Healthcare in the United States

The Affordable Care Act (ACA), also known as Obamacare, and Medicare and Medicaid are three (3) government programs that provide health insurance coverage to millions of Americans. However, there are some key differences between the three programs. The ACA is a health care reform law that was enacted in 2010. The ACA expanded health insurance coverage to millions of Americans by creating new marketplaces where people can shop for and compare health insurance plans. The ACA also made it illegal for insurance companies to deny coverage to people with pre-existing conditions.  McNichol Financial, a leading provider of health insurance coverage, can help you compare different health insurance plans and choose the one that is right for you. We can also answer any questions you have about health insurance coverage.

• February 2023, Governor Brian P. Kemp of Georgia designated a transition to a State- based Exchange (SBE).
  During Open Enrollment 2025, Georgians will be able to visit GeorgiaAccess.gov to shop for, compare, and directly enroll in health insurance coverage, and how to enroll in health insurance for 2024. Georgians should continue to shop for and enroll in health insurance coverage as they do today on the Federally-facilitated Exchange, also known as Healthcare and dental care.gov.

Medicare is a federal health insurance program for people aged 65 and older, as well as certain younger people with disabilities. Medicare is divided into two parts: Part A covers hospital stays, skilled nursing facility care, hospice care, and some home health care; Part B covers doctor’s services, outpatient care, medical supplies, and preventive services.

• Medicaid is a joint Federal and State health insurance program for people with low incomes and resources. Medicaid covers a wide range of health services, including doctor’s visits, hospital stays, Medicare prescription drugs, and a Medicare dental plan design for seniors.

and vision insurance care.

Summarized key differences between the ACA, Medicare, and Medicaid:

Eligibility	Coverage
Most Americans are eligible to purchase health insurance through the ACA marketplaces. ACA Marketplace:McNichol Financial can shop for and know how to compare health insurance plans and know “how to choose the right health insurance plan for me” from the ACA Marketplace. We can also show you how to enroll in health insurance plan that is right for you.	The ACA requires all health insurance plans to cover a set of essential health benefits, including doctor’s visits, hospital stays, prescription drugs, and mental health care.
People aged 65 and older, as well as certain younger people with disabilities. Medicare:If you are eligible for Medicare, McNichol Financial can help you choose a Medicare Advantage Plan, or a Medicare Supplement plan that meets your needs. We can also help you enroll in Medicare Part D plan.	Medicare and Medicare Supplement plans cover hospital stays, skilled nursing facility care, hospice care, and some home health care. Medicare also offers Medicare supplement plans with drugs coverage through Medicare Part D plans.
People with low incomes and resources. Medicaid:McNichol Financial can help you determine if you are eligible for Medicaid and can assist you with the enrollment process.	Medicaid covers a wide range of health services, including doctor’s visits, hospital stays, prescription drugs, and dental and vision insurance.

Which program is right for you?

The best way to determine which health insurance program is right for you is to consider your individual needs and circumstances. If you are age 65 or older, or if you have a qualifying disability, you may be eligible for Medicare. If you have low income and resources, you may be eligible for Medicaid. If you are not eligible for Medicare or Medicaid, you may be able to purchase health insurance through the ACA marketplaces.

How to compare health insurance plans

When comparing health insurance plans, it is important to consider the following factors:

• Cost: How much may you pay in monthly premiums, deductibles, copays, and coinsurance?
• Coverage: What services are covered by the plan?
• Network: Which doctors and hospitals are in the plan’s network?
• Quality: What is the quality of care provided by the plan’s doctors and hospitals?

How to choose the right health insurance plan for you

The best health insurance plan for you may depend on your individual needs and circumstances. Consider the following factors when making your decision:

• Age: If you are 65 or older, you may be eligible for Medicare. Medicare is a good option for many people, but it may not be the best choice for everyone. For example, if you have a high income, you may have to pay higher Medicare premiums.
• Health: If you have a chronic health condition or a pre-existing condition, you may need to choose a plan that covers your needs. Some plans may have exclusions or restrictions on coverage for certain conditions.
• Medications: If you get prescription from a Medicare Part D plan, you may need to choose a plan that covers your medications. Make sure to check the plan’s formulary to see if your medications are covered.
• Budget: How much can you afford to spend on health insurance premiums? Keep in mind that you may also have to pay deductibles, copays, and coinsurance.

How to enroll in health insurance

• If you are eligible for Medicare or Medicare Advantage, you can enroll online at the Medicare website or by calling McNichol Financial, a leading provider of health and Medicare dental plans and vision insurance care plans at 1-678-575-8494.

If you are eligible for Medicaid, you can enroll through your state’s Medicaid agency. You can find your state’s Medicaid agency by visiting the Medicaid website.

The yearly period (November 1 – January 15) when people can enroll in a Marketplace health insurance plan. Outside Open Enrollment, you may still be able to enroll in Marketplace coverage if you have certain life events, like getting married, having a baby, or losing other health coverage, or based on your estimated household income.

• Job-based plans may have different Open Enrollment Periods. Check with your employer.
• You can apply and enroll in Medicaid or the Children’s Health Insurance Program (CHIP) any time of year.

Healthcare and dental Insurance plan type	Annual enrollment period
ACA Marketplace plan	November 1 – January 15
Medicare Advantage plan	October 15 – December 7

How to file a health insurance claim

If you receive medical care from a doctor or hospital that is in your health plan’s network, you may need to file a claim, or an appeal, with your insurance company to get reimbursed for the cost of care. To file a claim, you may need to provide your insurance company with information about the services you received, the date of service, and the cost of service.

How to get health insurance without a job

If you do not have a job, you may still be able to get health insurance. There are several government and private programs that offer health insurance to people without jobs. You can learn more about these programs by visiting the Healthcare, Medicare dental plans and vision insurance at Healthcare.gov. or from United Healthcare.

Health insurance for small businesses

Small businesses can offer health insurance to their employees through group health plans. Group health plans can be less expensive than individual health plans, and they offer a wider range of coverage options.

Health insurance for self-employed

Self-employed people can purchase health insurance through the individual market. The individual market is a marketplace where individuals can shop for and compare health plans.

Health insurance for retirees

Retirees can get health insurance through Medicare, Medicaid, or private health plans. If you are retired and have Medicare, you may also want to consider purchasing a Medicare supplement plan or a Medicare prescription drug plan.

Healthcare and dental Insurance care for non-citizens

Non-citizens in the United States may be eligible for health insurance coverage through a variety of programs, depending on their immigration status and income.

• Lawfully present immigrants: Lawfully present immigrants are generally eligible for coverage through the Health Insurance Marketplace, Medicaid, and Medicare. However, there are some restrictions on coverage for certain groups of immigrants. For example, most lawful permanent residents (green card holders) must wait five years before they are eligible for Medicaid.
• Undocumented immigrants: Undocumented immigrants are not eligible for coverage through the Health Insurance Marketplace, Medicaid, or Medicare. However, there are some limited options for undocumented immigrants to obtain health insurance coverage, such as through emergency Medicaid or through private health insurance plans that do not require proof of citizenship or immigration status.

Health insurance for veterans

Veterans may be eligible for health care through the Veterans Health Administration

Healthcare and Medicare dental plan agents and brokers

Healthcare and dental care insurance agents and brokers are licensed professionals who can help you find and enroll in a health insurance plan. They can also answer your questions about health insurance and help you understand your coverage options.

Agents typically work for a single insurance company and represent that company’s products and services. Brokers represent you, the customer, and can shop around with multiple insurance companies to find the best plan for your needs and budget.

Here are some of the things that healthcare and Medicare dental insurance agents and brokers can do for you:

• Help you understand your health insurance needs and budget.
• Explain the different types of health insurance plans available.
• Compare plans from different insurance companies.
• Help you choose the right plan for you and your family.
• Enroll in a health insurance plan.
• Answer your questions about health insurance and your coverage options.
• Assist you with filing claims.

• If you are considering using a healthcare and Medicare dental plans agent or broker, here are a few things to keep in mind:
• Make sure the agent or broker is licensed in your state. You can check your state’s insurance department website to verify their license status.
• Ask about the agent’s or broker’s fees. Some agents and brokers charge fees for their services, while others are paid commissions by the insurance companies they represent.
• Be clear about your needs and budget. This will help the agent or broker find the best plan for you.
• Don’t feel pressured to sign up for a plan right away. Take your time and compare plans from different insurance companies before deciding.

McNichol Financial can help you choose the right health insurance plan for your needs and budget. We can also help you enroll in a plan and answer any questions you have about health insurance coverage.  Contact McNichol Financial, a trusted source for information on health insurance today to learn more about your health insurance options. We can help you choose the right plan for you and your family.

Licensed and Authorized in the following States: Georgia (GA), Florida (FL), Connecticut (CT), Texas (TX), Georgia (GA) Mississippi (MS), Tennessee (TN).

We are agents representing Insurance Carriers (Companies):

• Aetna
• Anthem Blue Cross Blue Shield
• Humana
• Cigna
• Mutual of Omaha, 
• United Healthcare, 
• Wellcare 
• Medico
• Ambetter
• Health First
• Molina 
• Capital Health Plan
• Oscar Health
• Aetna CVS Health
• AmeriHealth Caritas Next
• Dominion Dental Services, Inc.
• Alliant Health Plans
• Ambetter from Peach State Health Plan
• Blue Cross Blue Shield Healthcare Plan of Georgia
• Kaiser Permanente
• UnitedHealthcare
• CareSource
• Oscar Health
• Vantage Health Plan of Mississippi
• US Health and Life
• Educators Health Plans Life, Accident, and Health, Inc
• Cigna Healthcare
• Community First Health Plans  
• Community Health Choice
• Scott and White Health Plan
• Moda Health, Inc.
• Solstice Healthplans of Texas, Inc.
• US Health and Life
• Imperial Insurance Companies, Inc.