Individual Health Plans

 

Updated 10/22/2017 (This page will be updated frequently)  

    President Trump ordered on 10/13 that 'Cost Sharing' Reduction payments will be not paid to Oregon.  Oregon is ordering plans to increase Silver plans by 7.1% to pay for this expected lost revenue.   The rates should be updated by November 1.

[Before you get digging into options, I want to reassure you that I will do all that I can to help you understand your options. It can be overwhelming to try to navigate so much information. Try not to worry as things change, just make the best decision you can from year to year]

ARE YOU ELIGIBLE FOR A TAX CREDIT?

    Before looking at the plans, use the Marketplace tool below to check to see if you may qualify for a tax credit.  You can only qualify for a tax credit if you purchase coverage through the Federal Marketplace.

 https://www.healthcare.gov/see-plans/


   This tool determination is not definitive tool. If it says you don't qualify for a tax credit, please, for your sake, verify this with me.  I've met many people who really did qualify for the tax credits and paid full price errantly.  I will have the link above updated by November 1 for 2018.

 

WHICH PLAN IS RIGHT FOR YOU?

     Something unique I offer my clients is a comparison of similar plans by type.  You can do this with 3 plans the Federal Marketplace website, but not quite like this.   Once you determine a plan you are interested in, the next step is to visit my page for that company (Like my Kaiser Page on the right tabs) to learn more, read the fine print, and read about some pertinent issues.

TOP 5 BRONZE PLANS COMPARED

    OK, Let's look at my comparison of the best Bronze/Lower cost plans for 2018 with Providence, Kaiser and Moda.  Please click on the link below to view:

Top 5 SILVER PLANS COMPARED

   I will have this on the page shortly.

 

KAISER PAGE

 

      To learn more about the Kaiser plans please click on my Kaiser Tab or just click the link below:

 http://www.danneils.citymax.com/kaiser-page.html

PROVIDENCE PAGE

     To learn more about the Kaiser plans please click on my Kaiser Tab or just click the link below:

MODA PAGE

 

 

PACIFICSOURCE PAGE

 

    PacificSource is offering 4 plans using the Legacy Health Network.  Plans are expensive, but available both on the Marketplace and direct.  The only other plan that uses the Legacy Network is HealthNet.  Visit my PacificSource page to learn more.

 

REGENCE  AND BRIDGESPAN PAGES:

     Regence is offered only direct, and Bridgespan will only be offered on the Marketplace.  Both companies will only be offering plans using the smaller OHSU Plus Network of providers.  If you are with one of these 2 companies, please check to see if your providers will be covered in 2018. 

MORE ABOUT THE TAX CREDITS:
 
    With rapidly rising premiums it is critically important to understand exactly how much you can earn and qualify for a monthly tax credit.  For example:  in 2017 (in Portland area), a couple age 60 can earn about $64,000 adjusted gross income to qualify for a $804 monthly tax credit, but earning $65,000 they qualify for $0 tax credit.  That knowledge could save this couple $9648 on their health insurance.  

     Consulting with my clients about issues like this is one of the many reasons to work with an broker like myself.  Web-brokers and Marketplace representatives just cannot help you understand the many issues beyond the price and coverage.

 

Try not to worry about how things may change in the future.
All we can do is plan one year at a time.

 

 

APPLY DIRECT VS MARKETPLACE

     Each year I am increasingly convinced that purchasing your plan through the Marketplace is to your advantage compared with buying direct.  

 

Marketplace Advantages



1.  TAX CREDITS:  You can only qualify for a tax credit if you have coverage through the Marketplace.  You may start the year not eligible, then life changes and you are.   You cannot apply mid year if you lose a job or have another life situation if you purchased your plan direct with the company.

2.  COVERAGE FOR KIDS:  If your children qualify for the free health care (Oregon Health Plan), buying through the Marketplace is the way to go and gets them enrolled in one step.

3. GRACE PERIOD:  After your first payment is made, you have a longer grace period with the Marketplace (90 days) compared with buying direct (20 days) should there be a billing snaffoo.  The carrier will drop you and not reinstate you, and you will be out of coverage for the rest of the year.

4.  FLEXIBILITY TO CHANGE PLANS:  If you have a major income change mid-year, you MAY be able to change plans if your coverage is through the Marketplace.  Buying direct robs you from this flexibility.

5.  ENROLLMENT EASE:   From the year with just a phone call to me we can discuss the plan changes and align your coverage to meet your needs for the coming year.   We can often complete the Marketplace application and plan enrollment over the phone with a screen-share so you can see what I  am doing at every step.

6.  INITIAL BILLING:   If you buy from Kaiser direct you need to pay at the point of application.  If you buy Kaiser through the Marketplace you do not need to pay at the point of selecting the plan.

7.  PLAN DESIGN FLEXIBILITY:  When you buy through the Marketplace you can select different family members to be on different plans with ease.  I will often recommend this as needs are sometimes different from person to person.  
 

 

WHERE TO START  

      IF YOU'RE ONE OF MY CLIENTS NOW:    

     If you are currently one of my clients you will be hearing from me by email in October about the upcoming Open Enrollment period.  I recommend we pencil in a time to talk between late October to early December at your convenience.  I know this isn't fun each year to do, but needful.    Please consider how your plan may have changed, and let's see if there is a new plan that may better meet your needs.   Friday, December 15 is the absolute last day you can change plans or renew, so please don't wait until then as the system my freeze on that day.

IF YOU'RE NOT MY CLIENT NOW

   I'm happy to help, but need to talk with you before I can make a recommendation.  Just so you know I am only compensated for my services if you list me as your agent on your direct-application or Marketplace application at no cost to you. How about we start with a phone call to talk over your situation.  I am best reached at 503-650-4325.   

So we've talked it over and you are ready to apply.    

 

PHONE & SCREEN-SHARE APPOINTMENTS  
   I found the most effective way to help most of my clients is a combination of a phone appointment, and 'Screen Sharing', so you can see my computer screen through your computer while we talk.   It's pretty easy:

1. Phone Appointment:  Call me to talk about your situation at 503-650-4325

2. Screen Sharing:   If you can be in front of a computer go to www.join.me and I'll give you a code to enter in the box that says "Join Meeting".  

    With screen sharing you can see my computer screen and I can share brochures, do a Marketplace application or Life Change for you, show you how to look up providers, and more.  It's and extremely effective way for me to advise you so you can follow easily what I am doing and saying.

IN-OFFICE APPOINTMENT

   Some of my clients like the face-to-face meeting in my office, which is fine, as I love to see you!  I'm generally available 9:00 am 5:00 pm most days.  If an evening or Saturday is your only time to talk we can arrange a special time.  You can reach Dan at 503-650-4325 to set up an appointment, or email me at danneils@gmail.com

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

     

Dan's Top 5 Bronze Plans compared

Click filename below to access file

2018_Dan_s_Top_5_Bronze_Plans_Compared.pdf