Frequently Asked Questions: Oregon and Washington Medicare, Medical Insurance, and Health Insurance
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- How much does it cost to use an insurance agent?
I do not collect money from my clients. I am paid a commission by the insurance carrier, not the client. This means that my interest is not in "selling" you a certain kind of policy or a certain company's policy. My interest is in making sure you're in the right plan, and in doing an annual review every year to plan for the next year's needs. You will pay the same premium whether you go through an agent, directly to the insurance carrier or purchase on-line. The benefit to you is the personalized customer service you will receive from me, not just at time of sale but on a go forward basis. back to top
- What is Medicare?
Medicare is the 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). Medicare was created in 1965 when people over 65 found it virtually impossible to get private health insurance coverage. Medicare has made access to health care a universal right for Americans once they reach age 65. This has helped improve the health and longevity of older Americans. back to top
- Why do I need an Insurance Agent to explain my Medicare benefits?
When you turn 65 (or otherwise become eligible for Medicare), you will notice a dramatic increase in the amount of mail and phone calls you'll be getting from insurance agents. This is simply a sales gimic. Without a proper review of your unique medical needs (Your prescription drugs, your doctors, your health goals, etc), there can be no way to properly know what direction will be best for you- and you deserve that. That's why I'm here, to educate you and help you understand your benefits. back to top
- How much does health insurance cost?
It depends. Some of the factors used by insurance companies to determine their monthly premiums are: Age, Sex, Tobacco Use, and Zip Code. The Federally Funded Marketplace (www.healthcare.gov) has all qualified health plans organized by "metal" categories: Bronze, Silver, Gold, and Platinum. Visit the website at https://www.healthcare.gov/choose-a-plan/plans-categories/ for a full description. back to top
- Am I breaking the law if I don't have health insurance?
No. You're not. You may, however, be subject to a financial fee if you spend three or more months of the calendar year uninsured. However, there are exceptions. If you didn't have a health plan in 2015 and didn't qualify for an exemption, you'll pay the fee when you file your federal tax return for the year. For 2015, the fee is $325 per person ($162.50 per child) or 2% of your household income, whichever is higher. If you don't have a health plan for 2016 and don't qualify for an exemption, you'll pay the fee when you file your federal tax return next year. For 2016, the fee increases to $695 per person ($347.50 per child) or 2.5% of your household income, whichever is higher. back to top
- What is the Oregon Health Plan?
The Oregon Health Plan is Oregon's name for our Medicaid system. Healthy Kids is the name of our CHIP (Children's Health Insurance Plan). Medicaid and CHIP provide free or low-cost health coverage to millions of Americans, including some low-income people, families and children, pregnant women, the elderly, and people with disabilities. Both programs are run jointly by federal and state governments, and details vary somewhat between states.
www.oregonhealthcare.gov back to top
- Can I keep my Doctors?
Absolutely. When you come to see me, that'll be one of the questions I ask you before we find a plan for you and your family. I will enroll you in the plan that best suits your needs, and that includes Doctors. back to top
- Will I pay more if I have a pre existing condition?
No. A pre existing condition is a health problem you had before the date new health coverage starts. Health insurance companies can't refuse to cover you or charge you more just because you have a pre-existing condition. They also can't charge women more than men. However, the rules are different for some Medicare plans. These intricacies are the reason you require an educated, licensed professional on your side. back to top