By Ulla-Undine Merritt (Dee) National Producer Number (NPN) 8853366
There are Special Election Periods for eligible individuals to purchase creditable health insurance coverage. Most life change events have a maximum of 60 days to make that change. The majority of the time you’re earliest effective date is the 1st of the month following your application.
Medicare and Under 65 Medical Plans have similar Special Election Periods but do have some variations.
www.healthcare.gov or www.medicare.gov
Medicare – partial list below please check with Medicare
• Move to a New Home that is not in the plans service area
• The plan is available but I now have new options
• Moved back to the U.S. after living outside the country
• Moved into, currently live in, or just moved out of an institution (like a skilled nursing facility or long-term care hospital)
• Released from jail
• No longer eligible for Medicaid
• Left coverage from an employer or union (including COBRA coverage)
• Involuntarily lose other drug coverage that’s as good as Medicare drug coverage (creditable coverage), or the coverage changes and is no longer creditable.
• Drug coverage through a Medicare Cost Plan and you left the plan
• Dropped coverage in a Program of All-Inclusive Care for the Elderly (PACE) plan.
PPACA – The Affordable Care Act (others may apply please check with Market Place
• Losing job-based coverage
• Losing individual health coverage for a plan or policy you bought yourself
• Losing eligibility for Medicaid or CHIP
• Losing eligibility for Medicare
• Losing co0verage through a family member
• Change in household size: Marriage; had a baby, adopted a child, or placed a child in foster care; divorced or legally separated and lost health insurance, death.
• Change in residence: Moving to a new home; a student moving to or from the place they attend school; seasonal worker moving to or from the place they both love and work; moving to or from a shelter or other transitional housing
• Other life changes: Change in your income that affect the coverage you qualify for; gaining membership in a federally recognized tribe or status as an Alaska Native Claims Settlement Act (ANCSA) Corporation shareholder; becoming a U.S. Citizen; leaving incarceration (jail or prison); AmeriCorps members starting or ending their service.
Short Term Medical Insurance is available all year long. These policies can be bought for up to 1 year. They do have medical underwriting so not everyone will qualify. But they are many times less expensive and you can purchase higher deductibles or catastrophic plans. They do not meet the government’s creditable coverage standards so you could still be subject to the tax penalty for not having coverage.
Employer Group Coverage – New groups can be formed all year long. This is very important as the government made the law very specific to say that an employer may NOT pay for an employee’s medical insurance (or any part of) and if they do they will be assessed a $100 per employee penalty per day. So if you are and employer that is doing this it’s time to shop for group insurance again. The advantages for individual insurance policies are going away and group is your best option now going forward. You want to speak to a Broker that deals with both group and individual so they can build a strategy that would best suit your and your employee’s needs.
Also remember when moving to check your wills, trusts, and make sure they follow Florida’s laws and guidelines. Establish yourself with a local attorney, CPA, Financial Planner / Insurance Agent. An annual review is very important. To many times people assume, don’t assume ask a professional most of the time your first consultation is at no charge.
Logical Insurance Solutions
To learn more schedule an appointment contact: Logical Insurance Solutions- Dee Merritt www.Logicalinsurance.com 239-362-0855 Dee@Logicalinsurance.com