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QLE/SEP (Qualifying Life Event / Special Enrollment Period)

This is the only exception to the Open Enrollment rule.  If you have a QLE, you have a 60 day SEP to buy new individual health insurance or make changes to your existing plan.  Examples of QLE’s include marriage, divorce, birth of a child, moving to a new state, recent immigration to the US, loss of employer sponsored health insurance, COBRA running out, and more.  Please remember that ALL insurance companies are requiring paper documentation to prove your Qualifying Life

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Open Enrollment / OE

Under the guidelines of the Affordable Care Act (ObamaCare), this is the ONLY time of the year people can buy new individual health insurance or make changes to their existing plan.  Right now, those dates are November 1st through January 31st of every year, but for plans starting January 1st and later.

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Medicare-for-all

This is a universal health insurance model in which the federal Medicare program expands to cover everyone, but still allows for the purchase of private insurance to help supplement the coverage.

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AGI / Adjusted Gross Income

Line 37 on your 1040 tax form.  This is the income that determines whether or not you’re eligible for a federal subsidy to help pay for your individual health insurance.  In short, it’s your income after expenses but before taxes.  Simple.

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Are AHCA concerns making you sick? Pre-existing conditions and MacArthur and more….

Holy cow, folks!  What a crazy time for health insurance! Politics aside, The Insurance Mom wants you to be really, totally clear about what’s happening in the wacky world of health insurance. The first thing most clients ask me these days is about pre-existing conditions.  What if I have an illness before I buy health insurance?  What if my sick child loses coverage?  “What-ifs” all over the place! All we can do right now is breathe.  We don’t know what’s

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Have You Heard? BIG changes coming to health insurance in 2018! BEWARE – BE AWARE!!

In 2018, if you’re buying individual health insurance for you and the fam (not through an employer),  PAY ATTENTION! Open enrollment is scheduled to start NOVEMBER 1, 2017 (for new coverage starting January 1, 2018) NEW RULE:   Open enrollment will ONLY be for FORTY-FIVE days, ending December 15th.  That’s half of what it’s been in prior years.  YES!!!  No kidding.  PAY ATTENTION!!   Health insurance will be harder to buy – or change —  in 2018. So The Insurance

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Is TrumpCare my Care??

The Insurance Mom is back to blogging after a very busy Open Enrollment!  Thank you to all our followers and lovely clients who sent along referrals.  We are very grateful for you!   It’s been an interesting end of 2016 and beginning of 2017.  With that, we are seeing a TON of proposed changes that could affect your health insurance.    But, we probably won’t know for quite some time.   Remember, it takes a while to un-law a federal law!  

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Open Enrollment is almost here– Are YOU Ready!?

  Calling all insured and soon-to-be-insured!  Open Enrollment is JUST AROUND THE CORNER…. November 1 through January 31st.  Have you made an appointment to talk to your Insurance Mom? We posted this back in August in preparation and wanted to remind you what’s new for 2017.  Please review! —————————————————————————————————————————————— Are you ready for health insurance news for NEXT year??   Sit, get cawfee, or a cocktail and let’s tawk! This interesting article from the NY Times and this one from the

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“What’s Up, Doc?” Blog Series Part 11: All Better… But OUCH, This BILL!!

Oodles of gratitude for taking this virtual trip to the doctor with us!  Here’s even more in the series “What’s Up, Doc?”  Catch up with parts one, two, three, four, five, six, seven, eight, nine, and ten.  And now, our last in the series… “All Better… But Ouch, THIS BILL!!” Your doctor is IN-network right?    The doctor’s office MUST submit the bill (aka “the claim”) directly to your insurance company. The IN-network doctor CAN ask you for the office visit co-pay at

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“What’s Up, Doc?” Blog Series Part 10: Fanks, Doc, I Pheel Bmuch Mbetter

Hi again, my friends!  Thank you so much for taking the virtual blog version of a doctor’s office visit with us.  Here is our tenth part in the series, How to make the most of your office visit- a multi-part series.”  Check out parts one, two, three, four, five, six, seven, eight, and nine. And now, a segment we call “Fanks, Doc, I Pheeell Bmuch Mbetter.”  Your clothes are on and you’re out the door.  On your walk to the

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