UNDER 65 HEALTH INSURANCE PLANS

Because people under the age of 65 usually do not qualify for Medicare coverage, we have provided options for persons under 65. If you would like to learn about the specific requirements, visit our Medicare Eligibility for People Under 65 page.

Buffalo Health Advisors understand that the health insurance marketplace is an ever-changing environment that leads to mass confusion and stress. Especially when individual, family, and small businesses all require different products and coverage strategies.

We Help You Find the Right Health Insurance Plan

We have the ability to compare multiple plan options and provide you with the best health insurance in Tennessee or any state our advisors practice in. And, even better, we find the best health insurance plans available within your available budget. We offer:

• Major medical policies from top carriers such as:
  • Cigna
  • Aetna
  • Oscar
  • CVS Health
  • Anthem Blue Cross Blue Shield
  • Humana
• Medicare Advantage plans
• Short-term health coverage
• Medi-Share options
• Fixed benefit plans
• Guaranteed issue plan
• Dental
• Vision

Our health insurance agents work with each of these insurance providers to find the plan that is the exact fit for you. We don’t work for these companies, so we will never try to sell you a plan that you don’t need.

What is Short-Term Health Coverage?

Also known as term health insurance and temporary health insurance, short-term plans provide coverage when you’re between plans. For example, if you’re out of work and open enrollment is far away, you can receive temporary benefits until you can join a full plan.

Other qualifications for short-term coverage include waiting for coverage to start, or waiting for Medicare eligibility.

What is Medi-Share Coverage?

When you join Medi-Share, you join a community of people who share the costs for qualifying medical bills. You pay a certain amount each month that goes towards paying off your bills. When you hit the yearly payment amount, your payments go toward helping other members pay off their medical expenses.

What are Fixed Benefit Plans?

Also known as a fixed indemnity plan, these plans offer fixed yearly benefits. For example, you can choose plans that offer different numbers of doctors visits, or simply one wellness visit per year.

These plans are not designed for full medical coverage, but they are good options if you are in good health and would like to customize your plan.

What Does Guaranteed Issue Mean?

This is the protection of your rights to purchase health insurance. Essentially, this right prevents insurance providers from denying the sale of plans based on your current health, age, or gender. However, the guaranteed issue does not limit providers from increasing the cost of your plan.

Our health advisors are equipped to help you find out which one of these plans is right for you.

Meeting With a Health Insurance Agent

When you visit with one of our insurance agents, they’ll ask you about your medical history, your prescriptions and your other medical needs. Our agents use a variety of tools and specific questions to get you the healthcare coverage you need.

The Effect of the Affordable Care Act

Tennessee has defaulted to a federal health insurance exchange after the Affordable Care Act went into effect in 2010, so you must purchase a plan for the minimum essential coverage under the law. There is income-based assistance for plans in the Health Insurance Marketplace.

Essential benefits include:

• Emergency services
• Hospitalization
• Maternity and newborn care
• Mental health
• Prescription drugs
• Preventive medicine
• Emergency services
• Lab services
• Pediatric services

Plans that qualify and have minimum essential coverage include plans bought on the Health Insurance Marketplace, a “grandfathered” insurance plan since March 23, 2010 or earlier, a job-based plan, and more. Plans that don’t qualify are plans that only cover vision or dental, workers comp, or coverage for only a specific disease. If you have questions about your current insurance plan, contact Buffalo Health Advisors, LLC for assistance.

Enrollment Periods

It’s important to purchase coverage during the state’s open enrollment period, but there are life events that will allow you to purchase coverage at any time:

• Losing your employer coverage
• When COBRA coverage expires
• Getting married or divorced
• Losing coverage after turning 26
• Having a baby or adopting
• Moving to a new zip code
• Becoming a U.S. citizen
• Being discharged from the Armed Forces

A private individual or family health plan may be the right choice for you if these circumstances apply:

• Self-employment
• An employer doesn’t offer a group plan
• A group plan does not cover dependents
• If the plan you are on has a high premium
• You need different benefits

However, if you missed the 2019-2020 open enrollment period, there is a chance that you can still get health insurance.

Special Enrollment Periods

Because our lives are always changing, there are allowances for people to sign up outside of the normal enrollment periods. However, these special enrollment periods do have some requirements.

You may qualify for a special enrollment period if you have experienced one or more of the following.

• Losing employer-related health insurance
• Losing Medicaid Eligibility
• Losing coverage from a parent’s plan by turning 26
• Marriage or divorce
• Having a baby
• Adopting a child
• Death of a family member
• Moving
• Becoming a U.S. citizen

The special enrollment period opens immediately after one of these events occurs, and stays open for 60 days. If you try to buy health insurance during special enrollment, insurance companies usually require proof of a qualifying event.

This might look like providing birth certificates, adoption records, marriage licenses, housing papers, death certificates, and so on. If you want to sign up for health insurance, it can be overwhelming trying to jump through all the hoops on your own. Call one of our expert health insurance advisors, and we’ll help you get there.

Entering the Health Insurance Market

Because health insurance can be so overwhelming to navigate, here are a few things to consider as you begin looking for a plan. First, you should take note of your healthcare needs coming up in the near future.

While we don’t always know what the future will hold, there are certain treatments you can see on the horizon. For example, if you know you need your teeth looked at, you should tell your healthcare advisor that you need a plan with dental benefits.

Second, while you’re searching for Nashville health insurance, or in another city, you should look at your previous coverage. As you evaluate your past benefits, that will help you identify any changes you need to make.

In addition, you should consider which doctors you would prefer to see when you need to change your plan. Especially if you have a specialist that you prefer seeing on a regular basis.

Third, you should prepare a list of key prescriptions and formulations. Everyone’s list is different, so your list should be as accurate as possible to help you find the right plan. Doing so will reduce the risk of losing coverage for an important prescription that you can’t afford otherwise.

Call A Buffalo Health Insurance Agent

There are many policies available in the state of Tennessee to choose from. Not to mention, you can qualify for certain tax breaks if you meet certain Tennessee requirements.

We can’t say it enough–having health insurance helps when accidents occur. The protection it gives you and your family goes beyond the means and costs of a hospital visit. Call or visit Buffalo Health Advisors serving Nashville, TN, to learn how to get a health care plan for you and your family and if you have any questions about your policy.