The Future of Health Insurance with Trump

health-insurance-changes-ahead-2017BOOKMARK THIS PAGE: We will Update as changes are made to Individual Health Insurance

We all know that due to the election of Donald Trump there are going to be many changes. One of the largest is regarding Individual Health Insurance. Especially since he has proclaimed to repeal “Obamacare”. 

Don’t be worried, as we are here to notify you of any changes as they occur! Our goal is to guide you through what happens next…

The 2017 Open Enrollment will continue as planned from Nov 1st 2016 to Jan 31st 2017.

(Click Here) for Information on 2017 Health Insurance Options

BOOK A MEETING to go over 2017 Plans!

It took 3.5 years from when the Affordable Care Act was passed on March 23rd 2010 until it was implemented on January 1st 2014. From speaking with many other professionals we are projecting that it would take about 2 years for any real structural change to occur. The soonest changes would be made are for 2018 plans since you are locked in. At least we can hope..

Changes to Expect:

Pre-Existing Conditions: There will be a waiting period for pre-exisiting conditions (there was a 9 month waiting period before the ACA). This would LOWER prices since people would not be able to “game the system” of getting coverage instantly for immediate medical issues occuring while uninsured. However if coming from a Group Plan they would waive the “waiting period” for having continuous coverage.

More Choices: With the ACA, the fully loaded Gold/Silver/Bronze policies currently cover “all” medical conditions. If you are able to choose a more “catastrophic only” policy this will result in cheaper policies for those that choose these and more expensive policies for those wanting the full coverage plans.

How to Enroll: It’s expected there will be no Open Enrollment period since the health insurance carriers will be able to underwrite and use waiting periods to “manage risk”. This means you will most likely be able to buy any time of the year.

Individual Mandate: Trump has proclaimed to end the manadate to buy health insurance and eliminate the tax penalty if you don’t.

Below is an independent article going over potential changes.

How Trump Might Change Health Insurance

Health Insurance carriers would not stand for any changes to simply drop coverage immediately since policies are locked in for a calendar year. Changes for the next year would move you to the next closest plan just like it did when the ACA was first implemented and you were moved to a new Gold/Silver/Bronze plan.

Give us a call at 425-802-2783 if you have any questions, as we want to ensure that you make an informed decision about your medical needs.

Below are our areas of expertise:

Gary Franke, Tamara Chandler, Justin Cross
Independent Broker
Achieve Alpha Insurance, LLC 
12507 Bel-Red Rd, Ste 103
Bellevue, WA 98005
(425) 802-2783
health@achieve-alpha.com
www.achieve-alpha.com

Apple Health Medicaid in Washington State

Welcome to Apple Health (Medicaid)

Washington Apple Health

Welcome to Apple Health which is what we call Medicaid in Washington State.

DOWNLOAD and save the document below that explains Apple Health.

2017 Apple Health Guide to Services

Apple Health Detailed Guide

There are a variety of reasons how you got to be on an Apple Health plan.

From signing up clients for individual health insurance plans in Washington State I have seen both the positive and negative aspects of this plan. It really depends on how you use medical care.

In general the Apple Health plans have a smaller network of doctors and more limited coverage, however the plans have no deductible and are free (or low cost), especially if your income is going to be a bit lower for 2017. At least you get health insurance for major medical issues.

INCOME

There are many reasons why someone is on Apple Health. Typically it is because your income is below a certain level for the number of people in your family. Other main reasons are Pregnancy, Disability, and Adoption.

If you apply through the Washington Health Exchange, children are often automatically put onto Apple Health, while the parents have to choose a discounted Health Insurance plan. The family income has to be much higher in order for the children to be put onto an exchange health plan.

There are five carriers for Apple Health. The process once you are assigned to Apple Health is for them to randomly assign you a carrier. You can change to another Apple Health provider any month (at this time), yet recommend to pick one and stick with it.

DOCTOR NETWORK

You may be able to keep your current doctor. Follow this exactly for best results:

1. Call your current doctors office and ask them “Do you take Apple Health or Medicaid plans?”

2. If they say NO, then your doctor is not covered (you can still pay cash to see them).

3. If they say YES, ask them “Which carriers to you take?”. After calling all your doctors offices, then assess which of the 5 carriers covers most of your doctors (or the most important ones to you).

4. If you need to switch plans, call the 1-800 number on the back of your PROVIDER ONE Card. Done.

ALTERNATIVE TO APPLE HEALTH

For those with a more acute medical issue or simply need certain doctors covered there is another option. That is to buy a plan direct from a carrier. Yes paying full price is not always an easy option financially, yet if you need better medical care it is worth paying for.

Give us a call at 425-802-2783 if you have any questions, as we want to ensure that you make an informed decision about your medical needs.

Below are my areas of expertise:

Gary Franke, MBA
Independent Broker
Achieve Alpha Insurance, LLC 
12507 Bel-Red Rd, Ste 103
Bellevue, WA 98005
Phone:(425) 802-2783
gary@achieve-alpha.com
www.achieve-alpha.com

Individual Dental Insurance

dental insurance logoGETTING DENTAL COVERAGE

Please read this entire blog before calling us about Individual Dental Insurance at 425-802-2783 or health@achieve-alpha.com. It’s very simple as long as you go over your options and click on the blue links for additional information.

There is no such thing as a great individual dental insurance. Typically the people that ask specifically for dental coverage have more dental needs. In general a group plan has better benefits since they are able to spread the costs across all the employees (especially those that don’t use as much dental services).

In Washington State there are a few decent options. The two that I have found that are the best are:

  1. Delta Dental (more expensive, has a large network of dentists, yet with more limited annual services)
  2. Dental Health Services (lower cost, has a smaller network of dentists, yet extremely good coverage for services)

NOTE: One key disadvantage of getting Individual Dental Insurance is that you need to keep the plan for an entire year, so if you are looking for longer term dental coverage these are great options!

Delta Dental logo2

Check out the OVERVIEW of Delta Dental

If you want to see a specific dentist, then you want the Delta Dental plan. We typically recommend the Enhanced Plan, as its a bit more expensive than the other Delta Dental plans, but provides significantly more value! It really does. So be smart and choose the Enhanced Plan.

The downside is that with the Enhanced plan is that there is a max out of pocket of $1,000 per year. You get strong discounts on dental services until you hit the max that Delta Dental will pay. Then the discounts end on your plan as well.

Since services are covered up front there is a 12-month waiting period for Major Dental services (Crowns & Root Canals), however if you had prior group coverage that is ending you have up to a 60 day period to enroll in a plan. In that case the Major Services would be covered at the beginning of the sales period.

delta-dental_pricingMAJOR SERVICES COVERED

  • Cleanings
  • Fillings
  • Crowns
  • Root Canals
  • Dentures
  • Braces (not covered for any reason)

Steps for getting Delta Dental:

  1. FAQ for Delta Dental

  2. Enhanced Plan Extremely Detailed Outline of Benefits

  3. Check the Dentist Directory (Very Wide Network of Dentists)

  4. Sign Up for a Delta Dental Plan (CLICK HERE)

 

Dental Health Services logo

Check out the OVERVIEW of Dental Health Services

I personally have the Dental Health Services Smart Smile plan, as it’s a low cost plan and I did not care which dentist I saw…as saving money for me was worth it and I found a good dentist in their network.

The reason that Dental Health Services (DHS) is so affordable is that any fees you pay the dentist is what they keep for services. This means that DHS can keep the overhead lower and provides clients with a more straight forward cost for services. Check out the information below, then click on the link to sign up.

NOTE: Another huge advantage is that there is NO max out of pocket, so if you intend on using a lot of dental services this is the plan for you!

dhs-pricing-for-2016

MAJOR SERVICES COVERED

  • Cleanings
  • Fillings
  • Crowns
  • Root Canals
  • Dentures
  • Braces (yes, this plan covers them!) If you have a child that needs braces chose this plan!

The cost for services are broken out for every single procedure done. The brochures below show an estimated full price for that service with and without insurance that doctors charge. This helps when looking at the entire value for what the plans provide.

Steps for getting Dental Health Services:

  1. Smart Smile (Detailed Cost Breakout)

  2. SuperSmart Smile (Detailed Cost Breakout)

  3. Check the Dentist Directory (It’s fairly limited. Pick a dentist when signing up, you can switch anytime)

  4. Sign Up for a Dental Health Services Plan (CLICK HERE)

 

Below are my areas of expertise:

Gary Franke, MBA
Independent Broker
Achieve Alpha Insurance, LLC           
12507 Bel-Red Rd, Ste 103
Bellevue, WA 98005
(425) 802-2783
gary@achieve-alpha.com
www.achieve-alpha.com

Achieve Alpha