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Important Info

Frequently Asked Questions

Will I be covered?

When you meet with a consultant, we’ll ask you questions about your doctors and providers, medications, and how you’d like to receive your care, along with any special concerns you might have. We’ll help you compare plans that cover your needs and concerns, before you make any decisions.

What will it cost?

When you meet with us, you’ll be able to compare the costs of plans, along with any additional help available to you, like subsidies, aid, and government programs. And, if you’re eligible for Medicare, there may not be any monthly premium. Prime Planners will help you find out, before you make a decision.

What are my benefits?

Benefits can vary by plan and your geographic area. Prime Planners is ready to help you view the available benefits and features, including extra included supplemental benefits, for each plan that could be a choice for you. And, if there are benefits you are particularly interested in, Prime Planners can help you qualify for those benefits, whether they are included or are an extra add-on.

How will I be covered where Medicare or an ACA plan won’t cover me?

Ancillary and supplemental programs can help fill the gaps. And, special programs from drug companies and grant programs for special health issues are also available. Your Prime Planners consultant will be with you to help you find and qualify for various programs that will help cover wherever a plan doesn’t have coverage.

Who do I call for help?

Your Prime Planners consultant is your one call to get answers. Whether you need help understanding your benefits, to making sure your plan is working for you, just call a Prime Planners consultant for guidance on where to turn next. And, if you need help with Medicaid, Extra Help, Allkids, Social Security, Medicare, or other programs, Prime Planners will help you to get your questions answered and your problems solved.

What if my health changes?

Prime Planners is here to help you make changes when your health needs change. Whether you need more care, you move, or your healthcare situation requires different services, we can help you to understand your options, make the changes that will serve your needs in the best way possible, and help you to gain access to additional services you might need.

What are my choices?

Whether you need Medicare or a standard health plan, having a choice in important. And, making the right choice is what Prime Planners is about. We’ll take the time to discover and explain your choices, and give you the information to make an informed choice. From comparisons between programs to adding additional optional benefits, we have the tools and experience to help guide you through many choices.

How does Medicare work?

Medicare will cover your hospitalization, your outpatient services, preventive medicine, and medications. Some insurance programs will add dental, vision, hearing, and fitness features, which are not normally covered by Medicare. For a closer look at Medicare and how it works for you, meet with a Prime Planners consultant, or attend one of our free Medicare Education Workshops. Contact us for the next event.

When are my deadlines?

For almost all health plans, you have 60 days to choose a replacement program. Medicare generally allows you to make a change from October 15 to December 7, which starts January 1 st of the next year. You can change your mind once, if you have a Medicare Advantage program, between January 1 and March 31, and choose a different program, or return to Original Medicare and pick a separate drug program. If you move, or have certain chronic illness develop, you can make changes once throughout the year. And if you’re looking for a non- Medicare program, Open Enrollment is from November 1 st until January 15 of the next year. If this is all to much to keep in mind, don’t worry! Your Prime Planners consultant will help remind you and will even give you a call to let you know when and what you can do, if you are thinking about changing or starting a plan.

What’s my coverage and cost?

Coverage and costs vary with different plans and benefits. Your Prime Planners consultant can give you all the details about the different plans, compare costs and benefits, and make sure that you are in the plan that will take care of you. From doctor and hospital networks, to dental, vision, and hearing coverages, a Prime Planners consultant can help summarize the coverage and costs of the plans you want to check out.

Will you help me if I need Medicaid?

Prime Planners is here to help. If you are on Medicaid, planning to apply for Medicaid, or have questions about Medicaid, young or old, we have answers for you. Ask to attend our Medicaid Planning and Application Workshop, which is held at various organizations throughout the year.

What if my plan won’t pay for something?

Prime Planners is your advocate. Unless your plan specifically let’s you know why they won’t pay, you have the right to have it reconsidered. Prime Planners will help you file an appeal, ask a question, or locate supporting documentation. We will make sure you get the benefits that you are entitled to with your plan.

Can I get the plan my friend has?

If you qualify, and if the plan is right for you, Prime Planners will help you to change or enroll into a plan you’ve heard about. Remember, while many people can show you one plan, Prime Planners will show you all of the plans, and teach you how to select the one that fits you best. And, if the plan does not work out for you, due to a misunderstanding or change in the plan benefits, Prime Planners will take every effort to change you to a more appropriate plan, or even return you to your former plan.

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