Happy New Year!
Everyone at The Health Insurance Store would like to wish all of our friends and customers a healthy and happy 2022.
New Year Announcements
There’s no question today because there are some very significant announcements and information to go over and review as the New Year is upon us. They’re not just for those on Medicare, but for people who are under 65 and buy their insurance on their own or will need to soon, business owners, and practically everyone who lives in Pennsylvania or West Virginia, the states The Health Insurance Store is licensed in.
Expanded Access to PACENET
Let’s start with the great news for those 65 and older. The PA Senate recently passed a bill that will expand access to PACENET, which is paid for with proceeds from the state lottery and limits the cost of prescription drugs to $9 for generics and $15 for brand name meds and eliminates the high cost of medications in the Donut Hole. PACENET can save seniors thousands of dollars per year.
The new income limits are $35,282 for a single person and $45,064 for a married couple. Eligibility is based on 2021 income. To calculate if you qualify, add your gross social security on your 1040 EZ form to your earned income. Be advised that you must add back in any losses. If you want to make it easy, feel free to email or mail me a copy of your 1040 with your Social Security number blacked out and I can quickly make a determination. You can also walk in to either of our offices with your return as well. If you do qualify, we will make the PACENET application for you at no cost.
Five Star Year-Round Enrollment
Another announcement that I’ve already made is the ability for year-round enrollment in Five Star Medicare Advantage Plans. So many people have chosen HMO’s or PPO’s that have overpriced premiums, higher than necessary hospital co-pays or Maximum Out of Pocket (MOOP), and fewer ancillary benefits. We currently enroll our Advantage Plan clients in only three company’s plans and there are less than 10 out of the 100 or so that are available in Western PA I feel are worthy of consideration. Please reach out to us to ensure you are on one of those we recommend. If you have parents, aunts, uncles, brothers, or sisters on Medicare, encourage them to contact myself or another of our agents. As I’ve written on numerous occasions, I estimate 50% of those on Medicare are not on one of the best plans.
For those who are self-employed, work at a job that doesn’t provide health insurance, or those who are looking to retire prior to 65 which is Medicare age, individual health insurance through the Affordable Care Act, Marketplace, Obamacare, or whatever you prefer to call it has never been more affordable thanks to provisions in the American Rescue Act. For example, a single person making $48,000/year can get a Bronze level plan with UPMC or Highmark for as little as $72 to $114. A married couple making $90,000 could get the same policies for $155 to $240. Those who make less than those amounts would have even lower premiums. If you don’t currently have insurance, the deadline to apply for a 2022 plan is January 31st. If you would like a second opinion if you are on the best ACA plan, we can provide that.
Those who are currently working and have insurance can enroll in a Marketplace all year round when they leave their job as can anyone who loses Medical Assistance, which brings me to another very important piece of information. Due to COVID, no one has been kicked off of MA in the last year or so, even if they no longer qualify. I believe at some point this year, possibly soon, tens of thousands are going to be losing their MA. The good news is those who are slightly or moderately over the income limit will not only get a low very premium, but also decreased deductibles and copays. For example, someone making $24,000 per year can get a plan with UPMC or Highmark with a $0 or $1,000 deductible, reduced co-pays, and a very low MOOP from $1 to $44 per month. That’s not a typo.
Please be advised, all the agents at The Health Insurance Store are licensed and well trained to help people apply, choose, and enroll in ACA plans.
The affordability of the ACA is a Godsend to small business owners and The Heatlh Insurance can help attract and keep good employees. Those who haven’t been able to provide and or had to drop group health insurance due to the high cost can now request help from us to help advise and enroll employees in an ACA plan or Medical Assistance if they qualify. You can offer a raise to cover the premiums at a fraction of what it would cost to provide a group health plan. What we also suggest is paying for some AFLAC benefits such as Cancer, Accident, Hospital Indemnity, Disability, or Life Insurance policies. With competition for employees fiercer than ever before, this can set you apart at a surprisingly low cost.
For those small employers who are already providing group health insurance, but are seeing premiums rise once again, dropping that policy and doing what I just described can save a huge amount of money. I have a client in Crawford County who paid $80,000 for her 14-person group plan this past year and is getting another increase in March. We’re going to move everyone to individual ACA plans and she’s going to pay for $100/month of the AFLAC policies of each employee’s choice. I’m estimating we’re going to save her $30,000 to $50,000 a by doing so. If you own a business and would like a no cost consultation to determine if this may be a viable option for you and your employees, please contact myself via email, aaron@getyourbestplan.com.
Dedicated Life Insurance Agent
This last announcement is for the majority of Pennsylvanians. About a year ago one of my best friends, only 49 years old, at the was diagnosed with Cancer. Thankfully it was discovered early and he needed only a single surgery. However, he had no life insurance and very little money saved. Had it been terminal, he would have left his wife and two kids in a very bad financial situation with a mortgage and car payments that his wife’s salary alone could not support. He motivated me to hire a Life Insurance agent who specializes in providing policies that can protect spouses and kids by paying off existing debt, help create generational wealth, pay for funeral costs, and protect and continue a family business.
Thank you!
If you have any questions or concerns regarding this column topic, or would like to make an appointment for a no-cost consultation, please feel free to give us a call – we would be happy to help. I’d like to remind everyone that I do a live call-in talk show called Medicare A to Z every 1st and 3rd Monday of the month on WMBS Uniontown, 590AM and 101.1FM, from 1 to 3 PM. You can listen in on their website, wmbs590.com.
Erie County Area
1105 West 12th Street, Suite – A
Erie, PA 16501
Phone: 814-920-5275
Fax: 814-920-5276
Fayette/Westmoreland County Area
121 North Pittsburgh Street
Connellsville, PA. 15425
Phone: 724-603-3403
Fax: 724-603-3402
Pittsburgh Area
21 Yost Blvd., Forest Hills, PA 15221
Mailing Address: 128 Forest Hills Plaza, Pittsburgh, PA 15221
Phone: 412-349-8818
Fax: 878-302-3149
Albuquerque/Santa Fe, New Mexico Area
821 Coors Blvd. NW
Albuquerque, NM 87121
Phone: 505-200-0069
Fax: 505-200-0073
Serving These Areas
We proudly serve the health insurance and Medicare needs of the following Pennsylvania areas: Connellsville, Uniontown, Greensburg, Mt. Pleasant, Scottdale, Irwin, N. Huntingdon, Murrysville, Monroeville, Plum, Lower Burrell, New Kensington, Pittsburgh, Plum, Oakmont, Penn Hills, Forest Hills, Wilkinsburg, East Liberty, Lawrenceville, Bloomfield, Natrona Heights, Leechburg, Washington, Morgantown WV, Latrobe, Monnessen, Jeanette, Erie, Edinboro, Northeast, Girard, Fairview, Union City, Harborcreek, Corey, Meadville, Waterford, Ligonier, Kittaning, Somerset, Waynesburg, Fayette County, Westmoreland County, Armstrong County, Butler County, Somerset County, Erie County, Crawford County, Venango County, Allegheny Valley, Pennsylvania
We proudly serve the following New Mexico areas: Albuquerque, Rio Rancho, Sante Fe, Bernalillo, Belen, Los Lunas, Espanola, Moriarty, Corales, Tijeras, Cedar Crest, Edgewood, Soccoro, Sandoval County, Sante Fe County, Bernalillo County, Rio Arriba County, Valencia County, Soccoro County, New Mexico
Not affiliated with the U. S. government or federal Medicare program.
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.