Washington State Healthcare Solutions

  How does we know that big changes is coming to Medicare for 2025 without talking about insurance plan details? Well it is real simple, the Inflation Reduction Act put in some very positive changes that impact Prescriptions in a big way. 1. Insulin at $35/month (already started). 2. vaccine access (already started). 3. Expansion of low income subsidy (already started). 4. $2000 yearly out of pocket max of prescription drug cost 2025. 5. Medicare Prescription Payment plan starts in 2025. 6. Manufacturer discount program starts in 2025. 7. In 2026 we will see the first 10 negotiated drug prices. These impact every Medicare Prescription Plan including Medicare Advantage plans that have prescriptions! Yes, large insurance companies have been predicting 50% of people using Medicare with prescriptions will switch plans this year. The Medicare Annual Enrollment Period runs from October 15th through December 7th. Set your appointments early for Suzie . While we can not discuss Medicare ...

Suzie and I have been working with Health and Medicare Plans for years. What happens when my medicare advantage plan leaves ? It comes up frequently during the initial enrollment period. The quick answer is we go through the different options and select a different one at that time. We have seen Molina & Premera paid plans leave our Chelan County. Lifewise leave and come back, Moda leaves the state, Soundpath Health Medicare Advantage wave goodbye to North Central Washington. We have been taking care of the entire Washington state for over eleven years. It is tough when a plan that you are comfortable with cannot continue in your area. Not every county in Washington state has Medicare Advantage plans. The insurance company has to identify that there is enough people who qualify, obtain contracts with providers in the area, and have enough profits that can be made in the area to continue to operate. Every year, some Medicare Advantage plans may leave the Medicare program by Dec....

  The Suzie @ Wenatchee Insurance is asked about Medicare a lot. We help people understand and enroll. If you are looking for PEBB information then go to the HCA and request customer service and if you don't like their options request that they contract with brokers. Once they contract then we get access to the specialized training and can effectively assist PEBB retirees. We work with plans that contract out with licensed producers.  Who can get Medicare? Medicare is the federal health insurance program in the United States that provides coverage to individuals who are 65 years or older and certain groups of people including: 1.        Individuals who are 65 years or older: If you are a U.S. citizen or a legal permanent resident and you or your spouse have worked and paid Medicare taxes for at least 10 years, you are eligible for Medicare at age 65. 2.        Individuals with certain disabilities: If you h...

How big is the unwinding effecting our neighbors. Let's look at the Continuous Enrollment Data that was pulled 02/14/2023 Chelan County 5,766 Douglas County 3,030 Grant County 8,012 Okanogan County 3,210 Kittitas County 2,324 Yakima County 22,744 Yes, Central Washington is looking at 45,086 people that have been enrolled continuously renewed into Apple Health. We are looking at a large percentage of our neighbors having to review their health insurance over the next year. Most of that will be outside of Open Enrollment period which runs usually from November 1st through December 15th.  People are setting appointments year round  so that we can travel to outreach events around the state to assist in education and enrollments.  Yes, CHIP payments are restarting Key resources are the Enrollment Centers . Our office moved to 413 N Mission street a few months ago if you want assistance in Central Washington we can do phone, online and in person appointments . The reason th...

An insurance plan is not set in stone. Apple Health is an insurance program that when your income changes more than $150 a month then you need to report the income change. If you make over the specified income limit then you are not eligible for Apple Health and may qualify for a reduced cost plan. We have been talking to people and some are very unaware of the change that is almost upon us.  Apple Health is what Washington State Medicaid has been called since 2013. They renamed it when the Affordable Care Act changed Healthcare in the United States. There is a ton of cool state names like Husky Health, MedQuest, BadgerCare, Green Mountain Care....etc. There are groups that help people understand and enroll in Apple Health with out charging a fee.  Suzie Health Solutions is one of ten Enrollment Centers in Washington State that work with the Washington Healthplanfinder. We have to meet special conditions like explaining all plans on the Healthplanfinder and not charging fees...

 Suzie Health Solutions has been assisting people in Wenatchee and surrounding counties going on ten years. We make it easy as possible because this is a life changing moment. Suzie takes her time during enrollment and answers questions through the year making her high in demand. She does take appointments and people have set them as far out as five years. We do not charge fees .  To enroll in Medicare, you must be a U.S. citizen or permanent resident who is 65 years or older, or have a qualifying disability or end-stage renal disease. Yes, if you have a Permanent Resident Card (I-5551) then you can qualify for Medicare! To quote or set appointment here. We do assist people in office for an initial enrollment or receive forms to activate Medicare B from a delayed start. You can enroll in Medicare online, by phone, or in person at your local Social Security office. You will need to provide your Social Security number, date of birth, and other personal information. Once you h...

There is a variety of coverages out there. At Suzie Health Solutions , the Enrollment Center located in Wenatchee for the Washington Healthplanfinder , we work with Qualified Health plans.  We are going to talk about non-medicare health insurance plans today. We offer a lot of insurance but health insurance we have worked through 10 open enrollments which usually run from November 1st through December 15th across the United States.  This means that they cover the 10 Essential Coverages.  Inpatient and outpatient medical care Prescription drug coverage Preventive care and screenings Mental health and substance abuse treatment Emergency services Hospitalization Rehabilitation services Pregnancy and maternity care Laboratory services Pediatric care, including dental and vision services. Each plan will cover them in a variety of ways. We do run applications year round however are limited by enrollment dates. If we are outside a open enrollment then a person may have to ...

  At The Suzie at Wenatchee Insurance Agency , we can explain and assist in enrolling in Health and Medicare Insurance Plans. We are trained by the companies, have annual certificates for Medicare and the Healthplanfinder and hold licenses in Washington state. Annual Enrollment Periods are limited: Enrollment Periods Medicare is from October 1 through the 14 we can talk about the changes for the following year.   From October 15 th through December 7 th , we can enroll and make changes to Medicare plans. Note we do not work for company retirement plans such as PEBB or SEBB. We can assist with Medicare Plan D Prescription plans, Dental or alternatives. Healthcare enrollment is from November 1 st through December 15 th for plans starting January 1 st 2023. Since we have a state-run exchange, they can extend it like this year we have a bonus enrollment period from December 16 th through January 15 th for plans starting on February 1 st , 2023. We are not employees o...

 This year Suzie is going through her Annual Medicare Training . It is done every year and allows her to contract with Medicare Plans, educate and enroll consumers and receive a commission for her services. If you have been to our main webpage then you notice that we do a lot of different types of insurance.   Insurance is an heavily regulated industry. It requires being trained and then licensed with the Office of the Insurance Commissioner. We purchase equipment, open office spaces, and software so that we can effectively interact with the public. We have to secure contracts with companies if we want to be able to offer their products. Now not every company offers contracts with Agents. So we had to put up a new disclaimer. "We do not offer every plan available in your area. Any Information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. " Yes, since not every compan...

  We do a lot of work with the Washington Healthplanfinder as an Enrollment Center for Healthcare. Seriously, we are open year round answering questions and enrolling people in healthcare. When Suzie first started transitioning from being a Pharmacy Technician, she wanted to lead helping Medicare Individuals with their plans.  Yes, we assist people with Medicare. We stock materials Medicare Advantage, Supplement and Drug plans so that we can help with questions at our office in Wenatchee for your initial enrollment. Most people can enroll into Medicare plans 3 months before their 65 th Birthday, the month of and 3 months after their Birthday. Folks also can delay enrollment if they are covered by   plan through work. We can do a lot over the phone however sometimes there is nothing like having a complete enrollment packet in your fingertips. We like to take the time to do it correctly and it is not a problem to answer questions through the year. The best part is ...

 We have been hearing some mean rumors about folks telling the unvaccinated that they can not get health insurance. If you lose coverage from a job then it opens a special enrollment and you have 60 days. We have had enough questions that we did a quick 10 minute video on it. For the unvaccinated, the Affordable Care Act protects you from being discriminated against. You can get a individual health plan on the Washington Healthplanfinder until January 15th, 2022. We recommend getting some assistance from an enrollment center as they cost nothing and some areas have over 70 health plans to choose from.  There are some carve outs. Large Group plans can add surcharges for the unvaccinated. Kroger  and Delta Airlines  are good examples of doing a soft mandate.  A Healthshare Ministry while allowed under the ACA is not insurance so if they can change their rules leaving subscribers no avenue of appeal. We do not work with these products because we like regulated pr...

 It's October and we have started the Enrollment Season. The last couple of weeks, we have had people with Covid call us looking for Health Insurance and people losing their coverage due to opting out of a vaccine mandate at their work. It is our job to educate and enroll people in insurance regardless of their position. We are the Enrollment Center located in Wenatchee. Enrollment Centers are unique to Washington state and there are only 11 of us . We work with the Washington Healthplanfinder and can be found linked to their site. We have to go through special requirements like explaining every plan and not charging any fees. Some of the brokers sites like The Suzie @Wenatchee Insurance  work additionally with Medicare plans and Life Insurance so that you have additional opportunities.  We saw a big reduction in the cost of Healthcare because of the American Rescue Plan. In Washington state we enrolled thousands of people into plans for $1 or less starting in June. These...

 Each year at The Suzie @ Wenatchee Insurance  we talk about rates in June . It is one of the few times that the public has a chance to lower their insurance rates. If you follow our podcast or facebook page then you have a greater chance of knowing when this occurs. We even did a follow up video about the thousands of Washington State Residents that were able to purchase Healthcare for $1 or less.  For 2021 thanks to ARPA, nearly half were paying $100 or less for a qualified health plan and these savings will continue through 2022 at least!  The office of the Insurance Commissioner has released some results. The first round impacts the plans found on the Washington Healthplanfinder . If you are not using this tool to shop for insurance then you should just because of the American Rescue Plan's lowering of rates through 2022. Since the adjustment to the top bracket opened up reduced pricing to the upper income brackets, there is very little reason to be shopping ...

 Open Enrollment for Healthcare will run November 1st 2021 through January 15th 2022 . This is when people can make changes to their healthcare. There are 11 Enrollment Centers spread throughout Washington State and we are located in Wenatchee . Enrollment Centers have been around for six years and are almost a secret way to get no cost help with understanding health insurance. It has been a great program to be part of. Some are even set up to assist with Medicare and Life Insuranc e as well.  Outside we have what is called Special Enrollment .  One of the myths is that you can enroll any time of the year unrestricted is not true. You may be required to submit documentation to prove that you have a valid reason to get healthcare outside of special enrollment.  We have seen Special Enrollments for: Income - You have low income and Qualify for Apple Health : Do not be surprised if the Healthcare Authority asks to see how much you make .  Native American/Ala...

  Confluence Health announced that they are going to terminate the contract with Premera January 31,2022. We started hearing about the negotiations back in May so we double checked with the Premera Filings in June. Our county is zone 7 and you can quickly see how we are priced compared to the rest of the state. You can also see that Premera intends to be in our area because it is literally in their filed plans. If they don't reach an agreement then professionals already have solutions.  We have had insurance companies leave the area before. The last we saw this was Soundpath Health a Medicare Advantage Plan bought by Premera closed its's doors January 1, 2019. We saw it when Premera, Lifewise and Molina left the individual marketplace during a contraction. At any given time, there is about two hospital systems negotiating with an insurance company. Insurance professionals have dealt with this before and have plans for when this happens.  We are recommending to not do a...