Chaperone Health Insurance Plus
Insurance Closest to You: Extra Help and Special Situations Near You in Fort Lauderdale, Florida
Some coverage decisions come with extra rules. If you have both Medicare and Medicaid, need help paying for prescriptions, live with a chronic condition, or just went through a major life change, the options open to you are different from the standard ones, and so are the deadlines. I’m Roxroy Ashley, an independent licensed agent with HealthMarkets, and I help people in these situations understand what they may qualify for and compare their choices in plain language. Book a free plan review and we’ll start with your situation.
I’LL EVEN CALL YOUR DOCTOR
Get a Free Quote From a Licensed Medicare Agent Who Does the Research for You
Special situations come with their own plan rules, so before I recommend anything, I check:
- Your doctors and hospitals against each plan’s network, including HCA Florida, Memorial, and Baptist Health, since a doctor may accept Medicare but not a particular Special Needs Plan
- Your prescriptions and pharmacy against each Part D drug list, even if you get Extra Help
- Your full-year cost, accounting for any help you already receive
If you’re under 65 and changing coverage after a life event, I check Marketplace plans the same way. If a detail is unclear, I call your doctor’s office myself. Your quote is free, with no obligation to enroll. Get your free quote and I’ll do the research for you.
Hear how I help you choose a plan with confidence.
MORE THAN A FREE QUOTE
Why Choose Me: Extra Help & Special Situations
When you’re comparing Medicare agents who handle special situations, here’s what to look for, and what you can expect from me.
Your Doctors, Hospitals, and Prescriptions Checked First: A doctor may accept Medicare but not a particular Special Needs Plan. Before I recommend any plan, I check your doctors, hospitals, and every prescription against its network and drug list, including your pharmacy. If something is unclear, I’ll call your doctor’s office myself.
Every Question Answered, at Your Pace: Medicaid, Extra Help, and Special Needs Plans each have their own rules, and they’re confusing even for people who’ve had Medicare for years. I take as long as you need, explain each piece in plain language, and answer every question until it makes sense. There’s no pressure and no obligation to enroll.
What You Qualify For, Checked First: Before we look at plans, I check whether you may qualify for Extra Help, a Medicare Savings Program, or a Special Needs Plan, and I help you apply. Eligibility is decided by the program, not by me, and I’ll tell you what to expect.
The Plan That Costs Less for You: With Extra Help or Medicaid, your costs still depend on the plan. I calculate your full-year cost for every option, accounting for any help you already receive, so you see what you’d actually pay.
My Help Costs You Nothing Extra: Insurers pay my commission, and plan premiums are generally the same whether you enroll through me or directly, so you get personal guidance and ongoing support at no additional charge.
Coverage That Works With the Help You Have: Some plans coordinate closely with Medicaid and others don’t. I check how each plan fits with your Medicaid, Extra Help, or condition, so your coverage works together instead of against itself.
Licensed and Verified, Not a Government Office: I’m an independent agent, not Medicare, Medicaid, or Social Security. I’m licensed in 33 states and AHIP certified for the 2027 plan year. You can verify my license (Florida License #W323530, NPN #17946070) anytime through your state’s insurance department.
I Stay Your Agent After You Enroll: Work with me directly, in person, by phone, on Zoom, or at your home in Broward, Miami-Dade, or Palm Beach, and I reply within 24 to 48 hours. If you have Medicaid or Extra Help, you may be able to change plans more than once a year, and I’ll tell you when a change is worth making and when it isn’t.
You can read all 25 reasons we should work together on my Why Choose Me page.
Medicare Agents in Your Area for Extra Help and Special Situations
Special situations cover more ground than most people expect. On this page I walk through the four I help with most: Medicare and Medicaid dual eligibility, Special Needs Plans, Extra Help with Medicare drug costs, and Special Enrollment Periods for both Medicare and Marketplace coverage. These programs aren’t only for people turning 65. Medicare also covers many people under 65 who have a qualifying disability, End-Stage Renal Disease, or ALS, and many people who qualify for both Medicare and Medicaid are under 65.
Each program has its own eligibility rules, and the programs often overlap. Someone with full Medicaid, for example, generally qualifies for Extra Help automatically, may be able to join a Special Needs Plan, and has more chances during the year to make certain coverage changes. Because one decision affects the others, I look at the whole picture together instead of one piece at a time.
Medicare and Medicaid Dual Eligibility
You’re considered dual eligible when you have Medicare and also qualify for some level of Medicaid help. Medicare is a federal program, while Medicaid is run by each state, so Medicaid rules depend on where you live. In Florida, Medicaid eligibility is determined by the Department of Children and Families.
Dual eligibility comes in two broad forms. Full-benefit dual eligibility means you qualify for your state’s full Medicaid benefits in addition to Medicare. Partial-benefit dual eligibility usually means you qualify for a Medicare Savings Program, which may help pay your Medicare Part B premium and, depending on the program, other Medicare costs such as deductibles, coinsurance, and copays. Medicare generally pays first, and Medicaid may help with costs and services Medicare doesn’t cover.
Getting the most out of both programs means making sure your Medicare coverage works with your Medicaid benefits, your doctors, and your prescriptions. I’ll help you understand which level of help you have, what it covers, and which Medicare options fit alongside it. If you think you may qualify but haven’t applied, I can explain where to apply and what the process involves.
Special Needs Plans, Explained in Plain Language
A Special Needs Plan (SNP) is a type of Medicare Advantage plan (Part C). Like other Medicare Advantage plans, it’s offered by a private insurance company approved by Medicare, and it’s an alternative way to receive your Part A and Part B benefits. You still have Medicare. A Special Needs Plan is not a Medicare Supplement (Medigap) policy, which is a separate type of coverage that works alongside Original Medicare. Special Needs Plans generally include Part D prescription drug coverage.
What makes a Special Needs Plan different is who can join. There are three kinds: Dual Eligible Special Needs Plans (D-SNPs) for people who have both Medicare and Medicaid, Chronic Condition Special Needs Plans (C-SNPs) for people with certain severe or disabling chronic conditions, such as diabetes or chronic heart failure, and Institutional Special Needs Plans (I-SNPs) for people who live in a nursing home or similar facility, or who need that level of care at home. Each plan designs its benefits, provider network, and care coordination around the group it serves.
Special Needs Plans aren’t available everywhere, and benefits, networks, and costs vary from plan to plan. Before I recommend one, I check your doctors, hospitals, prescriptions, and pharmacy against the plan’s network and drug list. My familiarity with South Florida health systems, including HCA Florida, Memorial Healthcare System, and Baptist Health, helps me spot network issues early. If a Special Needs Plan isn’t the right fit, I’ll also walk you through your other options, including Original Medicare with a stand-alone Part D plan.
Extra Help With Prescription Drug Costs
Extra Help, also called the Part D Low-Income Subsidy, is a federal program that helps people with limited income and resources pay for Medicare prescription drug coverage. Depending on your situation, it may help with your Part D premium, your deductible, and the copays you pay at the pharmacy. Income and resource limits are updated each year, and you can apply through Social Security or your state Medicaid office.
Some people qualify automatically. If you have full Medicaid, get help from a Medicare Savings Program, or receive Supplemental Security Income (SSI), you generally qualify for Extra Help without a separate application, and Medicare will let you know by mail. Since 2024, everyone who qualifies receives the full level of Extra Help, which replaced the older partial level.
Extra Help works with the Part D coverage you choose, so the plan still matters. Drug lists, pharmacy networks, and costs differ from plan to plan and can change every year. I run your full medication list and preferred pharmacy through each plan we consider, and I repeat that review every Annual Enrollment Period. If you aren’t sure whether you qualify, I’ll explain the general requirements and how to apply.
Special Enrollment Periods for Medicare and Marketplace Coverage
Most people can change their coverage only during set enrollment windows each year. A Special Enrollment Period (SEP) lets you enroll or make a change outside those windows after certain events or because of certain circumstances. The rules for each SEP, including how long you have to act, depend on the reason you qualify.
On the Medicare side, common reasons include moving to a new area, losing employer or other coverage, moving into or out of a nursing home, or a change in your Medicaid or Extra Help status. Since January 1, 2025, people with Medicaid or Extra Help can use a once-per-month Special Enrollment Period to switch to Original Medicare with a stand-alone prescription drug plan, or to change stand-alone drug plans. People with full Medicaid can also use a separate once-per-month SEP to join certain Dual Eligible Special Needs Plans that coordinate closely with Medicaid. Some exceptions apply, so I’ll confirm which options are open to you.
For people under 65 who buy their own coverage, Marketplace Special Enrollment Periods usually follow a qualifying life event, such as losing health coverage, moving, getting married, or having or adopting a child. In most cases you have 60 days after the event to choose a plan, and you may be asked for documents that confirm the event. If you qualify, you may also be eligible for financial help that lowers your monthly premium, depending on your household income.
Qualifying for a Special Enrollment Period doesn’t mean you should switch. A change can affect your doctors, your prescriptions, and your costs, and some changes are hard to undo. I’ll compare your current plan with your other options side by side, and if your current plan is still the right fit, I’ll tell you to keep it.
Why Choose Me for Extra Help & Special Situations
Special situations often involve more paperwork and more moving parts, and here’s what you can expect working with me.
I’m independent, not captive. I’m not tied to one insurance company, so I can compare plans from multiple carriers side by side. I’m upfront that I don’t offer every Medicare plan available in your area, and you can review all of your options at Medicare.gov.
I have the experience for these specific situations. I’ve spent 14 years in insurance and the last 8 focused on Medicare, working with clients who qualify for both Medicare and Medicaid, Special Needs Plans, and Extra Help.
I’m licensed and verified. I’m licensed in 33 states (Florida License #W323530, NPN #17946070), AHIP certified for the 2027 plan year, and registered with the federal Health Insurance Marketplace. HealthMarkets has recognized me among its top 100 agents every year from 2022 through 2026.
You’ll always work with me directly. No hand-offs to an assistant or call center, and I reply within 24 to 48 hours. I stay involved after you enroll, reviewing your coverage every year and helping with claims and billing questions.
I meet you where you are. Many people in special situations find it hard to get to an office, whether because of a disability, a health condition, or caregiving responsibilities. I meet by phone, over Zoom, at my office in Fort Lauderdale, or at home, with home visits throughout Broward, Miami-Dade, and Palm Beach counties. If you live outside South Florida, I can still help by phone or Zoom in any of the 33 states where I’m licensed.
Your information stays protected. Applying for Medicaid, Extra Help, or a Special Needs Plan often means sharing sensitive documents, including income and resource details. With a BA in Information Technology, I understand how important data security is, and I handle your information with care every step of the way.
I can help with all of your coverage. I help with Medicare plans, turning 65 or retiring, individual and family health insurance for anyone under 65, small business and self-employed coverage, Extra Help and special situations like Medicare and Medicaid dual eligibility, and dental, vision, life, and supplemental insurance. You can see everything I help with on my services page.
You can read all 25 reasons we should work together on my Why Choose Me page.
MORE WAYS I CAN HELP
Find the Right Coverage for Every Stage of Life
Most households need more than one kind of coverage, and what you need changes as life does. Keep reading for the details on this page, or see all the coverage I help with and my guides to each type of insurance:
Is Extra Help or a Special Needs Plan Right for You?
This page may be a good starting point if you have Medicare and Medicaid, have received a notice about a Medicare Savings Program or Extra Help, are having trouble keeping up with prescription costs, live with a chronic condition, live in a nursing home or need that level of care, or recently had a life change that affects your coverage. It also applies if you’re under 65 and have Medicare because of a disability.
Eligibility for these programs depends on factors such as your income, resources, health, and where you live, so the best way to know is to review your situation. I’ll explain what you may qualify for, what each option would mean for your doctors, prescriptions, and yearly costs, and what the next steps are.
Frequently Asked Questions
How Much Does It Cost to Work With You, and What Will My Coverage Cost?
Nothing to work with me. My help comes at no extra cost, and plan reviews and quotes are free with no obligation to enroll. I’m paid a commission by the insurance company when you enroll in a plan through me, and that commission is already built into the plan’s premium, so you pay the same whether you enroll through me or directly with the carrier. Your actual yearly cost depends on the plan itself: premium, deductible, copays, drug costs, and out-of-pocket maximum, and I give you a full-year estimate for each option. Depending on your eligibility, you may also qualify for help with costs, such as Extra Help with Medicare drug costs, a Medicare Savings Program, full Medicaid, or financial help for Marketplace plans. All quotes are estimates until you’re enrolled.
How Do I Know if I Qualify for Extra Help or a Dual Eligible Special Needs Plan?
To join a Dual Eligible Special Needs Plan, you generally need Medicare Part A and Part B, need to qualify for the level of Medicaid the plan requires, and need to live in the plan’s service area. Extra Help is based on your income and resources, and you may qualify automatically if you have full Medicaid, a Medicare Savings Program, or SSI. Otherwise, you can apply through Social Security or your state Medicaid office. Limits change every year and Medicaid rules vary by state, so I’ll walk through your situation during a free plan review. I can’t guarantee eligibility, but I can make sure you know which programs are worth looking into.
Can I Keep a Medicare Supplement Plan if I Qualify for Medicaid?
Usually not. If you have Medicaid, it’s generally illegal for an insurance company to sell you a Medigap policy, with limited exceptions, because Medicaid may already help with many of the costs Medigap would cover. If you already have a Medigap policy and later qualify for Medicaid, you may be able to suspend it for a limited time. I’ll help you understand how Medigap, Medicare Advantage, and Medicaid each work, and I keep those options clearly separate so you know exactly what you’re comparing.
Are You a Medicare Representative?
No. I’m an independent licensed agent with HealthMarkets, not a representative of Medicare, Medicaid, or any government agency, and this website isn’t operated by or affiliated with the federal Medicare program. What I do is explain your options clearly and help you compare them. To reach Medicare directly, visit Medicare.gov or call 1-800-MEDICARE (TTY 1-877-486-2048), 24 hours a day, 7 days a week. For Medicaid questions in Florida, contact the Department of Children and Families.
How Do I Find an Agent Who Understands Dual Eligibility and Special Needs Plans?
Look for someone licensed in your state who completes Medicare training and certification every year and has experience with dual eligibility, Special Needs Plans, and Extra Help. You can verify any agent’s license through your state’s insurance department. What matters most is whether the agent checks your doctors, prescriptions, and Medicaid benefits before recommending anything. I do that for Special Needs Plans, other Medicare Advantage plans, and Original Medicare with a Part D plan. I’m licensed in 33 states, including Florida (License #W323530, NPN #17946070), and AHIP certified for the 2027 plan year.
What Does an Independent Agent Do Differently?
A captive agent represents one insurance company. An independent agent can offer plans from more than one, which makes it easier to compare options side by side. I compare plans from multiple carriers, including Special Needs Plans where they’re available. No agent offers every plan, and I’ll always be clear about what’s available through me and where you can see all of your options.
Can You Help if I’m Under 65 and Need Health Insurance After a Life Change?
Yes. I help about 148 individuals and families with ACA/Marketplace coverage each year, based on my own client records, including people who qualify for a Special Enrollment Period after losing coverage, moving, getting married, or having a baby. I compare Marketplace and off-Marketplace plans with you and check whether you may qualify for financial help, which is only available through Marketplace plans. I’m also a good fit for households where one spouse is on Medicare and the other needs individual coverage.
Where Are You Located, and How Can We Meet?
My office is at 6360 NW 5th Way Ste 101, Fort Lauderdale, FL 33309. We can meet there, at your home anywhere in Broward, Miami-Dade, or Palm Beach County, by phone, or on Zoom. Clients in the other 32 states where I’m licensed work with me by phone or Zoom. Whichever you choose, I reply within 24 to 48 hours.
- How It Works
How we'll work together
Five steps, no pressure, and I stay with you after you enroll.
1
We talk about you
By phone, Zoom or face to face. Your health, your budget, your doctors.
2
I check the details
Doctors, hospitals, prescriptions and pharmacy, checked against each plan.
3
We compare real costs
A full-year estimate for each option, explained in plain language.
4
You decide, I enroll you
No pressure. If you choose a plan, I handle the application with you.
5
We review every year
Plans and networks change. I check yours each year and help with claims in between.
Book a Free Plan Review
Pick a time for a free 15-minute call by phone or video. I’ll check whether your doctors are covered, and my help never costs you anything extra.
Call or text: (954) 410-3710
Email: contact@chaperonehealthinsuranceplus.com
Office: 6360 NW 5th Way Ste 101, Fort Lauderdale, FL 33309
Meet by: phone, video, at my office, or at home in Broward, Miami-Dade and Palm Beach.