FAQ
Common questions, answered clearly.
Insurance can be complex, but I believe in making it simple. Here are some of the most common questions I receive.
What is the difference between HMO and PPO plans?
HMO (Health Maintenance Organization) plans usually require you to choose a primary care physician (PCP) and get referrals to see specialists. They often have lower premiums but stick to a strict network. PPO (Preferred Provider Organization) plans offer more flexibility to see any doctor or specialist without a referral, inside or outside the network, though generally at a higher cost.
When is the Medicare Annual Enrollment Period (AEP)?
The Medicare Annual Enrollment Period runs from October 15 to December 7 every year. During this time, you can join, switch, or drop a Medicare Advantage Plan or Medicare Prescription Drug Plan. Coverage begins on January 1st of the following year.
Do you offer Florida Blue or UnitedHealthcare plans?
Yes, I'm an independent agent representing most major carriers in Florida, including Florida Blue, UnitedHealthcare, Aetna, Humana, Cigna, and Wellcare. I compare all options to find the best fit for your specific doctors and medications.
Can you help with Affordable Care Act (Obamacare) enrollment?
Absolutely. I assist individuals and families in navigating the Health Insurance Marketplace (Healthcare.gov). I help determine if you qualify for premium tax credits (subsidies) to lower your monthly insurance bill.
How do I avoid the Medicare Part D late enrollment penalty?
You can avoid the penalty by joining a Medicare drug plan when you're first eligible (usually during your Initial Enrollment Period when you turn 65). If you have creditable prescription drug coverage (like from an employer or VA), you won't pay a penalty if you switch to Medicare later.
Does Medicare cover dental and vision?
Original Medicare (Part A and Part B) does not cover most dental care, eye exams, or glasses. However, many Medicare Advantage plans include these extra benefits at little to no extra cost. I can help you find a plan that includes the dental and vision coverage you need.
What is the "donut hole" or coverage gap?
The coverage gap means there's a temporary limit on what the drug plan will cover for drugs. It begins after you and your drug plan have spent a certain amount for covered drugs. Not everyone will enter the coverage gap. I review your medications to help predict your costs for the year.
Do you assist with claims or billing issues?
Yes. Unlike 1-800 numbers, I'm your local advocate. If you have a billing error or a claim denial, you can call my office directly. I work with the insurance carriers to resolve issues on your behalf so you don't have to fight them alone.
What do I need for a quote?
To provide an accurate comparison, I typically need a list of your current doctors and prescription medications (dosage and frequency). This allows me to ensure your providers are in-network and your drugs are covered at the lowest tier cost.
Is there a fee for your services?
No. My services are completely free to you. I'm compensated directly by the insurance carriers if you choose to enroll in a plan. Your premium is exactly the same whether you use my expert guidance or enroll on your own.
Still have questions?
I'm here to help. Reach out directly for answers specific to your situation.