Marketplace T.R.I.P. Process
Our road map to help you navigate Your Marketplace Journey with Confidence
Your Answers, Your Choices, Your Guide
Marketplace T.R.I.P. Process
Our road map to help you navigate Your Marketplace Journey with Confidence
Your Answers, Your Choices, Your Guide
This road map will guide you through the different mile markers you will encounter and need to understand on your Healthcare journey. Serving as your navigational guide, I highlight the options and empower you to choose. Each year during open enrollment we will recalculate to verify everything is still moving in the right direction.
This road map will guide you through the different mile markers you will encounter and need to understand on your Healthcare journey. Serving as your navigational guide, I highlight the options and empower you to choose. Each year during open enrollment we will recalculate to verify everything is still moving in the right direction.
Our T.R.I.P. Process
T - Take Time To Connect:
First, let's embark on a 20-minute chat where we will take time to connect, understand each other better, and uncover what truly matters to you. During this call we will delve into your current circumstances and explore your unique healthcare needs. It's an opportunity for us to lay the groundwork, ensuring we're aligned on your personal healthcare journey.
R - Realize Your Options:
During our Healthcare Comprehension Analysis, we'll meticulously walk through our comprehensive 17-point questionnaire. This questionnaire serves as a roadmap to uncover any uncertainties or misunderstandings you may have and help you realize your Marketplace options. We will cover the different plan types and the coverage they offer. Throughout this analysis, our goal is to empower you with knowledge and clarity, dispelling any confusion or misconceptions along the way.
I - Identifying Your Needs:
This involves a comprehensive exploration of various aspects of your life and healthcare preferences. Here's how we'll approach it:
Lifestyle: Understanding how you live your life allows us to tailor your Marketplace plan to seamlessly integrate with your lifestyle.
Existing Concerns or Prescriptions: Your current health concerns and prescription medications play a pivotal role in shaping your healthcare decisions. This information enables us to select a Marketplace plan that provides comprehensive coverage for your specific medical requirements.
Network Clarification: This ensures that you have access to the healthcare providers you trust, without unexpected out-of-network costs.
P - Put a Plan in Place:
We'll place you in a Marketplace plan that aligns with your specific needs and preferences, providing you with peace of mind.
Also, every year we will conduct a comprehensive review of your plan to ensure it continues to meet your evolving needs. Life is dynamic, and circumstances change. Whether it's shifts in your health status, changes to your prescriptions, or alterations in your financial situation, we'll evaluate your current plan and make adjustments as needed to keep you on the right track.
Our T.R.I.P. Process
T - Take Time To Connect:
First, let's embark on a 20-minute chat where we will take time to connect, understand each other better, and uncover what truly matters to you. During this call we will delve into your current circumstances and explore your unique healthcare needs. It's an opportunity for us to lay the groundwork, ensuring we're aligned on your personal healthcare journey.
R - Realize Your Options:
During our Healthcare Comprehension Analysis, we'll meticulously walk through our comprehensive 17-point questionnaire. This questionnaire serves as a roadmap to uncover any uncertainties or misunderstandings you may have and help you realize your Marketplace options. We will cover the different plan types and the coverage they offer. Throughout this analysis, our goal is to empower you with knowledge and clarity, dispelling any confusion or misconceptions along the way.
I - Identifying Your Needs:
This involves a comprehensive exploration of various aspects of your life and healthcare preferences. Here's how we'll approach it:
Lifestyle: Understanding how you live your life allows us to tailor your Marketplace plan to seamlessly integrate with your lifestyle.
Existing Concerns or Prescriptions: Your current health concerns and prescription medications play a pivotal role in shaping your healthcare decisions. This information enables us to select a Marketplace plan that provides comprehensive coverage for your specific medical requirements.
Network Clarification: This ensures that you have access to the healthcare providers you trust, without unexpected out-of-network costs.
P - Put a Plan in Place:
We'll place you in a Marketplace plan that aligns with your specific needs and preferences, providing you with peace of mind.
Also, every year we will conduct a comprehensive review of your plan to ensure it continues to meet your evolving needs. Life is dynamic, and circumstances change. Whether it's shifts in your health status, changes to your prescriptions, or alterations in your financial situation, we'll evaluate your current plan and make adjustments as needed to keep you on the right track.
Common health insurance terms and definitions to help you on your journey:
Premium:
The amount you pay for your health insurance plan, often monthly.
Deductible:
The amount you pay out-of-pocket for covered medical services before your insurance plan begins to pay.
Copayment (Copay):
A fixed dollar amount you pay for certain covered services, like a doctor's visit.
Coinsurance:
Your share of the costs of a covered healthcare service, calculated as a percentage (e.g., 20%) of the allowed amount for the service, after you've met your deductible.
Out-of-Pocket Maximum:
The most you will have to pay for covered services in a plan year.
Out-of-Network:
A provider who does not have a contract with your insurance plan.
Formulary:
A list of prescription drugs covered by your health insurance plan.
Claim:
A request for payment of benefits from your insurance company after receiving treatment or services.
Explanation of Benefits
(EOB):
A statement sent by your insurer after you receive care that details what the company paid and what you owe.
Prior Authorization:
The process where your health insurance company decides whether to cover a specific medical service or procedure before it happens.
Balance Billing:
When an out-of-network provider bills you for the difference between the amount they charge and the amount your plan pays.
Cost-Sharing:
The amount you pay to cover your share of costs for a covered health care service, in addition to your premium.
Common health insurance terms and definitions to help you on your journey:
Premium:
The amount you pay for your health insurance plan, often monthly.
Deductible:
The amount you pay out-of-pocket for covered medical services before your insurance plan begins to pay.
Copayment (Copay):
A fixed dollar amount you pay for certain covered services, like a doctor's visit.
Coinsurance:
Your share of the costs of a covered healthcare service, calculated as a percentage (e.g., 20%) of the allowed amount for the service, after you've met your deductible.
Out-of-Pocket Maximum:
The most you will have to pay for covered services in a plan year.
Out-of-Network:
A provider who does not have a contract with your insurance plan.
Formulary:
A list of prescription drugs covered by your health insurance plan.
Claim:
A request for payment of benefits from your insurance company after receiving treatment or services.
Explanation of Benefits
(EOB):
A statement sent by your insurer after you receive care that details what the company paid and what you owe.
Prior Authorization:
The process where your health insurance company decides whether to cover a specific medical service or procedure before it happens.
Balance Billing:
When an out-of-network provider bills you for the difference between the amount they charge and the amount your plan pays.
Cost-Sharing:
The amount you pay to cover your share of costs for a covered health care service, in addition to your premium.
Important Dates For Marketplace
Open Enrollment
Dates for 2025 is Nov. 1 to January 15
Open enrollment is a specific, annual period when individuals can sign up for or change their health insurance plans.
Important Dates For Marketplace
Open Enrollment
Dates for 2025 is Nov. 1 to January 15
Open enrollment is a specific, annual period when individuals can sign up for or change their health insurance plans.
We do not offer every plan available in your area. Please contact www.medicare.gov or 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or your local State Health Insurance Program (SHIP) to get information on all of your options.