Naples Florida Health Insurance Agency
Kast Health Insurance has been providing health insurance to the local Naples market and the surrounding areas of Bonita Springs, Marco Island, Estero, and Ft. Myers since 2005. We can show you all health coverage options available and simplify the application process. Our experienced professionals can help you get the most for your money. We offer:
Affordable Care Act Plans are plans that qualify for the Affordable Care Act which was passed March 23rd 2010. Most all group plans as they exist today are Affordable Care Act qualified plans as these are the norm. Very few companies offer individual Affordable Care Act Qualified Plans, but we can offer them. All must allow those with pre-existing conditions, even on day one of coverage. All have 10 essential benefits as designated by congress. These benefits are:
- Outpatient services
- Emergency services
- Maternity/newborn care
- Mental health/substance abuse
- Prescription drugs
- Rehab services
- Pediatric services
Obamacare is not a defined term so it’s important to understand that it means different things to different people. Usually, Obamacare refers to a plan that is “subsidized” by the government. These subsidies are given in the form of a tax credit, which are based on income. Generally, if you are single, and your income is under $48000/yr, you will qualify. If you are married, and your income is under $65,000/yr, you should qualify. But we would recommend you call us so that you understand the process completely based on your income and family size which is highly individualized. You may be surprised that you can get a tax credit through preparing ahead. But in any case, we can help you understand and best qualify for Obamacare.
Private plans refer to the plans that are sold by insurance companies. These come in all forms of plans for all ages which we can offer:
- For under 65, examples are full major medical plans, short term, cancer, sickness, and limited benefit plans. Just because a plan is private, does not mean it cannot be subsidized with tax credits (also referred to as Obamacare). Right now, the only plans that qualify for subsidies are Affordable Care Act qualified plans, but it the future, it is possible that other plans will qualify. The Trump administration has proposed allowing for other plans such as Short Term Plans to be able to use tax subsidies.
- For over 65 private plans include Medicare Supplements and Medicare Advantage plans.
Many companies sell short term coverage. These plans are very limited, though they have been extended (in some cases) to 3 years of coverage. Anyone with pre-existing conditions should know that they will not be covered for anything that has been diagnosed with in the past, or even anything they should have known about. This includes if you have been taking drugs for high blood pressure, and it is controlled. Drug, mental health, maternity coverages are limited if they exist at all. Insurance companies will tell you “these plans are not for everybody” and they mean it. Short term plans are meant as a “band aid” to cover between other policies. We can help you if you have the need.
Medicare plans are a hybrid between the government and private plans. The government sponsors part A and B coverage. Private plans offer Supplements, Part C, and Part D plans. If you are eligible for Medicare, it will be critical to get educated on your choices before committing. You have two distinct choices:
- Stick with Traditional (Original) Medicare Part A and B. Add a Prescription Drug Plan (Part D). Add a Supplement.
- Purchase Part C coverage (Medicare Advantage).
There are big differences between both, and in some cases, you may never be able to change your choice. We can educate you and help you proceed in the best way possible for your situation.
Alternative Options refer to options outside of Obamacare or Affordable Care Act plans. Usually, these options include Short Term Plans, Christian Healthsharing, Critical Illness/Cancer Plans, Limited Indemnity Plans, and Association Plans. There are few real options that will cover individuals in the same manner that people are used to seeing under group plans or individual ACA plans. It seems that more and more there are “holes” in the newer plans and gaps in coverage. Prescription drugs are rarely covered outside of Affordable Care Act Plans. If there is coverage, there are severe limitations, generally $3000/yr maximums or less. Should a person have cancer, would $3000/yr be enough to cover the drugs? This is a question many people will need to consider before moving forward on such options. But in any case, you will understand your plan before purchasing and we can be your advocate.
Most importantly, Christian Healthsharing is not considered insurance. These plans are based on Christian faith, and as such, you will need to sign a “statement of faith” in most cases. These plans are becoming more popular because they are actually written into the Affordable Care Act and considered legitimate health coverage options. Interestingly, some of these plans eliminate pre-existing condition exclusions after a period of time (unlike short term plans today), and can be a realistic way to count on help to cover health care costs for an unexpected incident. However, since they are not insurance, they are not regulated by the state insurance commissions, so there is an element of financial risk that they can go out of business. In addition, most do not cover Rx or have drastic limitations. We can help you fully understand the process and what to expect.
On June 13, 2019, the U.S. Departments of Health and Human Services, Labor and the Treasury issued a final rule allowing employers of all sizes that do not offer a group coverage plan to fund a new kind of health reimbursement arrangement (HRA), known as an individual coverage HRA (ICHRA). The departments also posted FAQs on the new rule.
Health Savings Accounts have evolved over the years and work effectively with many individual plans. We can guide you and help you set up and account if you qualify for this type of arrangement.
Up until now, direct primary care and concierge relationships were not considered qualified expenses under the IRS guidelines. This will likely change in the near future.