Healthplanfinder does send out 1095 forms for taxes
If you pay for your health insurance on the Washington Healthplanfinder then you must file your taxes every year. It is an IRS rule. Yes, regardless of your income level, you will always want to file your taxes. If your Uncle Fred says that you do not need to then look at what Uncle Sam has to say about the IRS rule.
During the first couple of weeks of the year a copy of a Form 1095-A is mailed out. If you can not find a your copy then let us know. Since the second year, we have been printing and email copies to our customers at no charge so that they could file their taxes.
(If you have Apple Health then you could receive a Form 1095-B. This form is not required to file your taxes and you can request a new copy from the Healthcare Authority. )
When you file your taxes, you take the information from your 1095-A and reconcile it using the IRS Form 8962. It involves comparing the amount of premium tax credits used with the eligible amount, based on final annual income. This is why you want your income on the Washington Healthplanfinder as accurate as possible and you can updated it during the year if your income changes.
The Advanced Premium Tax Credits are what is used to lower your monthly cost of health insurance. It is an advance so if you underestimate your income then you will be asked to pay back the portion that was advanced to you. The reverse is true if you over-estimate your income while you will pay more monthly for health insurance then you will also be paid back any unused tax credits.
Some reasons you could lose the Advanced Premium Tax Credits because:
You did not file taxes and reconcile tax credits from previous years.
Did not consent on application for the Washington Healthplanfinder to request updated tax information.
Customers who are married filing single instead of jointly on their tax return.
If you lose the Advanced Premium Tax Credits then suddenly what you are required to pay for health insurance can increase!
You could receive a letter you don’t understand otherwise known as the scary letter that looks like this:
If you get a scary letter an want help then give Suzie or Matt a call at Wenatchee Insurance. We can confirm what the situation is and how to correct it. This is insurance so it does take times to make changes and it is one of the reasons that we recommend filing taxes as early as possible to reduce problems with your advanced premium tax credits.
Open Enrollment for the Washington Healthplanfinder is November 1 through December 15.
Let’s talk about the least exciting calendar dates you’ll ever mark with a glitter pen—health insurance and Medicare enrollment deadlines. But just because they don’t come with cake or party hats doesn’t mean they’re not important. Miss the window, and you might end up paying more than your fair share (or going without coverage—yikes!). Luckily, Suzie from Wenatchee Insurance has your back, clipboard in hand, ready to keep you on track across North Central Washington.
Health Insurance Enrollment (AKA: Don’t Snooze, or You’ll Lose)
If you’re under 65 and buying your health insurance through the Washington Healthplanfinder, here’s what you need to know:
Open Enrollment: November 1 – December 15 This is the biggie. You can sign up, switch plans, or renew your current coverage. Want to ring in the New Year without a health insurance hangover? Select an appointment early as this is the shortest enrollment ever in Washington State!
Special Enrollment Periods (SEP): Life happens—marriages, babies, losing job-based insurance, moving, or even getting out of jail (yes, that’s a legit trigger). These events may qualify you for a 60-day SEP.
Suzie’s advice: “If you’re not sure whether your life change qualifies, give me a call. I love solving insurance mysteries more than I love huckleberry pie. And I really love huckleberry pie.”
If you or a loved one is turning 65, you’ve got your own enrollment clock ticking. Medicare has its own little maze of dates, but Suzie knows the shortcuts.
Initial Enrollment Period (IEP): Starts 3 months before you turn 65, includes your birthday month, and goes 3 months after. That’s a 7-month window to get into Medicare Part A and Part B.
Medicare Advantage & Drug Plans (Part C & D) Annual Enrollment: October 15 – December 7 This is the time to change, drop, or add Medicare Advantage or Prescription Drug Plans. Your changes kick in January 1.
Medicare Advantage Open Enrollment Period: January 1 – March 31 Didn’t love your Medicare Advantage plan after New Year’s? You get one switch during this time.
Suzie’s tip: “Don’t wait until December 6 to call me. I’ll be caffeinated, but it’s best to chat while we’re both relaxed and not trying to understand Medicare with Christmas music blasting in the background.”
Native American Health and Apple Health
These applications have year round enrollments. Apple Health is Washington State’s Medicaid program that we have a special information site set up for. If you have a Tribal Affiliation then yes, you can enroll every month of the year. It is why we run applications year round.
Navigating enrollment periods in Washington state is like trying to find a parking spot at Pybus Market on a Saturday morning—possible, but easier with a little help. Suzie doesn’t just know the dates, she knows the plans, the fine print, and where to find extra savings or better networks across North Central Washington.
Call Suzie at Wenatchee Insurance before your deadline becomes a dead-end. She’ll make sure you’re covered, confident, and maybe even chuckling through the paperwork.
So, you’re turning 65. Congratulations! You’ve officially leveled up in life. Along with senior discounts at restaurants and the ability to yell at kids to get off your lawn with newfound authority, you now have to deal with something equally exciting (or terrifying): Medicare enrollment.
Suzie helps with important birthdays year round.
Before you run away screaming, let me introduce you to your new best friend—Suzie from Wenatchee Insurance. She’s the kind of insurance expert who can turn Medicare mayhem into something that actually makes sense.
Wait… Do I Even Have to Sign Up for Medicare? Great question! If you’re already drawing Social Security, the government enrolls you in Medicare Part A and Part B automatically. Boom. Done. Easy.
But if you’re still working or have insurance through a spouse, you might need to make some decisions. Do you delay Part B? Do you enroll right away? Do you flip a coin and hope for the best? (Hint: Don’t do that last one.)
Suzie can help you figure it out so you don’t get slapped with penalties later. Yes, Medicare penalizes procrastination. Who knew?
Medicare: The Alphabet Soup of Insurance Medicare comes in four parts, and much like choosing between sugar and salt for your morning coffee, picking the wrong one can be a disaster.
Part A (Hospital Insurance): Covers hospital stays, skilled nursing care, and some home health services. Usually free if you worked long enough. Part B (Medical Insurance): Covers doctor visits, outpatient care, and preventive services. This one comes with a monthly premium. Part C (Medicare Advantage): A bundle of A & B (and sometimes D) offered by private insurance companies. These can include perks like dental, vision, and even gym memberships—because apparently, seniors are required to be more active than they were at 40. Part D (Prescription Drug Coverage): Because medications aren’t free, and no one wants to take out a second mortgage for allergy pills. Suzie will help you navigate these options without making your head explode. She’ll translate all the Medicare jargon into normal human language—so you can focus on more important things, like enjoying retirement.
Medicare Supplements vs. Medicare Advantage—Which One’s Right for You? If Original Medicare (Parts A & B) was a basic car, you’d probably want to add insurance so you’re not left paying for repairs (aka, giant hospital bills). That’s where Medicare Supplements (Medigap) or Medicare Advantage plans come in.
Medigap helps cover out-of-pocket costs like deductibles and coinsurance. Medicare Advantage, on the other hand, rolls everything into one plan, including some extras. It’s like deciding between buying car insurance or getting an all-in-one ride-sharing subscription with bonus perks.
Suzie can break it down for you without using confusing sales talk. She’ll compare plans from different companies and find one that fits your needs, not the one that gives her a bigger commission (because that’s not how Wenatchee Insurance rolls).
Don’t Wait Until the Last Minute! Your Initial Enrollment Period (IEP) starts three months before your 65th birthday and lasts until three months after. Miss it, and you might have to wait until the next General Enrollment Period—plus, penalties could be lurking in the shadows.
But don’t stress. Suzie’s got this. Whether you need a plan, a translator for Medicare lingo, or just someone to remind you that yes, you are still incredibly cool at 65—she’s here to help.
Call Suzie at Wenatchee Insurance—Because Medicare Shouldn’t Be Scary Want to skip the stress and actually enjoy turning 65? Call Suzie. She’ll handle the hard part, and you can get back to celebrating your milestone birthday—preferably with cake. Lots of cake.
The 1095 Form, Taxes, and Individual Health Insurance: A Match Made in (Paperwork) Heaven
Ah, tax season—when we trade our snow shovels for calculators and every mailbox visit feels like a lottery draw, except instead of money, we get… forms. If you’ve got individual health insurance, there’s one form you can’t escape: the 1095. It starts the third week in January. But don’t worry! Suzie from Wenatchee Insurance has seen it all, and with her knack for breaking things down (and a good sense of humor), she’s here to help you understand how your health insurance and taxes go hand-in-hand.
What Is the Mysterious 1095 Form?
The 1095 form is like the awkward cousin of the W-2. It doesn’t hold the keys to your refund, but it’s crucial for showing Uncle Sam you had health insurance last year. Think of it as your golden ticket to avoid paying the “Individual Shared Responsibility Payment” (aka the we-didn’t-see-your-coverage penalty).
If you bought health insurance through the Washington Healthplanfinder, you’ll likely receive a 1095-A. If your coverage came directly from a private insurer, you might get a 1095-B. If you received Apple Health then you may be looking at a 1095-B form. Either way, they both scream, “Proof I’m covered!”
Suzie will tell you straight: Don’t panic. When the form arrives, here’s your action plan:
Check it for Errors Suzie swears by the two-minute error check. Are your name, address, and Social Security number correct? Is the coverage period accurate? If you spot a mistake, reach out to your insurance provider ASAP.
File It with Your Taxes The IRS doesn’t need you to send in the form, but keep it handy. Your tax software or accountant might ask for it to confirm your coverage.
Double-Check Tax Credits If you received premium tax credits (yay, lower premiums!), the 1095-A is your BFF for reconciling them on Form 8962. Suzie’s advice? Don’t skip this step—it could mean the difference between a sweet refund and an awkward bill.
How Does Individual Health Insurance Affect Your Taxes?
Suzie often says, “Health insurance and taxes are like peanut butter and jelly: a weird combo, but they work.” Here’s how:
Tax Credits If you qualified for tax credits through the Marketplace, your 1095-A shows how much the government chipped in. If your income changed during the year and you didn’t update the Marketplace, you might owe (or get back!) some of that credit.
Penalties (Not So Much Anymore) Suzie says the big bad penalty is mostly a thing of the past, but some states (like California and New Jersey) still have individual mandates. If you live in one of these, your 1095 form is your get-out-of-jail-free card.
Self-Employed Deductions Here’s a silver lining: If you’re self-employed, you might be able to deduct your health insurance premiums. That’s right—your individual plan could save you money on taxes.
Suzie’s Top Tip for Stress-Free Tax Season
Suzie’s golden rule: Organize early, relax later. Don’t let your 1095 form live under a pile of junk mail until April 14th. As soon as it arrives, add it to your tax folder—or, as Suzie calls it, “The Box of Financial Doom.”
If you have lost your 1095 or don’t have a printer then stop in. We do print copies for our clients.
And if you’re confused about your plan, tax credits, or which 1095 form you should expect, don’t hesitate to call Wenatchee Insurance. Suzie and Matt specialize in turning health insurance headaches into manageable to-dos.
When in Doubt, Ask for Help
Taxes are complicated, health insurance is complicated, and when you combine the two? Let’s just say Suzie has seen some impressive forehead wrinkles from her clients. But that’s why Wenatchee Insurance is here—to make things simple, funny, and as painless as possible.
When you have a plan from the Healthplanfinder then you are required to file your taxes every year.
Topics: health insurance, tax document, 1095, apple health, Molina, Ambetter, Community Health, Suzie, Chelan County, Okanogan, Grant County, Douglas County, 509, Leavenworth, Quincy, Cashmere, Entiat,
Ah, the new year. A time for resolutions you may or may not keep, gym memberships that go unused after January 15th, and… Medicare Advantage Open Enrollment! That’s right, folks. While the world is busy pretending kale smoothies are delicious, you’ve got the golden opportunity to switch, drop, or tweak your Medicare Advantage plan from January 1st to March 31st.
So, what exactly is Medicare Advantage Open Enrollment? Don’t worry, we’re here to make it crystal clear, with fewer big words and more laughs. And if it still feels like a brain bender? That’s when you call Wenatchee Insurance and let Suzie save the day.
The Open Enrollment Lowdown
Imagine you bought a car, but by January you realize it’s more of a lemon than a luxury ride. Maybe it gets terrible mileage. Maybe the stereo only plays polka music. Either way, you need a switch. Well, Medicare Advantage Open Enrollment is your chance to ditch the “lemon” plan and grab something that fits your life—minus the accordion solos.
During this special window:
You can switch to a different Medicare Advantage plan (because sometimes you just need a better deal).
You can drop your Medicare Advantage plan and go back to Original Medicare (hello, freedom!).
You can add a Medicare Part D plan for prescriptions (because paying full price for meds isn’t on anyone’s vision board).
It’s a relaunch for this year’s health insurance. But here’s the kicker: you can only make ONE change during this window. That’s right—no double-dipping. So, we have to make it count!
Here’s the deal: Medicare rules can feel more confusing than assembling furniture with no instructions. One minute you’re comparing plans, and the next you’re buried in pamphlets muttering, “What even is a deductible?” It’s a slippery slope, my friend.
Enter Suzie. She’s not just any insurance agent; she’s the Medicare whisperer of Wenatchee Insurance. Picture this: while you’re sipping coffee and trying to remember what Part C does, Suzie’s already found three plans that cover your favorite doctors, lower your out-of-pocket costs, and include extra perks like dental or vision. She’s like a superhero, but instead of a cape, she wears a friendly smile and has a phone glued to her hand.
Need examples? Let’s say you’re Steve from East Wenatchee. Steve didn’t call Suzie last year and ended up with a plan that didn’t cover his prescriptions—ouch. Meanwhile, Betty from Cashmere gave Suzie a ring, and now her plan includes gym memberships and a dental cleaning so good her dentist asked for her secret.
Don’t be a Steve. Be a Betty.
Where can we get our one stop insurance shop in North Central Washington?
At Wenatchee Insurance, Suzie, Matt and Shayla make the Medicare Advantage Open Enrollment period a breeze. They do the research, break down the jargon from the different insurance companies, and find you the best plan for you and your family. No accordion solos, no paperwork nightmares—just great coverage and a sigh of relief.
So, if you’re ready to switch things up (or just make sure you’re on the right plan), pick up the phone and call Suzie. Trust us: your future self will thank you.
Ah, health insurance. It’s like the ultimate adulting test, but instead of a grade, you get co-pays. And if the thought of picking the right health insurance plan makes you feel like you’re trying to solve a Rubik’s Cube blindfolded, don’t worry—Suzie and Matt at Wenatchee Insurance are here to help. Let’s dive into what every health insurance plan must cover, using examples that prove even the mundane can be hilarious.
1. Doctor Visits: The “Ouch!” Standard
All health insurance plans must cover preventive care, like your annual physical or flu shots. So, when you stub your toe on the coffee table for the fifth time this month, rest assured you’re covered for a doctor visit.
Example: Remember Bob from East Wenatchee? He thought his sore throat was a sign of his budding opera career. Turns out, it was strep. Thankfully, his insurance covered the visit, and Suzie from Wenatchee Insurance helped him pick a plan that didn’t leave him crying in the pharmacy aisle over antibiotic prices.
2. Emergency Services: For When You Really Mess Up
Whether it’s a car accident, a kitchen knife mishap while perfecting your “Chopped” audition, or your kid thinking their LEGO belongs in their nose, emergency services are covered.
Example: Matt once helped a family in Cashmere who needed an ambulance after their teenager attempted a backflip off the barn roof. The good news? Their plan covered it. The bad news? The kid’s TikTok account gained 20,000 followers from the footage.
3. Prescription Drugs: Because Over-the-Counter Isn’t Always Enough
Insurance plans cover a range of medications, so you’re not stuck Googling “natural remedies for gout” in the middle of the night.
Example: One client, Nancy, tried to cure her migraines with a DIY essential oils concoction that ended up attracting bees. Suzie found her a plan that covered real migraine meds—and a bee sting cream just in case.
4. Mental Health Services: Brain Care Counts Too
Every plan covers therapy and mental health treatment. Because sometimes, adulting really is that hard.
Example: Fred, a Wenatchee resident, found himself overwhelmed by his parrot, who had learned to imitate his mother-in-law. Therapy sessions covered by his plan helped him cope (and gave him the courage to teach the bird new phrases).
5. Maternity and Newborn Care: Tiny Humans, Big Bills
Pregnancy care and newborn checkups are a must. And honestly, who doesn’t need a little financial help when baby formula is practically worth its weight in gold?
Example: A couple in Leavenworth came to Matt for help after realizing their baby’s hospital bill rivaled their down payment on a house. With the right plan, they saved enough to afford diapers and pizza delivery during sleepless nights.
6. Preventive Care: Because “An Apple a Day” Isn’t Enough
From cancer screenings to vaccines, your plan’s got you covered here. It’s like insurance for your future self.
Example: Suzie helped a Wenatchee apple farmer find a plan that covered his annual skin cancer screening—important when you’re out in the sun all day naming your trees after your favorite superheroes.
7. Pediatric Care: Kids Break Things (Including Themselves)
From immunizations to vision checks, pediatric care is mandatory. Because it turns out, kids aren’t as indestructible as they think.
Example: Matt once worked with a family whose son mistook a skateboard ramp for a launch pad. Good news: His arm healed. Better news: The family’s plan covered the X-rays and cast.
Suzie and Matt Have You Covered
Navigating health insurance might feel like wandering through a corn maze blindfolded, but that’s where Wenatchee Insurance shines. Whether you need coverage for everyday aches and pains or for those epic fails that deserve a highlight reel, Suzie and Matt are the dynamic duo to guide you.
So, call Wenatchee Insurance today. Because picking the right health plan shouldn’t feel like surgery—just a checkup with friends who know the ropes (and have probably seen it all).
Ah, braces —the rite of passage that every kid (and some adults) in North Central Washington dreads. If you’re wondering whether dental insurance will help you foot the bill for straightening little Dillan’s teeth, you’re in good company. This question comes up all the time at Wenatchee Insurance, especially when people start tallying up the cost of those shiny metal brackets like they were made of gold.
Orthodontic / Braces Coverage Basics
Dental insurance can cover orthodontics, but it’s not always a guarantee. It’s a bit like assuming all apples in Wenatchee taste the same—they don’t! It is tough to eat a Red Delicious from cold storage. Orthodontic coverage depends on your plan, and most plans that do cover it will only do so for kids under 18. The magical phrase is “Medical Necessity” especially if there is an Apple Health Plan in play.
If your parents couldn’t get you braces when you were a kid then there are a couple of individual unicorn plans available. Suzie and Matt went hunting for plans that could be purchased by the individual for this purpose and they have some restrictions.
How Much Is Covered?
If your plan does cover braces, it typically covers a percentage of the total cost—usually around 50%. So, if little Billy’s braces cost $6,000, your insurance might cover $3,000, leaving you to pay the rest. It’s like getting a discount on a family-sized apple pie at the local bakery—not free, but better than full price.
Example
Let’s take young Emma from Omak, who needed braces but didn’t want to look like she had a mouth full of railroad tracks. Her mom found a dental insurance plan that covered clear aligners instead of traditional braces. Now Emma’s teeth are straightening out just in time for high school, and she can smile confidently in all her Instagram pics—no filters required.
At Wenatchee Insurance we have found that exploring some of your options early can have some of the lowest costs for braces. As we get older, it gets a little tough but not impossible for dental insurance to cover orthodontics as adults.
Living in the scenic countryside of North Central Washington comes with its own set of perks and challenges. One thing’s for sure, finding a health insurance plan shouldn’t be one of those challenges. Whether you’re in Wenatchee, Leavenworth, or the far reaches of Okanogan, Wenatchee Insurance is here to guide you through the corn maze of health insurance options with a sprinkle of country humor and a whole lot of experience.
First off, let’s talk about the sheer variety of health insurance plans out there. It’s like walking into a pie contest at the Chelan County Fair – there are many different varieties, and they all look good at first glance. However, not everyone likes Rhubarb or maybe you are allergic to strawberries. Insurance plans need a closer look to see if they fit your needs like Grandma’s Blue Ribbon Apple Pie on a Sunday night.
Imagine our friend Bob from Cashmere. Bob’s as fit as a fiddle, but he’s had a few run-ins with the old John Deere tractor. Last year, he tried to fix a loose bolt without using a wrench and ended up in the ER with a broken toe. Bob needs a plan with emergency coverage and low out-of-pocket costs. During Open Enrollment, Suzie at Wenatchee Insurance helped him find a plan that doesn’t cost his prized pig Wilber but covers those unexpected barnyard mishaps.
Now, let’s say you’re Marge from Chelan, and you’ve got a family to think about. Little Jimmy’s shiny braces, Megan’s allergies, your spouse’s latest, high blood pressure meds – they all keep adding up. You need a plan that covers a wide range of services and has a good network of doctors. Wenatchee Insurance can sort through the options and find a plan that keeps everyone healthy and happy, without driving you to sell the farm.
For our older folks, say you’re Aunt Mildred in Pateros. She’s past the age where she’s wrestling cattle, but she needs regular check-ups and prescription medications. Medicare Advantage plans can be tricky to navigate, but that’s where Suzie shines. Suzie was a pharmacy technician for 20 years and knows how to look through the formularies like they are hairs on the back of her hand. Suzie will find a plan that covers everything from her heart pills to her arthritis cream, ensuring she can enjoy her golden years fishing by the Columbia River.
Choosing the best health insurance plan is a bit like picking the right peach at DeLap’s Fruit Stand– it takes a keen eye and a bit of know-how. You don’t want peaches that are too small or too expensive. With Wenatchee Insurance, you get the local touch and the expertise to pick the plan that fits just right.
So, next time you’re sipping your coffee from Little Red’s Espresso, remember: Wenatchee Insurance is just a call away, ready to help you find the perfect health insurance plan. Because whether you’re mending fences or running the family orchard, you deserve peace of mind knowing you’re covered.
Topics: Health Insurance, Apple Health, Ambetter, Lifewise, Community Health, Wenatchee Insurance, Suzie, Enrollment, Glasses, Contacts, Chelan County, Okanogan, Grant County, Douglas County, 509, Leavenworth
Why Working with a Health Insurance Broker Like Suzie or Matt Just Makes Sense (and Cents!)
Because insurance jargon can be confusing, we are talking about insurance producers who work with several different companies.
Navigating health insurance is like walking through a maze of paperwork, confusing terms, and deadlines that feel impossible to hit without a little help. Enter Suzie or Matt from Wenatchee Insurance! Having an insurance broker on your side is like having a GPS that not only gets you where you need to go but also tells you where the free snacks are along the way. Here’s why teaming up with a broker can be the best decision you make for your health—and your sanity.
Reason #1: Brokers Do the Homework for You (So You Can Actually Relax!)
Imagine you’re sitting at your kitchen table, staring at a pile of health insurance pamphlets, each one promising to be just what you need. But which one actually is? That’s where Suzie (or Matt, he’s a gem too) shines! Brokers are like insurance detectives, decoding complex policies to find the plan that’s best for you.
Suzie once helped a client who thought “deductible” was just another word for “tax return,” and “copay” was some sort of buddy system. It turns out, the client didn’t just need insurance; they needed a translator. Suzie swooped in, found a plan that met all their needs, and explained everything in plain English. No more guessing games, no more jargon—just clear, simple guidance.
Reason #2: Brokers Have a Personal Stake in Getting You the Best Deal
Insurance brokers aren’t tied to any single company, so they genuinely care about getting you the best bang for your buck. Suzie and Matt love nothing more than saying, “Yes, that plan is great—and yes, it actually covers that!”
Matt’s favorite story? He once found a plan for a client that covered everything from acupuncture to chiropractic care. The client was thrilled! He had been on the hunt for months, but every plan he came across either had sky-high premiums or the coverage wasn’t quite right. Matt did some digging, called around, and managed to find a plan that was basically a one-stop shop for the guy’s wellness needs. That’s the power of a broker: they go beyond the generic recommendations to find you that perfect match.
Reason #3: Brokers Are Not Robots—They Actually Listen!
Unlike a certain popular insurance website with an “instant quote generator,” Suzie and Matt will actually listen to your needs. Brokers make it their mission to know what’s important to you, like making sure that your favorite doctors are in-network or ensuring your child’s allergies are covered without a hassle.
Imagine Suzie, notebook in hand, jotting down your concerns like an insurance detective. She’s not just a broker; she’s like your insurance BFF. If you’re worried about unexpected medical bills, Suzie will find ways to minimize those costs. If you’re in a health club or have a wellness routine, she’ll find a plan that rewards you for staying healthy.
Reason #4: Peace of Mind, Especially When Life Happens
When your health is on the line, having someone knowledgeable to turn to is invaluable. And Suzie and Matt aren’t just there for the enrollment process. They’re your go-to for questions, claims, and even random inquiries like, “Will this cover my acupuncture for my dog?”
In a world of confusing options, Suzie and Matt at Wenatchee Insurance stand out by offering personalized help, a bit of humor, and plenty of wisdom. So why go it alone? Let Suzie or Matt be your guide—you’ll be in safe hands, with maybe a laugh or two along the way!
What Are the 10 Essential Coverage for Health Insurance? (And Why You’ll Want Suzie at Wenatchee Insurance on Speed Dial)
Health insurance can feel like a magical mystery tour, except it’s more like a trip through paperwork and less like a rock concert. But don’t worry! Suzie from Wenatchee Insurance is here to save the day, kind of like a superhero, but instead of a cape, she has a computer full of insurance plans. Let’s take a look at the 10 essential coverages that every health insurance plan must have (thanks, Affordable Care Act!), and how they make life easier here in Eastern Washington.
1. Ambulatory Patient Services (aka Your Everyday Doctor Visits)
You wake up, sneeze three times, and suddenly, you’re Googling “Is sneezing a sign of a rare disease?” Instead of spiraling down the rabbit hole of WebMD, you can make a quick visit to your doctor. Ambulatory services cover routine check-ups and visits to specialists. Suzie’s here to make sure you’re covered whether you’re seeing Dr. Jones down the street or a specialist for your “seasonal allergies” (also known as dust from last year’s ski gear).
Imagine this: you’re having the best day at Mission Ridge, catching air and looking like a pro. Then… BAM! You misjudge a jump and suddenly find yourself needing an ambulance. Don’t panic—your health insurance has you covered for all those “Oops, I did something dumb” moments. Emergency services mean that your insurance will handle that surprise ER trip.
3. Hospitalization (If You Need More Than Just a Band-Aid)
Okay, so your skiing mishap turned into something bigger when you escaped Bigfoot on Stevens Pass. Maybe you need surgery or a few days in the hospital. Hospitalization coverage makes sure you don’t have to start a GoFundMe to pay your medical bills. Let’s find you a plan with a higher success rate.
4. Maternity and Newborn Care (Because Babies Don’t Come Cheap)
Expecting a baby? Congratulations! Maternity and newborn care are essential coverages, so whether you’re welcoming your little bundle of joy in Wenatchee or elsewhere in North Central Washington, you won’t have to sell the farm for the newest hand. Suzie’s got the inside scoop on which plans make it easier to manage prenatal visits, delivery, and all those newborn checkups. Postnatal Care is important and we have additional resources in Washington State.
5. Mental Health and Substance Use Disorder Services (We All Need Therapy Sometimes)
Let’s face it—life can be stressful. Maybe you’ve binge-watched House one too many times and are now convinced you have every rare condition ever featured on the show. Good news! Your health insurance covers mental health services, so you can talk to a therapist and work through your House-induced hypochondria. Happy brain coverage while easier than before the ACA, is still not always the fastest hunt in Eastern Washington.
6. Prescription Drugs (AKA The “Why Is This So Expensive?” Coverage)
When your doctor prescribes medication, you shouldn’t have to choose between paying for your meds or your next Netflix subscription. Prescription drug coverage means you’ll get help with the cost of necessary medications. Suzie can point you to plans that cover the things you need, whether it’s allergy meds, insulin, or that mystery cream for the rash you got hiking up Saddle Rock.
7. Rehabilitative and Habilitative Services (Getting You Back on Your Feet, Literally)
If your big skiing adventure left you needing physical therapy, you’re in luck. Rehabilitative services are designed to help you recover from injuries, illnesses, or even surgeries. Suzie will ensure your plan covers those sessions where you learn to bend your knee again without yelping like a golden retriever stepping on a Lego.
8. Laboratory Services (Testing Without the Guessing)
Routine blood work or diagnostic tests? No problem! You don’t have to skip your annual check-up at Confluence Health just because you’re worried about the cost of tests. It seems like when you get over forty the doctors have a fleet of tests for you. There are a variety of options when it comes to how an insurance company handles this.
9. Preventive and Wellness Services (Keeping You from Becoming a WebMD Expert)
Preventive care is like that nagging friend who reminds you to take care of yourself—except now it’s your insurance! Whether it’s vaccines, screenings, or a flu shot from your local pharmacy, preventive care is 100% covered. Little work now to prevent the big job later.
10. Pediatric Services, Including Oral and Vision Care
Got kids? Your insurance will cover regular check-ups, dental care, and vision tests for them. Suzie can help you find a family-friendly plan so you don’t have to pay out-of-pocket when little Johnny needs glasses because they spent too much time squinting at their phone playing Monopoly Go!
Conclusion
Choosing the right health insurance plan doesn’t have to feel like running a marathon in flip-flops. With Suzie and Wenatchee Insurance, you’ll have an expert who can help you navigate the corn maze of coverages and find a plan that fits your needs. Whether you’re in Wenatchee, Colville, or anywhere in Eastern Washington, you’ve got someone in your corner who knows the ins and outs of health insurance—and has a heck of a butterfly collection!
While we do have Open Enrollment from November 1st through January 15th, there are also Special Enrollment Periods (SEP). SEP are documented reasons like losing coverage from a job, low income, getting married, or even a tribal affiliation. Suzie likes to run the application to see if one of the conditions can trigger an immediate enrollment or else we are prepared for the next Open Enrollment Period in fall.
You do not have to go alone when you have Suzie on your insurance team.
Topics: health insurance, Medicare, Medicare Advantage, health alliance, wellcare, Molina, humana, Suzie, Chelan County, Okanogan, Grant County, Douglas County, 509, Leavenworth, Quincy, Cashmere, Entiat,
For nearly a decade we have assisted with Health & Medicare Solutions. We are proud to be selected by the Washington Healthplanfinder to be one of ten Enrollment Centers located in Washington State.
