We are native Texans and only focus on the Texas market. Contact us today and see how we can find coverage that is the right fit for you, with the doctors you want, and the medications you need.
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.
Medicare Advantage plans often provide additional benefits beyond Original Medicare, such as coverage for prescription drugs, dental care, and vision services. These plans may offer lower out-of-pocket costs for some services compared to Original Medicare, potentially saving beneficiaries money. However, Medicare Advantage plans typically have network restrictions, meaning members may need to use specific healthcare providers to receive full benefits.
A Medicare Supplement plan, also known as Medigap, helps cover out-of-pocket costs not paid by Original Medicare, such as copayments, coinsurance, and deductibles. These plans can provide financial predictability and potentially lower overall healthcare expenses for beneficiaries. Additionally, Medicare Supplement plans often offer the freedom to see any doctor or hospital that accepts Medicare, without the need for referrals.
Dental, hearing, and vision insurance plans typically cover routine preventive care and basic procedures for teeth, ears, and eyes, helping maintain overall health and catch issues early. These plans often reduce out-of-pocket costs for more extensive treatments like dental crowns, hearing aids, or corrective lenses, making essential care more affordable. By bundling these services, such plans can offer comprehensive coverage for sensory health needs that are often not included in standard medical insurance, potentially leading to better overall health outcomes and quality of life.
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).
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.
Seniors can sign up for Medicare during several key periods:
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.
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.
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!
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.
To be eligible for health insurance coverage under the Affordable Care Act (ACA), also known as Obamacare, you must meet the following criteria:
Residency: You must lawfully live in the United States.
Citizenship: You must be a U.S. citizen, U.S. national, or lawfully present non-citizen
Incarceration Status: You must not be incarcerated
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.