Medicare Supplement Protection

Transcription

1 Medicare Supplement Protection United American Insurance Company is not connected with or endorsed by the U.S. Government, the federal Medicare program, Social Security, or any other government agency. Policies and benefits may vary by state and have some limitations and exclusions. Medicare Supplement Insurance Policy Forms MSA06-MSD06, MSF06, MSHDF06, MSG06, MSK06 and MSL06 are available from United American where state approved. Some states require these plans be available to persons eligible for Medicare due to disability. This is a solicitation for insurance and you may be contacted by a state-licensed insurance Agent representing United American Insurance Company.

2 MEDICARE is a governmental health insurance program for Seniors age 65 and older and people with disabilities. Medicare is divided into two parts. Medicare Part A Covers Hospital Insurance Room and Board Other costs associated with confinement Skilled nursing facility care and some home health and hospice care Medicare Part B Covers Medical Insurance Doctor and surgeon fees Most lab tests and X-rays performed outside the hospital Outpatient treatment

3 Medicare Enrollment: Medicare Part A Enrollment is automatic through Social Security Premium Free (for most people) Enrollee responsible for certain deductibles and out-of-pocket expenses Medicare Part B Enrollment is Optional Monthly premium of $96.40 Enrollee responsible for certain deductibles and out-of-pocket expenses

4 Medicare Deductibles: Medicare Part A deductibles must be paid by the beneficiary each benefit period. Hospital: Medicare Pays: You Pay: Days 1-60: Most confinement $1,024 deductible costs after deductible Days 61-90: All eligible remaining costs $256 daily Days : All eligible remaining costs $512 daily Days 151 on: Nothing All hospital costs Skilled Nursing: Medicare Pays: You Pay: Days 1-20: All eligible expenses Nothing Days : All eligible remaining $128 daily expenses Days 101 on: Nothing All costs

5 Medicare Deductibles: Medicare Part B has an annual deductible of $135 for. For each eligible Part B medical expense, Medicare determines a reasonable fee called the approved charge. Medicare generally pays 80% of the approved amount; you pay 20% plus excess costs. Annual Deductible: Approved Charges: Excess Charges: Medicare Pays: $0 Generally pays 80% $0 You Pay: $135 annual deductible 20% 100% of charges above Medicare approved charges

6 Medicare Supplement plans are designed to cover some of the deductibles and out-of-pocket expenses that Medicare alone does not pay. All Medicare Supplement plans were standardized by the federal government to make benefit comparisons easier. There are 14 standardized plans. (Except MA, MN & WI) Insurers can offer any or all standardized plans, but they must offer the core Plan A. (In PA, Plan B must also be offered.)

7 All standardized Medicare Supplement plans include these core benefits: Hospitalization: Part A coinsurance plus coverage for 365 additional days after Medicare benefits end Medical Expenses: Part B coinsurance (generally 20% of the Medicare-approved expenses) Blood: First 3 pints of blood each year

8 Medicare Supplement Need After Medicare, substantial liability can remain let s review a hypothetical example. WITHOUT Medicare Supplement Plan C Pays Plan D Pays Plan F Pays Plan G Pays PART A: (Hospital Insurance) Part A Deductible 30 Days at $ Days at $512 Additional Hospitalization 3 units of blood (at $60/unit) Patient Liability $1,024 $7,680 $30,720 $20,000 $180 $1,024 $7,680 $30,720 $20,000 $180 $1,024 $7,680 $30,720 $20,000 $180 $1,024 $7,680 $30,720 $20,000 $180 $1,024 $7,680 $30,720 $20,000 $180 Skilled Nursing Facility 80 Days at $128/day $10,240 $10,240 $10,240 $10,240 $10,240 At-Home Recovery: 14 visits at $40/visit $560 $560 $560 PART A SUB TOTAL $70,404 $69,844 $70,404 $69,844 $70,404 PART B: (Medical Insurance) Outpatient Hospital Services $12,619 $8,354 $8,219 $12,619 $11,631 TOTAL $83,023 $78,198 $78,623 $82,463 $82,035 YOU PAY $83,023 $4,825 $4,400 $560 $988 (Applicable premium rates apply)

9 Comparison of Benefits: United American s ProCare portfolio consists of 9 of 14 standardized plans. (Shown in color) Plans/Benefits A B C D E F G H I J K* L* Part A - Basic Benefits 100% 100% Part B - Basic Benefits 50% 75% Part B Preventive Services 100% 100% Skilled Nursing Facility Coinsurance 50% 75% Part A Deductible 50% 50% Part B Deductible Excess Doctor Charges 100% 80% 100% 100% Foreign Travel Emergency At-Home Recovery Preventive Care Out-of-Pocket Annual Limit* $4,440 $2,220 Some states require designated Medicare supplement plans also be available to people under age 65 and eligible for Medicare due to disability (different application forms may be required). Policy benefits are identical for people over or under age 65. Premiums for people over age 65 vary by age and state of residence. Premiums for people under age 65 do not vary by age (there is one premium for all ages) but do vary by state of residence. Preventive Care benefits included with Plans E, J, and high deductible Plan J are for preventive care not covered by Medicare. This benefit is not the same as the Part B Preventive Services included only with Part B - Basic Benefits for Plans K and L. Plans F and J also have an option called a high deductible Plan F and a high deductible Plan J. These high deductible plans pay the same benefits as Plans F and J after one has paid a calendar year deductible. Benefits from high deductible Plans F and J will not begin until out of pocket expenses exceed the calendar year deductible ($1,900 in ). Out of pocket expenses for this deductible are expenses that would ordinarily be paid by the policy. These expenses include the Medicare deductibles for Part A and Part B but do not include the separate foreign travel emergency deductible in Plans F and J. * Plans K and L provide for different out-of-pocket cost-sharing (50% for Plan K, 25% for Plan L) for items and services than Plans A-J. Once you reach the annual limit ($4,440 for Plan K, $2,220 for Plan L), the plan pays 100% of the Medicare co payments, coinsurance, and deductibles for the rest of the calendar year. The out of pocket annual limit does NOT include the charges from your provider that exceed Medicare-approved amounts, called excess charges. You will be responsible for paying excess charges. The out of pocket annual limit will be increased each year for inflation. See Outline of Coverage for details and exceptions.

10 There are a number of factors to consider before deciding on a Medicare Supplement plan. Your Needs: How much coverage will you need now and in the future? Compare the benefits of each plan carefully. Above all, the plan should be suitable to your individual needs. Your Budget: Consider whether you will be able to afford the premiums on the plan you ve selected. The Company: Only policies are standardized, companies are not. Research the company s track record number of years in the industry, ratings and claims paying history. The best company is not necessarily the one with the lowest premiums.

11 Premium Type Companies have three different methods of pricing policies based on age. The three methods of pricing are: Community Rating The premium is the same for all customers who buy this policy regardless of age. Issue Age If you first buy the policy at age 65, you will pay the premium that the company charges 65-year-old customers, and will continue to pay the age 65 rate as you get older, no matter what your current age. Premiums may increase on a class basis by state. Attained Age With this type of policy, your premium will increase each year based on your age.

12 Since 1947, United American Insurance Company has brought protection and security to hundreds of thousands of Americans across the nation. Special commitment to serving Seniors for more than four decades Personal one-on-one Agent Service for the life of the policy One of the largest writers of individual Medicare Supplements in the country* Pioneered nationwide Automatic Claims Filing Service** *2007 NAIC Final Medicare Supplement Experience Report 08/2007. **Available with the purchase of UA s optional non-insurance discount health services program UA Partners.

13 Outstanding Features / Added Value of United American: No Pre-Existing Conditions/No Waiting Periods (If Replacing Another Medicare Supplement or Open-Enrollment) Your Choice of Doctors/Hospitals Guaranteed Renewable, as long as premiums are paid on time* Top Ratings Local Agent Commitment to Senior Life/Health Market Optional UA Partners non-insurance discount health services program including optional Automatic Claims Filing * Premium rates or benefits may change at a certain age or class.

14 United American strives to deliver quality, innovative service to our policyholders through extensive Home Office support and one-on-one Agent attention. UA delivers: Fast policy issue Claims processing averaging less than a week* Automatic Payment Plan (Bank Draft) eliminates unintentional lapse and provides non-stop protection Easy to understand product brochures clearly defined benefit descriptions and simple yes/no applications. *Based on Company records as of

15 United American is proud of its strong tradition of financial stability. We continually receive top industry ratings, proof we will be here for the long term. A+ (Superior)* - for financial strength - A.M. Best Company, more than 30 consecutive years AA- Very Strong **- for financial strength - Standard & Poor s These ratings refer only to the overall financial strength of the company and are not a recommendation of the specific policy provisions, notes or practices of the insurance company. *Rating as of 6/07, **Rating as of 11/07.

16 With our Optional UA Partners program, members can receive discount health services from thousands of participating providers nationwide. Savings range from: Chiropractic Dental Eye Care Hearing Aids Prescriptions Mail Order Pharmacy to 40% 10 to 50% 20 to 60% Average of 20% up to 30% save even more money DISCLOSURE: This plan is NOT insurance. The plan provides discounts at certain health care providers of medical services. The plan does not make payments directly to the providers of medical services. The plan member is obligated to pay for all health care services but will receive a discount from those health care providers who have contracted with the discount plan organization. The range of discounts for services offered will vary depending on the type of provider and service. Discounts on hospital services are not available in Maryland. This is not a Medicare prescription drug plan. This plan is administered by Coverdell & Company, Inc., a discount medical plan organization at 8420 W. Bryn Mawr, Suite 700, Chicago, IL 60631, You have the right to cancel this plan within 30 days of the effective date for a full refund of fees paid.

17 Automatic Claims Filing virtually eliminates the need to file as a majority of all Medicare Supplement claims are Part B and come to UA directly. Helps ensure no missed claims Speeds claims delivery Direct provider payment Consolidated monthly claim statement Note: Federal law requires Medicare to file a small number of claims directly with insurers.

18 NO DEDUCTIBLE We offer fixed copayments for drugs Nationwide pharmacy network All states Call or visit United American Insurance Company is a Medicare approved provider of the Part D plan and contracts with the federal government. Form MSP-07