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What is the Marketplace?
The health insurance Marketplace or Exchange is an online shopping center. Both federal Marketplace and state-based Marketplaces exist.
Marketplace health plans are all required to offer the same essential health benefits, including doctor visits, preventive care, hospitalization, prescriptions, pregnancy and mental health, to name a few.
In the Marketplace, you can:
Resources like HealthCare.com can help you shop for Marketplace plans with ease and support, providing you with quotes and recommendations.
Which Plan is Right For Me?
There are four categories of plans through the Federal Health Insurance Marketplace. These categories will help you choose a plan that’s right for you.
The categories are based on the costs that the plan covers and the costs for which you will be responsible. In other words, the category you choose affects how much your premium costs each month and what portion of the bill you will pay for things like hospital visits or prescription medications. The plans in each category all offer the same set of essential health benefits. The categories do not reflect the quality or amount of care the plans provide. The four categories are:
As with all health plans, you will have a monthly payment (or premium). However, it is also important to understand how much of the out-of-pocket costs you will be responsible for when you receive care.
A Bronze plan will likely have a lower premium, but you will pay a higher share of out-of-pocket costs when you receive care.
Premiums are usually higher for plans that pay more of your out-of-pocket medical costs. For example, if you have a Gold plan, you will likely pay a higher premium, but may have lower costs when you go to the doctor or use other medical services.
Platinum plans will likely have the highest monthly premiums and lowest out-of-pocket costs. The plan will pay more of the costs if you require frequent medical care.
In general, when choosing your health plan, keep this in mind: the lower the premium, the higher the out-of-pocket costs when you need care; the higher the premium, the lower the out-of-pocket costs when you need care.
Ask yourself, "Do you expect a lot of doctor visits or fill prescriptions on a regular basis"?
If you answered yes to either of these questions, you may want to choose a Gold or Platinum plan.
If not, you may prefer a Bronze or Silver plan. But keep in mind that if you have a health emergency, Bronze and Silver plans will require you to pay more of the costs.
The Marketplace also offers “catastrophic” plans to people under 30 years old and to some people with very low incomes.
There are 4 Ways to How to Enroll:
Navigating Medicare: A Comprehensive Information Guide with MediConnectAre you turning 65 soon or approaching eligibility for Medicare? Understanding your healthcare options is crucial for ensuring you receive the coverage you need. With Medicare being a cornerstone of healthcare for millions of Americans, its essential to familiarize yourself with its information. At MediConnect, our Medicare advisory firm, were here to help you find the plan that works best for you.What is Medicare?Medicare is a federal health insurance program primarily designed for people who are 65 or older. However, it also covers certain younger individuals with disabilities and those with end-stage renal disease. It consists of different parts, each providing coverage for specific services:1. Medicare Part A: Hospital insurance that covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care.2. Medicare Part B: Medical insurance that covers outpatient care, doctor visits, preventive services, and some home health care.3. Medicare Part C (Medicare Advantage): A private insurance alternative to Original Medicare (Part A and Part B), often including prescription drug coverage and additional benefits like vision, dental, and wellness programs.4. Medicare Part D: Prescription drug coverage available through private insurance companies approved by Medicare.Understanding EnrollmentEnrolling in Medicare can be a straightforward process if you understand the information for your options and the timing of key decisions: Initial Enrollment Period (IEP): Typically, this is a seven-month period that begins three months before the month you turn 65, includes the month you turn 65, and ends three months after the month you turn 65. General Enrollment Period (GEP): If you missed your Initial Enrollment Period, you can enroll during the General Enrollment Period, which runs from January 1 to March 31 each year. However, late enrollment may result in penalties. Special Enrollment Period (SEP): Some individuals may qualify for a Special Enrollment Period due to specific life events, such as moving, losing employer coverage, or qualifying for additional assistance programs.Making Informed Choices with MediConnectChoosing the right Medicare coverage depends on various factors, including your healthcare needs, budget, and preferences. At MediConnect, our Medicare advisory firm, we take the information you give us to offer personalized guidance and expertise. Helping you make informed decisions: Coverage Needs: Our team will work with you to assess your healthcare needs, including prescription medications, doctor visits, and any specialized care requirements. Costs: Well help you understand the premiums, deductibles, copayments, and coinsurance associated with each Medicare option to determine the total cost of coverage. Provider Networks: Well explain the differences between Original Medicare and Medicare Advantage plans, helping you choose the option that aligns with your provider preferences. Prescription Drug Coverage: Our experts will evaluate your prescription drug needs and compare Part D plans to find the one that best covers your medications at the lowest cost.Additional ResourcesNavigating the complexities of Medicare may seem daunting, but youre not alone. Here are some resources to give you additional information along the way: Medicare.gov: The official Medicare website offers comprehensive information, including plan comparisons, enrollment guidance, and eligibility criteria. State Health Insurance Assistance Programs (SHIPs): These programs provide free, personalized Medicare counseling and assistance to help you understand your options and make informed decisions. Medicare Plan Finder: Use this tool on Medicare.gov to compare Medicare Advantage plans, Part D prescription drug plans, and Medicare Supplement Insurance (Medigap) policies available in your area.As you approach Medicare eligibility, remember that MediConnect is here to support you every step of the way. Our Medicare advisory firm is dedicated to helping you find the coverage that meets your unique needs and preferences.By understanding the various parts of Medicare, enrollment periods, and factors to consider when choosing a plan, you can make confident decisions about your healthcare coverage. Let us guide you through the process and ensure you have the peace of mind that comes with comprehensive Medicare coverage tailored to your individual requirements.
How Much Do You Really Know About Arthritis?Arthritis is a term that many people associate with older adults experiencing pain in their joints. But did you know that arthritis, itself, is not a diagnosis, but a term that describes dozens of diseases and conditions? According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), the word arthritis means joint inflammation, and may be used to describe any condition affecting the joints, for people of all ages. In fact, arthritis impacts one in five adults in the United States and is the leading cause of work disability.To help you better understand arthritis, weve posed five questions below that explore common arthritic diseases, who is at risk and how to manage these conditions. How many types of arthritis are there?There are more than 100 types of arthritic diseases, which can impact the joints, tendons, ligaments and bones by causing stiffness, swelling and pain. According to the Centers for Disease Control and Prevention (CDC), some of the more common types of arthritis include the following:Osteoarthritis. This kind of arthritis occurs when joints in the body break down. Its most commonly experienced in the hands, hips, knees and back.Rheumatoid arthritis. This is an autoimmune disease, meaning the bodys immune system causes deterioration by attacking its own tissues. It can damage the joints in the hands, wrists and knees. Potentially, it could also impact the lungs, heart and eyes.Gout. This type of arthritis tends to impact only one joint at a time. During a flare-up, uric acid crystals form within a joint and cause pain, swelling and tenderness. Often, it impacts the big toe.Fibromyalgia. By causing pain throughout the body, fibromyalgia can have a significant impact on a persons quality of life and ability to work.Juvenile arthritis. Also known as childhood arthritis, this condition impacts nearly 220,000 people younger than 18. Its caused by an immune system that is overactive and results in swelling in the joints. What are signs and symptoms to look for?Because there are so many types of arthritis, and because symptoms may overlap with other conditions, it can be difficult to diagnose. The Arthritis Foundation says that if youre experiencing the following signs and symptoms you should consider talking to a doctor:Tenderness, pain, swelling and/or stiffness in one joint or several jointsRedness on or around a jointA joint that feels warmTrouble moving a joint or engaging in your day-to-day activitiesAny joint symptoms that concern youWho gets arthritis?Anyone can get arthritis, no matter their age, gender or cultural background. However, some groups of people face a higher risk than others for certain types of arthritis. For example, according to the CDC women face a higher risk for fibromyalgia, osteoarthritis and rheumatoid arthritis while men are more likely to develop gout. Further, its not uncommon for people experiencing other chronic conditions, such as obesity, diabetes and heart disease, to also have arthritis.Other risk factors can include:Age, with the risk increasing as you get olderFamily history, with some types of arthritis have a hereditary connection, including rheumatoid arthritis, lupus and ankylosing spondylitisWeight, with people who are overweight or obese facing an increased risk for osteoarthritis impacting the knees and other jointsSmokingCertain infectionsAn injury to a jointService in the military Are there actions you can take to lower your risk for arthritis?Possibly. While there is no magic pill that can protect you from arthritis, some people may be able to reduce their risks or at least delay the onset of certain types of arthritis, according to the Arthritis Foundation. For example, maintaining a healthy weight may help lower your risk for osteoarthritis; quitting (or never starting) smoking may help prevent rheumatoid arthritis; and eating a healthy diet that is low in sugar and alcohol as well as purines (thats a chemical compound that turns into uric acid) may help decrease your risk for gout. What can you do to manage your arthritis?If youve been diagnosed with arthritis, there are a number of steps that you can take that may help to ease pain and decrease inflammation. Those include:See your healthcare provider regularly and follow their advice. They know you best and can help you devise a plan to address your symptoms and help you continue to do the things you enjoy in life.Move more. It may sound counterintuitive, but physical activity may actual help reduce pain and improve the way you feel and move, according to the CDC. Try out a variety of joint-friendly activities, such as cycling, swimming, walking and tai chi. If working out is new to you, talk to your doctor first. With their approval, start small, aiming for five to 10 minutes at a time, and work towards the goal of 150 minutes per week, along with two days of strength-building activities. Manage your weight. Weight can put additional stress on your joints. Aim to reach or maintain a healthy weight through diet and exercise. If youre struggling, ask your doctor for advice.Make healthy eating choices. Research shows that some foods can help control inflammation, while others may contribute to inflammation. People living with arthritis may benefit from an anti-inflammatory diet, which includes fish, nuts, beans, fruits and vegetables (the Mediterranean Diet is a good place to look for guidance, according to the Arthritis Foundation). At the same time, try to limit the foods you eat that cause inflammation, including processed foods like white bread and pastries, fried foods, soda and sugary beverages, red meat and processed meats, along with margarine, shortening and lard. Take care of your mental health. Any chronic condition can take a toll on how youre feeling. And if the condition is limiting your usual activities, as arthritis may do, it can be especially stressful and isolating. If youre feeling hopeless or anxious, or youve lost interest doing the things that once brought you joy, find help. Talk to your primary care provider or connect with a counselor or therapist. A support group might also be useful. The Arthritis Foundation is a good place to start if you think you might benefit from a virtual group.As mentioned, there are more than 100 different types of arthritis, ranging from common to rare. While weve touched on some of the more frequently asked questions, theres still a lot to learn about these conditions. If youre concerned about pain, swelling or tenderness youre experiencing in your joints, talk to your healthcare provider today. To find out more about Healthcare Insurance Plans that include Medicare, Individual & Family, Health & Dental and Vision, call BlueCross BlueShield of Alabama at 251-344-2115.
What is Medicare?Medicare is a federal health insurance program that gives you access to specific coverage and benefits. Medicare is different from health insurance you may have had before. It offers you a variety of coverage options and it has key enrollment dates and guidelines you need to follow. Were here to help you make sense of it all. How is Medicare Different From Other Health Insurance?You may be surprised at the differences between Medicare and other types of health insurance. If youve had health coverage through your employer, your plan likely included medical and prescription drug coverage, along with other benefits. It also may have covered both you and your spouse.Medicare only covers one person at a time. This means you and your spouse must enroll separately. In addition, Medicare gives you options that can make it possible to receive your benefits in a variety of different ways.You can: Choose hospital and medical coverage delivered through the federal government. Add prescription drug coverage delivered through a private company. Purchase a supplemental insurance policy from a private insurer that can help cover some of the costs. Choose coverage from a private insurer that combines hospital, medical and often prescription drug coverage into one plan.In short, with Medicare you can choose coverage that fits your needs, budget and lifestyle. We can help you take full advantage of that freedom. Who is Eligible for Medicare? - Age 65+ - Under age 65 with certain disabilities - Have End-Stage Renal Disease (ESRD) When and How Do I Apply?If youre like most people, youll enroll in Medicare around the time you turn 65. Your Initial Enrollment Period begins three months before your 65th birthday, includes the month you turn 65 and ends three months after that birthday.Keep in mind that if you dont get Medicare during this Initial Enrollment Period, you may have to pay Medicare Part B or Part D late enrollment penalties. Plus, you could be missing out on coverage and benefits that can help protect your health and finances. Thats why its generally a good idea to enroll as soon you can. How you enroll generally depends on if youre getting benefits from Social Security, the Railroad Retirement Board or the Office of Personnel Management.Contact me today at 724-554-7989 for a FREE consultation.
Enroll AlabamaEnroll Alabama, a program of AIDS Alabama, is a federally-funded, statewide Affordable Care Act (ACA) Marketplace Navigator program. Navigator staff helps the public sign up for health insurance through the ACA Marketplace as well as complete applications for Medicaid and AllKids, Alabama's Children's Health Insurance Program. If you do not have health insurance through your job or are not eligible for other programs such as Medicare or Medicaid, you can qualify for a Marketplace-based plan through a private insurance company such as Blue Cross & Blue Shield of Alabama, Bright Healthcare, Ambetter of Alabama, and United Healthcare of Alabama. Additionally, depending on your household and income you can qualify for tax subsidies to help you pay for your insurance premiums and co-pays. Many Alabamians end up paying little or nothing per month for comprehensive health insurance! Clients also have the option of signing up for dental insurance through the marketplace.As part of the Enroll Alabama program, AIDS Alabama has partnered with varied organizations including AIDS Alabama South in Mobile, The Right Place in Anniston, East Alabama Medical Center in Opelika, United Ways of Alabama (statewide), 211 Connects Alabama (statewide), Project Say Something in Florence, DCH Regional Medical Center in Tuscaloosa, and The Wellness Coalition in Montgomery to provide general information about the Patient Protection and Affordable Care Act, Medicaid, and CHIP to communities across Alabama. If you have a business, community or professional organization that would be interested in a presentation from a certified Navigator about the ACA Marketplace, you can give us a call or send us an e-mail and we will be in touch!Members of the public have the opportunity to schedule in-person appointments with Navigators online or by phone (by calling us at 211 or 1-844-248-7698 or visiting us online at www.enrollala.com) and can also receive enrollment assistance at regional enrollment events and home visits. Virtual and phone appointments are also available at the clients convenience. Call us between the hours of 9am to 4pm to see how we can assist you.If you have any questions about Enroll Alabama or the ACA Marketplace in general or to set up an appointment, you can call us at 1-844-248-7698 or e-mail enrollalabama@gmail.com. For immediate assistance, please call 211 and ask to speak with a healthcare Navigator. We look forward to assisting you and your family!Contact Torri Peyton at 251-465-5897