Health Insurance – 2016 Open Enrollment coming soon!

By Ulla-Undine Merritt (Dee) National Producer Number (NPN) 8853366

Health InsuranceMedicare & Medicaid turned 50 this
year (1965-2015)
Current Medicare Advantage Plan and Part D clients will be receiving their “Notice of Change” documents in September. These notices compare any plan changes from your current 2015 to your new 2016 plan. You will be automatically re-enrolled in your current plan if you do nothing and the new changes will take place January 1st 2016. OPEN ENROLLMENT for MEDICARE PLAN changes starts October 15th and runs through December 7th, 2015 for a January 1st, 2016 effective date. If you make a change during this time and later you decide on something else you can do so up until December 7th. The last plan you select will be your plan for 2016. There is a Medicare Advantage Disenrollment Period that starts January 1st and ends February 14. (

What can you do during this time?
• If you’re in a Medicare Advantage Plan, you can leave your plan and switch to Original Medicare.
• If you switch to Original Medicare during this period, you’ll have until February 14 to also join a Medicare Prescription Drug Plan to add drug coverage. Your coverage will begin the first day of the month after the plan gets your enrollment form.

What can’t I do?
• Switch from Original Medicare to a Medicare Advantage Plan.
• Switch from one Medicare Advantage Plan to another.
• Switch from one Medicare Prescription Drug Plan to another.
• Join, switch, or drop a Medicare Medical Savings Account (MSA) Plan.

Medicare can be very confusing so I would recommend that you meet with a licensed insurance agent that represents multiple insurance carriers. You should explain to them your current needs and concerns. Before choosing a plan you need to check the network to make sure you can see your doctors and check your medications to make sure they are in the plans formulary. Having a local agent that you can sit down and go visit if you have a question later I feel is very important. There is something to be said for looking someone in the eye, when you are making such an important decision.

Patients Protection and Affordable Care Act (PPACA) – (Obama Care) the Open Enrollment Period is November 1st to January 31st, those that enroll between November 1st to December 15th will have a January 1, 2016 effective date; Dec. 16th – Jan. 15th eff. Feb. 1, 2015; Jan. 16th – Jan. 31st eff. Mar. 1st 2015.

*** This is for every individual that wishes or needs to purchase health insurance in the United States and is not covered under Medicare, Group Health Insurance, VA and Tricare.

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 qualify through the Market Place and be registered. To see if you qualify for tax credit you can check the IRS website at If you do not qualify for subsidy you can still purchase your plan through the Market Place or the Insurance Company, both available with the help of a local agent by adding their name and National Producer Number (NPA). 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. Some insurance carriers are allowing their policy holders to keep their current plan, others have issued cancel notices. Before you cancel what you have make sure that you check to see if your doctors are in network as this has been a big problem. Also 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. Qualified High Deductible Health Plans (H.S.A.) plans also have a tax advantage. You need to do the math, explain your needs both health and financially with a licensed insurance agent. Check to see how many companies they represent, if they only represent one ok guess what you get? There are a lot more choices it is worth your time to check your alternatives.

There is a lot to know and I would recommend that you work with a licensed insurance professional that is Market Place Certified and licensed to sell many insurance carriers. They can help you through the enrollment process, and explain the different insurance policies available to you in your area.

To learn more schedule an appointment contact:
Logical Insurance Solutions
Dee Merritt

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