Your Health insurance Coverage Depends on This Number

The people in the doctor’s waiting room watched with sympathy as an elderly lady, completely bent in half over her cane, shuffled from the door into the examining area.

Amazingly, half an hour later she emerged walking spritely, erect and with her head held high.

“It’s a miracle!” exclaimed one of the patients who’d been waiting. “She was bent over and now she’s walking upright!  The doctor has performed a miracle!”

“Miracle, shmiracle” said the old lady. “He gave me a taller cane.”

 

Your health insurance coverage depends on this number.

The Marketplace (Exchange) does not assign HMOs properly. Check your card.

The majority of health insurance plans offered by Ambetter, Cigna and Blue Cross are Health Maintenance Organizations (HMOs). (link to How the ACA has changed health insurance) Each HMO has a Medical Group or Site Number that must appear on your insurance card so you can get the insurance benefits you signed up for,

For instance, the medical group number for Blue Cross Blue Precision HMO for use in the Northshore University Health System may be 447 or 284.

BUT healthcare.gov doesn’t understand this. If you bought an HMO health insurance plan through them online or by phone, they never asked you for the Medical Group or Site Number of your HMO. They assign them willy-nillly.

You must call the Customer Service number on your new insurance card. Tell them what doctor/hospital you are using. They can look up the doctor’s HMO affiliation and  send  you a card with that number.

Do it at your earliest convenience. Your coverage depends on it.

Contact us if you have any questions at 847.362.8888


How to Avoid Losing Your New 2019 ACA Health Insurance

A guy is grocery shopping and notices he’s being followed by a little old lady. She smiles at him. Stares at him. When he stops, she stops. Finally, they meet up at the checkout counter.

She says sadly, “I hope I haven’t made you feel ill at ease; it’s just that you look so much like my late son.”

He’s touched and says, “That’s okay.”

She smiles, “I know it’s silly, but if you’d call out ‘Good bye, Mom’ as I leave the store, it would make me so happy.”

What can he do but agree? She goes through the checkout, and as she’s leaving the store, he calls, “Goodbye, Mom.”

The little old lady waves giving him a big smile and leaves.

Pleased that he has brought a little sunshine into someone’s day, he proceeds to pay for his groceries.

“That comes to $121.85,” says the clerk.

“Can’t be,” the guy says. “I only bought five items.”

“Oh, says the clerk. “Your mother said you’d be paying for her things, too.”

If you have individual/family major medical health insurance through Ambetter, Cigna or Blue Cross, you should have received information about your plan continuing into 2019. In most cases, if you’re keeping that plan, you don’t have to do anything other than keep paying your premium.

But if you are buying a new policy, there are deadlines for making the first month’s payment. Miss the deadline and you’ll lose your insurance. You cannot reapply. You won’t have insurance for 2019.

Here’s what you need to do to avoid that problem. Since Blue Cross is the only ACA provider of individual/family major medical health insurance in all Illinois counties, we’ll follow their system.

If you get your new health insurance through an agent (like us) or Blue Cross directly, you’re required to pay the first month’s premium when you apply. You’ll give Blue Cross your banking information for an EFT (Electronic Funds Transfer) or your credit card. Your binder payment is made. No need to worry.

If you get your new health insurance through the Exchange with premium assistance, the government will send your application to Blue Cross. (It takes about 5 days). You must then pay your portion of the premium before the effective date: January 1, 2019. You should get notice from Blue Cross that they have your application and a number to use when making your payment.

1. Call 800-538-8833. Important: Tell them you got your Blue Cross Insurance ON EXCHANGE. Then, they can find your account by your name and Social Security number.

2. Mail your check or money order to:

BCBSIL ON EXCHANGE

PO Box 650774

Dallas TX 75265-0774

3. Overnight your check or money order to

BCBSIL ON EXCHANGE c/o First Data/Remitco

1010 Mockingbird Lane, Suite 100, Box 650774

Dallas TX 75247

Remember: December 15th is the deadline to sign up for 2019 health insurance. You’ll need a specific “life qualifying event” to get health insurance after that date.

Jerry S. Pearlstein is the winner of the Healthcare.gov Elite Service Award.  

We’ve helped hundreds save thousands of dollars on their health insurance.

Call us: 847.362.8888. Let us help you, too.

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How to Get the Most Out of the Affordable Care Act

 

From Phyllis Diller

Cleaning your house while your kids are still growing up is like
shoveling the sidewalk before it stops snowing.

The reason women don’t play football is because 11 of them would never
wear the same outfit in public.

I want my children to have all the things I couldn’t afford. Then I
want to move in with them.

The only time I ever enjoyed ironing was the day I accidentally put
gin in the steam iron.

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How to Get the Most out of the Affordable Care Act

Since 2014 the Affordable Care Act (ACA) has governed health insurance for people under 65 who do not get group benefits from an employer or union; entrepreneurs, sole-practitioners, part-time and W2 workers. The focus of our practice.

Here are 4 tips for getting the most out of the ACA.

  1. Use all the benefits the law makes insurers offer you.

Apply for insurance even if you have a pre-existing condition, even if you’re pregnant. You will be insured without paying more than someone in good health. Get your free annual wellness visit. Get the free inoculations and dentist check-ups for your children. IVF is covered. Once your maximum out-of-pocket is reached, the insurer must pay 100% of medical care, no limit. Do all the things you and your health care provider feel are necessary for your health.

  1. Apply on time.

Get your insurance during the enrollment periods the ACA sets. You cannot buy or change whenever you want. You must apply between November 1 and December 15 to have health insurance in 2019. If you don’t, you will not be able to buy major medical health insurance except for specific life events like turning 26, losing group benefits, getting married or divorce, moving.

  1. Make sure your doctor and hospital accept the plan you enroll in.

There is no one insurance card individuals/families who have ACA insurance can use at all area and hospitals. Unfortunately, the government resources at the Exchange still don’t understand what plans cover what health care in our area. Use a qualified agent.

  1. Get Premium Assistance and Cost Sharing when you’re eligible.

Based on projected income (not assets), the government will pay part of your premium and even share the cost of your deductible and out-of-pocket maximum. If you’re in job transition, have your own business, just want to know if you qualify, please call us.

Jerry S. Pearlstein Insurance was awarded the 2018 healthcare.gov Elite Certificate of Recognition for getting hundreds of individuals/families into the right plan with savings of thousands of dollars.

Small group health insurance offers ACA benefits, too. And more access to care than individual/family plans. Ask us how small a group can be.

Don’t wait. You have until December 15th. Call 847.362.8888 today to find out how to get the most out of your health insurance.

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Alert: Open Enrollment Begins Today

Open Enrollment for 2019 Affordable Care Act Individual and Family Health Insurance begins today.

  • Has your plan been discontinued?
  • Are you looking for better options?
  • Are you eligible for premium assistance or cost sharing?
  • Can you benefit from small group health insurance?

You have from today until December 15th to enroll for 2019.

Winner of the healthcare.gov Elite service award, Jerry S. Pearlstein Insurance Ltd. offers free help. 847.362.8888.

Caution: Whether online or by phone, the government continues to misinform about what plan covers what care in our area. These mistakes are difficult to undo. Please call 847.362.8888 for free help.

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How Can I Get Help Paying Health Insurance Premiums? And More…

A teenager loses a contact lens while playing basketball in his driveway. He gets down on his hands and knees and searches every inch but it’s fruitless. So finally, he has to tell his mom what happened.

She comes out of the house, takes a walk around and within minutes she finds the lens.

“I looked everywhere,” whines her son. “How did you do that?”

“We weren’t looking for the same thing,” she explains. “You were looking for a small piece of plastic. I, on the other hand, was looking for $150!”

The Affordable Care Act offers help paying premiums for ACA individual and family health insurance. This is called Premium Assistance or a Tax Credit.

There’s also help meeting deductibles and out-of-pocket expenses. This is called Cost Sharing.

Jerry S. Pearlstein Insurance has earned the 2018 healthcare.gov Elite Circle of Champions award for taking hundreds of people through this process and saving them thousands of dollars.

  • Assistance and Cost Sharing are based on a projection of your 2019 taxable adjusted gross household income. Yes, this is a projection. We can help you make it even if you’re out of work now or if your earnings depend on sales or a bonus that you can’t predict.
  • After determining your projected income, we’ll tell you if you’re eligible for assistance or cost sharing.
  • We’ll help determine which 2019 ACA health insurance plan best fits your needs and gets the greatest benefits from the government.
  • We’ll be with you on a conference call with the government to help you answer their questions…and yours…to get the health insurance plan you want with the Assistance and Cost Sharing you’re eligible for.
  • We’ll make sure the government information reaches the insurance company, that your plan is properly issued and that the government is making their payments properly. We’ll show you how you can track this, too.
  • If there are any adjustments that need to be made throughout the year, we’ll help.

***To date online enrollment systems and “navigators” have not been aware of how coverage works in our area. It is very hard to undo their mistakes of placing you in the wrong plan.

Award winning agents Jerry Pearlstein and Rebecca Bloomfield are certified by the federal government and licensed by the state of Illinois to do this work with you. We’re up-to-date on what you need and how to get it. Enrollment services are free.

Act now. Open Enrollment begins November 1. You must apply by December 15th.

We’ll help you from the beginning and through the whole process. Call us for this free service. Or just to find out if you’re eligible. 847.362.8888.

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The Healthcare.gov Elite Certificate of Recognition

Billboards Outside Indian Hills, Colorado (true)

Cow grazes in pot field. The steaks have never been higher.

Becoming a vegan would be a big missed steak.

Electricians have to strip to make ends meet.

Dogs can’t operate MRI machines. But cats scan.

Life is short. If you can’t laugh at yourself, call me. I will.

The Healthcare.gov Elite Certificate of Recognition.

Why is the government  recognizing our work?

The certificate from the Health Insurance Marketplace reads: “This certificate is proudly presented to Jerry S. Pearlstein Insurance Ltd. in appreciation of your ongoing contribution and success during the 2018 Health Insurance Marketplace Open Enrollment period. Thanks to your hard work, you have increased access to health care and made a lasting positive impact on your community.”

Our Mission has always been to help independents get the best benefits: health, Medicare, disability, life and long-term care insurance. The Affordable Care Act has presented opportunities and challenges we didn’t contemplate 17 years ago.

We’re accredited with the Health Insurance Marketplace, ACA as well as non-ACA health insurance providers. We’re educated on government procedures and health insurance providers’ plans.

We pass that education on in these newsletters, Alerts, public presentations and counselling sessions for people on COBRA.  We use it with every individual, family, small business that asks for our help.

As Open Enrollments for Medicare, Affordable Care Act and Small Group health insurance approach, we’re ready to assist you step-by-step to get the best health insurance plan at the best price.

This award acknowledges how well we do this  including government assistance if you’re eligible.

We’re proud of the service we give our clients. Our clients tell us they appreciate our help by returning and referring. And now, the government has told us they appreciate us, too.

We’re very proud.

Jerry Pearlstein

Rebecca Bloomfield

 

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What Will Your Health Insurance Look Like in 2019?

A new minister is called at the last minute to do the funeral rites of a homeless man. He follows directions to what he thinks is the poverty section of the cemetery. There’s no hearse or mourners, but this was a homeless guy. He does see the backhoe and the crew and the big hole, so he begins a service.

As he says the prayers, his heart is opened to the idea of being homeless and friendless and he pours his heart out to show the deceased some love. The crew is moved, too. They began to add “Amen” and “Praise the Lord” and “Hallelujah.”

When the young preacher finishes, one of the workers shakes his hand and says, “I ain’t never seen anything like that before, Preacher. And I been digging septic tanks for 20 years.”

 

What Will Your Health Insurance Look Like in 2019?

Open Enrollment for 2019 health insurance is November 1- December 15. Small Group Special Enrollment is November 15-December 15. Here’s what 2019 looks like for individuals, families and entrepreneurs.

Tax Penalty Removed.

Last November, Congress removed this penalty for not having ACA-compliant health insurance

 

New options in non-ACA plans.

Providers like Humana and United Health Care will offer indemnity plans that should be available without penalty. These plans are considerably less expensive than ACA. If you are healthy, they are an excellent new option. But you must understand how they work. Ask an expert.

 

Congress extends Catastrophic Health Insurance coverage periods.

If you are between jobs, between semesters, these are excellent plans at a very low cost. In May, Congress said you could buy one for up to 364 days. But there is a bill on Gov. Rauner’s desk to limit the coverage period to 6 months.

Again, you must understand how catastrophic health insurance works. Ask an expert.

 

Blue Cross and Cigna file for new premiums.

It is reported that Blue Cross will reduce individual/family health insurance premiums slightly for most plans in 2019.

Cigna will increase premiums 10+%.

 

Premium Assistance for ACA plans continues.

We’re almost 100% successful in determining if you are eligible and getting you assistance paying premiums and cost-sharing. We’re ready to help again

 

Group Health Insurance is more attractive

Blue Cross reduced group health insurance premiums in July. We’ve helped establish groups for entrepreneurs and sole practitioners. Check out the Group Special Enrollment Period November 15-December 15. It waives an employer’s obligation to pay any part of the employees’ premium.

 

Once again, Jerry Pearlstein and Rebecca Bloomfield are fully accredited and licensed nationally and by the state to get the latest and best health insurance for you.

We’ll be holding free information sessions on New Options in Health Insurance

Sept. 24 Blossom Café 8349 W. Lawrence, Norridge 8:30-10am Networking and $16 for breakfast.

Oct. 3 Northbrook Chamber office 2002 Walters Ave, Northbrook  Noon-1pm Brown bag lunch

Oct. 4 Skokie Library Business Center 5212 Oakton St. , Skokie 5:15-6:15pm

Oct. 11 LifeWorking Coworking 717 Forest Ave, Lake Forest Noon-1pm Brown bag lunch

Start a conversation with us now. Call us at 847-362-8888.

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