Yes, there is a misbelief out there that Medicare is free. A couple of times a month a person will exclaim, ‘I thought Medicare was free.’ This is a Mandela effect as a large segment of the population recalls something different than what has occurred.
Medicare, the United States Federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD), was signed into law on July 30, 1965, by President Lyndon B. Johnson.
From its inception, Medicare was divided into two main parts:
Medicare Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care. For most beneficiaries, there is no premium for Part A because they or their spouse paid Medicare taxes while working in the U.S. However, there is a deductible and copayments for some services.
Medicare Part B covers certain doctors’ services, outpatient care, medical supplies, and preventive services. There is a monthly premium for Part B, which has been adjusted over the years. Beneficiaries also pay a deductible and coinsurance for many Part B services.
From the very beginning, beneficiaries of Medicare Part B have been charged premiums. Over the years, additional parts of Medicare, like Part C (Medicare Advantage) and Part D (prescription drug coverage), have been added, each with its own cost structure. So, while some parts of Medicare have free premiums based on previous tax contributions, there have always been charges associated with various components of the Medicare program since its introduction.
It is always good to consult your local independent agent, to see what cost is associated with Medicare. There are coverages that if you miss enrollment then you can accrue a permanent penalty.
Topics: Health Insurance, Medicare, Wenatchee Insurance, Enrollment Center, Healthplanfinder, Affordable Care Act, ACA, Obamacare, Prescription Drugs, Medicare Advantage Plan, Medigap, Health Alliance, Wenatchee, Washington State
We get a lot of questions from non-professionals seeking what their plan covers. Questions are great as prior to the Affordable Care Act Health Insurance there were a ton of problems from unjustified rate hikes, lifetime limits, and infamously pre-existing conditions. The ACA standardized health insurance.
The Affordable Care Act (ACA) requires health insurance plans to cover 10 essential health benefits:
Ambulatory Services: Outpatient care without hospital admission.
Emergency Services: Care in emergency rooms.
Hospitalization: Surgeries and overnight hospital stays.
Maternity & Newborn Care: Care before, during, and after childbirth.
Mental Health & Substance Use: Counseling and substance abuse treatments.
Prescription Drugs: Medications.
Rehab & Habilitation Services: Recovery therapies for injuries or conditions.
Lab Services: Tests to diagnose/treat illnesses.
Prevention & Wellness: Vaccinations, screenings, and chronic disease management.
Pediatric Services: Dental and vision care for children.
These are the core services health plans need to cover under the ACA. A health plan will have elements of these covered to various degrees. It is important for whoever you get your plan from to walk you through the coverages.
The annual open enrollment period runs from November 1st through December 15th. Some states that run a state exchange like Washington can make a decision on extending enrollment periods. If you don’t have insurance set an appointment or call immediately so that we can see if there are any special enrollments that would speed your start date.
We have been providing this service since the Washington Healthplanfinder Opened on October 1, 2013. We have been part of the Enrollment Center located in Wenatchee and serve the entire state. If you ever have a question about a plan do not hesitate to talk to Wenatchee Insurance or Suzie Health Solutions.
Topics: Health Insurance, Medicare, Wenatchee Insurance, Enrollment Center, Healthplanfinder, Affordable Care Act, ACA, Obamacare, Prescription Drugs, Emergency Room, Wenatchee, Washington State
When an insurance policy covers a deer accident (or any other accident involving a collision with an animal), it’s typically under the “comprehensive” coverage portion of an auto insurance policy. Here’s a breakdown of how insurance might cover a deer accident:
Comprehensive Coverage:
Description: This covers damage to your vehicle that isn’t caused by a collision with another car. This includes theft, vandalism, natural disasters, falling objects, and, relevantly, collisions with animals like deer.
Deer Accident: If you hit a deer and have comprehensive coverage, the damage to your vehicle would typically be covered. You would be responsible for paying your deductible first, and then the insurance company would cover the remaining repair costs up to the value of the vehicle.
Liability Coverage:
Description: Liability insurance covers bodily injury and property damage that you cause to others. It doesn’t cover your own injuries or vehicle damage.
Deer Accident: This wouldn’t come into play if you only hit a deer. But, if hitting the deer caused you to then collide with another vehicle, your liability coverage might cover the damages or injuries you caused to other parties.
Collision Coverage:
Description: This covers damage to your vehicle when it collides with another vehicle or object.
Deer Accident: Generally, collisions with animals are covered under comprehensive, not collision. But if, for example, you swerved to avoid a deer and hit a tree or another car, then collision coverage would come into play for damages to your vehicle.
Medical Payments (MedPay) or Personal Injury Protection (PIP):
Description: These are optional coverages in many states that can cover medical bills for you and your passengers regardless of who’s at fault. This is a good to have coverage.
Deer Accident: If you or a passenger were injured in the accident with the deer, MedPay or PIP could potentially cover medical expenses.
Uninsured/Underinsured Motorist Coverage:
Description: This covers your injuries or property damage if you’re hit by a driver who doesn’t have insurance or doesn’t have enough insurance.
Deer Accident: This coverage wouldn’t apply to a deer accident unless you were somehow involved in an additional accident with an uninsured or underinsured motorist immediately afterward. Deer are animals and do not have liability insurance.
Important Notes:
The specific details of coverage can vary based on your insurance company, your policy, and local regulations.
If you live in an area with a high deer population or frequently travel through such areas, it’s wise to ensure you have comprehensive coverage to protect against potential deer collisions.
After a deer accident, it’s important to document the scene, report the accident to the police (if required), and contact your insurance company as soon as possible.
Remember to always check your specific policy details or consult with your insurance agent to understand exactly what’s covered.
Topics: auto insurance, home insurance, independent insurance broker, deductible, Wenatchee Insurance, Okanogan, Methow Valley, Deer, Chelan County, Douglas County, liability, property
We have been dealing with COVID for a couple of years. From Masks to working through the first of the Covid Pandemic, and even mandates. It looks like the 2024 Enrollment Season will be no different this year.
The Annual Enrollment Period for Medicare runs from October 15th through December 7th. We have hundreds of people that enroll, get educated or change their Medicare Plan.
We see folks with various degrees of health. We want them to live long and prosperous lives. Currently Washington state is tracking three respiratory illnesses including COVID, If you suspect that you have an illness then let us work over the phone or with a video chat.
On Day 6 we test and test a couple more times and if nothing shows up we can end our masks.
We are stocking KN95 Masks in our office. You want a N95 or KN95 level mask. They run $19 per 50 and if you see us wearing them then we are in the middle of our testing cycle as we have been exposed.
If we are sick and lose our ability to work for two weeks then we can not see at least 86 families. Yes, our appointment spaces fill up and we work seven days a week taking care of people. Not only does that take away our household income for the year, it has the potential of taking away health insurance for families for the year.
Every now and then, residents of Washington come across startling images on their Facebook feeds of cars or trucks colliding into homes. Naturally, the immediate question is: Who covers the repair costs? Imagine a Wenatchee homeowner relaxing with the latest Stranger Things episode when suddenly a sports car crashes into their living room. The flat screen goes flying, the cat freaks out and the night is ruined. The urgency to find out who’ll fix everything is real. The answer is straightforward with a couple of twists.
Good News: The driver responsible for crashing into your home is liable for the damages, typically covered by the Property Damage section of their auto insurance liability. In a perfect world, they will be paying for everything. Sometimes perfection needs a hand.
Not-so-Good News:
There’s a catch. Roughly 20% of drivers in Washington State don’t have any auto insurance. In fact, the state ranks fifth in the number of uninsured drivers. This means if such a driver crashes into your home, you can’t claim any compensation from them.
Additionally, in Washington, the minimum Property Damage coverage for auto policies is $10,000. So, if repair costs exceed this amount, the insurance company will pay you up to this limit, leaving you to cover the rest. This underscores the importance of opting for more than just the minimum liability coverage.
How Do I Cover the Repair Costs?
Bright Side: Your Home Insurance is likely your savior here. Central to your policy are ‘Perils’, essentially risks or incidents, your policy covers. Most home insurance policies offer coverage for damages from car crashes. Your dwelling coverage steps in to facilitate home repairs, while personal property coverage compensates for damaged items. However, remember your deductible. If the damages (or the amount left after the auto claim payout) are less than your deductible, claiming might not be beneficial. Thus, consulting your insurance agent is key.
Topics: auto insurance, car insurance home insurance, independent insurance broker, deductible, Wenatchee Insurance, Chelan County, Douglas County, liability, property, local insurance,
In North Central Washington, a restaurant should have several insurance coverages to protect its business, employees, and customers from various risks. Running a Pizza place in Wenatchee is going to have different risks than a Mexican Restaurant in Winthrop or a Café in Leavenworth. We quote every business is uniquely.
Here are four essential insurance coverages for a restaurant:
General Liability Insurance: This insurance is essential for any business, including restaurants. It covers bodily injury, property damage, and personal injury claims that may arise from accidents or incidents on the restaurant premises. For example, if a customer slips or suffers food poisoning, general liability insurance can help cover legal expenses and settlements.
Property Insurance: Property insurance, sometimes known as commercial property insurance, protects a restaurant’s physical assets, including the building, equipment, inventory, and furnishings, from damage or loss due to events like fire, theft, vandalism, or natural disasters. It can also include coverage for business interruption, which can compensate for lost income if the restaurant needs to close temporarily due to covered damage. Business Interruption was a tremendous asset for the COVID shutdowns.
Liquor Liability Insurance: If your restaurant serves alcohol, liquor liability insurance is essential. It provides coverage for claims related to alcohol-related incidents, such as fights, accidents, or DUI incidents, that occur on or because of your premises. This coverage can protect your restaurant from costly lawsuits and damages.
Food Contamination or Spoilage Insurance: Restaurants rely on fresh ingredients and food products. Food contamination or spoilage insurance helps cover the costs of replacing spoiled or contaminated food due to power outages, equipment failures, or other unforeseen circumstances. This coverage ensures that you can maintain food safety standards and avoid financial losses.
Additional coverages
Additionally, depending on the specific circumstances and location of your restaurant, you may need other insurance coverages such as cybersecurity insurance, commercial auto insurance (if you have restaurant-owned vehicles), or employment practices liability insurance (for protection against employment-related lawsuits). There are cases where these can be bundled together in a Business Owner Policy.
If you are catering or hosting large events then Event Insurance is an affordable way for hosts to fill in coverage gaps.
It’s crucial to work with your local insurance agent to assess your restaurant’s unique needs and select the appropriate insurance coverage to provide comprehensive protection for your business.
Topics: Restaurant Insurance, BOP, Small Business Insurance, General Liability, Pizza, Café, Chelan Insurance, Event Insurance, Business Interruption, Liquor Liability, Wenatchee Insurance, Local Insurance Agent,
We get asked about Health Share Ministries a lot being the Full Service Enrollment Center located in Wenatchee. We are going to talk about something that is not insurance.
Health Share Ministries have some advantages, such as lower monthly costs and a sense of community among members who share similar beliefs. We have had companies offer us commissions to offer these plans and most have fallen short during the selection process.
Health Share Ministries have displayed some problems and limitations:
Limited Coverage: Health share ministries often have more restricted coverage compared to traditional health insurance. They may not cover certain medical conditions, preventive care, or pre-existing conditions, which can leave members with significant healthcare expenses. We want our clients to have the freedom to treat all their medical conditions that can occur.
Lack of Guarantees: Unlike traditional health insurance, health share ministries are not legally obligated to cover medical expenses. If you have ever gone to use something and it wasn’t there than the normal reaction is to get angry. We don’t like angry customers. There’s no guarantee that your expenses will be shared, and coverage decisions are subject to the ministry’s guidelines.
Eligibility Restrictions: To join a health share ministry, you may need to meet specific religious or ethical criteria. This can exclude individuals or families who don’t share the same beliefs. We run an inclusive office and don’t discriminate. Why would I want to have a product not suitable for more than half our neighbors?
4. Uncertain Future: Health share ministries are not as regulated or financially stable as traditional insurance companies. They may be vulnerable to financial difficulties or changes in their sharing policies, which can affect members’ coverage. We have seen several of these companies with legal action against them over the years.
5. No Consumer Protections: Health share ministries are not subject to the same state and federal regulations as health insurers. This means members have fewer protections and may have limited recourse if they encounter problems with the ministry. With insurance, we can go to the Office of Insurance and file a complaint.
6. Administrative Hassles: Members often need to handle medical billing and paperwork themselves, which can be time-consuming and challenging, especially when dealing with multiple providers and claims. Confluence Health is not known for negotiating pricing.
7. Non-Comprehensive Coverage: Health share ministries may not cover mental health services, maternity care, prescription drugs, or other essential healthcare needs that are typically covered by traditional insurance.
8. No Financial Assistance: Government subsidies or financial assistance, which are available for many with traditional health insurance through programs like the Affordable Care Act or Cascade Care, are not available for health share ministry members.
Before considering a health share ministry, it’s crucial to carefully review your policies, coverage limitations, and eligibility requirements. As the full-service Enrollment Center located in Wenatchee, we have been educating options for eleven-plus years at no cost.
Topics, Alternative Health, Wenatchee Insurance, Healthcare, Health Ministries, Financial Assistance, Enrollment Center, Cascade Care, Affordable Care Act, ACA, Confluence Health, Chelan County
Four of the top ten stolen list were pickup trucks. They are handy. I have used them from a couple hauling a couple of bales of hay to helping countless friends move. It’s not a surprise that thieves like them too.
Report to the police immediately. When reported as stolen in the first 24 hours, passenger vehicles has a 34% same-day recovery rate in 2022.
Report it to the insurance company. They will probably ask for the police report number. If you have comprehensive coverage then you have coverage that covers theft.
While liability is required in the state comprehensive coverage is not however it is one of the good to have coverages that you want to talk with your insurance agent about.
Topics: Truck Insurance, Car Insurance, Auto Insurance, Wenatchee Insurance, Comprehensive, stolen car, Independent Insurance Agency, Hyundai, Kia, Ford,
While alternatives to traditional health insurance can offer cost savings and flexibility for some individuals, they also come with their own set of challenges and potential problems. It’s crucial to be aware of these issues before considering an alternative to health insurance.
Many alternatives provide limited coverage compared to comprehensive health insurance plans. They may not cover pre-existing conditions, essential health benefits, or preventive care, leaving you vulnerable to unexpected medical expenses.
Lack of Regulation:
Health insurance is heavily regulated to ensure consumer protection and guarantee certain standards of care. Some alternatives, such as health-sharing ministries and discount health plans, may not be subject to the same regulatory oversight, which can lead to less transparency and potential risks.
We have seen Health Share Ministriesforced to leave the state over bad behavior. Despite some offering lucrative commissions offered by some of these companies, we want coverage access to all our clients with minimal fight when they utilize the product.
Pre-Existing Conditions:
Some alternatives may exclude coverage for pre-existing conditions or impose waiting periods before covering them. This can be a significant drawback if you have chronic health issues. If it has a waiting period then it is not a qualified health plan.
Limited Provider Networks:
Direct Medical Providers can be on a subscription or fee basis. They have a registry, and some people use it to supplement primary care availability. However most do not have access to major care such as surgery so be aware of limitations. Lupine Family Medical is one example in Wenatchee.
Alternative plans like short-term health insurance or discount health plans may have limited provider networks. Short-term plans have severe limitations in Washington State. We utilize the flexibility of the Special Enrollment periods to enroll and disenroll people into a qualified health plan for a few months.
Potential for High Out-of-Pocket Costs:
Catastrophic plans are limited to people under 30 or with a hardship exemption and are not available in all areas of the state. They also usually have a high deductible so in many cases a Cascade Care plan
Ineligibility:
Some alternatives, like Medicaid, Medicare, or health-sharing ministries, have specific eligibility criteria. If you don’t meet these criteria, you may not be able to enroll in these programs. Read the fine print.
Risk of Non-Payment:
In the case of health-sharing ministries, there is a risk that other members may not contribute their share, leaving you responsible for your medical bills. Be aware of any program that requires you to negotiate with the provider.
Before choosing an alternative to health insurance, it’s crucial to carefully evaluate your healthcare needs, budget, and risk tolerance. Consult with a financial advisor or insurance expert to determine which option is best suited to your individual circumstances. Additionally, staying informed about changes in healthcare laws and regulations can help you make informed decisions about your coverage.
Topics: Health Insurance, Healthcare, Molina, Apple Health, Medicare, Obamacare, Mi Seguro, Seguro de Salud, Coordinated Care, Medicare, Health share, Health Ministry, short term medical, catastrophic health, Direct Medical, Washington State, Cascade Care,
November 1st, 2023, Immigrant are eligible to sign up for health insurance regardless of residency status. Immigrants were blocked during the creation of the ACA from purchasing health insurance and they are one of the largest uninsured groups left. This includes over 800,000 Dreamers living in the United States. If your income level is under 250% of the poverty level, then you may reduce your cost with Cascade Care Credits.
Note when Feds update DACA then DACA could see both Cascade Care Credits and Federal Credits to lower cost.
250% of the poverty level is about $36,000 a year for a single person.
The enrollment process involves a few steps:
Gather your Information: You will need to provide information such as names, birthdates, and income of the household. If your employers offer health insurance, then you will not be eligible for this program; however other household members may be. You may also need to provide your social security numbers, but you can still apply if you do not have one. You should also bring paystubs or tax returns for proof of income.
Immigrant Identity Proof Document need one from List A
or Identity Proof Document need two from list B
Apply: The application process will ask for information about you and your household, and it usually takes about 15 to 30 minutes. We recommend using an in-person assister. We have them available in Wenatchee.
Choose Your Health Plan: Washington Healthplanfinder offers many plans and ways to save. The plans you qualify for depend on your details and county. You can filter plans by premium, deductible, out-of-pocket maximum, carrier, metal level, and more.
Stay Covered!: You will want to make the first payment. The insurance company will then send your card and welcome packet about two weeks later. Each year, we have open enrollment where you review and make changes to your plans.
If you enroll from November 1st to December 15th, then your plan will start on January 1st, 2024. If you enroll from December 16th to January 15th, then your plan will start on February 1st, 2024.
If your income is under 138% of the poverty level, starting from July 2024, you will be eligible for Apple Health on a first-come, first-served basis. This is about $20,000 per year.
July 1st, 2024, Apple Health plans for immigrants will start.
In-person assistance is recommended due to the inability to verify identity using the Federal Hub, necessitating a manual process with documentation. We work primarily with English in Wenatchee.
Topics: Health Insurance, Healthcare, Molina, Apple Health, Obamacare, Mi Seguro, Seguro de Salud, Coordinated Care, Medicare, Immigrant Healthcare, DACA, Dreamers, Washington State,Independent Insurance Agent,
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.
