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James Ball Insurance, Inc.

Your local insurance agency. 


What other health insurance options do I have besides Obamacare? 

There are a couple of different  carriers that are offering alternative health insurance options. Some of them are temporary, some are for one year, all seem to be partially underwritten. 


Short term plans - UnitedHealthCare is offering an 89 day catastrophic plan. These plans are much more affordable than regular health plans, but there are a couple things you should know. 1) They're only available for 89 days at a time. 2) They don't help with smaller medical claims, only catastrophic. 3)The deductible starts over at each policy renewal. 


Annual plans - Cigna is offering two plans that are good for one year. They seem to be more affordable and not a bad looking health plan. There are underwriting questions so you could get denied if you have a poor health history. 


Price isn't everything. With both of these plans you may be saving a lot of money each year on your premium, but what about the other costs involved with having these plans? Since the UHC plans aren't good for minor events, you pay for your doctor visits, and you may be repaying your deductible every 3 months. Neither UHC nor Cigna are compliant with the Affordable Care Act. Which means you'll be paying the penalty for not having adequate health insurance when you file your taxes. 


There's a lot to consider when purchasing an alternative plan. 


How much life insurance do I need?
This is a very common question we get from our clients. The answer ALWAYS varies from one client to the next. Everyone’s situation is different, so their needs are different. When trying to calculate exactly how much your death benefit should be, we consider: your annual income, how long you plan on working, your spouse’s income, how long they plan on working, your household expenses (mortgage, insurance, taxes, etc.) any debt you have (auto loans, credit cards, etc.), and college expenses for your children.

These are just some of the examples of what we look into. Many people already have a number in mind and focus on coverage just one of those categories. Coverage a mortgage if the breadwinner passes is one of the most common reasons for life insurance. It’s important to step back and look at the entire picture though, we don’t want you to be under covered, but we also don’t want you to be over covered either!

There are a lot of calculators you can use online to determine exactly how much you’ll need. The beauty of life insurance in today’s world is how versatile tit is. If the calculator shows that you need $786,454 in death benefit, then that is exactly what we will write your policy for. No, we won’t write it for $800,000 because that isn’t what you need. You would be paying too much at that point.

The true answer is, it depends, but it’s very easy to figure out with today’s technology and a quick phone call to one of our agents. 


I don’t like my current health insurance plan, when can I change it?  
This question is regarding a health insurance plan designed for those under the age of 65, and not enrolled in their employer’s health plan. This is individual/family health insurance.

We have to start at the beginning for this one, back to the Affordable Care Act and when it was first implemented. The ACA is a set of rules and regulations that dictate what insurance companies can offer and at what times. There are things inside the health plans now that weren’t there in the past. Time constraints are also part of the ACA rules.

The time frame for purchasing a health plan, for the 2018 calendar year, is form November 1 – December 15, 2017. This is also known as “open enrollment.” If you are currently enrolled in a health plan and don’t like it for whatever reason, you must wait until open enrollment in order to switch plans. Keep in mind however that the new plan will not take effect until January 1, 2018. The same rules apply if you don’t have medical insurance and wish to enroll in a new plan. Even if you’re sick and desperately need insurance to cover upcoming expenses, you must wait.

The reasoning for this is to keep everyone paying into the system at all times. If everyone is paying a premium it will offset the cost of those who are costing the insurance company the most.

Can I travel with a Medicare plan that has a network?
We come across this question/concern a lot. The big misconception is that when you have a Medicare Advantage plan, which has a provider network, that you can’t go to other states and receive coverage. The truth is, it all depends on the plan you enrolled in.

The plans we recommend are PPOs, which means you CAN travel outside the plan’s network and still be covered by the plan. You will have to pay more for these services, but at least you still have coverage. The best example we can give is: Jane Doe was diagnosed with a rare form of cancer, the local cancer center says they have a 60% survival rate, but a facility in another state has a 90% survival rate. Of course Jane would prefer to go to that other state and receive treatment there. With a PPO she has the ability to do that.

With an HMO however, she can go to that facility and receive treatment, but the entire cost of the treatment is on her. Another concern with an HMO we come across is “what if I’m traveling for vacation and have an emergency? I can’t receive coverage because I’m not in my home state?” You will always receive coverage as if you were in your home state if it’s a medical emergency. If Jane were visiting family in Michigan and cut her finger while slicing onions, she can go to the ER and would be charged as if she were here in Venice, her home town.

The big thing to consider is what fits your needs most and what are you comfortable with? For me personally, I would want the option to travel outside of my plan’s service area if there is better treatment available. Sometimes these plans cost more, but I’m willing to pay that if it means a better chance of recovery.

Statistics about life insurance and our response to them:
There are some interesting statistics about life insurance that can be easily found on the web. The first is that “38% of people don’t have life insurance because they are unsure of how much, or what to buy.” Talking to a life insurance professional can easily fix that. (Enter sales pitch here). But that’s why we don’t push you towards any specific strategy or solution, it’s whatever is best for you and your situation. There are many calculators that help you determine exactly how much life insurance you need. They look at your income, your spouse’s income, age of your children, college tuition, mortgage, and a few other factors. When the calculator shows you need $443,286, that’s exactly how much we write your policy for. We don’t push you up to $450,000 because it isn’t needed! The type of policy can be easily determined, but that’s case by case scenario as well.

Statistics number two and three: “85% say they need life insurance, but only 62% say they have it. Those without life insurance think it’s more expensive than it really is.” You don’t know how much it cost until you shop it. But doing a google search and generating a quote from the first company that you see is not going to be accurate. The 23% difference however may have shopped it and might have even applied for it. But there’s always a chance they didn’t qualify or applied for too high of an amount. Again, talking to a professional can help with these concerns. We were able to save one gentleman about $400 per year after we switched him to a newer product. He had the policy for 4 years already and said it was the most affordable plan on the market, we showed him there was something more for less and he switched right away.Shop your life insurance like you shop your auto and homeowners. Rates change each year and you never know what the carriers might be offering. If you have a term policy you should shop it at least every 3-4 years. If you’re in a permanent life insurance product you should be meeting with your insurance agent each year at your plan’s anniversary date.


Affordable Care Act (ACA or Obamacare) update:

Winning 217-213 in the House of Representatives, the American Health Care Act of 2017 (AHCA or Trumpcare) is the first phase of three in repealing Obamacare.  The AHCA will focus on the budget side of Obamacare versus the mandates on health insurance carriers. Here’s a quick list of some of the changes that are to come:

Currently, Obamacare charges a penalty for not having insurance that equals a certain percent of your income. The AHCA doesn’t charge a penalty for not having insurance, but will allow insurance carriers to impose a one-year 30% surcharge for not having insurance longer than 63 days.
Obamacare allows insurance carriers to charge up to three times the premium to an older client than what they charge a younger one. The AHCA will allow carriers to charge up to five times more, but each state can apply for restrictions on the insurance carriers in their state.
Health Savings Accounts (HSAs) are limited to deposits of $3,400 yearly for individuals, and $$6,750 for families. Under the AHCA an individual can deposit $6,550 and a family $13,100 into their HSA.
 Insurance carriers are currently not allowed to put a limit on the financial coverage they provide. The new AHCA will allow carriers to limit how much they spend in one year on each insured.

These are just some of the changes that are currently being voted on. It has passed the House of Representatives and will be voted on by Congress in the near future. If you have any further questions regarding these changes and whether they affect your situation, please feel free to contact us.


Which Medicare plan is better for me? Advantage or supplement? 

- The answer is both, except you can't have both at the same time. When it comes to Medicare and choosing a plan, you have to weigh the benefits of each option. Your agent should go over all aspects of the two choices before you discuss specific plan information. 


With an Advantage plan you have much lower monthly premiums that what you would pay for a supplement plan. Advantage plans require you to pay small amounts (copays) when you see your doctor, visit the urgent care center, have a hospital stay, etc.  There is an out of pocket maximum that you would have to pay IF something catastrophic happened. Advantage plans are ideal for those who don't have multiple doctor visits outside of their annual physical and isn't expecting any major medical costs within the next year. You can save the premiums you would have spent on a supplement plan to cover any medical costs that might occur. Premiums for advantage plans range from $0 - $150 per month. The plans we like are less than $50. 


Supplement plans are ideal for the opposite type of person. One who is expecting higher medical costs that they don't want to pay any portion of. Certain supplement plans will cover 100% of your medical bills (some exclusions apply of course). The doctors you're allowed to see with this type of plan is almost unlimited, if the doctor accepts Medicare, then they accept your plan. The beauty with these plans is you don't have to worry about the medical copays when you need medical attention. The premiums for this can cost up to $300 per month, much higher than an Advantage plan. But if you're worried about covering the cost of a surgery then this is the better option for you. 


Be sure to weigh both options carefully with your insurance agent. Take a look at the consequences of signing up for one and whether you can switch at a later time. That topic will be discussed in another blog. Stay tuned!