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MyChoice Market FAQ

Medicare and Medigap (over 65)

Supplement plans require enrollment into a Medicare plan. Individuals who are approaching Medicare age have a full seven-month window in which to enroll in Medicare, which includes the three months before your 65th birthday, the month OF your 65th birthday, and the three months after your 65th birthday. If you sign up in the three-month window before your birthday, coverage effective date will begin in the month of your 65th birthday. Enrolling after your birthday could create a delayed effective date.

No. Medicare supplements are additional insurance coverages that are either to help cover the costs of prescriptions or supplements to add to Medicare Part A or Part B plans (also known as “Original Medicare”). These supplements can help bridge the gap for out of pocket costs on prescriptions, coinsurance, co pays and deductibles.

Medicare Advantage is sometimes also called Medicare Part C. By law the Advantage plan covers at least the same benefits as Parts A and B, with some additional benefits, such as dental, vision, hearing support, and other services. Medicare Advantage is sold through insurance companies.

More information about Medicare supplement plans and the Medicare Advantage plan can be found on mychoicemedicaremarket.com.

Yes. Medicare supplement plans are often also called Medigap.

Part D is a coverage specific to prescription drugs. You can purchase Part D to supplement any other Medicare plan.

Individual and Family Coverage: Medical

If you have experienced a loss of coverage for a variety of reasons, you are eligible for a special enrollment period (SEP) to choose a medical plan to cover yourself and/or your family. There are options at various premium costs (monthly payments) both in the ACA state-based “exchanges” or marketplaces and directly through health insurance carriers. Typically, these individual plans have an open enrollment period from Nov. 1 – Dec. 15 each year. Some states have extended periods.

A qualifying event is a life event that changes the status of your insurance coverage. An event in this category allows you to make changes to your coverage or purchase different coverage outside of the typical “open” enrollment period near the end of the calendar year. You have 60 days from the time of the qualifying event to elect coverage. In the individual market (on or off-exchange), qualifying events include:

  • the birth or adoption of a child
  • marriage (and divorce, if the exchange or insurer counts it as a qualifying event)
  • loss of other coverage (loss of access to employer-based benefits, not applicable for non-payment to COBRA plan or individual coverage plan)
  • a permanent change of residency to an area where different health plans are available (if you already had coverage prior to the move)
  • a change in income that changes your subsidy eligibility (only applies if you already have coverage through the state-based exchange)
  • an increase in income that moves you out of the Medicaid coverage gap
  • a grandfathered or grandmothered plan’s non-calendar-year renewal

becoming a US citizen or lawfully-present resident

The ACA stands for the Affordable Care Act, which was passed in 2010. It is also known as “Obamacare,” as it was signed into law by President Obama. Among the provisions in this act was the creation of state and federal based insurance exchanges designed to provide affordable coverage. The provisions of the act were intended to make health insurance coverage more accessible, lower health care costs and eliminate potentially discriminatory practices in the industry, such as pre-existing condition denial.  

based health plans are compliant, if you are enrolled through an employer. You may purchase health coverage through a marketplace provider, like MyChoice Market. This type of coverage can be subsidized with tax credits based on your annual income. The MyChoice Market also provides a limited coverage known as “minimum essential coverage.” Additionally, you may be eligible for Medicare (65 and up) or Medicaid (income-based determination. Finally, you have the option of purchasing health insurance directly from a provider.

Learn more about the IRS Individual Shared Responsibility Provision.

The ACA makes a provision for tax credits or subsidies to reduce the cost of individual coverage, based on your income. In order to know whether you qualify for this option, you will need to report your annual income.

Consolidated Omnibus Budget Reconciliation Act (COBRA): COBRA coverage means that your employer provides a method for you to continue the coverage you had at the time of your job loss or departure. You are required to pay the monthly premium for this coverage, which may or may not be subsidized by your employer. You have a few options now in order to maintain medical coverage. First, you can pay the monthly premium payment to remain with your employer’s health plan. The COBRA coverage option typically last for 18 months. Second, you may opt not to elect your COBRA coverage and elect an individual or family health plan from the marketplace, such as MyChoice Market. There are varying levels of coverage and costs to choose from, and the plans are ACA-compliant. Your third option is to purchase health insurance directly from a health plan provider.

Individual and Family Coverage: Other

You may be used to having dental and vision coverage through your employer-based benefits. These coverages and discount plans are also offered on the MyChoice Market [link to navigation] through our providers: New Dental Choice, VSP, and United Vision Plan.

MyChoice Market can provide coverages similar to employer-based benefits and beyond. You can research and purchase legal insurance, long-term and short-term care plans, identity theft protection, telemedicine coverage, and more.

MyChoice Market partners with leading insurers in the industry to provide you with options at many price points. Our partners include:

  • Pets Best
  • VSP
  • ARAG Legal
  • Liberty Mutual
  • New Dental Choice
  • Identity Force
  • Chubb
  • United Vision Plan
  • InfoArmor
  • CirrusMD
  • Acsia Partners

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