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How to Transition to Medicare Coverage

If you have a health plan through the Health Insurance Marketplace and will soon have Medicare eligibility, it’s not too soon to start planning for your coverage to switch.

If you have a Marketplace plan now, you can keep it until your Medicare coverage starts. Then, you can cancel the Marketplace plan without penalty.

When to apply for Medicare

Once Medicare eligibility begins, you’ll have a 7 month Initial Enrollment Period to sign up. For most people, this is 3 months before, the month of, and 3 months after their 65th birthday.

It’s important to sign up for Medicare when you’re first eligible because once your Medicare Part A coverage starts, you’ll have to pay full price for a Marketplace plan. This means you’ll no longer be eligible to use any premium tax credit or help with costs you might have been getting with your Marketplace plan. 

Also, if you enroll in Medicare after your Initial Enrollment Period, you may have to pay a late enrollment penalty. It’s important to coordinate the date your Marketplace coverage ends with the effective date of your Medicare enrollment, to make sure you don’t have a break in coverage.

Getting Help

Our insurance agency works with people all across the state of Texas to help transition people into Medicare coverage, as well as insuring people of all ages in this state for their health insurance options.  If you are a resident of Texas, we want to help you!  Please call Jim Lindeneau, at 832-445-0211, ext. 2# for more information.  

Rx Home Delivery and Reminder Service Now Available

There is a new Rx fulfillment  "service" that could be helpful for those who need assistance in remembering which medications to take, and when.  The company is called Pill Pack, and they say they are compatible w/ most Medicare Part D plans, as well as other insurance plans (except Humana, Optum, VA and Medicaid plans). They state in most cases, there are no additional fees, although it would be a good idea to check with them on the fees and plan compatibility before actually signing up with them, but we do think the service could be very helpful for those that need it.  For anyone who maintains an extremely busy lifestyle, or for those caregivers who could use a little extra relief, each "pill pack" is broken out not only by the days of the week, but the time they should be taken.  Pill Pack also offers an app to help as a reminder.  To learn more about Pill Pack and their services, please CLICK HERE.

Abilify $5 Copay and Changes

In April of this year, the generic for Abilify (Aripiprazole) became available to purchase in the U.S.  Abilify is generally taken for depression and other mental health issues.  Abilify is a fairly expensive medication in the brand name form, so it is important to know that a lesser expensive generic option is now available.  Anyone interested in changing from the brand name to generic should consult with their physician.  If a generic is not deemed suitable by your physician, Abilify is offering a program to get the brand name version for as little as a $5 copay.  For more information on the Abilify program, please click the link below.

Learn More About the Abilify Savings Card

New Health Insurance Special Enrollment Period for Tax Season

The Centers for Medicare and Medicaid Services (CMS) announced a new Individual Health Insurance Marketplace Special Enrollment Opportunity beginning on March 15 through April 30. This Special Enrollment Opportunity is for individuals and families who did not have health coverage in 2014 and are subject to the fee or "shared responsibility payment" when they file their 2014 taxes in a Federally Facilitated Marketplace (FFM) states.

Who is Eligible
Clients who live in a FFM state are eligible for this Special Enrollment Opportunity if they:

• Are not currently enrolled in health coverage through the FFM for 2015,
• Attest that they paid the fee for not having health coverage in 2014, and
• Attest that they first became aware of, or understood the implications of, the penalty or shared responsibility payment after Feb. 15, 2015, when Open Enrollment ended, in connection with preparing their 2014 taxes.

State-based Exchanges (SBE) have the flexibility to determine whether they will establish a similar special enrollment period. Check specific SBE websites for additional information. 

What This Means
Eligible clients will have the opportunity to purchase an On-Exchange Individual Health Plan from March 15 through April 30.

• Enrollments made by the 15^th of the month will have coverage effective on the 1^stday of the following month.
• Enrollments made after the 15^th of the month will have coverage effective on the 1^st day of the second month.

The fee for not having health insurance increases to $325 per adult or 2% of income for 2015. Individuals taking advantage of this special enrollment period will still owe a fee for the months they were uninsured and did not receive an exemption in 2014 and 2015. This special enrollment period is designed to allow such individuals the opportunity to get covered for the remainder of the year and avoid additional fees for 2015.Our office will be open Sunday, March 15th for anyone who pre-schedules an appointment, to enroll for coverage.  The reason for this is because March 15th is the cutoff for an April 1 effective date.  Anyone who waits until April 16th or after, will have an effective date of either May 1 or June 1 (depending on the exact date of enrollment).  For anyone desiring an April 1 effective date, it is imperative to enroll no later than this Sunday, March 15th.  

TO SCHEDULE AN APPOINTMENT OR TO FIND OUT IF YOU ARE ELIGIBLE, PLEASE CALL DANA LINDENEAU AT 832-445-0211, EXT. 1#.  

Patient Safety Week

Welcome to Our New Website!

We are kicking off our new site, with the introduction of Patient Safety Week!  

This worthwhile health care campaign started this past Sunday and will run thru this upcoming Saturday.  It's an initiative led by the National Patient Safety Foundation that is designed to help patients navigate the health care system better, as well as provide important and valuable informational resources on helping educate and protect yourself and family when you or a loved one is not feeling well.  We will be updating with links to additional resources this week on this subject matter.  If you have further questions, please feel free to contact us directly.  

We advocate for patients and our clients here!

RESOURCES FOR PATIENTS

Roadmap for Patient + Family Engagement

Courtesy of Gordon and Betty Moore Foundation

The Roadmap was designed to increase patient and family engagement by providing specific strategies to be applied across the continuum of care.

The Patient's Toolkit for Diagnosis
Courtesy of Society to Improve Diagnosis in Medicine
Preparing ahead of time for your medical appointment allows you to think about your concerns, symptoms, other important information your doctor/nurse will need from you, and what you want to get out of your conversation with your doctor/nurse.  The Toolkit has a set of prompts and questions to help you participate and partner with your medical care team – doctors, nurses, and other health care professionals and support staff. Fill out the first three pages of this Toolkit before you go to a medical appointment. Finish filling it out during the appointment or soon afterwards. You can bring the Toolkit with you to your appointment and refer to it. You can also copy it after filling it out, and give it to your doctor or nurse. Not all diagnoses are correct, and a diagnosis may be certain or uncertain. Making a diagnosis can be easy or difficult.  

DISCLAIMER:  All links above connect with external websites, and open in a new browser window.