How ACA may help you

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With many people curious about how the law impacts their situation, we wanted to high light an age group we know does very well under the new law.  Those who are 50 years old or older often do well under the new law. 

If you have:

  • No access to group coverage through your employer or spouse’s employer
  • Income between $16,000 to $60,000

The new changes will work in your favor.  Here is a real life example:

John, 64, is retired and unable to work due to declining health.  His wife Betty, 55, is currently disabled but not yet eligible for disability or Medicare.  Currently they have no health insurance and have suffered tremendous financial hit due to Betty’s recent health conditions.

John and Betty contacted us for assistance with their options.  John receives $1455/mo from social security and an additional $1000/mo from a company pension.  Betty has no income presently.

Based on their household size and income the marketplace determined that they are eligible for the following:

·         Monthly subsidy of $1,170 

·         Silver Enhance plan (this offers cost sharing reductions to the silver plan).  Total plan cost was $1,355.  With the subsidy the monthly premium they are responsible for is $185/month

·         Plan Benefits are as follow:        

o   $1000 individual deductible

o   $2000 out of pocket maximum

o   $5 primary copay

o   $10 specialist copay

o   $15 urgent care copay

o   $100 ER copay

o   RX copays of $10/$25/$50/$70/25%

As the above shows John and Betty are able to obtain the health coverage they need at a premium they can afford.  Some of our clients have premiums as low as $4.60/month with benefits better than these above.

Here are some common questions we receive from people we help.

Will you charge me to help me enroll?  Will I pay more to use you?
No, we are compensated by the carrier you choose.  The price is the same if you go through the exchange by yourself or with us.  However, we have enrolled hundreds of people so far.  We are very experienced with the system and know what works and what causes it to give errors.  We learned the hard way so you won’t have to.

Why use you?  Why not use a navigator or call the 800 number?
Again, there is no cost to use our services.  You get our 16 years of insurance experience at no cost to you.  We are contracted with both carriers and certified to write coverage on the Marketplace.  We help you understand how the plans work and show you some of the holes in coverages that you need to be aware of.  Navigators have no idea what the networks are or where the holes in coverage are because they aren’t licensed with each carrier.

How do you help me?
From the comfort of your own home, we take the time to “hold your hand” through the entire process.  We walk you step by step through the system over the phone or online.  From subsidy eligibility, plan review, enrollment, and covering what you will need to do after enrollment. 

I hope we have shown you the value of working with us as compared to calling the website or working with a Navigator.  Why not give us a try to see how we can help you enroll.


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