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Request An Affordable Care Act Quote!
Call today for quotes on health insurance for
or any other type of health or life insurance!

877-734-3884 (TTY: 711)

All Other:
786-970-0740 (CELL)


Medicare - April 2024




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Medicare does NOT cover medications prescribed only for weight loss but does cover such medications when they are prescribed for a specific medical condition for which the drug is approved by the FDA.

Please note that there has been concern about drug shortages for drugs like Ozempic that cause weight loss but are primarily diabetes medications.

With very few exceptions Part D drug plans have prior authorization requirements for medications like Ozempic and Mounjaro (this means that the provider must submit a request for coverage of the medication, including the reasons for prescribing the medication, and the carrier must approve dispensing the drug before it can be covered by the plan.) If you are prescribed one of these medications and the plan requires prior authorization, you have a better chance of having the drug approved under the plan if the request for prior authorization comes from a specialist (in most cases an endocrinologist) rather than an internist or primary care physician. 

The number of carriers who will dispense these types of medications without requiring prior authorization is exceedingly small. Although there may be others, we are aware of only one carrier in Florida that does not require prior authorization for Mounjaro and are not aware of any carriers who do not require prior authorization for Ozempic. However, we have a system that checks carriers and Part D medications, and please contact us at 786-970-0740 if you’d like us to check to see if any of your diabetic medications require prior authorization.

Please see this article from AARP that contains more information about this issue.


Going to see the doctor soon? Prepare to be hounded with appointment reminders by phone. By text. By robocall. By email. And in your online “patient portal.”


Doctor's and dentist's offices for years left a courtesy voicemail on patients’ home answering machines giving them a heads-up about their appointment. But now, medical practices are flooding patients with reminders of upcoming appointments — and warnings of cancellation penalties.


The financial pressure for medical practices to keep patients from ghosting them is a major factor. Practices miss out on revenue when a patient doesn’t show up for an appointment or cancels at the last minute and the slot sits empty.


But the notifications are getting worse because new software systems enable medical providers to send automated messages to patients. Health care providers often have multiple notification systems — one for electronic medical records, another for prescription medications, and a different one from the marketing department, for example — that do not coordinate with each other. This can lead to notification overload for patients.


Read the entire article written by Natalia Gdovskaia that appeared on March 16 in CNN Business here.


Star ratings apply to plans covered under Part C (Medicare Advantage) and D (Medicare drug plans). Such ratings are NOT applicable for Medicare Supplement plans. Star ratings are important for two basic reasons: (1) they are one way a consumer can compare Part C and D plans and (2) Medicare pays quality bonuses (i.e., additional payments) to carriers who achieve star ratings of four or more. These bonuses are used, in part, to provide higher benefit levels from carriers who receive them.

Beginning in 2027, the Centers for Medicare and Medicaid Services (CMS) will reward Medicare Advantage plans that demonstrate progress addressing health disparities. At the same time, the agency scrapped a bonus policy that benefited insurers that sustained high overall quality ratings over time.

Without the reward factor, no Medicare Advantage carrier would have earned a five-star rating this year, according to a data review Baltimore Health Analytics performed on its star ratings software platform for Modern Healthcare. That top score qualifies insurers for bonus payments up to 5% and enables them to market Medicare Advantage plans year-round.

Modern Healthcare estimates that Centene (which owns Wellcare) and Clover Health will benefit most from this change in methodology, as these carriers serve a greater percentage of the underserved population than their major competitors.

Read this article that appeared in the March 20 issue of Modern Healthcare and that explains this change in more detail.

About Paul Cholak

Paul is a licensed, independent health and life insurance agent and has over forty years of benefits experience and specializes in helping Medicare beneficiaries obtain health insurance. However, he offers a complete array of life and health insurance products to individuals of all ages.

He guides Medicare beneficiaries through the steps of getting insurance and is available to help clients both BEFORE and AFTER they've made their purchase decision.

Disclaimer for Part C and D plans: "We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact or 1-800-MEDICARE (TTY: 1-877-2048) to get information on all your options."

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Schedule For 2024
Affordable Care Act Enrollment

Affordable Care Act open enrollment for 2024 plans began November 1, 2023 and ended January 16, 2024 on the Federal Facilitated Marketplace (

You’re eligible to enroll ONLY if you have a Qualifying Life Event.
There are no pre-existing condition limitations.

Call Us At 786-970-0740 (Cell)
to determine what kind of plan you may be eligible for.

2024 Annual Enrollment Period For Medicare Eligibles

The Annual Enrollment Period for Medicare-eligibles that ran from October 15 through December 7, 2023 for a January 1, 2024 effective date has ended.

You’re eligible to enroll now ONLY if you’re first becoming eligible for Medicare or are eligible for another type of enrollment period. Enrollment rules differ between Medicare Supplement plans and Medicare Advantage, Medicare Advantage Prescription Drug, and separate Medicare drug coverage (Part D).

Call us at 877-734-3884 (TTY: 711) for details.

family consulting

We offer a comprehensive set of Affordable Care Act (“Obamacare”) plans

to individuals and families qualified to buy health (tax- and non-tax subsidized) insurance and dental/vision and/or hearing plans through the Federal marketplace (this is called buying “on-exchange” or “on-marketplace”) or directly from insurance carriers (this is referred to as buying “off-exchange or -marketplace”). Our Affordable Care Act policies comply with the Affordable Care Act and contain all of the “essential health benefits” required by that law.

The dental/vision and/or hearing insurance

products are available both on an insured or discount basis

We offer short-term health insurance policies

for those who are looking for more inexpensive coverage and shorter term alternatives.

We offer Medicare Supplement, Medicare Advantage, and Part D Drug plans

to Medicare-eligibles. Our site is compliant with federal, state, and carrier guidelines in selling these policies. See the Medicare-eligibles section of this site for details.

We represent many carriers that offer supplemental benefits

to both individuals and families and Medicare beneficiaries, and the site contains information about hospital indemnity, cancer, critical illness, gap, accident, and international medical insurance offered by many different carriers. This section of the site also contains valuable information and tools about lowering the cost of prescription medications. Call us if you want more information about or would like to enroll in one of these products.

We also offer Short- and Long-Term Disability products

and can also help you meet the costs of long-term care, nursing home, or short-term (recovery) care needs.

Finally, we have a complete array of Life, Final Expense, and Annuity products

and offer pre-need services in Florida, as we have both life insurance and pre-need licenses in that state.

You pay nothing for our services:

we’re paid directly from the carriers we represent, Premiums are NEVER EVER marked up to include paying us for our services: you pay the same whether you order directly from the carrier or the marketplace on your own or directly through us or from our site.

We ONLY offer alternatives that are suitable for you and for which we feel meet YOUR needs.
When or if we feel a product or service is not appropriate for you from either a cost or benefit point of view we will tell you so.

We’re fully compliant with privacy and security guidelines, have signed all required privacy and security agreements, have developed a privacy and security policy, and take extraordinary steps to safeguard your protected health and personal information.
In short, we’re experts in all aspects of health and life insurance and also have relationships with professionals who can help you with very specialized situations.

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