Frequently Asked Questions

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We help consumers navigate both the Medicare ecosystem and the Marketplace to find insurance coverage that fits their needs by:

  • Offering personalized help at no cost to you. We start by doing a complete and thorough needs analysis, then help you compare and choose a health plan that meets your specific healthcare needs.
  • Ensuring quality. We will ensure that all health plans meet basic standards, including quality standards, consumer protections, and access to a wide range of doctors and clinicians.
  • Increasing transparency. We will convey clear and detailed information about health plan prices, benefits, and quality so that you can make meaningful comparisons between plans.
  • Leveraging Our Expertise. Plans are not allowed to deny you coverage, limit your benefits or charge higher premiums simply because of any pre-existing or chronic conditions, like cancer or diabetes.

For Medicare recipients, coverage will always begin on the first of the following month or the date your Medicare coverage begins.

For ACA in most situations, any enrollment before the 15th of the month, will begin on the first of the following month. For instance, if you enroll on May 12th, your coverage will begin on June 1st. If you enroll on May 20th, your coverage will begin on July 1th.

Yes. When you join a Medicare Advantage plan, you must continue to pay your Medicare Part B premium if not otherwise paid for by Medicaid or another third party. If you meet certain eligibility requirements for both Medicare and Medicaid, your Part B premium may be covered in full. Some Medicare Advantage Plans reduce the Medicare Part B premium. The reduction is set up by Medicare and administered through the Social Security Administration (SSA). Depending on how you pay your Medicare Part B premium, your reduction may be credited to your Social Security check or credited on your Medicare Part B premium statement. Reductions may take several months to be issued. However, you will receive a full credit.

Yes. However, as long as you are a member of a plan you must not use your red, white and blue Medicare card to get covered medical services (with the exception of clinical research studies and hospice services). Keep your red, white, and blue Medicare card in a safe place in case you need it later. Here’s why this is so important: If you get covered services using your red, white and blue Medicare card instead of using your membership card while you are a plan member, you may have to pay the full cost yourself. If your ID card is damaged, lost or stolen, contact us right away and we will send you a new card.

In many cases, the answer is yes. If you have a Special Election Period then the answer will always be yes, if you act quickly.

Medicare open enrollment is annually from 10/15 to 12/7.

In many cases, the answer is yes. If you have an ACA plan and have had a change in income you may be eligible to make a change because of your income change. If you have Medicare there are many options available that you may qualify for. Also, if you have a Special Election Period then the answer will often be yes if you act quickly. Give us a call to learn more!

If you are moving, the best thing to do is call us within 60 days of the move. After that, it is often too late. Even a move from one side of town to another must be reported to the marketplace (or Medicare insurance company). Our advice, NEVER do this on your own. Correcting mistakes made by the marketplace personnel, or by you, may be difficult to change. People have lost coverage by not letting us make the change.

Yes, because they are considered a part of your medical expenses! You may deduct them in case of your medical expenses for the year exceeding 10% of your Adjusted Gross Income. People who are self-employed can often ignore the 10% AGI limit and deduct 100% of the premiums. We advise you consult a tax professional for guidance before taking any steps!

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Health Plan Options is a licensed insurance agency that is appointed, certified, and trained to represent multiple insurance plan options that include Medicare Supplements, Medicare Advantage plans and stand-alone prescription drug plans. Health Plan Options brokers are NOT associated with the Center for Medicare and Medicaid services or any other state or federal agency.