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Health Insurance – 2015 Open Enrollment and Annual Election Periods can be very confusing this fall.

By Dee Merritt

Health InsuranceMedicare enrollment period is now called Annual Election Period which runs October 15th to December 7th 2014 for January 1st 2015 effective date.  Medicare is for adults that are 65 or older, or others that are on Medicare due to disability. In September each year Medicare Advantage Plan Member ‘s and  Medicare Part “D” Prescription Drug Plan member’s  receive a copy of their upcoming year summary of benefits and any changes that are being made to their current plan. During this time you should review the new plan and make sure it still suits your needs. You can compare plans, if you make changes your last selection you made by the end of the day on December 7th, this will be your new plan for the following year.  Some agents represent multiple insurance carriers and will reduce the amount of time you will need to compare 2015 plans.  If you miss this window you can dis-enroll from a Medicare Advantage Plan and go back to regular Medicare and a Prescription drug plan Jan. 1st – Feb. 15th 2015, then you are in a lock-in period until next year unless you have a special election period (i.e. loss of group coverage, move out of service area, carrier plan cancels, Low Income Subsidy, Dual Eligible, etc.) please visit www.Medicare.gov for more information.

For others that are not on their employers group plan or mediocre there is now also an enrollment period. The law under the Patients Protection and Affordable Care Act (PPACA) – (Obama Care) the Open Enrollment Period is November 15th to February 15th, those that enroll between November 15th to December 15th will have a January 1, 2015 effective date; Dec. 16th – Jan. 15th eff. Feb. 1, 2015; Jan. 16th – Feb. 15th Mar. 1st 2015. After that you will not be permitted to purchase health insurance that meets the government standards that avoids the tax penalty unless you have a special election period, please visit. https://www.healthcare.gov  for more information.  The PPACA plans have no medical under writing; short term policies are still available but currently still require medical underwriting which means you might be turned down if you have pre-existing conditions.

I am finding that many people think that the Affordable Care Act is only for people that are seeking government subsidy and that is not correct.  The law affects just about every type of health insurance in the USA.  In order to qualify for government subsidy you need to go through the Market Place or if the insurance carrier offers seamless applications through their platform it can be done that way as well.

To see if you qualify for tax credit you can check the IRS website at www.irs.gov/uac/The-Premium-Tax-Credit. If you do not qualify for subsidy you can still purchase your plan through the Market Place or the Insurance Company.   If you have an insurance policy for many years and drop that plan you will not be able to get it back as the plan will no longer exist to be re-purchased.  Many insurance carriers are allowing their policy holders to keep their current plan. Before you cancel what you have make sure that you check your doctors and totally understand the plans summary of benefits.  Cost is important but not only the cost of the plan you choose but also make sure you can afford the out of pocket cost when you need to use the plan, sometimes raising the premium a little it may make it easier to visit the doctor more often as needed. There is a lot to know and I would recommend that you work with a licensed insurance professional that is Market Place Certified that can help you through the enrollment process and explain the different insurance policies available to you in your area.

To learn more about Health Care Reform or schedule an appointment contact:
Dee Merritt – Logical Insurance Solutions at 239-362-0855
or visit www.Logicalinsurance.com .

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