Ask a Health Agent: Answers to Questions About Health Plans

Answers and Photo Provided by Lloyd McDonald

If someone doesn’t currently have a health plan, when can they enroll in one?

Typically, the Open Enrollment Period is from November 1-December 15 of each year; however, this year President Biden, in a historic move, opened the marketplace to everyone from February 15 to May 15. There are also private plan options that can be more affordable and allow greater flexibility. These plans are not subject to the enrollment periods.

What if someone is prescribed a medication that is awfully expensive and poorly covered/not covered by insurance? Is there a resource to bring the price down?

Prescription drugs are the Wild Wild West of the healthcare world and there are several options that are available to help bring the prices of medications down. The easiest option is to simply shop around. The GoodRx app shows the price of medications at different pharmacies and will also provide you with coupons that can be less expensive than using insurance sometimes. Other options include BlinkHealth.com or NeedyMeds.com that work with pharmacy and manufacturers’ discounts. Another option is to look at mail-order pharmacies such as PlanetDrugsDirect.com that ship drugs from a pharmacy in Canada.

If someone’s doctor doesn’t take their current plan, is there a health plan that will allow for continuity of care with the same provider?

The short answer is yes! There are literally dozens of plans available in Tennessee and working with a good agent can almost always guarantee there will be an option that allows a patient to continue seeing providers where they have existing relationships. A licensed health agent should be an advisor — first and foremost — and working with one is the best way to quickly sort through the options and make sure that someone is in the best spot possible, given their needs, lifestyle, and budget. The insurance companies pay agents to find clients, so agents should never charge for their services.

Lloyd McDonald has been helping individuals, the self-employed, and small business owners around the country find health plans to fit their needs, lifestyle, and budget. He enjoys reading, networking with other small business owners, and traveling with his husband Neyder.
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