Utilizing Gap Insurance

Tuesday Tip: Open Enrollment opens November 1!

Unless you have a life-change event – losing your job, insurance, a qualified COBRA plan, a birth, etc, you will be unable to enroll in a plan until November 1.

If you are on a Marketplace plan for this year, I recommend that you probably should look at it again, during the open enrollment, because there will be some new plans available. I’ve heard there are some new players, some new companies who are going to offer some plans, meaning there may be something better out there. Most people will get a letter in the mail telling them what their new premium will be (because premiums always go up every year!), and so that is going to be our chance to re-look at things.

One thing I wanted to focus on today was gap coverage.

Many people don’t know that I can help them with filling in the gaps on any Marketplace plan they have. There are a couple of different ways that we can do this. If you pick a plan that has a very high deductible, for example, there are some things we can put in place to help offset that deductible if something bad happens.

But there are also some things we can do that will become more like gap insurance. Many people ask me, “Can you have two insurances?” Well, you could have two major medical insurance, but it doesn’t make sense to do that, because they both don’t pay. The primary one will pay and the second one would just look at the claim and conclude that they would have paid the same thing, and so will pay nothing. And here you are having paid for two insurances.

On the other hand, I have people that have Marketplace insurance, which is considered major medical, and then have a health insurance plan, which is not considered to be major medical. It can be either a private PPO or a type of indemnity plan that pays some benefits, regardless of any other coverage they have. The main reason you would consider this is if you have a large deductible. It is one way to help minimize your deductible and your out-of-pocket costs.  If you have a private PPO or an indemnity plan, you could actually come out ahead, as they often pay cash for procedures or when you have to see the doctor. There are some rules for preexisting conditions, but I review all of that information with you, to find what makes the most sense for you.

Asking me and finding out the information about what plans are available can be extremely helpful for you. We currently have got all these great subsidies that are available through the end of next year on the Marketplace, which could make this type of gap insurance an option for you. So, if you have a particular health situation, and you want to talk to me about it, we can certainly look at it and see if any of the gap or supplemental insurances makes sense for you. We could consider switching your Marketplace plan when open enrollment comes up.

Remember, open enrollment is a very busy time for me – so get your appointments booked early in my calendar so that we can get you the best possible coverage!

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