Questions we are asked

Nothing. There is no fee, no consultation charge and no cost of any kind to the people we advise. We are compensated by the carriers whose plans we place, and that compensation is already built into the filed rate. Your premium is identical whether you enrol through us, through another agent, or directly with the carrier.

We are independent in the sense that matters: we are not employed by, owned by or captive to any one carrier, and we are not paid more to place one carrier over another on the same line of business. We will also tell you when the right answer is the plan you already have, which costs us the sale.

No. We call when you ask us to, when a plan you hold changes materially, and once each autumn before the Annual Enrollment Period. That is the whole contact schedule, and you can opt out of any of it.

Two lists. Every doctor and facility you use, and every prescription with its strength, dose and frequency. Also your Medicare card if you have one, and any letters from an employer about creditable coverage. Those two lists decide most of the answer.

Yes, every day, both individual appointments and employer enrolment meetings. Plan summaries and enrolment paperwork are available in Spanish on request, and we run a Spanish-language seminar in Pinellas Park.

We are licensed in eleven states. Call the office and we will tell you straight away whether your state is one of them and, if it is not, point you to a state health insurance assistance programme that can help.

Your Initial Enrollment Period runs seven months: the three months before the month you turn 65, that month, and the three months after. If you were born on the first of a month, the whole window shifts a month earlier. Our enrollment calculator works out your dates and shows what each month does to your start date.

If you have active employer coverage through an employer with 20 or more employees, you can usually delay Part B without penalty and enrol later through a Special Enrollment Period. With fewer than 20 employees, Medicare generally pays first and delaying is usually a mistake. COBRA and retiree coverage do not count as active employer coverage for this purpose.

It depends on five things: how attached you are to your doctors, how much you travel, whether you prefer a low monthly cost or a low worst-case year, how you want drug cover carried, and how likely you are to want to switch later. Our decision matrix weighs all five and shows the counter-argument for whichever structure loses.

It starts the first month you are both 65 or older and enrolled in Part B, and runs six months. Inside it, supplement carriers must issue you a policy regardless of health. Outside it, in Florida, they can medically underwrite you and decline. It happens once, and it is the most consequential deadline in the whole system.

Only with a Special Enrollment Period. Losing employer coverage, a permanent move, a change in Medicaid or Extra Help status, moving into or out of a facility, a plan leaving your area, or a switch to a 5-star plan can all open one. Each has a different length, and our calculator lists them.

Original Medicare does not cover routine dental, eye exams for glasses, or hearing aids. Many Medicare Advantage plans include allowances for them, and standalone dental, vision and hearing policies are the other route, particularly for people on a supplement.

Almost always yes, unless you have other creditable drug coverage such as an active employer plan or VA benefits. Going 63 days or more without creditable coverage after eligibility triggers a permanent late-enrolment penalty that is recalculated every year.

Deductible first, where you pay the plan's discounted price until the deductible is met. Then initial coverage, where you pay a tier-based copay or coinsurance. Then catastrophic coverage, where you pay nothing more for covered drugs once your out-of-pocket spending hits the annual cap. Our Part D stages tool walks through where a year's spend lands.

You can request a formulary exception with a supporting statement from your prescriber, ask about a covered alternative, or change plans at the next Annual Enrollment Period. We file these requests for clients regularly and they succeed more often than people expect.

A federal subsidy, also called the Low Income Subsidy, that substantially reduces Part D premiums, deductibles and copays if your income and resources fall under the published limits. It also removes the late-enrolment penalty. Many people who qualify never apply. We screen for it at every appointment.

Three usual reasons: the deductible reset, the drug moved tier when the plan refiled its formulary, or a new prior authorisation requirement was added. All three are visible in the Annual Notice of Change your plan sends each autumn, which is why the October review matters.

From your estimated modified adjusted gross income for the coverage year and your household size. It is reconciled on your federal tax return, so an estimate that turns out low means repaying part of the credit and an estimate that turns out high means a refund. Report income changes during the year and neither happens.

You can buy a Marketplace plan, but if your employer's offer is affordable under the federal test you will generally not qualify for a premium tax credit. That is the first thing we check, because it is where most subsidy repayments come from.

A 60-day window after a qualifying life event: losing other coverage, marriage, birth or adoption, a permanent move, or certain changes in income or household. Outside those, you enrol during annual Open Enrollment.

They are cheaper and they are not insurance. They are not regulated as insurance, are not required to cover pre-existing conditions, and have no legal obligation to pay a claim. We do not place them and we will explain exactly what is missing if you are considering one.

Up to age 26 on most plans, regardless of whether they live with you, are married or are financially independent. Ageing off a parent's plan is itself a qualifying event that opens a Special Enrollment Period.

Most Florida small-group carriers will write a group with at least two enrolling employees, subject to participation rules. Owner-only arrangements generally are not eligible for small-group coverage; an individual or Marketplace plan is the route there.

Carriers commonly require around 70% of eligible employees to enrol after valid waivers are removed, and an employer contribution of around 50% of the employee-only premium. Employees with a spouse's plan, a parent's plan or Medicare are usually removed from the participation calculation.

You cannot stop premiums rising, but you can choose who absorbs it. A defined contribution model, a flat dollar amount per employee per month, caps the company's exposure and makes budgeting predictable. A percentage model puts renewals on the company. We price both at your headcount.

Ninety days before the anniversary. Groups marketed late accept increases they should have challenged, because there is no time left to move.

No. Broker compensation is already built into filed small-group rates. Going direct to a carrier does not make the plan cheaper; it just means nobody runs your enrolment meetings or answers your employees' claim questions.