We help a lot of people in Washington State with their enrollment and education about health insurance. If you are using the Washington Healthplanfinder during Open Enrollment then you have a pay now button feature to get the initial payment completed. We are brokers and don’t charge fees for our work.
When you log into the desktop version. You will see a row of buttons across the top. You want the one labeled Payments.
During most of the year, the payment tab will list payment options. However during Open Enrollment, the Washington Healthplanfinder will list a pay now button for most companies. When you click on the pay now button for it will create a pop up which goes to a secure payment site for the company.
This first payment is important as it secures the insurance policy. Most companies wil then send the policy’s insurance cards and information booklet after this payment has been made. A few of the companies will allow you to schedule monthly payments using the popup while others you will have to set up with them at a later time. The booklets and cards usually arrive about two weeks after the payment.
At Wenatchee Insurance Agency, Matt and Suzie have been lending a hand to our community for over 13 years with Health Insurance. While our agency does a whole lot more, we get asked a lot of questions regarding Health because it is complicated.
Beginning January 1st, 2026 some medical procedures under traditional Medicare will require Prior Authorization in six states before performing the service. Yes, Washington state has been selected. Arizona, New Jersey, Ohio, Oklahoma, and Texas.
This updates individuals with Medigap plans such as Plan G or Plan N, if they are using traditional Medicare coverages. While common in health plans and Medicare Advantage Plans these are new for original Medicare.
What Procedures will require a Prior Authorization?
There were 17 types of procedures that were flagged to now need approval. Here is what made the list.
Facet joint procedures for back pain
Nerve and muscle tests (electrodiagnostic testing)
TENS units and similar electrical stimulation devices
Hyperbaric oxygen therapy
Spinal cord stimulators
Deep brain stimulation (commonly for Parkinson’s)
Sacral neuromodulation (for urinary conditions)
Transcatheter aortic valve replacement (TAVR)
Arthroscopic knee cleaning or debridement
Vertebroplasty/kyphoplasty for spine fractures
Epidural steroid injections
Non-emergency ambulance transport
Botox injections for medical issues
Negative pressure wound therapy pumps
Hernia repairs
Lumbar spinal fusion
Skin graft substitutes for chronic wounds
Physicians will be required to submit documentation before the service is performed. If approval is not granted, coverage can be denied requiring the patient to pay out of pocket.
At Wenatchee Insurance we do our best to lend a hand in understanding and enrolling in Medicare and insurance Programs. We are an independent insurance agency. If you are looking at supplemental policies then let us know and there are enrollment periods.
OK, Tariffs are playing an important role in what the administration is doing with drug pricing. TrumpRX appears to be using them to inflate the price on medication for companies that don’t participate with the administration.
Trump is imposing a 100% Tariffs. Effective October 1st, 2025 if a company reaches an agreement with the Administration then they will be immune to them. There is the common consensus that everyone participating in this deal will have customers paying inflated costs due to the tariffs.
Companies working with TrumpRX
Pfizer is one of the first companies to reach an agreement. They are one of the largest drug companies and Eliquis, Ibrance and the Covid vaccine are among the drugs that they manufacture. Eliquis was one of the drugs with the Medicare Negotiated price for 2026. Ibrance was selected for the Inflation Reduction Acts Medicare negotiated price for 2027. So thanks to the Inflation Reduction Act from the Biden administration,
They will be doing a Direct to Consumer Model with a yet to be launched website. There is a marked page at TrumpRX.com but it is not functional as of publishing this blog.
It could be very similar in the direct to consumer model of AmericasMedicines.com from a Pharmaceutical trade group PhRMA where people can go directly to the manufacturers.
It sounds like a stepped up version of Mark Cuban’s CostPlus. Where they have a few drugs that they ship directly to the consumer.
Only time will tell if it has more savings than GoodRX.
Important Dates for Medicare and Health
Medicare Advantage and Prescription plans can be enrolled or changed October 15 through December 7th.
Healthcare Plans can be enrolled or changed November 1st through December 15th.
Maintaining your health can be a challenge, and paying for healthcare costs can make that challenge even harder. If you don’t get health insurance through your job, purchasing private health insurance can make a big difference to your budget. Privacy plays an important role. If you are in the Wenatchee, WA area, our team at Wenatchee Insurance Agency would like the opportunity to explain the benefits of health insurance.
Health Insurance and Your Privacy Rights
Today’s increases in technology use have brought many advantages, but they have also created opportunities for unauthorized access to personal information. Your health status and healthcare information are very personal. When you visit a healthcare provider, you don’t want to worry about whether your diagnosis, treatment, and medication information will be shared with anyone except the companies that need that information to work with you.
According to the Washington Office of the Insurance Commissioner, you have a right to privacy when it comes to your healthcare information. This means that your personal information can be shared only with sources that need to provide service to you. The same website assures you that you can have sole access to your healthcare information. Privacy is especially important for clients under the age of 18 who are legally entitled to consent to healthcare procedures, including procedures related to their reproductive rights.
You never know when you’ll need an emergency medical procedure. Our team at Wenatchee Insurance Agency can help you find a policy that fits your needs and budget. Clients in the Wenatchee, WA area have discovered that our team is knowledgeable and provides consistently excellent customer service. Call us for an appointment today, and let’s work together to find the right insurance policy for you.
In our area we have a select few dentists and orthodontists that accept Apple Health. When our son needed braces, every six weeks we would make the drive from Wenatchee to Ellensburg so that he would have his teeth worked on. It took a lot of coordination between his pediatric dentist and the orthodontist to get the approval.
Where to find Apple Health Dental care?
OK, have you been to the Dentist Link Set up by the Healthcare Authority? It provides an excellent search tool to find a dentist accepting Apple Health Dental in your area. You can also call or test a referral specialist 844-888-5465 from 8 am to 4:30 pm on weekdays.
What does Apple Health Dental cover for adults?
If you have Apple Health as an adult it covers more than people think. Yes, it really does take care of fillings, front teeth root canals and dentures. There are some things that it doesn’t cover by it’s self like Dental Implants and Adult Orthodontics.
How do I enroll?
Suzie and Matt have been assisting people enroll for over a decade into Apple Health plans. We have never charged a fee and do not get paid for enrolling people in these plans. We do it because people in our community use healthcare and it is expensive to go without. There are no enrollment periods with Apple Health and it is based on our income level.
Children have expanded access to Apple Health using the Children’s Health Insurance Program (CHIP). Some will be zero cost or there will be a $20 or $30 monthly charge per child fee. We have a lot of families where the parents are on a paid health plan and the kids are on Apple Health. The important thing is that the family is being covered.
What happens if I am no longer eligible for Apple Health Dental
We have the conversation. We have access to several dental plans that a person can enroll year round. Some with waiting periods and some without. We even have plan that can assist adults with getting braces after a waiting period at Wenatchee Insurance. We make it as easy as possible to review your options.
There are times when it get’s incredibly busy for healthcare so you may have to wait a little bit longer in the Fall.
For Medicare the Annual Enrollment Period for Medicare Drug Plans and Medicare Advantage plans is October 15th through December 7th.
For Medicare’s Initial Enrollment it is three months before you turn 65, the month of your birthday and three months after.
For Healthcare the Open Enrollment Period is November 1st through December 15th. (some states may have an extension so do not hesitate to ask).
Yes, people set appointments early in the year for fall appointments to insure that they are able to have a conversation about the changes to their health plan.
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.
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.
