap policies also offer coverage for services that Original Medicare doesn't cover, like medical care when you travel outside the U.S. If you have Original Medicare and you buy a Medigap policy, Medicare will pay its share of the Medicare-approved amount for covered health care costs.
Then your Medigap policy pays its share.
A Medigap policy is different from a Medicare Advantage Plan. Those plans are ways to get Medicare benefits, while a Medigap policy only supplements your Original Medicare benefits
Medicare Advantage Plans
Individual Health Insurance
With all of the changes taking place in the insurance market today its nice to know that a professional can help navigate Individual Health Insurance.
We experienced and knowledgeable brokers can assist individuals as well as large employer groups with over 50 employees. We work with top companies nationwide to ensure that you receive the best customer service and most competitive rates available. With all of the changes taking place in the insurance market today its nice to know that a professional can help navigate you and assist in selecting the best insurance that fits your needs. We also have the low cost virtual medical care.
Indemnity Plans
What are Indemnity Plans?
Indemnity Plans are designed to pay upon the occurrence of a contractually-specified event. Examples include hospital indemnity where if the insured is hospitalized that individual would receive a daily benefit for each day in the hospital. Another common indemnity plan is cancer insurance. This type of coverage may pay a lump sum benefit after being diagnosed with a cancer diagnosis or pay specific benefit amounts for various expenses that arise. Our experienced & knowledgeable agents offer many various types of Indemnity plans on the market today.
Life-Health-Annuity
IS WHEN YOUR LOVED ONE'S WELL-BEING IS JUST AS IMPORTANT AS YOURS.
A type of Medicare health plan offered by a private company that contracts with Medicare to provide you with all your Part A and Part B benefits. Medicare Advantage Plans include Health Maintenance Organizations, Preferred Provider Organizations, Private Fee-for-Service Plans, Special Needs Plans, and Medicare Medical Savings Account Plans. If you’re enrolled in a Medicare Advantage Plan, most Medicare services are covered through the plan and aren’t paid for under Original Medicare. Most Medicare Advantage Plans offer prescription drug coverage.
Different types of Medicare Advantage Plans
How to join a Medicare Advantage Plan
Who can join a Medicare Advantage Plan?
When can I join, switch, or drop a Medicare Advantage Plan?
What if my plan decides to stop participating in Medicare?
What if I have End-Stage Renal Disease (ESRD)?
How do Medicare Advantage Plans work?