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Your 2016 Medicare question checklist

by Lauren Mandel

As the Medicare Open Enrollment Period quickly approaches, you may be wondering how you can prepare to find Medicare coverage for the upcoming year. We’ve shared information about when you can get Medicare, but do you know what questions to ask yourself now so that you’re prepared come October 15?

Senior couple on cycle ride in countryside

Below is a list of questions to ask yourself in advance of searching for a Medicare plan. Reviewing this checklist will help ensure your Medicare shopping process runs smoothly, and you’ll have more information you need to find the right plan on October 15.

  • Have you researched what type of Medicare you need?
  • Will you need help understanding how Medicare works?
  • Do you currently have health insurance coverage?
  • Do you have a primary care physician?
  • How many times a year, on average, do you see a doctor?
  • Do you see a specialist for any current health conditions?
  • Will you need Medicare prescription drug coverage?
  • Do you have a preference for what type of Medicare coverage you get?
  • Do you need a plan just for yourself or for others, too?
  • When would you like your Medicare coverage to begin?

If you have questions about this list or need more information about Medicare coverage, feel free to call 1-877-568-1851 – TTY 711 to speak with one of our licensed sales agents. To enroll in Original Medicare, please contact your local Social Security office.

Medicare has neither reviewed nor endorsed this information.

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When to sign up for Medicare coverage

by Lauren Mandel

If you’re approaching your 65th birthday or you already have Medicare coverage, now is the time to start thinking about your Medicare coverage options for the upcoming year. While you’ll likely automatically get basic Medicare coverage once you turn 65, there are additional Medicare coverage options available.

But when can you get them and should you start preparing now? We’ve shared basic information you need to know about Medicare coverage options in the past, and now we’re providing all the key Medicare dates you need to know.

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Your 65th Birthday

When you first become eligible for Medicare, you have the option to enroll in a Medicare Advantage plan once you get Parts A & B. This is called your Initial Coverage Election Period, and it is the seven-month period that runs from 3 months before the month of your 65th birthday through 3 months after your birthday month.

Remember: You must have both Original Medicare Parts A & B to complete your coverage with Medicare Advantage or a Medicare Supplement plan. You’ll likely be automatically enrolled in Part A around your 65th birthday, but you may have to call your Social Security office to actively enroll in Part B.

Have Original Medicare and ready for more options?

Medicare Open Enrollment is from October 15 to December 7, 2016. You’re not required to re-enroll in Medicare each year, but you can review and change plans if needed. During this time period, you can do the following:

  • Change from Original Medicare to a Medicare Advantage plan
  • Change from a Medicare Advantage plan back to Original Medicare
  • Change Medicare Advantage plans
  • Find a new Medicare Advantage plan that offers prescription drug coverage
  • Join a Medicare Prescription Drug plan
  • Switch from one Prescription Drug plan to another

Medicare has neither reviewed nor endorsed this information.

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Why are men more likely to be uninsured than women?

by Catherine Tims

The Affordable Care Act has helped lower premiums for the elderly, and women in particular have benefited from the health law. But why are so many men still uninsured?

Thanks to the Affordable Care Act, the number of uninsured Americans is at an all-time low. According to a recent survey, 20 million more people are signed up for health insurance when compared to six years ago before the ACA came into play.

But that same data tells us there are still 24 million uninsured Americans. Interestingly, a growing percentage of men are uninsured, accounting for 58 percent of the overall uninsured population. Three years ago, that number at 52 percent.

What could cause this disparity? Let’s take a look at the possible reasons why so many American men are still uninsured.

mens uninsured

Medicaid expansion – or lack thereof

One of the primary goals of the ACA was to expand Medicaid so more non-elderly adults could access affordable health insurance. Medicaid covers lower-income individuals; however, a wide gap still exists for people whose income is too great for Medicaid but not high enough to afford individual health insurance.

The ACA allowed states to attempt to fill that gap by expanding Medicaid’s upper income limits. But some states have chosen not to expand Medicaid.

According to Kaiser Family Foundation’s analysis of the 2015 Current Population Survey for non-elderly adults, not only are fewer men than women insured overall, but men are also less likely to have Medicaid coverage.

Before the ACA era, Medicaid excluded adults with no dependent children. Do men simply think they can’t get Medicaid without a dependent? Do they see Medicaid as a women-only program? Almost half of all the births in this country are accompanied by Medicaid, so it is possible Medicaid is perceived in this light.

No more men-specific rates

Let’s not forget: Before the ACA, insurers were allowed to charge gender-based premiums for health insurance. The difference was justified by the fact that women typically visit the doctor more often.

But now under the ACA, insurers are not allowed to charge women more than men. Due to this new provision of the law, some men may have seen their premiums actually go up after Obamacare went into effect. This increase could have deterred them from getting coverage at all.

Lack of outreach and education

A lack of information may also be responsible for the increase in uninsured men. The Kaiser Family Foundation analysis reports that 44 percent of uninsured men are actually be eligible for some sort of financial assistance under the ACA.

Around half of that 44 percent are eligible for a tax credit to lower the cost of coverage; 50 percent are also eligible for Medicaid. And, specifically, 6 out of 10 uninsured African American men  are eligible for a tax credit, Medicaid, or the Children’s Health Insurance Program (CHIP) but don’t take advantage of these benefits.

When it comes to uninsured men in this country, the issue appears to be either affordability or lack of education. Do you think the male uninsured population will decrease during the upcoming Open Enrollment Period?

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Celebrate Women’s Equality Day with these women’s health tips

by Lauren Mandel

In celebration of Women’s Equality Day on August 26, we’re excited to work with our partner, YWCA Metropolitan Chicago, to raise awareness for the importance of women’s health. While women have faced various health challenges throughout history, the Affordable Care Act has been a fierce advocate for women’s health care over the past few years.

Open Enrollment under the health care law begins again on November 1, and all women are encouraged to evaluate their current and future health care needs in preparation. To celebrate Women’s Equality Day, we’ve outlined 4 of the most important tips you can consider before enrolling in health insurance this fall.

womens equality day

Remember what’s covered under the Affordable Care Act. 

Let’s not forget all that the Affordable Care Act has done for women in just a few short years: insurers are now required to cover birth control, maternity and newborn care are covered as essential health benefits, and all women now have access to covered mammograms. And those are just a few of the benefits for women under the Affordable Care Act.

It’s also important to remember that you cannot be denied or charged more for coverage if you have a pre-existing condition. So if you’ve been denied in the past, now is the time to get the coverage you deserve.

Review your current and future health care needs.

Before getting health insurance, it’s important to consider what you need from the plan you select. Do you need extensive coverage for an illness? Are you looking for basic coverage to help you afford regular doctor visits? Do you have plans to expand your family in the near future? All of these and more are things to consider when looking for health insurance.

Even if you have health insurance from last year, you may benefit from reviewing your plan this year. Maybe you’ve developed a recent health condition that needs more comprehensive coverage, or perhaps you’re taking a new prescription drug not covered by your current plan. No matter your situation, it’s always important to evaluate what you need now and in the future.

Consider the needs of everyone in your family. 

While many people are looking for a plan only for themselves, other shoppers need coverage for their entire family. If your spouse and children also need health coverage, there are family plan options that might make sense for your situation. Licensed agents are available to help you make the best decision for your family.

Prepare to enroll in coverage.

While November 1 might seem like long time from now, it will be here before you know it. The last thing you want is to be unprepared when Open Enrollment arrives and you can finally shop for new coverage. By taking the steps above for Women’s Equality Day and preparing to find a plan now, you’ll be that much more prepared when the shopping seasons begins.

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How can we improve veteran health insurance options?

by Catherine Tims

The U.S. Department of Veteran Affairs (VA) is long overdue for an update. There’s a plan for doing just that, and it’s sitting in Congress right now. But is health insurance for veterans included?

The VA has faced its fair share of criticism when it comes to helping war veterans here at home. Preventable patient deaths, unacceptable delays for patients seeking medical care at VA hospitals, and lavish rewards for senior executives are among the most notable discrepancies, according to the American Legion.

While it may seem obvious that our system for veteran health care needs an overhaul, exactly what to do about the health insurance component is up for debate.veterans health insurance

The nation has been plagued by problems with the VA health care system for decades. In 2014, a report called Independent Assessment of the Health Care Delivery Systems and Management Processes of the Department of Veterans Affairs concluded that the only thing that would fix the system would be “system-wide reworking.”

We now have the Caring for our Heroes in the 21st Century Act, but it doesn’t necessarily focus on veteran health insurance.

What are the current options?

Under the current VA system, veterans’ health insurance is provided by the same people who also run the VA hospitals: the federal government. The government decides the health insurance costs and the cost of health care services, as well as how much the hospital doctors get paid.

For veterans, once they have their health insurance, they use their insurance cards to visit a VA hospital and see a VA doctor – the same ones that are run by the federal government.

The system was orchestrated during a time when the veteran population was far different from what it is today. And the demographics of the veterans, plus the nature of their injuries and situations, aren’t the only things which have radically transformed during the last century.

Our economy has changed, health care has changed drastically under the Affordable Care Act, and just about everything that makes up the VA health care system has seen significant change since the system was devised.

Looking ahead to future veteran health care options

Rep. Cathy McMorris Rodgers has proposed a new bill to Congress, called the Caring for our Heroes in the 21st Century Act. The bill reflects the need for our VA system to evolve, to come to terms with the enormous international changes that have resulted in our outdated, inefficient, and arguably harmful VA health care system.

One of the main details in the proposed bill is the separation of VA health insurance from the clinical functions of the VA system. This would be done by converting the VA system into a government-sponsored, not-for-profit enterprise, which would allow greater flexibility in responding to the very different needs of veterans in the 21st century.

Under the new plan, veterans would be able to use their health insurance to seek care from the private sector. Freed from having to deal with just one provider, they would be able to receive better health care when and where they need it. It may seem like a small step for the VA system, but it’s a huge step for veterans in America.

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How can we end the opioid epidemic?

by Catherine Tims

Philip Seymour Hoffman, known for the title role in the film Capote, was an esteemed, Academy Award-winning actor. Loved by fans, praised by critics, and respected by his peers, he’ll be forever considered an icon of his generation of actors.

Unfortunately, he may also be remembered for his untimely death as a result of a heroin addiction. Since his overdose two years ago, he’s become an example of the terrible opioid epidemic in the United States.

Congress just recently passed a bill that aims to rid the country of this epidemic, hopefully saving the lives of thousands of individuals just like Mr. Hoffman.


How bad is the opioid epidemic?

According to a report issued by the White House, there was a 45 percent increase in heroin-related deaths between 2006 and 2010.  What’s even more alarming are the stats relating to opioid pain relievers (OPR), which often serve as gateway drugs for heroin.

While heroin deaths totaled 3,038 in 2010, OPR deaths in general were at an alarming 16,651. And that represents a 21 percent increase since 2006. Meanwhile, cocaine deaths have been falling steadily during that same period.

There’s a new bill in Congress.

Just this month, Congress passed a landmark bill that some say has the potential to reverse these addiction problems. It’s called the Comprehensive Addiction and Recovery Act (CARA), and one thing it authorizes is increased access to naloxone.

The so-called “overdose drug”, naloxone reverses the effects of an opioid overdose and has been an essential item in emergency rooms since the epidemic began. Once injected or sprayed into the nose, it works to stop an overdose within two minutes.

You may have heard of Narcan, which is actually the brand name of the nasal spray, whereas the drug itself is just called naloxone. Naloxone saves lives by binding to receptors in the brain, essentially shielding them from any further effects of the opioids. Then the breathing process – which has been slowed down by the overdose – can start up again.

Naloxone shots are carried by first responders, and now thanks to the recently-passed bill, more people will have access, too. Now, family members, people working in community centers, and schools will have access to the pens that help stop overdoses.

Naloxone is just the beginning.

Of course, the Comprehensive Addiction and Recovery Act isn’t just about increased access to naloxone. Obviously, reviving addicts who are near death isn’t going to put an end to the problem. As many in Congress have noted (and fiercely debated with their opponents), treatment and prevention is key.

The anti-addiction bill, which is now on its way to the White House for President Obama’s signature, does address this issue. Law enforcement officers may soon start choosing to treat drug offenders with alternative sentencing rather than shipping them off to jail. Plus, there’s plenty in the bill supporting increased treatment and prevention measures.

So, while naloxone saves lives (and now more of them can be saved thanks to this bill), it’s not going to solve the problem. Only time will tell if the Comprehensive Addiction and Recovery Act will help put an end to this terrible epidemic.

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Zika Update: Should pregnant women avoid travel to Miami?

by Lauren Mandel

In a historic announcement, the Centers for Disease Control and Prevention (CDC) issued a specific warning against traveling to certain areas of Miami. Fourteen women were diagnosed with Zika in a neighborhood just north of the popular travel destination in Florida, which means that some mosquitoes in the United States now have and can spread the virus.

Facebook august - baby

But what does this mean for travelers and even residents of Miami? And most specifically, are pregnant women in the Miami area – and across the country – in danger of contracting the Zika virus?

Until recently, the CDC had only issued travel warnings for areas outside the United States, including Rio de Janeiro and a majority of the Caribbean. But Monday morning, the CDC advised pregnant women to avoid traveling to a specific area of Miami.

If you live in or must travel to this area of Miami, the CDC suggests waiting at least 8 weeks after leaving the area to try to get pregnant.

However, there are many people – including pregnant women or male partners – who live in this area of Miami. If you or someone you know think they may have been exposed to the Zika virus, it’s important to get tested right away. In addition, it’s important to protect yourself from possible infection by wearing long sleeves and pants, using air conditioning when possible, and liberally using bug spray if you’ll be exposed to mosquitoes. You can view the full list of suggestions here.

GoHealth will continue to provide updates about Zika as they become available. You can read more about the Zika virus and its origin here.


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Moving this summer? You could get new health insurance

by Jenny Fliegel

The average person will move almost 12 times during his or her lifetime. That’s a lot of boxes, a lot of packing tape, and a lot of things to think about during each move. There may be a lot on your mind, but if there’s one thing to prioritize it’s health coverage. Knowing your options when it comes to health insurance will give you peace of mind during a not-so-peaceful time in your life.

Under the Affordable Care Act, moving is considered a Qualifying Life Event, which gives you the opportunity to find health coverage outside of Open Enrollment. If your health coverage is affected by your change in residence, you could qualify for a Special Enrollment Period and be able to enroll in new coverage within 60 days of your move.moving

But how do you know if you qualify for a Special Enrollment Period? If you move to a new area that offers different coverage options than your previous ZIP code, you will qualify. This remains true even if your current plan is still offered in your new location. Plans are usually based on region, and your new location may offer health plans with different or more affordable prices.

Some situations that would help you qualify might include moving to a different ZIP code or country, a student moving to or from the place they attended school, a seasonal worker moving to or from the place they lived and worked, moving to or from a shelter or traditional housing, or moving to the United States from a foreign country. Keep in mind that moving solely for a medical treatment or vacation doesn’t qualify you for a Special Enrollment Period.

In order for your move to be recognized as a Qualifying Life Event, you’ll need to provide documentation proof that the event occurred. And be sure to pay attention to the start and end dates of both your old and new plans to avoid a coverage gap or double payments.

GoHealth can help determine your eligibility for a Special Enrollment Period and help you find a health plan for your new location. Compare plans and learn more about the enrollment process at or by calling 888-322-7557 to talk to a GoHealth licensed agent.

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GoHealth acquires Connected Benefits to move into group insurance

by Lauren Mandel

Late last week, GoHealth announced its acquisition of Connected Benefits, a provider of employee benefits management software and group insurance solutions. The reason for the acquisition? GoHealth will now offer a seamless marketplace solution to address the growing health insurance needs of both individuals and employers. Facebook - jan tax penalty

In the United States, 90 percent of workers are at a company that offers health benefits to at least some employees. Average annual premiums are also rising at more than double the rate of employee wages, and individuals who do not have access to employer-sponsored coverage may struggle to afford it on their own. Employers and brokers need a platform that is easy to understand, quick to implement, and offers affordable employee health benefits.

GoHealth’s new all-in-one technology platform will enable brokers to help employers establish employee benefit levels, access available tax subsidies, determine their employer contributions, offer voluntary products such as disability, and implement their chosen benefits quickly and accurately.

GoHealth CEO, Clint Jones, said he’s “confident that our innovative technology platform will help employers better navigate changes in the health care industry.”

You can read the full announcement and more about the acquisition here.

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Election 2016: Health Care and the Affordable Care Act

by Lauren Mandel and Adam Tock

The Republican National Convention came to a close this past week in Cleveland, and the Democratic Party is hosting their own convention this week in Philadelphia. These events are just the beginning of Election 2016 and a long race toward the presidency, and both Hillary Clinton and Donald Trump are letting their policies be known.

Health care will be a particularly important topic for the candidates, and Clinton and Trump are still revealing the specifics of their potential plans for the Affordable Care Act.  In the chart below, we outlined each candidate’s thoughts on the health law, plus what they intend to change if they become the next President of the United States.

Clinton vs. Trump

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