Frequently Asked Questions

The Affordable Care Act is a set of health care reform legislation. It comprises the Patient Protection and Affordable Care Act and the Health Care and Reconciliation Act, both of which were signed into law in March of 2010. Commonly, the Affordable Care Act is known as "Obamacare" and Marketplace plans.

The purpose of the Affordable Care Act was to provide all Americans, including those with lower incomes, with affordable, accessible, and quality health coverage. It accomplishes these by lowering health care costs and premiums; expanding access to Medicaid; applying stricter regulations to insurers; and ensuring that all reformed plans meet a certain high standard of quality health care (see next section for more).

Prior to reform, millions of Americans were unable to purchase health insurance because it was either too expensive or unavailable. The costs of premiums were steadily increasing as insurers would either increase rates for those with preexisting conditions or deny them coverage completely. Insurers would also set maximum lifetime benefits, resulting in many Americans losing their coverage once they became too expensive to insure.

With health care reform, the government not only helps pay for the monthly premiums of those with lower incomes, but also makes certain that for everyone, insurers can no longer deny coverage for preexisting conditions, or drop your coverage when you become too costly to insure.

Most people should enroll in Medicare Part A (Hospital Insurance) when they're first eligible, but certain people may choose to delay Medicare Part B (Medical Insurance).

In most cases, it depends on the type of health coverage you may have.

The size of the employer determines whether you may be able to delay Part A and Part B without having to pay a penalty if you enroll later.

The employer has fewer than 20 employees. You should sign up for Part A and Part B when you're first eligible. In this case, Medicare pays before your other coverage. Learn more about how to get Parts A and B.

The employer has 20 or more employees.

Ask your benefits manager whether you have group health plan coverage (as defined by the IRS). People with group health coverage based on current employment may be able to delay Part A and Part B and won’t have to pay a lifetime late enrollment penalty if they enroll later. If you want to delay both Part A and Part B coverage, you don’t need to do anything when you turn 65.

If you’re eligible for premium-free Part A, you can enroll in Part A at any time after you’re first eligible for Medicare. Your Part A coverage will go back (retroactively) 6 months from when you sign up (but no earlier than the first month you’re eligible for Medicare).

If you aren't eligible for premium-free Part A, and you don't buy it when you're first eligible, you may have to pay a penalty.

Medigap policies don't work with Medicare Advantage Plans. You may have one or the other.

You can have Original Medicare Parts A & B and a Medigap plan if you choose because Medigap plans supplement Original Medicare Part A and Part B

Advantage plans are administered by private insurance companies and they take the place of Original Medicare and may include extra benefits that Medicare does not cover.

If you join a Medicare Advantage Plan for the first time, and you aren’t happy with the plan, you’ll have special rights under federal law to buy a Medigap policy. You have these rights if you return to Original Medicare within 12 months of joining.

If you want to switch back to Original Medicare and buy a Medigap policy, contact your Medicare Advantage Plan to see if you're able to disenroll.

Also, if you want to cancel your Medigap policy, contact your insurance company. If you leave the Medicare Advantage Plan, you might not be able to get the same, or in some cases, any Medigap policy back unless you have a "trial right."

These are just a few ‘bullet points’ and there are other guidelines and requirements you won’t want to miss.

It's now illegal for insurance companies to cancel your coverage simply because you made an honest mistake or left out information that has little bearing on your health. When it comes to Medicare Supplement insurance, Marco Island, FL residents can count on the Michele Sanchez Insurance Agency to keep them covered.

When you turn 65, it's only mandatory to sign up for Medicare under specific circumstances. If you enroll in Social Security, it's mandatory to sign up for Medicare Part A because the two are permanently linked. However, Medicare Parts B, C, and D are optional and you can delay enrollment if you have creditable coverage. If you have any questions about signing up for Medicare Advantage insurance plans in Marco Island, FL, contact the Michele Sanchez Insurance Agency today.

What happens when you don't sign up for Medicare at 65 depends on the type of Medicare you need to sign up for. Medicare Part A is usually free and a late enrollment penalty doesn't apply for most people. However, if you fail to sign up for Medicare Part B on time, you'll risk a 10% surcharge on your Medicare Part B premiums for each year-long period you go without coverage upon being eligible. If you're unsure about whether you qualify for Medicare Supplement insurance in Marco Island, FL, contact the Michele Sanchez Insurance Agency today for more information.

According to Policy Advice, up to 4% of uninsured Americans on a yearly basis are forced to declare bankruptcy because of overwhelming medical costs. Your individual health insurance protects you from paying the full costs of medical services when you're injured or sick. It works the same way your car or home insurance works: you or your employer choose a plan and agree to pay a certain rate, or premium, each month. Michele Sanchez Insurance Agency has the best individual health insurance plans Marco Island, FL has to offer. Contact us today to learn more about your individual health insurance options.