New Shingles Vaccination

Source: CDC Urges Everyone 50 and Older to Get New Vaccine

It might be time to get vaccinated against shingles if you’re 50 or older.

Folks in this age group — even people who are healthy — should get a new shingles vaccine sold under the name Shingrix, according to the Centers for Disease Control and Prevention.

The CDC’s vaccine recommendations include a shingles vaccine for adults age 50 and older. Previously, the CDC specified a different shingles vaccine, Zostavax, as the go-to prevention for shingles. However, that recommendation only applied to folks 60 and older. The CDC still recommends Zostavax as an effective treatment for shingles, but now says Shingrix is the better option for most people.

The article goes on to say that Shingrix should be available in April. It’s much more effective than Zostavax…

The CDC’s Advisory Committee on Immunization Practices reports that clinical trials found the vaccine is more than 90 percent effective in preventing shingles in folks age 50 and older. Zostavax, by contrast, is anywhere from 38 percent to 70 percent effective, depending on age.

If you’ve ever spoken with anyone that had shingles, you know it’s time to get in line for your Shingrix vaccination.


Why you need to do your doctor research before signing up for Medicare Advantage | PBS NewsHour

Beware the lure of low or even zero dollar premiums –  Why you need to do your doctor research before signing up for Medicare Advantage | PBS NewsHour

Medicare Advantage plans generally only provide insurance coverage if you use doctors in their network, or may charge higher rates for out-of-network care.

Boulder clients need look no further than the Boulder Medical Center private practice. The only Medicare Advantage plan they accept or plan year 2018 is Humana: Humana Medicare Advantage comes to Boulder Medical Center.


Over 300 Frequently Asked Questions on ACA

Health Reform FAQs | The Henry J. Kaiser Family Foundation

Examples of more interesting questions:

  • I live in one state, but drive across the border every day to work in a different state. What marketplace should I use to buy coverage?
  • Can I buy a plan in the Marketplace if I don’t have a green card?
  • How does the “marriage” special enrollment period work?
  • I have  COBRA and am finding it difficult to afford, but Open Enrollment is over. Can I drop my COBRA and apply for non-group coverage outside of Open Enrollment?
  • Can I be charged more if I have a pre-existing condition?  (NO)
  • What’s the penalty if I don’t ahve coverage?
  • I had health insurance last year through a Marketplace plan but paid the full premium myself during the year. Now that Iv’e done my taxes, I know my income for the year was less than 400% of the federal poverty level, so I may be eligible for a tax credit. Can I still get it?

And many more!



2018 Enrollment Resources 1

I will post links to information on various plan options, especially for non compliant ACA options here as I add them to the site. Any plan that is not ACA compliant is not eligible for a tax credit.

Added 10/17/2017

  • United Health Indemnity Brochure
    • Subject to the ACA penalty unless you have a waiver
    • No deductible
    • Pays specified amount based on occurrence. What they pay is not affected by what is charged or covered by other insurance
    • Rx coverage is not a strength of this plan
    • There IS medical underwriting. Not everyone qualifies.
    • The plans are designed to fill in the gaps of your ACA plans.
    • No doubt, some will consider the fuller feature plans as stand alone plans.
    • This is a limited benefit plan. Technically it is considered an indemnity plan.

I will post information on the Altrua Healthcare Sharing Ministries Plans shortly. Update 10/26 – I am attending an Altrua update webinar tomorrow. Hope to have information to pass along.

Short Term coverage

  • National General Brochure
    • Subject to ACA penalty
    • Deductibles from $1000 to $25,000
    • Max coverage period is currently 90 days
    • Rx coverage only available if insured is in-patient
    • There is medical underwriting. Not everyone qualifies.
    • Does not cover pre-existing conditions
    • Does not provide preventive care (some exclusions)
    • Please read exclusions portion of brochure
    • Plan is non-renewable
      • You CAN get  a 2nd plan, but you must apply for a new policy. It is NOT a continuation of you current plan. Issuance is NOT guaranteed. Anything you were covered for in the 1st plan will be considered a pre-existing condition for the 2nd plan.

The right mindset for short term plans is that you are looking for a plan to cover anything NEW condition that would occur in the period of time that you own the plan (currently not more than 89 days).


Why I can no longer assist with Medicaid/Peak applications

Dear Clients,

I apologize in advance but I can no longer assist with Medicaid/Peak applications. There are a number of reasons that I will detail below.

#1. I am not paid by either Medicaid or Connect for Health Colorado to work on Medicaid applications. This has been a service that is basically gratis in order to gain clients and improve client satisfaction. For this effort I hopefully get a client and receive commission from the health insurance company. This is not a sustainable situation.

#2. Too often when working on PEAK/Medicaid applications, I am called on to answer tax or legal questions. I am not qualified to answer these types of questions, even when I believe I know the answer. Furthermore, my Errors and Omissions insurance would not cover me if a dispute was to arise regarding Medicaid or a tax credit determination. In other words, I am exposing myself to significant liability and doing so for no compensation. Not to mention the PEAK/tax credit determination is an error prone process and trying to fix these errors is a very time consuming process.

#3. The insurance companies have steadily lowered commissions to agents. I understand this is not directly your problem and am not asking for your sympathy. For 2018 it has reached to point where, putting legal exposure aside, it is simply impossible for me to justify working on Medicaid/PEAK applications from a financial perspective. For assistance with tax credit and Medicaid/Health First Colorado issues going forward, your points of contact are Connect for Heath Colorado, the Colorado PEAK website or your local Dept of Health and Human Services. These organizations pay their employees to help you and they are trained in this area.

In closing, my area of expertise and my licensing & certification have to do with health and life insurance. My area of expertise is in finding the plan that offers you the best value. I am qualified to do that and would appreciate the opportunity to continue our broker/client relationship as you search for a plan in 2018.

Best Regards,

Christopher (Chris) Adams
Boulder, CO
303.495.3045 – office
303.859.1709 – cell
CO Health & Life license #321982


Medicare Open Enrollment coming up

Medicare open enrollment is Oct 15th through December 7th. If you’re on Medicare what does that mean to you?

Medicare open enrollment is when you can renew or change your current Part D drug plan or Medicare Advantage (Part C) plan.

Hey, what if you’re on a Medicare Supplement? Can you change that during open enrollment? Well the answer is YES, but what you should really know is you can change your Medicare Supplement plan ANYTIME you want. This assume you can navigate the medical questions on the application.

What medical questions you ask? Well you’re most likely right that if you signed up when you turned 65 or when you left your employer’s medical plan after age 65 you it’s quite possible to have applied without having to answer medical questions. That was a ONE time event. To change plans now, you need to undergo medical underwriting. That said, if you health is good, or in most causes, just slightly better than mediocre, you can most likely change plans and save premium dollars.


Food for thought!


Approved Rate Increases for 2018 Individual Market

The Colorado Division of Insurance has approved rate increases for the individual market in 2018. At the present time, only the average rate increases have been released. They are summarized in the table below.


CompanyApproved Increase
Anthem HMO30.2%
Anthem PPO Catastrophic33.5%
Bright Heatlh27.4%
Denver Health12.7%
Friday Health
(Colorado Choice)
Rocky Mountain11.5%

The average rate increase across the state is 26.7% according to the division.