Get ready to shop for Health Insurance!

Individuals in Western PA who do not qualify for Medicare or Medicaid may purchase a plan from Highmark or UPMC.

Step 1: See if you qualify for Advanced Premium Tax Credits

You’ll need to project your income in the coming year, the birthdates of those applying for coverage and your zip code: 

Determine pre-eligibility 

Step 2: Call your doctors and ask what networks they are accepting this year:

UPMC: Partner/Select/Premier

Highmark: TogetherBlue/My Direct Blue/MyBlue Access

Step 3: Schedule an appointment with Liz for a phone call or in person meeting. 

Insurance Solutions for Individuals

    • Pennie Certified Broker

    • Free Medicare 101 Presentations

    • No fee to meet to review plans

    • Individual Plans for those under 65 or not
      on Medicare

    • Advantage Plans, Medigap Policies and Part D Plans

Medicare Q&A with Erin and Liz

On-site Group Medicare Education

Healthcare is a big topic that covers a lot of industries, options, and strategies. Our healthcare industry experts will come on-site to speak with your benefits team to help answer questions one-on-one.  This presentation will give the attendees the ability to navigate the health care system.

Free Medicare 101 Talks for Organizations

We tailor presentation topics to what your group wants to cover. We provide information about health insurance options and how they affect their bottom line and the direction of their health.

Topics covered can include:

    • Health Insurance Options

    • Custom healthcare navigation

    • Compliance with the Affordable Care Act

    • Self-insured strategies

    • Wellness Program Integration

    • Health incentives for employees

Changes to Medicare Part D in 2024 and 2025 Under the Inflation Reduction Act and How Enrollees Will Benefit

The Inflation Reduction Act is capping Out-of-pocket drug spending will at $2,000 – Beginning in 2025, Part D enrollees’ out-of-pocket drug costs will be capped at $2,000.

Employers should be aware their pharmacy benefits may soon not be considered “Credible Coverage.”

If not – employees over 65 must obtain a Part D Plan, or they will be penalized when they do. Beneficiaries must be enrolled in Part A ($0) and/or Part B (Premiums start at $164.90) to purchase a Part D Plan.

If contributing to an HSA, you must stop contributions 6 months before you enroll in Part A or B.

I am currently scheduling Medicare 101 talks – please email me to learn if this would benefit your group! Learn more about the upcoming changes.


Stay connected with the latest news and developments with Medicare by following our Facebook page:

Pgh Medicare Help

Turning 65? 

A question I’m commonly asked is – I’m turning 65! Do I need to enroll in Medicare? 

The answer is – it depends. 

If you are on a group employer plan or your spouse’s group employer plan that has more than 20 employees, do you do not need to enroll in Medicare A or B.

If you are not contributing to a Health Savings Account, you may choose to enroll in Medicare Part A through the Federal Govt, via the Social Security website. Part A will be $0 and may be used as additional hospital coverage, if you choose. 

Once you lose employer coverage, you will then have a Special Enrollment Period to enroll in Medicare Parts A & B through the Federal Govt, and choose a Medicare Advantage or Medigap plan. The recommended time frame for this process is 3 months, but could be done in about 4-6 weeks. 

When you know your anticipated retirement date, be sure to confirm your last day of coverage so that you can line up A & B to begin the first day of the next month.

Check out the article from CMS.GOV in the comment link.

#turning65 #medicare

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