Frequently Asked Questions

ABOUT US

How much do you charge for your service?


We never charge a fee to our clients. Our services are always FREE! The insurance company will pay us a commission which allows us to not have to charge our clients. Plus, you will always be able to reach us by phone or email to ask us questions about your insurance plan! We strive to always offer excellent customer service!




What is an independent agent?


As an independent agent we represent several different insurance companies, that way we can give you different options to make sure you have the coverage that fits your needs. There is no such thing as a one size fit all plan. We cannot tell you what plan to choose, but we'll sit down with you to explain and educate you on the differences between the options available to you and help you select a plan that you are most comfortable with. We will also make sure that the plan you choose is accepted by your doctor.




What states are you licensed in?


We are currently licensed in Washington, Idaho, Oregon and Arizona.




Where do you hold your meetings?


COVID-19 update: For 2020, all community meetings will be held virtually. We hold several community meetings in the area to make it easy for our clients to receive the necessary information to make an educated decision when it comes to deciding on an insurance plan that will fit their needs. We generally hold community meetings in King county, including, Seattle, Burien and Vashon. To see a schedule of when and where we will be hosting our upcoming seminars please click here.




Are you available to schedule a one-on-one personal meeting with me?


COVID-19 update: For 2020, all one-on-one meetings will be held virtually. YES! We can meet you at our local office or we can come to you! If you are more comfortable having a one-on-one meeting with us or you aren’t able to attend one of our community meetings, we can set up an one-on-one appointment with you. We prefer to meet people at our Seahurst office, but we can also meet you at your home or at your local quiet coffee shop, Barnes and Noble, etc. This gives us the opportunity to be more personable which will make it easier to find a plan that will meet your individual needs the best.





MEDICARE

When do I apply for Medicare Part B?


The majority of the time there are two time frames you will want to follow to apply for Part B. The first would be up to three months before you turn 65. If you are either retired, planning to retire, not receiving social security benefits yet or if your employer requires you to enroll in Part B. If this fits your needs then you can apply online to start Part B. The second would be if you have worked past age 65 and were not required to have been on Medicare by your employer. Now you will have to apply in person at a local Social Security office to start your Part B and have it start the month following your retirement. You will need a two part form to be able to do this. One form is to be filled out by your HR department to prove you had credible medical insurance coverage. The other form is the one that enrolls you on Part B. If you need these forms, please contact us and we will provide them for you. Additionally, if you are already drawing Social Security benefits before you turn 65, you will be automatically enrolled in Part B. You will receive your Medicare card in the mail with both Part A and Part B on it. The card is mailed approximately 3 months prior to the effective date of coverage.




How much will Part B cost me?


The standard amount for 2020 is $144.60. This is based off of Modified Adjusted Gross Income (MAGI) of $87,000 or less for individuals or $174,000 or less for married couples. The Part B premium may be higher if your income falls above these levels. Your Part B premium may also be lower than this due to the Hold Harmless rule.
Please see the most up-to-date income chart below: *If your income is higher then the base amount, you will also have an adjusted premium for Part D plans as seen in this chart below:




When do I become eligible for Part A and how much does it cost?


As long as you have worked in the United States for 10 years and paid into Medicare taxes, you will be enrolled into Part A at no cost. Part A will start on the first day of the month of your 65th birthday. However, if your birthday falls on the 1st day of the month, then your benefits will start on the first day of the previous month. If you do not qualify for Part A at no cost, e.g. you didn’t work here long enough to pay into it, then it can be purchased in 2020 for $458 a month.




What is the Medicare Part B penalty and how do I avoid it?


The Part B penalty is a 10% higher Part B monthly payment for every 12-month period that you could have had Part B but didn’t sign up for it. The best way to avoid this is to either sign up for Part B when you are first eligible to or make sure that you have credible medical coverage through your employer.




What is the Medicare Part D penalty and how do I avoid it?


This is a penalty for not having prescription drug coverage, at least as good as Medicare´s, when you could've but chose not to enroll. The late enrollment penalty is calculated by multiplying the amount of months you did not have credible prescription drug coverage when you were eligible to, under a Part D plan, by 1% of the national average drug price ($32.74 in 2020). Medicare will contact your Medicare prescription drug plan and tell then the proper penalty to charge you. This penalty never goes away. As long as you have a drug plan, you will have to pay this penalty, in addition to the monthly Part D premium. The best way to avoid this penalty is to make sure that when you are first eligible to you either enroll in a Medicare Advantage plan that includes drug coverage, enroll in a Stand Alone Prescription Drug Plan, or make sure your employer drug coverage qualifies as credible drug coverage with Medicare. You have 63 days once your Part A or Part B starts to enroll in a credible prescription drug plan to avoid paying the penalty.




What is the difference between a Medicare Advantage Plan and a Medicare Supplement (Medigap)?


The easiest way to describe this is to say that a Medicare Advantage Plan is a primary insurance plan and you do not need any other plan with it. They take over your Medicare benefits and agree to pay all of your claims, so Medicare can no longer be billed. Some Medicare Advantage plans will also include drug coverage for no extra cost. A Medicare supplement plan is a secondary insurance plan and is billed secondary to Medicare. Supplement insurance plans will only cover Medicare-covered medical items and, depending on which plan you choose, help either cover some or all of the deductibles or co-insurance that Medicare doesn’t cover. Supplement plans do not include drug coverage. If you want prescription drug coverage then you will need to enroll in a Stand Alone Prescription Drug plan. You can read more about this on the Medicare 101 pages.




Which type of insurance does my doctor accept? Which plans are they contracted with?


We can look this up for you easily. Please either fill out the ‘Contact Us’ box at the bottom of the page or give us a call and we will do the research for you.




How many plans do you represent?


We represent over 16 different insurance companies. We can help you select a Medicare Advantage, Medicare Supplement (Medigap) or Prescription Drug Plan that will fit your needs and one that is accepted by your doctor.




What is the difference between Medicare and Medicaid?


Medicare is administered by the federal government while Medicaid is administered by the state. Medicare is for anyone who qualifies at age 65, under age 65 upon collecting Social Security Disability Income for 24 months or anyone with ALS or End Stage Renal disease. Medicaid provides medical assistance for those who qualify based on income and asset requirements. Based on your qualification, the state may help pay your Part B premium or some or all of your medical co-pays or co-insurance. To view the income and asset requirements and to see if you qualify for Medicaid in Washington state for 2020, please click here.





INDIVIDUAL PLANS

When is open enrollment this year?


Open Enrollment this year, in Washington State, will begin November 1st and run through December 15th. Please keep in mind that you will have to select a new plan by December 15th if you would like a January 1st start date.




What is the cut off date to have coverage begin the following month?


You will have to enroll in a plan by the 15th of the month if you’d like it to begin the following month. Example: If you would like a plan to begin November 1st, you have from September 16th to October 15th to enroll in a plan.




Do I have to renew my plan or will it automatically renew?


It depends on how you enrolled into your plan. If you enrolled directly with the carrier it will automatically renew as long as your plan is still available next year. A lot of plans have been discontinued so please check or call us if you aren’t sure. If you enrolled through the Washington Health Plan Finder, then you will have to renew your plan each year. They simply want to check if your income has changed so it doesn’t take very long to renew your policy. No matter how you enrolled it is always wise to review your plan changes for the coming year to make sure it is still the best plan for your needs.




Is my premium rate locked in for 2020 or can it change at any time?


Unfortunately, your rate may change at any time throughout the year. This will depend on the plan you are enrolled in and what action the Federal Government takes. If the Federal Government decides to remove Cost Sharing Reductions, which they can do at any time, then some plans rates could increase as much as 60% of their 2019 rate. Some carriers have decided only certain plans will have their rates increased. We will have information on this and will go over this with our clients.





2104 SW 152nd St, Suite 2, Burien, WA 98166

(206) 466-1935

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