Joseph Dowless - CLC Financial

09/03/2026

Retired State Employees:

This year if you want to remain on the 70/30 plan and elect to additionally enroll on a medical only Medicare Advantage plan (which I HIGHLY recommend you do), you will need to take action during the State Open Enrollment or you will automatically be forced onto the Humana plan.

If you forget and get pushed over, please contact me and I can help you. If you had no idea this set up was even an option and would like to know more, please contact me as well.

08/20/2026

I don't usually post things that are unrelated to business here, but I'm very proud of my Kiwanis group for making backpacks available to every incoming kindergartner in Cumberland County. Only a small handful of schools already had donors and didn't participate.

Katrina McKinnon from Gray's Creek Elementary (left) and club member Joseph Dowless (right).  Photo provided by: Kiwanis Club of Cape FearThe Kiwanis Club of Cape Fear has been working to prepare the youth of today for a year of success. This year, the Club has worked to make backpacks avai...

08/14/2026

If you have a Medicare Advantage plan this year and you're thinking of putting off your dental work until next year...I advise you to not wait.

06/12/2026

Sharing a quick heads-up on a new CMS GLP-1 “Bridge Program” launching July 1.

What this is:

New CMS program to provide affordable access to GLP-1 medications

Separate from Part D (this is important)
Who qualifies:

BMI 27+ with a qualifying condition (ex: heart disease, prediabetes)
OR BMI 35+ (auto-qualifies)

How it works:

Requires prior authorization through a central CMS system.
Prescriptions are not processed through the member’s Part D plan
Providers do NOT need to be Medicare-enrolled to submit

Member cost:
$50 flat monthly copay at the pharmacy once approved

This is not a plan benefit chang, it’s a CMS-managed program.

IN LAYMAN'S TERMS:

if you're taking Ozempic, Wegovy, or any of the GLP-1 drugs and you are Medicare eligible, then this is a program you talk to your primary care to get involved in. This is outside the scope of any insurance plan you are on. Your plan has nothing to do with it. You must go through your doctor. The doctor must do prior authorization if you meet the criteria to get the $50 copay.

05/04/2026

Network Updates:

United Health Care:

April 29, 2026 — Vidant Medical Group physicians
July 15, 2026 — ECU Health hospital

UHC has gone OUT of network with Vidant Medical Group but are still in network for ECU Health until at least July 15th. They are still negotiating.

HUMANA - UNC Health is out of network for Humana Individual Medicare Advantage Plans. This does include ECU health as ECU Health falls under the UNC umbrella; however, State Retirees on the State Humana plan are still accepted.

Let me say that again because I keep getting asked.

State Retirees can still go to UNC Health, including ECU Health, with their STATE Humana plan. The State plan is a different network entirely from the individual medicare advantage plans. That being said, if you're on the state Humana plan, I can show you how to get superior coverage for yourself while still remaining on the state plan.

03/17/2026

To anyone with Medicare or who has loved ones with Medicare. One of my clients just called me to check on whether or not what she was being told is true. Someone called her and claimed to be from United Healthcare and told her she owed them $300 immediately or her insurance would be canceled due to legislation the federal government passed.

This is a scam.

Medicare companies will not call you direct demanding immediate payments like this.

If you're ever unsure about a phone call, always err on the side of it being a scam. You can hang up and call the customer service number on the back of your card and ask the company directly to confirm anything you've been told.

Be safe. Don't be sorry.

03/05/2026

11/15/2025

United Healthcare is now out of network with WakeMed.

From UHC -

"WakeMed’s facilities and specialty providers are out of network for people enrolled in the following plans, effective Nov. 15, 2025:

Employer-sponsored and individual commercial plans
Medicare Advantage plans, including Group Retiree and Dual Special Needs Plan (DSNP)


Primary care physicians employed by WakeMed are not impacted by this negotiation and will remain in our network. People enrolled in our Medicaid plans will continue to have network

access to WakeMed’s hospitals and providers. People enrolled in a Medicare Supplement plan can also continue accessing care with WakeMed on and after Nov. 15, 2025."

11/04/2025

Key ACA repayment rule changes for 2026

Repayment caps are eliminated: For the 2026 tax year, there will be no limit on how much excess APTC you have to repay if your income turns out to be higher than you projected when you enrolled.

Full repayment may be required: You will be responsible for repaying the entire amount of the excess subsidy, regardless of how high it is, which could be a significant sum if your income was underestimated.

Applies to 2026 plan year coverage: This new rule takes effect for coverage purchased for the 2026 plan year, and the repayment will happen when you file your 2026 tax return in 2027.
Increased affordability threshold: The IRS has set the ACA affordability threshold at 9.96% for plan years beginning in the 2026 calendar year.

TL;DR - don't under report income this year or you'll owe it all back. No caps on repayments this time around.

10/28/2025

As of Jan. 1, 2026 UNC Health is out-of-network with Humana, WellCare, and Health Care Service Corporation (HCSC/formerly Cigna) Medicare Advantage plans. Humana North Carolina State Employee Health Benefit Plan (Medicare Advantage for retirees) members will continue to be seen with no increase in cost.

Cape Fear Valley remains out of network wtih United Healthcare.

Please consider these factors when making a decision during open enrollment this year. Feel free to reach out to me for help.

Send a message to learn more