Medicare - Parts to the Puzzle 2019
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- Marvin Jennings
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1 Medicare - Parts to the Puzzle Medicare Handbook Medicare Parts Part A is for inpatient hospital expenses. Free as a part of Social Security. Available when you reach age 65* or after 2 years on Social Security disability. *Start the 1st of birthday month, prior month if birthday is on the 1st. Part B covers outpatient, doctors, surgery and equipment. Basic cost is $ per month*. Billed quarterly, monthly bank draft or deducted from one s Social Security. Medicare Supplement / Medigap plan pays the deductible and copays of your Part A & B coverage. Broadest plans with same coverage are F and G. G premium savings excess it s $185 deductible. Part D is the subsidized drug plan. Penalties apply if not enrolled during initial period. Typical premiums ~$20-35/month*. To determine the best plan for you, go to and enter your ZIP code, current drugs, and your pharmacy. A report will provide a list of plans starting with the lowest total cost until the end of the year. Total Cost = Premium + Deductible + Copays to end of the year. Carrier enrollment links are provided on the government site. We do not sell Part D plans but provide tips and the enrollment link on our website: It s imperative that you re-evaluate your Part D coverage during the annual fall open enrollment period (10/15-12/7) Part D Plans have a right to change premium, deductible, copays and what they cover. Every year we see 20+ -plans with some enter and leave the market. We send out several reminder notices, at the opening and near the end of the fall Open Enrollment Period. Part C - Advantage Plans - most are basically HMOs for seniors, some PPO.. You must pay for Medicare Part B, but you are leaving Medicare to purchase these plans. I will not sell these plans due to the lack of control over your own health coverage. I see 12 negatives and 2 positives - premium and some dental-vision-prescription coverage. *Adjusted Gross Income (bottom page #1 of 1040) of $85,000+ ($170,000+ couples) pay more. This is not a legal document, see actual law for specifics.
2 Introduction to Medicare Supplements & Chris Dee Medicare Supplement (Medigap) Basics 1. Contracts are all standardized federal contracts. However, the cost for same benefits varies 100% among carriers. (Sure beats the 15% people clamor about saving on their car insurance!) 2. Claims always sent directly to Medicare for processing and benefit determination. 3. All carriers pay out the same, they have no say, its whatever Medicare dictates. People who say that they love a particular carrier actually love Medicare itself. 4. No pre-existing limitations allowed. 5. No network limitations. 6. National Coverage - see any doctor anywhere who accepts Medicare. 7. Using an independent broker who s looking out for you adds nothing to your premium. Chris Dee years as an independent Broker in health insurance, with hundreds of senior clients. 2. Education - Notre Dame - Loyola, MBA and a CLU - Chartered Life Underwriter. 3. Prudential past National Sales Leader for small group. 4. General Agent with over 2500 group clients. 5. Medicare became our focus seeing it was over-marketed, underserved and overcharged. 6. We help with all 3 parts needed when transitioning to Medicare. 1. Enrollment in A & B 2. Supplements 3. Part D prescription plans 7. Providing ongoing Medicare information and for everyone we meet, including annual fall reminders to re-evaluate Part D - Medicare prescription program. 8. Our service is Free year after year. 9. Optimizing your Medicare Experience - saving Time and Money. 10. Our goal is to Providing service you want to recommend to others!
3 Omaha Companies Best Plan G rates for years with an A+ rating (AM Best company) 2nd largest Medicare supplement carrier. Omaha entered the Senior Medicare market as it began Billion+ paid to Medicare supplement policyholders. Million+ insureds. Applying up to 6 months prior to effective date is a good idea. First of 3 steps to Medicare, others are 3 and 1 month prior. Rates & Age locked in for 12 months on date application is signed, not effective date. Renewals are also Annual Rates no off anniversary increases 7% discount apply when 2 or more in a household are insured or survivor. Illinois, Plan G 3.5 % rates increased March Discount for non-smokers. Discount for female rates. Policies in a few days and for those starting Medicare in as little as 1 hour. We have Hundreds and Hundreds of happy clients with Omaha
4 70 SECTION 5: Medicare Supplement Insurance (Medigap) policies How do I compare Medigap policies? The chart below shows basic information about the different benefits that Medigap policies cover for If a percentage appears, the Medigap plan covers that percentage of the benefit, and you re responsible for the rest. Medicare Supplement Insurance (Medigap) plans Benefits 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) 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% Medicare Part B coinsurance or copayment 100% 100% 100% 100% 100% 100% 50% 75% 100% 100%*** Blood (first 3 pints) 100% 100% 100% 100% 100% 100% 50% 75% 100% 100% Part A hospice care coinsurance or copayment Skilled nursing facility care coinsurance 100% 100% 100% 100% 100% 100% 50% 75% 100% 100% 100% 100% 100% 100% 50% 75% 100% 100% Part A deductible 100% 100% 100% 100% 100% 50% 75% 50% 100% Part B deductible 100% 100% Part B excess charges 100% 100% Foreign travel emergency (up to plan limits) 80% 80% 80% 80% 80% 80% Out-of-pocket limit in 2018** $5,240 $2,620 * Plan F also offers a high-deductible plan in some states. If you choose this option, this means you must pay for Medicare-covered costs (coinsurance, copayments, and deductibles) up to the deductible amount of $2,240 in 2018 before your policy pays anything. ** For Plans K and L, after you meet your out-of-pocket yearly limit and your yearly Part B deductible ($183 in 2018), the Medigap plan pays 100% of covered services for the rest of the calendar year. ** Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits that don t result in an inpatient admission.
5 Plan G Rates United World of Omaha savings over Blue Cross* Blue Cross 4/2019 United World 3/2019-7% for Couples Couple Saving Age Unisex Female Male Female Male Blue Cross higher cost $185 Ded $185 Ded $185 Ded $185 Ded $185 Ded Annualized ** % More to % to % % % % % % % % % % % % % % % % % % % % % % % % % % 90 Age *United World of Omaha -NS Rates Blue Cross Metro rates Dee-Signed Programs - Lake Forest, IL (847) ** Savings for single females is about half and males about 1/3.
6 Omaha Companies Best Plan G rates for years with an A+ rating (AM Best company) 2nd largest Medicare supplement carrier. Omaha has been in the Senior Medicare market since the beginning Billions paid to Medicare supplement policyholders. Million+ insureds. Applying up to 6 months prior to effective date is a good idea. First of 3 steps to Medicare, others are 3 and 1 month prior. Rates locked in for 12 months on date application is signed, not effective date. Age locked in on date application is signed, not effective date. 7% discount apply when 2 or more in a household are insured or survivor. Illinois, Plan G 5% rate increases August 2017, March 2019 new rates decreased. Rates guaranteed 12 months and then change only on policy. anniversary. Most plans pass on increases with age and rate table changes. Discount for non-smokers. Discount for female rates. Policies are being issued in as little a an hour. We have ~ 700 happy clients with Omaha
7 Data needed to complete Medicare supplement application. Name initial C-ell H-ome W-ork Dob Skr Address County SS # s Medicare# Eff date A Eff date B Normally ss# with A = taking your SS T = working B = under spouse SS D= under decrease sp SS mm yy Current Plan: Group Individual Approx. Start date Start Date New Policy Bank route Act# 9 digit Routing # ( symbols at either end) Spouse initial C-ell H-ome W-ork Dob Skr SS # s Medicare# Eff date A and B Start Date New Policy
8 Shortcomings and Limitations of Medicare 2019 Ineligible Charges - What Medicare does not cover Note: Beginning in 2019, annual limits have been removed on Occupational Therapy, Physical Therapy & Speech-Language Pathology (SLP) services. Hospital observation is not covered by Part A and prescriptions are limited. Difficult if not impossible to change from observation to a covered admission status. Dental - see our website page - Skilled Nursing Care if not hospitalized for 3 days. Observation days do not qualify. Some doctor wellness testing - ask before your physical, ask that the bill be discounted. Limited Part D vaccination shots, Flu, Hepatitis B, Pneumococcal, Tdap (tetanus, diphtheria, pertussis) Some doctor wellness testing ask before your physical, ask that the bill be discounted.limited Part D vaccination shots* (Flu, Hepatitis B, Pneumococcal, Tdap (tetanus, diphtheria, pertussis)) * Shingles vaccination not included. Doctors outside of the Medicare system (opt-out practices). Signed notification required. Hearing aids and exams for fitting them. Omaha includes a discount service. Nursing home custodial care. (Short and Long Term Care policies can covers this area.) More than 190 days of inpatient psychiatric hospital services during your lifetime. Hospitalization after Lifetime Reserve of 60 days is exhausted. All Chiropractic except for adjustments, Acupuncture, Routine (maintenance) foot care Cataracts total cost for optional enhanced lenses. Standard lenses are fully covered. Vision - Eye refraction even if part of cataract surgery. Omaha includes a discount service. Infusion therapy may require service to be done as outpatient rather than at home. Medicare Supplements help pays Medicare eligible charges - deductibles, co-insurances & copays. They do not add benefits to Medicare, with the exception of adding an additional year of hospitalization. Plans F & G provide foreign travel emergency medical $250 deductible then 80% to $50,000. This overview is not a legal document, see actual law for specifics.
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