- Abdominal Aortic Aneurysm one-time screening
- Alcohol Misuse Screening and counseling
- Aspirin use to prevent cardiovascular disease for men and women of certain ages.
- Blood Pressure Screening for all adults
- Cholesterol screening for adults of certain ages or at higher risk
- Colorectal Cancer screening for adults over 50
- Depression screening for adults
- Diabetes (Type 2) screening for adults with high blood pressure
- Diet counseling for adults at higher risk for chronic disease
- HIV screening for everyone ages 15 to 65, and other ages at increased risk
- Immunization vaccines for adults–doses, recommended ages, and recommended populations vary:
- Hepatitis A
- Hepatitis B
- Herpes Zoster
- Human Papillomavirus
- Influenza (Flu Shot)
- Measles, Mumps, Rubella
- Tetanus, Diphtheria, Pertussis
- Obesity screening and counseling for all adults
- Sexually Transmitted Infection (STI) prevention counseling for adults at higher risk
- Syphilis screening for all adults at higher risk
- Tobacco Use screening for all adults and cessation interventions for tobacco users
- Have a religious exemption.
- Cannot afford coverage based on formulas contained in the law.
- Have income below the federal income tax filing threshold.
- Are a member of an Indian tribe.
- Were uninsured for short coverage gaps of less than 90 days.
- Have received a hardship waiver from the Secretary or are residing outside of the United States, or are bona fide resident of any possession of the UNited Stated.
- Marriage or divorce
- Having a baby, adopting a child or placing a child for adoption or foster care
- Moving your residence, gaining citizenship, leaving incarceration
- Losing other health coverage Voluntarily dropping coverage or losing coverage that doesn’t qualify as minimum essential coverage does not apply
- Having a change in income or household status that affects eligibility for subsidies Only for those already enrolled in marketplace coverage
- Gaining status as a member of an Indian tribe
Politics aside, it appears that “Obamacare” is here to stay. Most people are seeing about 20% increase in premiums. Overall, you have three options. Read our detailed PDF for more information:
You may qualify if you:
- Lose health coverage due to a job change
- Get married
- Have a baby
- Adopts a child or become a foster parent
- Get divorced or legally separated and lose coverage
- Move outside of a health plan’s service area
- Have a change in income
- Become a U.S. Citizen
The Affordable Care Act (ACA) requires most Americans to have health insurance starting in 2014. If I don't comply, what is the penalty I would have to pay?
People who don’t comply have to pay a penalty, the amount of which depends on several factors, including income and family size. This calculator lets you estimate the potential ACA penalty for individuals and married couples who don’t have health insurance coverage required by the ACA.
The answer is simple… because you are purchasing coverage to protect you for events that happen—not what won’t happen.
If you thought nothing was going to happen, then you would not purchase coverage at all. Here’s a brief explanation why you should purchase the other items included in the Life Protection Pyramid.
WHY LIVING BENEFITS: Purchasing the medical without the Living Benefits– exposes you to losing your medical coverage as well as losing your standard of living. You see most of us don’t have large sums of money to fall back on.
Ask yourself a question: Could you survive without a paycheck for 6 months or a year? Most of us would be destitute and foreclosed upon. Certainly, even if you could financially survive the loss of income… why? It is much easier to pass the burden of that onto an insurance company for a very reasonable premium. For others, it simply makes sense to not put YOUR savings in jeopardy. Use your savings for their original intention which for most people is retirement.
WHY Accident and Hospital Recovery: Simple mathematical logic and human nature. As an agent of 27 years, the number 1 complaint I have heard is this “I have insurance, why am I having to come up with several thousand dollars for my deductible“? Again, it just makes sense to plan that you ARE going to use the coverage. There is an old saying “the unexpected happens”. Having the Accident and Hospital Recovery coverage reduces or entirely eliminates your deductible for covered accidents and hospitalizations. At an annual rate of about $1,000 a year for a family, just one accident or hospitalization for a single family member reimburses or exceeds the premium. Point blank the math just makes sense. For others, it is the peace of mind that comes from having the freedom to go have something looked into without having to worry about your deductibles.
Why Dental Coverage: The silent epidemic- Really there are only 2 types of people in this world, those who have regular visits to their dentist and those who don’t. Protecting your smile and your health STARTS with ORAL Hygiene. Quality dental plans provide you ACCESS to a dentist twice a year and protect you from unexpected future expensive dental work. In addition, most of our plans provide up to $1,500 of treatment a year per insured for the unexpected. Going to the dentist twice a year and paying out of pocket is approximately the cost of the premium. The bonus to YOU is having the coverage for the $1,500 of unexpected per person. If you going to pay the dentist about the same—might as well be insured.
What happens at the end of your Short Term Medical plan when you’re sick with a preexisting condition?
You transition back into Obamacare.
Our agents are recommending that you purchase your short term coverage to coincide with the open enrollment period of the ACA “Obamacare”. This means syncing your coverage to cover you from January to January. This way if a family member is seriously ill or has high medical expenses, you can OPT back into Obamacare and get guaranteed issue coverage with a pre- existing conditions. In addition, since deductibles are calendar year anyway, this is the ideal time to make a change if necessary. Remember that ONLY the person with a health condition needs to OPT back into the expensive Obamacare plan. The balance of the family should re-enroll in the STM plan and continue to be covered at a lower rate.
We are available to help you register on the Texas Health Insurance Marketplace. Our fee for doing so is $100, payable in advance.
OR you may apply through our website using self-service at no additional charge.