Washington State Healthcare Solutions

 At the Enrollment Center we do a lot of different pricing for Dental Insurance.  One of the more popular is Delta Dental for our area. For 2022 they updated their pricing in our state. This is only a partial description of benefits; for full plan benefits and pricing then visit our site .  This is different from the state and may be different from other Delta Dental offerings as they have a wide variety of plans available. For example this is different from the plan offered on the Washington Healthplanfinder.  We also walk people through the coverages for a better understanding. We have appointments, online, over the phone or in person if you are in the Wenatchee Area .  We do enrollment year round for dental and a few other programs.  Catch our Blog Suzilla . 

Masks are back in a big way!  The Argosy Restaurant has had enough. They posted a No Vax, No Service sign on their front door.  Nearly all deaths and hospitalizations in the United States for Covid is from the unvaccinated. Covid deaths are 98% preventable however there is a group that is failing not to kill Americans, the unvaccinated.  Yes, on 7/28/2021 the CDC recommended that masks should be worn indoors regardless of vaccination status if you are in a substantial or high transmission area. We talked about this possibility yesterday on our podcast . These are area marked in Orange and Red .  To qualify for Substantial then you have a transmission rate of 50 to 99 per 100K in the last 7 days or percentage of positive tests of 8.0% to 9.9% To qualify for High then you have to have more than 100 transmissions per 100K or greater than 10% positive tests. Over half the country fell into these categories. In North Central Washington, it means masks are back indoors f...

At t he Wenatchee Enrollment Center, we have been running steadily since the first business closures in March of 2020. Since we enroll people in healthcare, we have been using masks, disinfectants and social distancing for over a year. Since our focus is on living insurance, we want our clients to be around as long and healthy as possible. The vaccines are a light at the end of a very dark period.  If you want healthcare then you have until May 15th. We are one of the eleven enrollment centers throughout the state that can answer these complex questions without charging a fee.    We have made it to Phase 1B Tiers 3 & 4 in Washington's state Covid-19 program. In Washington State 3.2 million doses have been given and about 15% are fully vaccinated! Private pharmacies are now offering the vaccine so the process is speeding up.   As 3/31/2021 1. If you meet the requirements then enroll: The Washington state site is located at:  https://vaccinelocator.doh....

We are deep into our second month of assisting people with enrolling in healthcare. Our main page always has good basic information including how to find us. This fall will be our eight open enrollment that we have assisted people with health-plans with out adding a fee. On to the questions. Did you receive a $1200 check to help you get by during Covid-19 stay at home/ quarantine? How about the extra $600 in unemployment. The help for the plans on the Washington Healthplanfinder are driven by income. If your income is not reported accurately then you could be overpaying for your healthcare or you could be required to pay back money when you file your taxes the following year. Let's take care of the top questions . special enrollment rules 1. Do I need to change the income in the Healthplanfinder for the $1200 check? The answer is a resounding no. The $1200 per person ($500 for children) does not count as income and does not need to be reported. 2. I am drawing an extra...

We run Suzie Health Solutions in Wenatchee, WA. In addition to running the Full Service Enrollment Center for the Washington Healthplanfinder . We help people navigate through Medicare without charging fees and assist in filling in any coverage gaps.  So far Centers for  Centers for Medicare & Medicaid Services ( CMS ) has not opened a special enrollment with FEMA under the declared  Emergency . But there are some special benefits going on for Medicare enrollees because of the Emergency Waver .  As a result of the Covid- 19 outbreak, have you lost your group health insurance offered through your or your spouse's job? Are you age 65 or older? If so, you, or someone you know in the same situation, should enroll in Medicare coverage right away as you most likely qualify for a Special Enrollment Period . If you already signed up for Medicare Part A (hospital insurance) while you were actively working, you’ll need to complete the following two forms and...

Expect a lot of junk plans from other sources. A couple of years ago, a group of individuals started the ACA Signup Project. I have helped out at Suzie Health Solutions and have been teaching and enrolling people in healthcare since 2013. There was a great concern that the incoming President would slash funds for the outreach and attempt to sabotage the Affordable Care Act which he campaigned against. Yes, he promised to "Repeal Obamacare from Day 1". Well it is still here and we are always looking forward to more friends joining the outreach effort. Here are some tools that will help. We have made huge improvements In Washington State we have made some huge gains and we are working on making more. We are up to one in four people receiving their healthcare from the Washington Healthplanfinder. It is open year round for enrollment of people that are at 138% of poverty or affiliated with a Native American Tribe. Some of the rural counties of Eastern Washington, we ...

Don't be afraid of winter. When you live in the Cascades and winter arrives that means snow. With snow, we have ice and the inevitable slips and falls. What does that mean if you have a deductible over $5000 or worse yet no insurance? Some people want to wrap themselves up with bubble wrap and park it on the couch for the next four months. We believe that people should get out and have fun. As insurance geeks and parents of a teenage boy, we understand about injuries and sports. We know that 1 out of 8 Americans each year seek medical care because of injuries. In almost every age group falls are the leading cause of accidental injuries. If you have a kid in sports then you know that 90% of young athletes have been injured while playing a sport. Millions of kids are seen in an emergency room for injuries related to sports and recreation every year. We know that the average Emergency Room visit is charged $1,389 and a lot of people don't have the money in the bank to cove...

What were you doing August 08, 2013? I was driving a couple of hundred miles to Olympia to test the Washington Healthplan Finder . There were four brokers in the room. As we walked through it, we built a list of questions/problems to help the exchange get better. The biggest shocker was what we were expected to do for free. Before the ACA brokers received payment for helping people enroll in Medicaid. Most people can't imagine getting paid for 1/4 of their work but it is how we keep our doors open.  I think I am the only one left writing individual healthcare. The only other one that is in the business in Tacoma does mostly large business solutions.  Pre ACA Problems The early days were wild. I had to create flyers from next to nothing. We did our best to go out and educate the public from radio interviews at KPQ in Wenatchee to Front page in the Wenatchee World. We did classes at the local YMCA , libraries and Rotary Clubs. Honestly, the worst experience was at my ...

Today is myth busting for the price of healthcare in Washington State. We run Suzie Health Solutions , a Full Service Enrollment Center in Wenatchee, WA . We are trained and answer questions all year round for our clients. It is like having your personal HR department that works for you.  In a recent survey of Uninsured , 2 out of 3 didn't even try to get healthcare with 1 out of 3 thinking price was a problem. The majority probably qualified to get reduced cost or no out of pocket to them. I found it a little strange that people didn't know what their options were deciding to gamble with a solutions. I don't want my neighbors to not get their kids to the doctor because they didn't get healthcare during open enrollment.  We make it easy to get help. Open Enrollment is very short running November 1st through Dec 15th for Healthcare. Medicare Enrollments are October 15th through December 7th. Outside of that time frame, you need documented reasons. It is wh...

I see more value to using the established systems than trying to recreate the wheel. Most of us insurance professionals are using exchanges so we just have to work on making it consumer friendly. I know that the brokers are a dwindling resource because most get torn up between customer needs and insurance company’s demands. Some companies have failed to pay brokers as they rely on the exchanges for their sales force, while others that have reduced their support to the point that some brokers have had to resort to charging additional fees to keep the lights on. If you ever need any help or want me in the room then let me know and we will be happy to be a resource for you. Here are a few talking points to improve the current system. –Matt McColm at www. Wahbroker.org A. The high risk pools proven to be unsuccessful in providing affordable service to the small population that they served. We recommend reinstating the reinsurance corridors to the companies participating in the Health ...

The information for Native American Services is spread pretty out. (The ACA is probably one of the worst marketed programs ever). Here are the basics for individuals that have their tribal affiliation. 1. At 300% or less of poverty level (400% in Alaska) you get the no cost sharing (the zero co-pays). This year that is $35,640 per year with a modified adjusted gross income. Which is fancy talk for you can write off some income and qualify for better rates. 2. You can enroll throughout the year. 3. You can apply for an exception for the tax penalty. 4. Improvements to existing Indian Health Services. I always recommend using a no-cost broker. (Ask up front if they charge because some are needing to charge). We don't charge fees, are licensed by the state, trained how plans work, and can help with situations like this. If you have any questions then let me know I am always glad to help out. Websites for more information: https://www.ihs.gov/aca/thingstoknow/ http://www.hh...

Suzie has been working hard. THese last couple of months adding new policies for Medicare Advantage plans all over the state. I made her sit down and do a county by county search to see if we could offer more plans as we are getting questions from all over. When you can cover under 65 with Healthcare and Prescription Plans (Part D) for the entire state then we knew that we could do more. For us it has always been about families helping families and this year we are prepared to help even more. Check out the coverage area for 2017.

Starting January 15, 2016, the Washington State Health Care Authority (HCA) will be mailing Washington Apple Health (Medicaid) clients a new tax form named the 1095-B. The 1095-B form provides of each month the client had minimum essential health coverage in 2015 through Washington Apple Health. The Health Care Authority transmits this information electronically to the IRS. Apple Health clients should keep the form for their records, since it contains important information they will need to complete their 2015 tax return. In some cases, people may get more than one tax form – such as 1095-A, 1095-, or 1095-C – depending on their employer and the kind of health coverage they had during 2015: · The 1095-A is furnished by the state’s Health Insurance Marketplace (Health Benefit Exchange) · The 1095-B can also be furnished by other government-sponsored programs, employer-sponsored group health plans, and more. · State employees and retirees enrolled in the Un...

‘My job offered me a plan for $60 a month but it has a huge deductible, do I have to take it? Last year it was $400 when I visited my doctor.’ We get these questions on a regular basis. I don't expect people to spend money on things that don't work or pay a penality when they don't have to . The employer offers a health plan that covers the employer for the Affordable Health Care Penalty but does very little to help the employee or their family. In Washington State, we have our own state exchange with a lot of plans. So many plans that brokers spend months learning plans so that we can help our clients get the most out of their money. There are Health Insurance companies that will only offer their plans using the state exchange. There are also some that are priced down to the point where a 28 year old was able to get health insurance for $209 a month with a $20 co pay to see his doctor without tax credits! There are times when it is best if a job does not offer health i...

1. Well, I found a first trap because of excessive exchange funding. This effects all clients that have had apple health. Clients are now able to get extensions automatically on their apple health up to a year at a time. I have a family that is now at 200%+ of the poverty level that was granted this extension. Their healthcare is paid by tax dollars and as their broker I receive zero commission. Would you like to make $60,000+ a year and have medicaid for the entire family? Previous to the ACA brokers were paid $100 per enrollment with an average of 10% of people a year coming off medicaid during any given year. 2. If you have been following this was an excerpt from a Health Care Authority recent audit sent Oct 23rd. HCA regularly conducts audits of Washington Apple Health eligibility. Recent audits by HCA found numerous cases of inaccurate income reported on Washington Apple Health (Medicaid) applications in Healthplanfinder. Clients found to have discrepancies in their reporte...

The Director for the Wenatchee Senior Center dopped in and gave Suzie McColm her plaque. It was the first one that she achieved. She has been helping for years people fill their prescriptions at the local pharmacies struggle. The struggle could have been from not having insurance to having a bad plan. When she had enough, she rolled up her sleeves, got her insurance license and started helping with the affordable care act. After her first year helping, she wanted to help more with Seniors so Medicare was a natural for her. She still helps as a pharmacy tech these days but her passion is helping people on the front in with insurance. Stop in and say hi to a proud member of our team .