By Ulla-Undine Merritt (Dee) National Producer Number (NPN) 8853366
Most of the major insurance companies that sell a Major Medical Plan, Employers Group Plans, Medicare and Medicaid have For many of us we have never had to choose our own insurance, our parents or our employers have done it for us most of our lives. If you are not on Medicare, you have a couple of options.
• Affordable Care Act/ Market Place/Obama Care (all the same thing)
• Short Term
It is important to understand how the plan works and the terminology associated with it.
• Contracted Price – This is the price the insurance company has contracted with the provider.
– Most deductibles and coinsurance are based on the contracted price which most of the time is much less.
• Deductible – A specific amount of money that you must pay before an insurance company will pay a claim.
• Copays – A fixed dollar amount for a covered service
• Coinsurance – Percentage of the cost you pay normally after the deductible
• Maximum out of Pocket – This is the maximum you can pay for your services in a policy or calendar year based on how your plan was set-up. Many of the newer plans include prescription drug costs in the out of pocket maximum. Medicare Advantage Plans do not include them in the health portions deductible or out of pocket maximum.
• Maximum Benefit Amount – What is the most the plan will pay overtime not just the plan year.
If you are considering retiring, or maybe choosing Medicare vs. Employer Group there is a lot to know and it could hurt you not understanding the facts. Work with a Local Insurance Agent that has an office that you can verify their location, you want to be able to the meet with them in the future and you should not have strangers in your home unless it is medically necessary. You also want a local company that works with most of the insurance companies in your area. Our office specializes in Medicare, we offer free workshops that you can attend and virtual sessions.
Coronavirus also known as COVID-19 how are insurance companies handling it? Most of the major insurance companies that sell a Major Medical Plan, Employers Group Plans, Medicare, and Medicaid have your back. Most are waving all members cost sharing, including copays, coinsurance and deductibles for COVID-19 diagnostic testing provided at approved locations in accordance with CDC guidelines. You can login to your providers website to find information on how your plan will handle the virus. You can also call the customer service number on the back of your card, but we highly recommend going online and logging in so urgent needs can be handled faster. Our clients are always welcome to call us, and we will help with questions. That is why having a local agent that is dedicated to their clients is important. CDC is the Center of Disease Control https://www.cdc.gov/ , this is the site that is most important. Many news media put a spin on things, the CDC is your best resource for up to date information.
If you think you may have been exposed to COVID-19, call your primary care provider right away. Your health care provider will determine if you should be tested, they will work with local and state health department to coordinate testing. The mostc ommon places are providers offices and clinics.
The care or treatment for COVID-19 will be covered in accordance with your health benefits plan. The initial test is free but if you have the virus your deductibles, copays and coinsurance will apply. If drive-up testing options become available in your area you need to check if it is an FDA approved facility/location.
Things have been changing daily, so check on the CDC website for updates also www.floridahealth.gov for state specific information. DO YOUR PART! Social Distancing, stay home as much as possible, enjoy our outdoors, bike, walk, boat etc. Always wash your hands, do not touch your face unless you have carefully cleaned your hands first.
Hurricane Season is here! Do you know the best time to get Flood Insurance is when you are NOT required to have it? The cost of Flood Insurance is not that much, especially when you consider the benefit. Flood Insurance is closed to purchase when a storm is named and a threat to your area. In many cases it is less than $40 a month. Do you know that 30% of all flood insurance claims are filed in low-to-moderate-risk areas? That is, the percentage of claims now, think how high that number would be if FEMA knew those that did not have flood policies. (* www.fema.gov)
We are happy to help, we have agents from Bradenton down to Marco Island, our headquarters are in Fort Myers and we also have an office we use part time in Naples.
To learn more about your options call to schedule an appointment contact:
Logical Insurance Solutions
HDQ 2365 West First Street, Fort Myers, FL 33901
Local Agents – Marco Island, Naples, Bonita Springs, Fort Myers, North Fort Myers
*We also do a complimentary homeowner, health insurance and employer group review’s