Best Health Insurance Agencies in Miami Beach

Frequently Asked Questions

• Introduction

  If you're looking for health insurance for yourself or your family, an agent can help you save time, understand your options, and manage your costs. Insurance agents must be licensed in the state where they operate. They can provide information about on- and off-exchange plans to help you weigh all of your options, and they can see if you qualify for tax credits that can lower your monthly premiums. There's no cost to work with an agent, and they can help you save quite a bit by recommending the best plan for your needs. Here's what you should know before you get started.
  

• What should you do if your health insurance policy in Miami Beach is canceled?

  If your health insurance in Miami Beach was canceled due to non-payment of premiums, but you made payments on time, contact the National Association of Insurance Commissioners at https://www.myfloridacfo.com/division/consumers/needourhelp. If you did not pay your premium by the grace period and your insurance lapsed, you will have to wait until the next open enrollment period, which begins on January 1. You may be eligible for a Special Enrollment Period under the Affordable Care Act to enroll during the year.

• What should you do if your insurer in Miami Beach refuses to cover a treatment or prescription pill your doctor says you require?

  If your insurer in Miami Beach refuses to pay a claim or denies pre-authorization for a service, you can file an appeal. Insurers must explain why they denied your claim or pre-authorization and how you can appeal their decision. An insurer's decision can be challenged in two ways: internally or externally. Your doctor can assist you in filing an appeal or provide you with the necessary medical documentation to demonstrate the need for the treatment or specific prescription medication.

• What is the Children's Medical Services Plan, and how do you know if your child is eligible for this plan in Miami Beach?

  CMS began as a specialty managed care plan for children with exceptional healthcare needs in August 2014, in accordance with Florida law. Its mission is to provide care for children with special health care needs from birth to the age of 21. Your child will be eligible for this plan in Miami Beach if they qualify for Medicaid, are under 21 years old, have serious physical, developmental, behavioral, or emotional disorders as defined by Florida law, and require health care services beyond what children require.

• Does the CMS plan provide coverage for medications in Miami Beach?

  Prescription medications may be prescribed by a Miami Beach physician who is on the CMS Plan. To view the complete inventory of medications covered by the CMS Plan, go to https://ahca.myflorida.com/medicaid/prescribed-drugs/medicaid-pharmaceutical-therapeutics-committee/florida-medicaid-preferred-drug-list-pdl. For the most up-to-date preferred drug list, it is best to consult the Preferred Drug List document on a regular basis.

• Who is eligible to purchase Marketplace health insurance in Miami Beach?

  In Miami Beach, Marketplace health coverage is available to residents who are US citizens or lawfully present in the country, are not in jail, and are not enrolled in Medicare. However, those restrictions only allowed for exchange enrollment. The Marketplace offers premium subsidies and cost-sharing reductions to households with incomes less than the second-lowest Silver plan in their area. To be eligible for financial assistance with your Marketplace plan, you must not be on Medicaid, CHIP, or have employer-sponsored health insurance.

• How can you find affordable health insurance? 

  Affordable insurance is available through employers, Medicare, Medicaid, and the federal Health Insurance Marketplace, which offers subsidies in the form of tax credits. You can also purchase coverage through private insurance companies and independent agents. Nearly half of all Americans have employer-sponsored health insurance, and about 10% of the population is uninsured.