Freedom Medicare Supplement

Transcription

1 Freedom Medicare Supplement Featuring Plan J and High-deductible Plan F Medicare Supplement protection to fit your needs and your budget. Z-1848

2 Freedom Medicare Supplement When you choose our new plans you could save money with our preferred rating. PLAN J Now, you can get more from your Medicare supplement insurance. When you choose Plan J, you get ALL the features of the popular Plan F coverage plus two key benefits that give you more financial security. Plan J helps pay for some of the costly out-of-pocket medical expenses not covered by Medicare or Plan F and that could save you money. With Plan J, you get all the Plan F benefits PLUS At-home recovery. When your doctor prescribes covered at-home care after an illness, injury or surgery, Plan J helps pay the cost. You ll get help with the activities of daily living, like eating, bathing and transferring, as you recuperate where you re most comfortable in your own home. Preventive care. Plan J pays $120 toward preventive care services (like annual physical exams and hearing tests) that Medicare doesn t cover. Our new Plan J gives you the most comprehensive Medicare supplement coverage available to help protect your financial security and give you greater peace of mind. And our new preferred rating and initial 12-month rate guarantee could add to your savings! 2

3 Plan J and High-deductible Plan F (HdF) Comparison Chart Choose the Plan That s Right for You Benefit HdF Plan J 100% of your Medicare Part A hospital deductible 100% of your Medicare Part B deductible 100% of your Medicare Part A hospital co-insurance 100% of your covered hospital expenses after your lifetime reserve days are used, up to a lifetime maximum of an added 365 days 100% of your Medicare skilled nursing facility co-insurance 100% of your Medicare Part B co-insurance 100% of your Part B excess charges above the Medicare-approved amount Plan J All the features of Plan F, PLUS 2 key benefits! First three pints of blood each year Worldwide foreign travel emergency care High-deductible feature At-home recovery not covered by Medicare Preventive care not covered by Medicare 2 Key Benefits High-deductible Plan F Are you looking for ways to lower your premium without having to go to a barebones plan? Your best solution may be our high-deductible Plan F (HdF). It provides comprehensive protection and the plan s higher deductible saves you money on your premium. How it works HdF starts paying after you pay the annual deductible for Medicare-approved Parts A and B expenses. For 2007, the annual deductible is $1,860. For more details, see charts on pages 4 and 5. 3

4 Medicare helps with health care costs but Medicare alone may not be enough. Here s how Freedom Medicare Supplement PLANS HdF and J work with Medicare to help pay hospital and medical expenses Medicare approves but does not pay. Before HdF starts paying, you must meet the 2007 annual deductible of $1,860 for Medicare-approved Parts A and B expenses. Medicare Part A Hospital Expenses (per benefit period) BENEFITS MEDICARE PAYS FREEDOM PAYS (HdF & J) YOU PAY 4 Hospital Confinement First 60 days All but $992 $992 Part A deductible Nothing (Part A deductible) Days All but $248 per day $248 per day Nothing (Part A co-insurance) Days All but $496 per day $496 per day Nothing (lifetime reserve days) After lifetime reserve days are used: Additional 365 days lifetime Nothing All costs Nothing 1 Beyond the additional 365 days Nothing Nothing All costs Blood/First 3 pints Nothing First 3 pints Nothing (blood deductible) Skilled Nursing Facility 2 First 20 days 100% of costs Nothing Nothing Days All but $124 per day $124 per day Nothing (skilled nursing co-insurance) Beyond 100 days Nothing Nothing All costs Hospice Care Available for the terminally ill who elect to receive these services All but very limited co-insurance for outpatient drugs and inpatient respite care $0 Balance 4

5 Medicare Part B Medical Expenses (per calendar year) BENEFITS MEDICARE PAYS FREEDOM PAYS (HdF & J) YOU PAY 4 Physician Services and Other Medical Expenses In or Out of the Hospital First $131 of Medicare-approved Nothing $131 Part B deductible Nothing expenses each calendar year Remainder of Medicare-approved amounts Generally 80% Generally 20% Nothing (Part B co-insurance) Covered charges in excess of Medicare- Nothing 100% Nothing approved amounts, up to any charge limitations established by state or federal law. 3 Blood First 3 pints (blood deductible) Nothing First 3 pints Nothing Medicare Parts A and B BENEFITS MEDICARE PAYS FREEDOM PAYS (HdF & J) YOU PAY 4 Home Health Care Medicare-Approved Services Covered home care visits and medical supplies 100% Nothing Nothing Durable medical equipment First $131 of Medicare-approved amounts Nothing $131 Part B deductible Nothing (Part B deductible) Remainder of Medicare-approved amounts 80% 20% Nothing Freedom Medicare Supplement PLANS HdF and J also pay for these expenses not covered by Medicare: Additional Benefits ADDITIONAL BENEFITS/PLANS HdF & J MEDICARE PAYS FREEDOM PAYS (HdF & J) YOU PAY 4 Foreign Travel Medically necessary emergency hospital and medical care beginning during the first 60 days of each trip outside the USA Nothing 80% of covered charges after a $250 deductible each calendar year, up to $50,000 lifetime Balance ADDITIONAL BENEFITS/PLAN J MEDICARE PAYS FREEDOM PAYS (J) YOU PAY 4 At-Home Recovery Services Home health care certified by your doctor during recovery from an illness or injury (within 8 weeks of last Medicareapproved visit) Nothing $40 per visit (up to 7 visits per week) up to $1,600 calendar year maximum Balance Preventive Medical Care First $120 each calendar year Nothing $120 Balance 5

6 Built-in Protection You Can Count On When you choose a Freedom Medicare Supplement plan, getting health care is easy. Best of all, you won t have to worry about losing your coverage. Your plan s built-in features keep you protected. Complete Freedom to Choose Your Own Doctors and Hospitals No Network Provider Restrictions. Rate Lock Guarantee. No rate changes your first 12 months of coverage guaranteed. New Preferred Rating could save you money on your premium. No Waiting Period for Preexisting Conditions. Preexisting conditions admitted on the application will be covered immediately when your coverage is issued. Preexisting conditions means prior medical conditions that exist before your coverage is issued. Your Benefits are Automatically Updated Each Year to Coordinate with Medicare Changes. Fast, Accurate Claim Service. No claim forms needed. Our fast, accurate claims service means you won t have to fill out any complicated forms. We work directly with your provider and Medicare. No Lifetime Maximum Benefit Limit for Medicare Part B Medical Expenses. Guaranteed Renewable for Life. As long as you pay the premium on time, your coverage will continue. Rates are subject to change. Thank you for allowing me to introduce Freedom Medicare Supplement to you. Please call me personally if you have any questions about this protection or other coverage that may be available to you. 6

7 American Republic The Care Company Since 1929, American Republic Insurance Company has built a tradition of caring. Our business is not only about providing you with the best in insurance and financial products, but also with exceptional service from people who care about you. With American Republic, you can be confident that you have selected quality insurance and financial products. We are a recognized leader in providing innovative individual life and health insurance, and we maintain a nationwide reputation for superior policyholder and claim service. In addition, American Republic is rated A- (Excellent) by A.M. Best Company, the leading independent non-government provider of insurance company financial ratings. Best s ratings range from A++ (Superior) to F (Liquidation), with A- (Excellent) being the fourth highest of fifteen possible ratings. Ratings reflect Best s independent opinion of balance sheet strength, operating performance and business profile and are not a recommendation of any specific product or service. February, Other Medicare Supplement insurance plans are available in addition to Plan J. Ask your American Republic Account Specialist for details. PREMIUMS. Your benefits and premiums will vary depending on the plan selected. Initial premium rates are guaranteed for 12 months from coverage issue date. Your premium could change if you move to a different area. After the initial rate guarantee period, should a necessary premium change be made, it will only be made on a renewal date and only if it is made on all policies in the same class as determined by us. Premiums increase because a person is one year older (except in AZ, GA and MO). READ YOUR POLICY CAREFULLY. This booklet provides a very brief description of the important policy features; it is not the insurance contract. Your policy contains all of the provisions with which both you and the Company must comply. The policy sets forth in detail the rights and obligations of both you and your insurance company. This is a limited policy designed to cover only those expenses which Medicare does not cover. You will have a 30-day free-look period to review your policy. If you decide to send the policy back to us within this period, we will return all premiums. Neither American Republic nor its agents are affiliated with or endorsed by Social Security, Medicare or any other governmental agency. 7

8 1 When your Medicare Part A hospital benefits are exhausted, the insurer stands in the place of Medicare and will pay whatever amount Medicare would have paid for up to an additional 365 days as provided in the policy s Core Benefits. During this time, the hospital is prohibited from billing you the balance based on any difference between its billed charges and the amount Medicare would have paid for Medicare-covered items or services. 2 Medicare only covers approved skilled nursing care in a Medicare approved facility. Facility licensing terminology may vary by state and may not use skilled nursing facility terminology (i.e. nursing facility in IA). Freedom Medicare Supplement pays the skilled nursing co-insurance for Medicare-approved stays in facilities certified to provide Medicare skilled care. 3 Under federal law, doctors who do not accept assignment can charge up to 115% of the fee schedule amount for nonparticipating physicians. The patient does not have to pay charges that exceed that amount. Laws in OH and PA prohibit medical providers from balance billing for charges above the Medicare-approved amount. Therefore, OH and PA policies provide benefits for Part B excess charges only when services are rendered in another state. 4 This is your liability for covered charges. You are responsible for all other noncovered charges including the deductible if you choose the high-deductible F plan. Colorado law requires carriers to make available a Colorado Health Plan Description Form, which is intended to facilitate comparison of health plans. For Medicare Supplement plans, the Outline of Medicare Supplement Coverage form is provided. In CO, KY, MS, MO, NC, NH, OK, OR and SD, coverage is available for qualified Medicare beneficiaries under age 65. National Headquarters, Des Moines, Iowa American Republic Insurance Company American Republic, Freedom Medicare Supplement and The Care Company are registered marks owned by American Republic Insurance Company. Policy Forms: A-4028, A-4080 Z US