Frequently Asked Questions
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Medicare Plans Frequently Asked Questions
I am turning 65 soon. What should I do about Medicare?
That’s an excellent question with a really long answer that depends on your unique circumstances and preferences. If you’re confused, we can help! We pride ourselves on educating people about their Medicare Health Plan options using a no pressure, consultative approach. We’d love to meet you and see how we can help.
When may I first enroll in a Medicare Health Plan?
During your Initial Enrollment Period. If you become eligible for Medicare by turning 65 years old, then your Initial Enrollment Period starts on the first day of the month that is three months before your 65th birthday month, and ends the last day of the third month after your 65th birthday month. So, if your 65th birthday is in July, then you may enroll in a plan starting April 1, for coverage to begin July 1.
When may I change my Medicare Health Plan?
Each year during the Annual Enrollment Period. Insurance carriers may start marketing the next year’s products starting October 1 and you may enroll from October 15 until December 7, for coverage to begin January 1 of the following year.
What is the difference between a Medicare Advantage plan and Medicare Supplement Insurance?
Medicare Supplement Insurance supplements the benefits you have under Original Medicare (Part A and Part B). You will have two cards to present at the hospital or doctor’s office: your Medicare card (red, white, and blue) and your Supplement card from your Supplement plan company. Your health care provider will bill Original Medicare first, the remaining amounts will be submitted to your Medicare Supplement Insurance carrier.
A Medicare Advantage plan takes the place of Original Medicare (Part A and Part B). You will have only one insurance card to present at the hospital or doctor’s office: your Medicare Advantage plan card from your the private insurance company from which you purchased the plan. Your health care bills will be submitted to that insurance company for payment per the terms of your plan.
Can I have both a Medicare Advantage Plan and a Medicare Supplement plan?
No, you cannot have both a Medicare Advantage Plan and a Medicare Supplement plan. You must choose one or the other.
Will it cost me extra to use an agent?
Nope! Agents are compensated by the insurance carriers whose plans they sell, so the cost is the same to you regardless of whether or not you use the services of an agent. Our agents love helping you pick the best plan and save you the most money. We are appointed with many different insurance carriers, so we are not tied to one company’s plans and are free to recommend the plan that is best for you.
Health Insurance Frequently Asked Questions
When is the Open Enrollment Period for ACA Marketplace health insurance plans?
The Open Enrollment Period for ACA Marketplace health insurance plans typically runs from November 1 to December 15 each year, with coverage starting on January 1 of the following year.
Can I enroll in an ACA Marketplace plan outside of the Open Enrollment Period?
Maybe. You may be eligible to enroll in an ACA Marketplace plan outside of the Open Enrollment Period if you experience a qualifying life event, such as losing job-based coverage, marriage, or the birth of a child. This would trigger a Special Enrollment Period for you to enroll in a new plan.
Can I change my ACA Marketplace plan during the year if I’m unhappy with it?
Generally, you can only change your ACA Marketplace plan during the Open Enrollment Period or if you qualify for a Special Enrollment Period due to a qualifying life event.
Are all ACA Marketplace plans required to cover pre-existing conditions?
Yes, all ACA Marketplace plans are required to cover pre-existing conditions without charging higher premiums based on your health status.
Am I required to have health insurance?
Yes. The Affordable Care Act (aka Obamacare) requires everyone to be covered by a health insurance plan. If you do not have coverage through an employer, you will have to purchase a plan on your own. We can help you find the best plan and figure out if you are eligible for tax credits to reduce your premium.
May I continue to see my current doctor when I sign up for a new plan?
Yes, but we need to make sure you pick a plan that has your doctor in its network. Here at Ulness Health Insurance Agents, we are familiar with which health care providers are each plan’s network, so let us help you find the plan that will be best for you and your current provider.
Should I use an agent to purchase health insurance?
We think so! It is possible to purchase health insurance without an agent, but it will cost you the same whether you use an agent or not. Why not take advantage of the expert help that an agent offers at no cost? With our agents, there’s no pressure or creative sales tactics. We use a straightforward consultative approach to analyze your situation, find the best plan for you, and save you the most money. If you prefer to sign up online but still have us as an agent in case you need our expert help, then click here (WI residents only) to find a plan and enroll online. Remember, an agent can also help you if you encounter problems after you enroll. If you don’t use an agent, you are stuck using your carrier’s call center, and you won’t have an expert to help guide you to a resolution.
Dental & Vision Insurance Frequently Asked Questions
Should I have dental insurance?
That is up to you. Dental expenses are typically predictable which makes them easy to budget for, but some people prefer to have dental insurance coverage. When signing up, be sure to understand the plan’s waiting period (if applicable), the services it covers, and its maximum benefit.
What does dental insurance cover?
Dental plans typically cover preventive services (such as cleanings), basic services (such as x-rays and sealants), and major services (such as implants and sometime orthodontia). Each type of service has different benefits. For example, one type might be covered at 80%, while another is only 50%. Be sure to carefully review your plan before enrolling.
Is my dentist in-network?
Using an in-network provider will always give you the most benefits. Be sure to look up your dentist on the plan’s website to verify that he or she is in your plan’s network.
Are cosmetic dental procedures, such as teeth whitening, covered by dental insurance?
Generally, dental insurance plans do not cover cosmetic procedures like teeth whitening, veneers, or bonding. They primarily focus on covering preventive, diagnostic, and restorative treatments.
Do I need to purchase my eyeglasses or contacts at the same place where I get my eye exam?
No. You are free to purchase eyeglasses or contacts from somewhere other than your optometrist’s office. Be sure to obtain your prescription from your eye doctor and check to make sure your eyewear provider is in your plan’s network to maximize your benefits.
Does vision insurance cover LASIK surgery?
Many plans offer discounts on LASIK procedures. Be sure to check the details of your plan to verify that it offers this discount.
Is my eye doctor in-network?
Using an in-network provider will always give you the most benefits. Be sure to look up your eye doctor on the plan’s website to verify that he or she is in your plan’s network.
Travel Medical Insurance Frequently Asked Questions
What is travel medical insurance, and why do I need it?
Travel medical insurance provides coverage for emergency medical expenses, such as hospitalization, doctor visits, and medical evacuation, incurred while you’re traveling outside your home country. It’s essential to have travel medical insurance because your domestic health insurance plan may not cover you abroad or may offer limited coverage, leaving you financially vulnerable in case of an unexpected medical emergency during your trip.
Does travel medical insurance cover pre-existing conditions?
Coverage for pre-existing conditions varies between travel medical insurance plans. Some plans may offer limited coverage for pre-existing conditions, while others may exclude them altogether. It’s important to carefully review the plan details and discuss your specific needs with your insurance provider before purchasing a travel medical insurance plan.
Can I purchase travel medical insurance after my trip has already begun?
In most cases, travel medical insurance must be purchased before your trip begins. However, some insurance providers may allow you to purchase coverage after your trip has already started, though there might be a waiting period before the coverage becomes effective. It’s best to purchase travel medical insurance before your departure to ensure adequate coverage.
Are adventure sports and activities covered under travel medical insurance?
Coverage for adventure sports and activities, such as scuba diving, skiing, or mountain climbing, varies between travel medical insurance plans. Some plans may offer coverage for these activities, while others may require an additional rider or exclude them altogether. Make sure to review the plan details and discuss your specific needs with your insurance provider before purchasing a plan.
What should I look for when comparing travel medical insurance plans?
When comparing travel medical insurance plans, consider factors such as the coverage limits, deductible amounts, and the scope of the benefits provided. Additionally, look for plans that include emergency medical evacuation, repatriation of remains, and 24/7 assistance services. It’s also essential to verify whether the plan covers pre-existing conditions and any specific activities or sports you plan to participate in during your trip.
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Ulness Health Insurance Agents are your local health insurance experts serving Appleton, Neenah, Menasha, and the rest of the Fox Cities. Our team provides free, personalized consultations year-round to help you understand and choose the right plan for your needs and budget. Contact us today to schedule your one-on-one meeting and get started on the path to affordable, comprehensive coverage.
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