I've seen so many people online searching for alternatives to ACA ("Obamacare") plans. I TOTALLY get why people are looking for less expensive options, as ACA premiums have certainly gone beyond anything I could have dreamed when the law first went into effect in 2014.

But having spent close to 20 years in this business, I've seen enough to know that most people find health insurance plans pretty darned confusing. Then throw in a bunch of "alternatives," and I'm concerned about the potential f...
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As I write this, we are moving very close to the opening day for shopping for 2016 health plans. The Annual Enrollment Period runs from November 1st through January 31st. This is the third AEP under the Affordable Care Act (ACA or "Obamacare"). Let's take a look at who can benefit from this opportunity to comparison-shop among plans.

They include those who are:

• Currently without health insurance, including those who have short-term (also called 'temporary') insurance, since those do not meet th...

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In another perplexing conundrum of the Affordable Care Act (ACA), health insurance benefits offered to employees and their families may well actually be costing the employees MORE!

How could that be? Here's how:

The ACA states that if a person has access to health insurance, whether through an employer plan (even as the spouse or child) or a government program such as CHIP or Medicaid or whatever, they are NOT eligible for any subsidy to reduce premium costs on an individual plan - even if thei...
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Any law has the possibility (probability?) of creating situations that demonstrate the Law of Unintended Consequences.

Unfortunately, to no one's surprise, the Affordable Care Act is no different. Sometimes the resulting gaps leave agents scratching our heads trying to come up with viable work-arounds.

Let’s look at a situation that cropped up recently for one prospective client and her husband that demonstrates this. It is a perfect example of the Catch-22 created by the collision of two l...
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No one is ever ready for the day the pink slip arrives. No one. Ever.

No matter how much the handwriting’s been on the wall. Not even if you hate the #@& job and are actually relieved.

I could write a whole post on how to handle a job loss, but there are many far more qualified than I to talk about that, and there’s certainly a ton of information online.

But one aspect I am uniquely qualified to address is the health insurance one.  And this is one decision I urge you NOT to make too hastily...
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Choosing prescription drug coverage (which is separate from what they call "original" Medicare - Parts A and B) was pretty simple for me, since I take two generally inexpensive generics. However, just to be sure, I decided to do my due diligence.

Thankfully, "due diligence" is made simple by the good folks at CMS (Center for Medicare & Medicaid Services), thanks to their Part D plan finder online.

A bit of an aside at this point: You may be wondering why in the world Medicare has all these "pa...
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Medicare has been very much on my mind lately - for very (ahem) personal reasons! Not 'personal' as in 'private,' but personal because I'm about to be eligible. (This obviously happened when I wasn't looking and there must be a clerical error because I most certainly KNOW I'm only turning 45, not 65 :-))

I have to say, other than that a-g-e thing, it's been pretty darned painless. I applied for my Parts A and B coverage online through an "Apply for Medicare" link on the Medicare website, and a...
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The time has almost arrived! If your health insurance plan is going away (several carriers in the Carolinas opted not to extend their transitional, if-you-like-your-plans plans for another two years) or if you just don't like your current coverage for any reason - too expensive, not happy with the company, don't like the benefits, whatever -  your opportunity to make a change is coming up starting on November 15th.

You'll have until December 15th to submit an application for a January 1st star...
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In order to meet the requirements of the Affordable Care Act, all individual (also called "private") health insurance plans must offer the same set of ten essential health benefits. These are services all plans must cover.

The essential health benefits include at least the following items and services:

• Ambulatory patient services (outpatient care you get without being admitted to a hospital)
• Emergency servicesHospitalization (such as surgery)
• Maternity and newborn care (care before and after your...

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When I've explained to people that under the Affordable Care Act there will be ONE annual enrollment period for buying or changing individual health insurance, many think that the rest of the year I'll be sitting with my feet propped up on the desk popping bon-bons.

Uh, no. Even if I were so inclined, that's not gonna happen! I will be busy helping people get health insurance all year round because of a phenomenon known as Life Happens. And when "life happens," it often creates eligibility...
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Over the years I've had many callers tell me they just wanted "catastrophic" health insurance coverage. What they wanted was just a basic plan with little to no bells and whistles with a high deductible.

Well, the Affordable Care Act provides for an actual "Catastrophic" plan. And, yes, that's the name of it with all carriers. Not only that, but, as far as I'm aware, the benefits are exactly the same with all carriers.

However, Catastrophic (with a capital "c") plans are generally open onl...
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You've left or are leaving your job. You're eligible for COBRA. What do you do next?

I know it sounds self-serving, but I can't overstress this: One of the very first things you should do when leaving a job is talk with a reputable health insurance agent. With the advent of the Affordable Care Act, it has never been more important to know your options in the decision-making process.

Leaving a job that offers health insurance benefits is considered a qualifying life event, triggering a Special E...
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A few weeks back we hosted our annual New Year's Day brunch for a few neighbors. The recent experience of one of my neighbors pointed out that even when an employer is picking up most of the tab for your health insurance premium, a pricier plan doesn't always turn out to be the best choice. Here's Joanne's (not her real name) story:

Joanne had opted for what she thought would be the best coverage her employer offered: one with a deductible (for the "big" things) and copays for certain services...
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If you or a loved one are eligible for Medicare soon, you're probably feeling overwhelmed at this point with all the "stuff" that's come in the mail. You may have figured out that you'll need a Medicare supplement (also called Medigap) policy to cover the things that original Medicare doesn't cover.

But you may be feeling a little confused about the prescription drug part. The short answer is this: You'll also need to purchase a separate plan for prescription drug coverage (a PDP, for ...
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Did you know that having your own health insurance can give you more flexibility when job-hunting?

1) It allows you to accept a part-time or contract position that doesn't provide health insurance benefits (but that might lead to a full-time job offer at some point).
2) It may make you more appealing to an employer who is concerned about the high cost of providing a full benefits package.
3) Having your own health insurance means you won't have to accept a position that you know really isn'...
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A new term in health insurance with which you should probably familiarize yourself is "grandfathering." Understanding what it means and how it could affect you is important, particularly as it relates to individual health insurance. In fact, because I specialize in individual (as opposed to group, i.e. employer-based) health insurance, I'm not even going to address its implications for group coverage.

Do you remember when Pres. Obama kept emphasizing that if you liked your current health insur...
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I had a situation come up recently that reinforced how important communication is - in ALL of life of course - but particularly during the health insurance buying process. I can't stress the importance of letting your agent in on any and all health-related issues that the potential insureds either have now or have had in the past that might impact the underwriting outcome.

I'm well aware that it can be uncomfortable to reveal personal health information to a virtual stranger, but we agent...
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More often than you would think, I come across potential clients who tell me they can't afford health insurance - or who don't come out and say it, but they just never seem to get around to applying for coverage.

Now, these are seldom people whose premiums for a basic policy would be $1200, or $800 or even $500 a month. I "get" that that could put a serious dent in a budget. (Although, I can say with 100% certainty that here in the Nuttall household even those kind of numbers wouldn't stand i...
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Bits and pieces of Health Care Reform are beginning to fall into place, although of course the lion's share will not go into effect until 2014. As we agents figure out how to best help our current and future clients get and keep coverage, I'll be keeping you up to date on the latest and how it may impact your health insurance decisions. Decisions which, directly or indirectly, often affect life decisions
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There is one particularly crucial point of which you should be aware, particularly if you...
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Did you know that over 600,000 emergency room visits each year involved adverse reactions to or interactions of prescriptions or over-the counter drugs or supplements? Here are some of the main risks:

• Taking different drugs prescribed by more than one doctor
• Using drugs to treat conditions for which they weren't originally prescribed
• Taking leftover drugs that were stockpiled and later used incorrectly
• Using a drug that was appropriate initially but caused a toxic interaction when a new dr...

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On my way home from a BCBSNC meeting today, I stopped to indulge one of my guilty pleasures, eating at McDonald's, and a less-guilty pleasure, reading the Charlotte Observer. I practically choked on my chicken strip when I came upon this letter to the editor on the Forums page:

In response to "Health care insurers' profits up 56% in '09" (Feb. 12):
Huge profits to health insurers while uninsured die? Shameful
So health care insurers made a 56 percent profit in 2009, and there's no chance for red...
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It didn't occur to me until just recently (um, like yesterday) that the way I do business nowadays is WAY greener than it used to be. How so, you ask? Well, let me iterate some of the "old" ways:

1. Everything used to be on paper. Everything! Paper brochures, paper contracts, paper rate sheets, paper marketing materials, and on and on.
2. All that paper stuff changed constantly and so was delivered to me regularly in (you guessed it) paper envelopes and cardboard boxes.
3. All that paper and cardboard st...

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A short-term, or temporary, health plan might be just what the doctor ordered for some situations. If you'll have a coverage gap of of just a few month until other coverage (employer-sponsored, Medicare or an individual health plan) is set to begin, it can be the perfect filler.

I usually don't recommend that short-term coverage be used in place of a regular major medical plans because of its limitations. Pre-existing conditions and annual physicals are not covered. However, in those situatio...
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Everybody complains about them but most don't do anything about them. I'm talking about health insurance premiums.

When was the last time you ran the numbers to see if what you're paying makes sense for your situation?

If you're dealing with major illness and have been in and out of the hospital and are receiving ongoing treatments, by all means, stay with what you have. You're most likely getting WAY more than your money's worth! (Which brings me to a question for a whole other day: why do p...
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Bill and I (and many of my clients) have an HSA-qualified high deductible health plan. The premiums are wonderfully low, but of course we had to give up a few things to get those low premiums - like office visit and prescription drug copays. We have found it an excellent trade-off. (And, by the way, we do have full coverage for our annual physicals.)

What hadn't occurred to me was how differently doctors tend to practice medicine when there aren't any copays. A key part of this has been that...
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