Health Navigation Services
Health Navigation
There are many different types of specialists you need to be aware of as well as nuances such as the difference between DO’s and MD’s, physicians vs extenders, and other providers including PA’s, NP’s, and PT’s. Traditional care is now complemented by telemedicine, concierge medicine, and asynchronous care.
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​It is time to simplify health navigation to ensure you get the right care from the right provider at the right time. No more undue stress in trying to figure out where to go for care when you are not feeling your best.
Health Plan Selection
It's easy to get overwhelmed by the numbers...
6,126
Health plans offered on healthcare.gov
3,998
Medicare Advantage Plans
900
Health Insurance Companies
Similar to our health system, health coverage is equally complex, especially given all the available plans and the contents within them. ​
Why is health plan selection important, especially for seniors? ​
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1
As we age, we need more medical care.
Adults, 65+, are the largest consumers of healthcare in the US.
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Chronic Conditions: Higher risk of chronic conditions like heart disease, diabetes, and cancer.
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Acute Illness: More susceptible to complications from illnesses that requiring hospitalization and intensive care.
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Functional Decline: Physical or cognitive decline, leading to a greater need for assistance with daily living activities.
2
Medical care is not cheap, especially if you are not insured.
The famed Olympic gymnast, Mary Lou Rhetton, faced an unexpected life-threatening bout of pneumonia last October. The illness prompted the 55-year-old’s daughter to turn to crowdsourcing to raise money for her medical bills, resulting in a reported $459,234 in donations. She was not insured.
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Believe it or not, seniors (65+) consumed $1.2 trillion in healthcare services in 2020.
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Limited Window for Plan Selection.
Medicare Advantage Plans for 2025:
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Initial Enrollment Period: Starts 3 months before the month you turn 65 and ends 3 months after.
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Annual Enrollment Period (AEP): October 15, 2024, to December 7, 2024.
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Special Enrollment Period (SEP): December 8, 2024, to November 30, 2025, for 5-star plans.
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Medicare Advantage Open Enrollment Period (MAOEP): January 1, 2025, to March 31, 2025.
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General Enrollment Period: January 1, 2025, to March 31, 2025.
Government Marketplace for 2025:
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Open Enrollment Period: November 1, 2024, to January 15, 2025.
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Coverage Start Dates: Plans selected by December 15, 2024, start January 1, 2025. Plans selected between December 16, 2024, and January 15, 2025, start February 1, 2025.
4
Not all care is available or covered.
Some plans have limited coverage or exclusions for specific services. Here are some common examples:
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Hospital Stay
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Mental Health Coverage
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Prescription Drug Coverage
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Rehabilitation Services
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Exclusions
