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on health insurance
for Medicare beneficiaries
or any other type of
health or life insurance!
Request An Affordable Care Act Quote!
Call today for quotes on health insurance for
Medicare beneficiaries
or any other type of health or life insurance!

What's Better For Me? A Traditional Health Plan Or A Plan That Permits Funding A Health Savings Account (HSA)?

What's An HSA?

Health Savings Accounts (HSA’s) can be used in conjunction with High Deductible Health Plans that have out-of-pocket maximums at or below $8,050 ($8,300 in 2025) for individuals or $16,100 ($16,600 in 2025) for families and that pay 100% of all covered expenses after the out-of-pocket maximum is reached.

Higher individual and family out-of-pocket maximums are permitted for ACA plans ($9,450/$18,900 individual and family maximums respectively for 2024 and $9,200/$18,400 for 2025), BUT HSAs cannot be established for any High Deductible Health Plan that has out-of-pocket maximums that exceed the $8,050/$16,100 threshold per individua/family for 2024 and $8,300/$16,600 for 2025.

Per Affordable Care Act requirements, these plans must cover 100% of preventive care benefits without a deductible. In accordance with IRS guidelines issued in 2019, carriers can cover certain chronic condition treatments as preventive care. For example, some carriers consider generic ACE inhibitors, beta blockers, statins and certain insulins or other glucose-lowering agents as preventive treatments under these guidelines.

People who establish an HSA account can fund that account with a bank or other financial institution and use that account (usually through use of a debit card) to pay for any qualified medical expense (generally any health, dental or vision care expense excluding cosmetic procedures). Annual contribution limits for an HSA are $4,150 ($4,300 for 2025) for an individual and $8,300 ($8,550 for 2025) for a family respectively for 2024. In addition, individuals 55 or over can make yearly "catch-up" contributions of $1,000, but only one catch up contribution can be made per HSA account (each family member can have a separate account).

Amounts contributed to a Health Savings Account are tax deductible. This means that someone who pays for an expense from his or her Health Savings Account saves the equivalent of that person's federal marginal tax rate (and state marginal tax rate in almost all states with state income taxes), including taxes for Social Security and Medicare. For example, an individual who has a $1,000 expense to pay and who has a 32% federal marginal tax rate and no state income tax will only be paying $680 for the service if s/he pays that from his or her Health Savings Account.


How Does A Traditional Office Visit Co Pay Plan Work?

Traditional office visit copay plans have a copay for items like doctors' visits and a deductible (possibly with coinsurance thereafter) for major expenses like hospitalization. Some ACA plans have copays for primary care office visits (or copays for a limited number of primary care office visits), and specialist (and, if applicable additional primary care) visits are covered after the deductible. With other copay plans all primary and specialist visits have copays.

These plans include drug coverage. Drug plans may have separate deductibles for the hospital/medical portion of the plan, BUT covered expenses for drugs count against the plan’s maximum out-of-pocket limit. (NOTE: some office visit copays have no deductibles at all, others have a deductible only for hospital/medical, and others may have separate deductibles for both hospital/medical AND drug coverage).

The ACA permits only two individual deductibles and one family deductible. Hospital/medical deductibles, copays and coinsurance AND drug deductibles, copays, and coinsurance, as applicable, count against the maximum out-of-pocket limit.


What Does This Mean For Me?

An individual or family purchasing an Affordable Care Act plan will normally have choices to select EITHER a High Deductible Health Plan (with or without a separate HSA account) or a traditional office visit copay plan. Individuals who have always had traditional office visit copay plans may find that it's more cost effective to purchase a High Deductible Health Plan and fund a Health Savings Account.

Schedule For 2024
Affordable Care Act Enrollment

Affordable Care Act open enrollment for 2024 plans began November 1, 2023 and ended January 16, 2024 on the Federal Facilitated Marketplace (https://www.healthcare.gov).

You’re eligible to enroll ONLY if you have a Qualifying Life Event.
There are no pre-existing condition limitations.

Call Us At 786-970-0740 (Cell)
to determine what kind of plan you may be eligible for.


2025 Annual Enrollment Period For Medicare Beneficiaries

Marketing for 2025 Medicare Advantage, Medicare Advantage Prescription Drug, and separate Medicare drug coverage (Part D) began October 1, 2024. Medicare beneficiaries can enroll in or change plans for 2025 by enrolling during the Annual Enrollment Period between October 15 and December 7 for a January 1, 2025 effective date. Individuals who want to keep their present plans, if they are available for 2025, do not need to submit enrollment applications. Individuals with terminating plans have until February 28 to enroll in a new plan but should enroll by December 31 to have a January 1, 2025 effective date. Except for individuals wishing to enroll in a Chronic Special Needs Plan, there are no health questions to qualify.

Medicare beneficiaries can enroll in a Medicare Supplement plan within 6 months of their Part A and B effective dates without answering health questions. Generally, individuals with Medicare Supplement plans can change plans at any time but in many cases will need to answer health questions to qualify. Individuals who have Medicare Advantage plans can enroll in Medicare Supplement plans during the Annual Enrollment Period but in most cases will have to answer health questions. There are special rules for individuals with “trial rights” or eligibility for guaranteed issue policies that don’t require answering health questions.

Call us at 561-734-3884 or 877-734-3884 (TTY: 711) for details.

family consulting

We offer a comprehensive set of Affordable Care Act (“Obamacare”) plans

to individuals and families qualified to buy health (tax- and non-tax subsidized) insurance and dental/vision and/or hearing plans through the Federal marketplace (this is called buying “on-exchange” or “on-marketplace”) or directly from insurance carriers (this is referred to as buying “off-exchange or -marketplace”). Our Affordable Care Act policies comply with the Affordable Care Act and contain all of the “essential health benefits” required by that law.

We offer individual group health insurance plans

as an alternative to individual and family Affordable Care Act plans to those who can’t qualify
and/or who are looking for less expensive alternatives.

The dental/vision and/or hearing insurance

products are available both on an insured or discount basis

We offer short-term health insurance policies

for those who are looking for more inexpensive coverage and shorter term alternatives.

We offer Medicare Supplement, Medicare Advantage, and Part D Drug plans

to Medicare-eligibles. Our site is compliant with federal, state, and carrier guidelines in selling these policies. See the Medicare-eligibles section of this site for details.

We represent many carriers that offer supplemental benefits

to both individuals and families and Medicare beneficiaries, and the site contains information about hospital indemnity, cancer, critical illness, accident, and international medical insurance offered by many different carriers. This section of the site also contains valuable information and tools about lowering the cost of prescription medications. Call us if you want more information about or would like to enroll in one of these products.

We also offer Short- and Long-Term Disability products

and can also help you meet the costs of long-term care, nursing home, or short-term (recovery) care needs.

Finally, we have a complete array of Life, Final Expense, and Annuity products

and offer pre-need services in Florida, as we have both life insurance and pre-need licenses in that state.

You pay nothing for our services:

we’re paid directly from the carriers we represent, Premiums are NEVER EVER marked up to include paying us for our services: you pay the same whether you order directly from the carrier or the marketplace on your own or directly through us or from our site.

We ONLY offer alternatives that are suitable for you and for which we feel meet YOUR needs.
When or if we feel a product or service is not appropriate for you from either a cost or benefit point of view we will tell you so.

We’re fully compliant with privacy and security guidelines, have signed all required privacy and security agreements, have developed a privacy and security policy, and take extraordinary steps to safeguard your protected health and personal information.
In short, we’re experts in all aspects of health and life insurance and also have relationships with professionals who can help you with very specialized situations.

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561-734-3884 or 877-734-3884
(TTY 711)