Image

Office Hours

M-F 9:00AM-5:00PM

Image

McKinney, TX

Image

Call Us Now

Stacey 214-923-6545

Shawn 214-531-3351

The Thomas Promise

Your Health. Our Priority.

We will work hard to earn your trust by finding coverage that fits your individual needs.

Why Is a the Affordable Care Act a Good Idea


Affordable Care Act (ACA) plans provide comprehensive health coverage, including essential benefits like preventive care, prescription drugs, and mental health services. These plans offer financial assistance through subsidies and tax credits, making health insurance more accessible for low and middle-income individuals and families. ACA plans also ensure consumer protections, such as coverage for pre-existing conditions and the elimination of annual and lifetime coverage limits.

Types of Affordable Care Acts Plans include:

Medicare Health Maintenance Organizations (HMOs)

Exclusive Provider Organization (EPOs)

When can you enroll?

You can enroll in a health insurance plan through the Affordable Care Act (ACA) during the

Open Enrollment Period, which typically runs from November 1 to January 15 each year.

Here are some key dates:

November 1: Open Enrollment starts. This is the first day you can enroll in, renew, or change health plans through the Marketplace.

December 15: Last day to enroll in or change plans for coverage to start on January 1.

January 15: Open Enrollment ends. This is the last day to enroll in or change Marketplace health plans for the year.

If you miss the Open Enrollment Period, you may still be able to enroll if you qualify for a

Special Enrollment Period. This can occur if you experience certain life events such as losing health coverage, moving, getting married, having a baby, or adopting a child.

Insurance carriers we work with on a daily basis:

How much do I have to pay for Medicare?

In 2024, the standard Medicare Part B premium amount is $174.70/month. If you didn't work long enough and pay Medicare taxes, you could also be required to pay a Part A premium (but most people don't). The Part B premium can be adjusted based on income. Right now they are looking at the 2022 tax return to determine if you will pay the standard amount or if they will charge you IRMAA (Income Related Monthly Adjustment Amount). 

Do I have to sign up for Medicare if I'm still working & covered by my employer group health plan?

If you are still working and covered by your employer group health plan and your employer has 20 or more employees, you are able to delay Medicare enrollment without a penalty for late enrollment. Most people will go ahead and enroll in Part A, which is zero premium if you worked enough time and paid Medicare taxes. The only time you will not want to get Part A is if you have an HSA. Medicare plans don't have a high enough deductible for you to quality for having an HSA account. Find out more info here: https://www.medicare.gov/basics/get-started-with-medicare/medicare-basics/working-past-65. Many people continue to work after 65 but still go on Medicare insurance because it may be less expensive and have more benefits. Contact me to help you compare Medicare costs and benefits to your employer plan.

When can I sign up for Medicare?

Seniors can sign up for Medicare during several key periods:

  1. Initial Enrollment Period (IEP): This period starts 3 months before you turn 65, includes the month you turn 65, and ends 3 months after your 65th birthday. This gives you a total of 7 months to enroll without facing any penalties.

  2. Special Enrollment Period (SEP): If you or your spouse are still working and covered by an employer group health plan, you can sign up for Medicare Part B during this period. You have 8 months to enroll after your employment or coverage ends.

  3. General Enrollment Period (GEP): If you miss the IEP and SEP, you can sign up between January 1 and March 31 each year. However, you might face a late enrollment penalty.

    If you have any specific circumstances or need more details, feel free to ask!

Why should I use an independent agent?

As independent agents, we don't work for just one insurance company. We represent multiple companies including United HealthCare, Aetna, Humana, Blue Cross Blue Shield, Amerigroup, Cigna, Wellcare, Omaha, and more. Different companies and plans could be a better fit for different people. 

We are able to help you by comparing plans available in your area that meet your needs. We will check networks to find out which plans your doctors accept, and will check drug costs to find the best Part D Drug plan for you. There is never any pressure. We are here to help answer your questions you have now and in the future.

We are able to help you get enrolled and help with plan changes in the future. Also, there is never any cost to use for our services and we take your privacy very seriously. Your info is never shared.

Who is eligible for Affordable Care Act?

To be eligible for health insurance coverage under the Affordable Care Act (ACA), also known as Obamacare, you must meet the following criteria:

  1. Residency: You must lawfully live in the United States.

  2. Citizenship: You must be a U.S. citizen, U.S. national, or lawfully present non-citizen

  3. Incarceration Status: You must not be incarcerated

  4. Medicare Coverage: You must not be covered by Medicare.

    Additionally, the ACA provides financial assistance to help reduce the cost of health insurance for individuals and families with incomes between 100% and 400% of the federal poverty level (FPL). Some states have expanded Medicaid under the ACA, making more people eligible for coverage.

    If you have any specific questions about your eligibility or need help with the application process, feel free to ask!

Stacey Thomas & Shawn Thomas are licensed and certified representative of Medicare Advantage and Part D Drug Plan organizations. Each of the organizations they represent has a Medicare contract. Enrollment in any plan depends on contract renewal. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. Not affiliated or endorsed by any government agency.