Our Port Lavaca team is here to provide you with a wide variety of Medicare and health insurance options. We specialize in Medicare Supplement and Advantage Plans, Individual & Family Plans, and many more health and life insurance products! Our expertise and knowledge about health insurance cost you nothing to utilize. You deserve a trusted guide to assist you in the complexities and confusing world of health insurance and Medicare. Schedule your FREE consultation with our team now to see how we can help you…
Port Lavaca’s Trusted Insurance Agency
Whether you need Medicare or an Individual & Family health insurance plan, using a broker allows you to have a wider selection and more options for your coverage. Unlike a captive agent, health insurance brokers work with multiple companies, allowing us to shop carriers and plans to provide the best price and coverage. Our Port Lavaca team works with you to assess your doctors, prescriptions and health needs, before putting you in a plan, to ensure we give you personalized insurance advice. Health insurance is a complex topic, so we recommended using agents like ourselves, so you have professional assistance and avoid making the wrong choices.
Medicare Agent Port Lavaca, TX
Our team offers assistance with the Medicare enrollment process and plan selection in the Port Lavaca area. Medicare is federal health insurance for anyone age 65 and older, and some people under 65 with certain disabilities or conditions. Medicare is a complex process with many rules, regulations, and yearly changes. Our job is to educate you on all of your options, the different periods you can enroll, and the common mistakes you want to avoid. When you work with us you get expert guidance for your Medicare insurance with no bias. Give us a call today to speak to one of our Medicare agents about your needs (361) 322-9357!
How Medicare Works
Original Medicare is broken up into two parts, Part A and Part B. You can sign up for parts A&B online or through your local Social Security Administration Office, which you typically will only have to do once. Throughout your working years you have paid into Medicare through Medicare taxes. If you have worked 10 years, or 40 quarters, then you qualify for $0 premiums on your Part A. You can utilize a current spouses or ex-spouses 40 quarters if you did not accrue them yourself (under certain conditions). Part B will come with a monthly premium that is adjusted yearly. Parts A&B also have a deductible that changes yearly as well.
Original Medicare offers you coverage, but has a high deductible for Part A, and a 20% coinsurance for Part B, that leaves you exposed to high medical costs if you are hospitalized. You can utilize Medicare Supplement Plans (Medigap) or Medicare Advantage (Part C) Plans to cover the gaps and lower the out-of-pocket costs associated with Original Medicare. We can educate you on all of your options and provide you with the knowledge to make a decision based on your specific needs for health insurance.
When to Enroll In Medicare
You will be able to enroll into Medicare depending on your specific circumstance upon turning 65 years old or retirement. For individuals turning 65, you can enroll into Medicare 3 months prior to your birthday, the month of, and 3 months after. We recommend starting the Medicare enrollment process during the 3 month period before your birthday to stay ahead and avoid late penalties. For individuals enrolling after retirement you will have an 8 month period to enroll into Original Medicare (Parts A&B), but you will only have a 63 day period to enroll into Medicare Part D (Prescription Drug Plan) before incurring lifetime penalties. We can assist you in the entire enrollment process while providing you expert, non-biased guidance based on your specific needs.
Medicare Supplement Port Lavaca, TX
Original Medicare has many gaps that expose you to high out of pocket costs for both Parts A & Parts B. Medicare Supplement Plans, also known as Medigap, fill in the gaps of Original Medicare and protect you from these costs. Medicare Supplements are standardized plans that are categorized by letters A-N. This means that the supplement plans within each category have the same exact coverage from carrier to carrier, the only difference will be the prices. Certain plan letters will have more coverage then others with Supplement Plan G being the most popular for our clients.
Medigap plans have the benefit of being accepted anywhere that Original Medicare is accepted. This allows for no networks or referrals such as an HMO/PPO network. Medicare Supplement plans have a monthly premium you pay, on top of the Part B monthly premium. You will still need to enroll into a Prescription Drug Plan as well as find dental, vision and hearing coverage separate from your Supplement Plan. Medicare Supplement plans trade copayments and coinsurance for a monthly premium, which may be beneficial to those who will need to utilize their coverage more frequently and lower their out of pocket expenses.
Medicare Supplements have yearly rate increases for their monthly premiums. This is the main drawback for these plans that otherwise offer very comprehensive coverage. We look at plans that have been established in the Port Lavaca market for a long time to avoid high rate increases and choose a plan that will be affordable for you long term. Medicare Supplements require medical underwriting after your initial enrollment period, so its important to work with an experienced broker to find the right plan the first time!
Medicare Advantage Port Lavaca, TX
Medicare Advantage Plans take over for Original Medicare (Parts A&B) with most plans including your Part D (Prescription Drug Plan). Although you must pay your Part B premium, Medicare Advantage plans allow for lower or $0 monthly premiums, which could potentially save you money on your insurance. It’s important to note that Medicare Advantage plans are a pay as you go system so you will be subject to copayments and coinsurance instead of a monthly premium. For those in good health this could be a great alternative to having a monthly premium for coverage you are not utilizing!
Medicare Advantage plans utilize either an HMO or PPO network, so its important to make sure your doctors & specialists are in network, and certain hospitals of choice accept these plans. Advantage Plans available to you will be based on your zip code and Calhoun County’s service area. We’ll also need to compare your prescription drugs to the plans formulary, to make sure those are covered, since most plans will have an included drug plan. Most plans will also include your dental, vision and hearing coverage as well as other perks such as gym memberships, grocery & OTC benefits, and transportation. Advantage plans also offer extra perks for individuals with chronic conditions and those who are eligible for Medicaid and Medicare (Dual Needs Plans). Our team can help you find and compare Advantage Plans available in Port Lavaca, TX!
Disclaimer: We do not offer every plan available in your area. We represent a number of MA organizations, which offer products in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program to get information on all of your options.
Mistakes to Avoid With Medicare
Medicare has penalties for late enrollments for both Parts B and Parts D. It’s important to enroll into these parts whenever you are initially eligible. You become eligible for parts A&B when you turn 65, after retirement and dropping employer insurance, or after 2 years of receiving Social Security Disability Income (SSDI). There’s different enrollment periods based on your specific circumstances, but it’s important to not miss your enrollment period for any of these options.
Aside from penalties, if you are choosing an Advantage Plan (Part C), you will need to make sure that the plan is correct for the zip code you currently reside in. You will also need to check your doctors and specialists are in-network, as well as make sure your prescriptions are on the plans formulary. Without doing so you can enroll into a plan that is not compatible and incur severe out-of-pocket expenses.
Health Insurance Agent Port Lavaca, TX
We specialize in Medicare and Individual & Family Health Insurance plans in Port Lavaca, TX. Our goal is to find the best options available to you based on your health needs and your budget. Transparency and honesty is our mission. We focus on giving you all of your options and informing you on the best coverage for your needs! Allow Insurance With Don to be your trusted agency in the Crossroads and guide you through your health insurance needs!
By utilizing a local agent you have access to an expert on health insurance that is in your area and knows the plans or options available to you. Every area has different networks, carriers, and formularies for your health insurance coverage. It’s best to work with a local agent that is a phone call away and knows the specifics for the area you live in!
Individual & Family Health Insurance
Marketplace Insurance or Affordable Care Act Insurance is offered to individuals and families that are not offered insurance through their employer, or their current work insurance is deemed unaffordable. The enrollment period ranges from Nov. 1st and ends Jan. 15th, during which time you can enroll into or change your health insurance plan. It’s important to compare your options yearly in order to save money on your health insurance and not experience high rate increases. ACA has become more strict with enrollment periods and qualifications for health insurance. Work with a trusted health insurance agent to avoid making mistakes and receiving penalties for incorrect applications.
How Marketplace Insurance (ACA) Works
Marketplace Insurance is offered through private insurance companies under the Affordable Care Act. The government utilizes tax credits and subsidies to offer affordable health insurance to US residents. Through the marketplace you can find coverage for health care as well as vision & dental. Most marketplace plans will offer coverage as an HMO network, meaning that you will need a primary doctor that can refer you to any of your specialists if needed.
You may receive an Advanced Premium Tax Credit (APTC) which will provide you with a discount on your health insurance coverage for the year based on your projected income. In order to receive a tax credit you will have to file a federal tax return at the end of the year. You may receive a refund or need to pay excess APTC if your income was higher or lower than anticipated for the year. We can assist you with all of the requirements and qualifications, enrollment periods and application process!
Mistakes to Avoid With Marketplace Coverage
The largest mistake we aim to avoid is enrolling individuals who do not qualify for subsidies or marketplace coverage. If you are offered work insurance you MUST utilize it, unless it is deemed unaffordable, based on a percentage of your income. The next mistake is having an incorrect household income on your application. Marketplace Insurance works as a tax credit with an added subsidy to offer affordable rates. Due to the nature of tax credits we need to estimate your income for the current year of coverage in order to determine your savings for the year. If this is done incorrectly it can result in you receiving a penalty, or owing money back at the end of the year. We always recommend estimating as high as possible to avoid any differences when you go to file your taxes. Make sure to report the income for any individual who will be on your household tax return (married/dependents).
Another common error on applications is having an incorrect household size or incorrect household members added to an application. Households are determined by whoever will be included on the tax return for the year, not everyone who may live in the house. If a member of your household will be on the tax return they will need to be added to the application, including their income, even if they will not be applying for marketplace coverage.
Dental & Vision Insurance
Dental & Vision insurance helps to lower your out of pocket expenses for dental and vision related services. These plans can be part of your comprehensive health insurance plan, or purchased separately from your heath insurance. Most plans will have allowances or a percentage of the bill that they will cover depending on how long you have had the coverage. Some plans will even offer day 1 coverage for certain preventative or routine services.
Life Insurance
Life insurance allows you to financially protect your loved ones in the event you pass away. Don’t leave your family’s well being up to chance, with life insurance you can a solution for paying off loans and debt, covering funeral expenses, and even providing an income for your loved ones.
There’s many different types of life insurance, but the one’s our team specializes in are term life and whole life insurance. Term life, like the name suggests, offers life insurance for a fixed period of time (term). This period of time can range from 10 – 30 years and once the term has ended your coverage ends. Term life tends to be more affordable than whole life, but does not last your entire lifetime. Whole life is a permanent policy, which costs more, but has the benefit of lasting your whole life and growing in value as time goes on.
Contact Us
Insurance With Don – Port Lavaca, TX | (361) 322-9357