MEDICARE SUPPLEMENT PLANS. Western Marketing Associates Corporation 318 W Huron St. Missouri Valley, IA 51555

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1 MEDICARE SUPPLEMENT PLANS FROM WESTERN MARKETING Western Marketing Associates Corporation 318 W Huron St. Missouri Valley, IA 51555

2 MEDICARE BASICS

3 WHAT IS MEDICARE? Social insurance program established by Congress in 1965 Administered by a government agency called the Centers for Medicare and Medicaid Services (CMS) Provides health coverage to over 44 million people*: Age 65 or older Under age 65 with certain disabilities Any age that has End-Stage Renal Disease (ERSD) * (23 April 2012).

4 ABC S (AND D) OF MEDICARE Original Medicare Part C Medicare Advantage Plan Part A Hospital Insurance Part B Medical Insurance Part D Prescription Drug Coverage

5 PART A: HOSPITAL INSURANCE Covers the following: Inpatient hospital care Skilled nursing facility care Home health care Hospice care

6 PART A: HOSPITAL INSURANCE Service Medicare Pays Patient Pays (2017) Hospitalization Deductibles Days 1-60: All but $1,316 $1,316 Days 61-90: All but $329 per day $329 Per Day Days : All but $658 per day Nothing beyond 150 days First 3 Pints of Blood: $0 $658 Per Day 100% of Expenses 100% of Expenses Usually Increases Each Year Skilled Nursing Facility Care Days 1-20: 100% of approved amount Days : All but $ per day Days 100+: $0 $0 $ per day 100% of Expenses

7 PART B: MEDICAL INSURANCE Standard monthly premium of $134 in 2017 Covers the following: Doctor s and other health care providers services Hospital outpatient care Durable medical equipment Home health care Many preventative services

8 PART B: MEDICAL INSURANCE Services Medicare Pays Patient Pays (2017) Doctor s and other health Care providers services Hospital outpatient care Durable medical equipment Home health care Many preventative services 80% of the approved amount 20% of the approved amount $183 deductible per calendar year May Increase Each Year

9 PART C: MEDICARE ADVANTAGE Offers health plan options run by Medicare-approved private insurance companies Option to choose Part C instead of utilizing Part A & Part B Most Part C plans also cover Part D Coverage Out of pocket costs can vary by plan May have to use certain providers who belong to the plan

10 PART D: PRESCRIPTION DRUG COVERAGE Helps cover the cost of prescription drugs Run by Medicare-approved private insurance companies that are subsidized by the government Plans may vary substantially, covering different drugs, charging their own premiums and co-pays

11 SO LET S RECAP Medicare wasn t designed to cover everything With Medicare Parts A and B, one must pay deductibles and co-payments and co-insurance Original Medicare does not offer coverage for prescription drugs in most cases One can enroll in Part D

12 MEDICARE SUPPLEMENT INSURANCE PLAN BASICS

13 MEDICARE SUPPLEMENT INSURANCE With a Medicare Supplement Plan, one can receive help paying some or all of the costs not paid by original Medicare, year after year

14 MEDICARE SUPPLEMENT INSURANCE Private health insurance designed to supplement Original Medicare Sometimes referred to as Medigap Insurance, as it strives to cover the gaps in Medicare Deductibles, co-insurance and co-pays These amounts change each year and supplement coverage covers those new amounts

15 MEDICARE SUPPLEMENT INSURANCE 10 standardized plans can be offered Plans are named for letters of the alphabet, and benefit levels vary by plan Cost can vary by plan, location, by company Plans are managed according to federal and state laws Can only cover one individual Can only have one plan at a time

16 MEDICARE SUPPLEMENT INSURANCE All plans cover basic benefits Part A coinsurance for inpatient hospital care Cost of 365 extra days of inpatient hospital care Part B coinsurance after deductible First 3 pints of blood each year

17 MEDICARE SUPPLEMENT PLANS Some of the plans also cover Part A deductible Part B deductible At-home recovery Medicare Part B excess charge Other services

18 Medicare Supplement Plans 2017 A B C D F* G K L M N Medicare Part A Coinsurance and hospital costs up to an additional 365 days after Medicare Benefits are used up Medicare Part B Coinsurance or Copayment 50% 75% *** Blood (First 3 Pints) 50% 75% Part A Hospice Care Coinsurance or Copayment 50% 75% Skilled nursing Facility Care Coinsurance 50% 75% Medicare Part A Deductible 50% 75% 50% Medicare Part B Deductible Medicare Part B Excess Charges Foreign Travel Emergency (Up to Plan Limits Out-of-Pocket Limit** * Plan F also offers a high-deductible plan. If you choose this option, this means you must pay for Medicarecovered costs up to the deductible amount of $2,200 in 2017 before your Medigap plan pays anything. $5,120 $2,560 ** After you meet your out-of-pocket yearly limit and your yearly Part B deductible ($183 in 2017), the Medigap plan pays 100% of covered services for the rest of the calendar year.

19 MEDICARE SUPPLEMENT PLANS Some of the things the plans generally do NOT cover Long-term care Vision or dental care Hearing aids Eyeglasses Private-duty nursing

20 WHO IS ELIGIBLE? Must be enrolled in Medicare Parts A and B at the time coverage begins Must be a resident of the state in which one is applying for coverage Must be age 65 or older, or under age 65 with certain disabilities

21 WHY CHOOSE A MEDICARE SUPPLEMENT PLAN? Helps manage out-of-pocket expenses Predictable costs good for budgeting purposes Guaranteed renewable As long as premiums are paid First day coverage No waiting period for pre-existing conditions

22 WHY CHOOSE A MEDICARE SUPPLEMENT PLAN? Medical coverage that can be used with any doctor or hospital throughout the U.S. that accepts Medicare assignment No referrals needed, no networks Covers Medicare-allowable services when traveling within the US Automatic claims filing, virtually no paperwork or claims to submit

23 MEDICARE SUPPLEMENT INSURANCE PRICING States can choose from three methods below: No-Age Rated (Community Rated) Everyone pays same Issue-Age Rated Premium based on age when purchased Attained-Age Rated Premium goes up automatically as you get older

24 MEDICARE SUPPLEMENT INSURANCE PRICING Other pricing elements: Gender Rating (Male and Female) Tobacco/Non Tobacco Area rating Height/Weight Rate Adjustments Help keep pace with rising Medicare claim trends and changes in annual deductibles co-insurance and co-pays. The premium may also change for reasons other than attained age. This type of premium change can occur on any Policy Renewal Date. However, such premium change cannot be made unless we make the same change to all policies of this form issued to persons of the same classification living in the same geographic area of your state. We will give you the advance written notice required by your state prior to any premium change.

25 MEDICARE SUPPLEMENT PLANS FROM WESTERN MARKETING

26 MEDICARE SUPPLEMENT PLANS FROM WESTERN MARKETING Standardized Plan A Least amount of benefits per the other plans Pays for Part A & Part B expenses Does not cover deductibles Standardized Plan F Covers 100% of Medicare approved procedures Covers excess No co-pays/deductibles

27 MEDICARE SUPPLEMENT PLANS FROM WESTERN MARKETING Standardized Plan G All the features of Plan F, EXCEPT does not cover part B deductible of $183 Standardized Plan N Covers 100% of Part A $20 co-pay for Doctors $50 co-pay for emergency room Does not cover excess