Helping You Navigate Health Care Reform
Health insurance companies are large, complex organizations. From getting coverage to ensuring claims are paid, it can be a challenge dealing with them. You’ll enjoy peace of mind working with me, and having an advocate with 20+ years of experience on your side.
Individual Health Insurance
What is individual health insurance?
Individual health insurance is coverage that you purchase on your own, on an individual or family basis, as opposed to obtaining through an employer or from a government-run program like Medicare, Medicaid, or CHIP.
Who needs individual health insurance?
Individual health insurance is for anyone who doesn’t have access to employer-sponsored or government-run health coverage. This includes people who are employed by a small business that doesn’t provide health benefits, people who are self-employed, and people who retire before they’re eligible for Medicare and have to get their own personal health coverage until they reach age 65.
Individual health insurance is also available both inside and outside the marketplace (“off-exchange“) statewide. However premium subsidies (premium tax credits) and cost-sharing reductions are only available if the plan is purchased through the marketplace.
In both cases — on-exchange or off-exchange — individual health insurance is only available during the annual open enrollment period or during a special enrollment period triggered by a qualifying event. In most states, the annual open enrollment period runs from November 1 to December 15, with coverage effective January 1.
We are currently in a special enrollment period, as a result of the American Rescue Plan Act (ARPA) signed by President Biden March 11th 2021. This Act allows for qualified individuals to enroll in an ACA compliant plan until August 15th 2021.
Regardless of whether you want to purchase your plan on-exchange or off-exchange, you can obtain personal assistance from an insurance broker such as myself. There are also navigators and enrollment counselors who can answer questions and provide information and assistance with on-exchange plan selections as well as Medicaid enrollment.
How much does individual health insurance cost?
The monthly premium payments for individual health insurance plans vary greatly, depending on the applicant’s age, zip code, whether they use tobacco, and the health insurance company they choose. But unlike policies issued in Colorado pre-2014, premiums do not vary based on gender or an applicant’s medical history.
“I’ve been working with Keith Taylor and Health Insurance Advocates for over 15 years. Keith is a man of integrity and character who builds relationships with clients through his demeanor, expertise, and commitment to excellence.”
– Linda Petsche.
Medicare
Medicare is a single-payer federal health insurance program created to provide health coverage for Americans aged 65 and older and later expanded to cover younger people who have permanent disabilities or who have been diagnosed with end-stage renal disease or amyotrophic lateral sclerosis (ALS).
Medicare does a pretty good job of covering medical expenses, however Medicare leaves significant exposure behind for it’s beneficiaries. There are basically two approaches the beneficiary can take to limit this exposure:
Add a Medicare supplement to your coverage. These are insurance products designed to cover some or all the exposure (holes) left behind by Medicare.
Enroll in a Medicare Advantage plan. This is also an insurance product. If you choose this approach, it transfers your health insurance from the federal government entirely to the insurance company. Many of them add additional benefits such as prescription drug benefits, dental, vision and hearing to name just a few.
You might consider speaking with a professional broker to discuss your options. Typically there is no fee for working with a broker. The broker fees are paid by the insurance companies. The rates in most cases are the same whether you utilize the services of a broker or not.
“I have known and worked with Keith Taylor for over a decade. In an ever changing industry, it has never been more important to have an experienced broker who has a true understanding of the insurance marketplace and who always provides exceptional service with the highest integrity. It has been a pleasure to work with Keith and his team and I am confident you will experience the same outstanding qualities.” – Troy Westegren.
Small-Group Health Insurance
What is small-group health insurance?
Small-group health insurance is medical insurance geared toward businesses with 50 or fewer full-time equivalent employees.
Small-group plans effective since January 2014 are compliant with the Affordable Care Act’s requirement of health coverage. Insurers can’t use a group’s medical history to set premiums for ACA-compliant small-group plans, and premiums for older employees cannot be more than three times those for younger employees.
ACA-compliant small-group plans also have to fit into one of the four metal levels and cover the ACA’s essential health benefits.
Businesses can buy small-group plans directly from an insurance company, via a broker or private exchange.
Find out whether your business would benefit by providing small-group coverage for employees.
“Keith has helped my company find the right health insurance for around 15 years. Buying health insurance has changed dramatically over that time and every year Keith takes the necessary time to inform us of the changes that are relevant to us.” – Ken Wandry.