Frequently Asked Questions

After receiving your Medicare ID card, you can enroll during the 3 months prior to turning 65, the month of your 65th birthday, and the following 3 months, for a total of seven months.

those who are eligible for Medicare should bring your Medicare card and list of your current medications if you would like us to find a compatible prescription drug plan. For those not eligible for Medicare, please bring a list of your current medications and your income information. Insurance carriers each have their own prescription formulary which is simply a list of prescriptions and at what level they are covered. If you would like a detailed explanation of how your prescriptions are covered under different carriers, bring a list of your prescriptions to your appointment or contact your consultant prior to the appointment so he/she can have that information ready for you.

• An HMO is a Health Maintenance Organization.  With an HMO you are required to select a primary care physician and benefits must be obtained from a network provider (except in the case of an emergency).
• A PPO is a Preferred Provider Organization which offers a network of providers and allows the member to obtain services out of network with a higher cost sharing.
• An EPO is an Exclusive Provider Organization which is a blend of the traditional HMO with elements of a PPO; you are not required to select a primary care provider but you are required to receive your care from a participating provider.

 Yes. As of January 1, 2014, the Affordable Care Act mandates that a person cannot be denied health insurance coverage because of a pre-existing condition.

You can get an individual Dental Insurance policy with an optional vision rider.

Members traveling outside of the plan's service area should seek only needed, urgent, or emergency care from the nearest provider and then contact their own doctor for a follow up visit.

Yes.  By federal and state law your employer is required to offer you a group continuation plan called COBRA. You have full responsibility for paying the premiums on a COBRA plan.

If you have a PPO plan you can go to an out of network provider with a higher cost sharing. With an HMO or EPO plan you will be responsible for all costs associated with services provided.

Insurance that provides the policyholder with benefits that replaces a portion of their income if they become ill or injured and unable to earn an income. The amount of disability that you need is based on income and expenses.

HSA is a health Savings Account that allows you to qualify for special federal tax savings when you're enrolled in a federally qualified high-deductible health plan. These accounts are meant to help pay for qualified medical expenses now and years from now.

Long Term Care is a form of insurance that provides benefits for the chronically ill or disabled over a long period of time. Long-term care services may include help with activities of daily living, home health care, respite care, and care in a nursing home.

 If you have a Medicare Supplement (Medigap) plan, you have to purchase a standalone prescription drug plan also know as Medicare Part D.

With a Medicare Advantage policy, prescription drug coverage is usually included in your plan.