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Important Health Insurance Plan Coverages

Health insurance for the emergency room

Ah, health insurance. It’s like the ultimate adulting test, but instead of a grade, you get co-pays. And if the thought of picking the right health insurance plan makes you feel like you’re trying to solve a Rubik’s Cube blindfolded, don’t worry—Suzie and Matt at Wenatchee Insurance are here to help. Let’s dive into what every health insurance plan must cover, using examples that prove even the mundane can be hilarious.


1. Doctor Visits: The “Ouch!” Standard

All health insurance plans must cover preventive care, like your annual physical or flu shots. So, when you stub your toe on the coffee table for the fifth time this month, rest assured you’re covered for a doctor visit.

Example: Remember Bob from East Wenatchee? He thought his sore throat was a sign of his budding opera career. Turns out, it was strep. Thankfully, his insurance covered the visit, and Suzie from Wenatchee Insurance helped him pick a plan that didn’t leave him crying in the pharmacy aisle over antibiotic prices.


2. Emergency Services: For When You Really Mess Up

Whether it’s a car accident, a kitchen knife mishap while perfecting your “Chopped” audition, or your kid thinking their LEGO belongs in their nose, emergency services are covered.

Example: Matt once helped a family in Cashmere who needed an ambulance after their teenager attempted a backflip off the barn roof. The good news? Their plan covered it. The bad news? The kid’s TikTok account gained 20,000 followers from the footage.


3. Prescription Drugs: Because Over-the-Counter Isn’t Always Enough

Insurance plans cover a range of medications, so you’re not stuck Googling “natural remedies for gout” in the middle of the night.

Example: One client, Nancy, tried to cure her migraines with a DIY essential oils concoction that ended up attracting bees. Suzie found her a plan that covered real migraine meds—and a bee sting cream just in case.


Medicare prescription plan d talk to Suzie at Wenatchee about Inflation Reduction Act

4. Mental Health Services: Brain Care Counts Too

Every plan covers therapy and mental health treatment. Because sometimes, adulting really is that hard.

Example: Fred, a Wenatchee resident, found himself overwhelmed by his parrot, who had learned to imitate his mother-in-law. Therapy sessions covered by his plan helped him cope (and gave him the courage to teach the bird new phrases).


5. Maternity and Newborn Care: Tiny Humans, Big Bills

Pregnancy care and newborn checkups are a must. And honestly, who doesn’t need a little financial help when baby formula is practically worth its weight in gold?

Example: A couple in Leavenworth came to Matt for help after realizing their baby’s hospital bill rivaled their down payment on a house. With the right plan, they saved enough to afford diapers and pizza delivery during sleepless nights.


6. Preventive Care: Because “An Apple a Day” Isn’t Enough

From cancer screenings to vaccines, your plan’s got you covered here. It’s like insurance for your future self.

Example: Suzie helped a Wenatchee apple farmer find a plan that covered his annual skin cancer screening—important when you’re out in the sun all day naming your trees after your favorite superheroes.


7. Pediatric Care: Kids Break Things (Including Themselves)

From immunizations to vision checks, pediatric care is mandatory. Because it turns out, kids aren’t as indestructible as they think.

Example: Matt once worked with a family whose son mistook a skateboard ramp for a launch pad. Good news: His arm healed. Better news: The family’s plan covered the X-rays and cast.

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Suzie and Matt Have You Covered

Navigating health insurance might feel like wandering through a corn maze blindfolded, but that’s where Wenatchee Insurance shines. Whether you need coverage for everyday aches and pains or for those epic fails that deserve a highlight reel, Suzie and Matt are the dynamic duo to guide you.

So, call Wenatchee Insurance today. Because picking the right health plan shouldn’t feel like surgery—just a checkup with friends who know the ropes (and have probably seen it all).

Does Dental Insurance Cover Orthodontics/Braces in Washington?

dental insurance braces wenatchee suzie

Ah, braces —the rite of passage that every kid (and some adults) in North Central Washington dreads. If you’re wondering whether dental insurance will help you foot the bill for straightening little Dillan’s teeth, you’re in good company. This question comes up all the time at Wenatchee Insurance, especially when people start tallying up the cost of those shiny metal brackets like they were made of gold.

Orthodontic / Braces Coverage Basics

Dental insurance can cover orthodontics, but it’s not always a guarantee. It’s a bit like assuming all apples in Wenatchee taste the same—they don’t! It is tough to eat a Red Delicious from cold storage. Orthodontic coverage depends on your plan, and most plans that do cover it will only do so for kids under 18. The magical phrase is “Medical Necessity” especially if there is an Apple Health Plan in play.

If your parents couldn’t get you braces when you were a kid then there are a couple of individual unicorn plans available. Suzie and Matt went hunting for plans that could be purchased by the individual for this purpose and they have some restrictions.

How Much Is Covered?

If your plan does cover braces, it typically covers a percentage of the total cost—usually around 50%. So, if little Billy’s braces cost $6,000, your insurance might cover $3,000, leaving you to pay the rest. It’s like getting a discount on a family-sized apple pie at the local bakery—not free, but better than full price.

Example

Let’s take young Emma from Omak, who needed braces but didn’t want to look like she had a mouth full of railroad tracks. Her mom found a dental insurance plan that covered clear aligners instead of traditional braces. Now Emma’s teeth are straightening out just in time for high school, and she can smile confidently in all her Instagram pics—no filters required.

At Wenatchee Insurance we have found that exploring some of your options early can have some of the lowest costs for braces. As we get older, it gets a little tough but not impossible for dental insurance to cover orthodontics as adults.

Topics: health insurance, Dental, Medicare, Implants, Braces, Bridge, Delta, Ameritas,  Dentures, Lifewise, Cavity, Suzie,  Chelan, Okanogan, Grant, Douglas, 509, Quincy, Cashmere, Entiat,

How to Choose the Health Insurance Plan in Washington State

Health insurance with Suzie and Wenatchee insurance

Living in the scenic countryside of North Central Washington comes with its own set of perks and challenges. One thing’s for sure, finding a health insurance plan shouldn’t be one of those challenges. Whether you’re in Wenatchee, Leavenworth, or the far reaches of Okanogan, Wenatchee Insurance is here to guide you through the corn maze of health insurance options with a sprinkle of country humor and a whole lot of experience.

First off, let’s talk about the sheer variety of health insurance plans out there. It’s like walking into a pie contest at the Chelan County Fair – there are many different varieties, and they all look good at first glance. However, not everyone likes Rhubarb or maybe you are allergic to strawberries. Insurance plans need a closer look to see if they fit your needs like Grandma’s Blue Ribbon Apple Pie on a Sunday night.

Imagine our friend Bob from Cashmere. Bob’s as fit as a fiddle, but he’s had a few run-ins with the old John Deere tractor. Last year, he tried to fix a loose bolt without using a wrench and ended up in the ER with a broken toe. Bob needs a plan with emergency coverage and low out-of-pocket costs. During Open Enrollment, Suzie at Wenatchee Insurance helped him find a plan that doesn’t cost his prized pig Wilber but covers those unexpected barnyard mishaps.

Now, let’s say you’re Marge from Chelan, and you’ve got a family to think about. Little Jimmy’s shiny braces, Megan’s allergies, your spouse’s latest, high blood pressure meds – they all keep adding up. You need a plan that covers a wide range of services and has a good network of doctors. Wenatchee Insurance can sort through the options and find a plan that keeps everyone healthy and happy, without driving you to sell the farm.

For our older folks, say you’re Aunt Mildred in Pateros. She’s past the age where she’s wrestling cattle, but she needs regular check-ups and prescription medications. Medicare Advantage plans can be tricky to navigate, but that’s where Suzie shines. Suzie was a pharmacy technician for 20 years and knows how to look through the formularies like they are hairs on the back of her hand. Suzie will find a plan that covers everything from her heart pills to her arthritis cream, ensuring she can enjoy her golden years fishing by the Columbia River.

Choosing the best health insurance plan is a bit like picking the right peach at DeLap’s Fruit Stand– it takes a keen eye and a bit of know-how. You don’t want peaches that are too small or too expensive. With Wenatchee Insurance, you get the local touch and the expertise to pick the plan that fits just right.

So, next time you’re sipping your coffee from Little Red’s Espresso, remember: Wenatchee Insurance is just a call away, ready to help you find the perfect health insurance plan. Because whether you’re mending fences or running the family orchard, you deserve peace of mind knowing you’re covered.

Topics: Health Insurance, Apple Health, Ambetter, Lifewise, Community Health, Wenatchee Insurance, Suzie, Enrollment, Glasses, Contacts, Chelan County, Okanogan, Grant County, Douglas County, 509, Leavenworth

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Health & Medicare

For nearly a decade we have assisted with Health & Medicare Solutions. We are proud to be selected by the Washington Healthplanfinder to be one of ten Enrollment Centers located in Washington State.

We work with all ages and charge no fees.

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