Learn about the best Medicare options for you: Original Medicare, Medicare Advantage, Medicare Supplement and Prescription Drug Plans.

Transcription

1 Learn about the best Medicare options for you: Original Medicare, Medicare Advantage, Medicare Supplement and Prescription Drug Plans. Medicare Choices Nursing Home & Home Healthcare What you don t know could cost you! Medicare Supplement Prescription Drug Plans Dental & Vision WHY PAY MORE WHEN YOU CAN GET THE EXACT SAME COVERAGE FOR LESS? FOR MORE INFORMATION CALL: Building a better quality of life for senior citizens in North Carolina since The North Carolina Senior Citizens Association (NCSCA) is a nonprofit organization chartered by the state of North Carolina in The information contained herein is to be used for general information purposes only. Final rates quoted can only be confirmed by a licensed agent and approved by the appropriate insurance company. There is no cost to you for our services. Royalty fees are paid to NCSCA for the use of its intellectual property from various companies. These fees are used for the general purposes of NCSCA. NCSCA Medicare Advisors are licensed agents and can provide information on Medicare Supplement Plans and Medicare Prescription Drug Plans. Not connected with or endorsed by the United States government or the federal Medicare program. NCSCA-MGB: 10/2018

2 Confused? Overwhelmed by the Medicare Maze? Medicare choices can be difficult to understand, especially if you are turning 65 or enrolling in Medicare for the first time. Seniors in North Carolina receive a lot of phone calls from insurance agents and telemarketers from all over the country, plus a lot of confusing and overwhelming information in the mail about Medicare. Don t be fooled or misled. Get the facts. When you are fully informed, you feel more confident about taking action. And taking the right action is the key to protecting the quality of your healthcare in the coming years. To make good decisions, you need good information. NCSCA Medicare Specialists can be extremely helpful and can turn a confusing situation into a rather easy process. We have been helping seniors in North Carolina for more than 40 years. There is NO COST to you for our services. Let us help you understand your Medicare options! Do you understand the differences in Original Medicare, Medicare Advantage and a Medicare Supplement? Your Medicare Choices. You have two choices for receiving your Medicare coverage when you turn 65. You can get your Medicare benefits through Original Medicare or a Medicare Advantage Plan. Understanding the difference between Original Medicare and a Medicare Advantage Plan is the first step in getting the coverage that is right for you and protecting the quality of your healthcare now and in the future. What Is Original Medicare? Original Medicare is the federal government-run health insurance program for people who are 65 or older. One of the many benefits of turning 65 is receiving Medicare benefits regardless of your health. If you are receiving social security benefits, you will be automatically enrolled in Medicare Part A and Part B when you turn 65. Your Medicare benefits will become effective on the first day of your birth month. The only exception is if your 65th birthday falls on the first day of the month. In this case, your effective date would be the first day of the previous month. Your Medicare card will be mailed to you approximately three months before your 65th birthday. Under Original Medicare, the government pays healthcare providers directly for the services you receive. With Original Medicare, there are NO network restrictions. That means you have the freedom to choose any doctor, specialist or hospital anywhere in the USA when you need care. When enrolled in Original Medicare you do not need to get prior approval, referral or permission from Medicare or from your primary care doctor when you need care. You just provide your red, white and blue Medicare card to receive Original Medicare services. Most people with Medicare get their health coverage directly through Original Medicare. What Is a Medicare Advantage Plan? A Medicare Advantage Plan is health insurance provided by private insurance companies that are contracted by Medicare and provide a different way to get your Medicare benefits. Each Medicare Advantage Plan must provide services offered by Original Medicare, but can do so with different rules, costs and restrictions that can affect how and when you receive care. If you enroll in a Medicare Advantage Plan, there are usually network restrictions. This means you are required to see the healthcare providers in the Medicare Advantage network; plus, in most cases, you will need to get prior approval when you need care, except in case of an emergency. With a Medicare Advantage Plan, the insurance company has been given the ability to make its own claims decisions, and some claims decisions have been made with profitability in mind. If you enroll in a Medicare Advantage Plan, you MUST follow the rules of the Medicare Advantage Plan you have joined. Also, if you enroll in a Medicare Advantage Plan you will automatically be disenrolled from Original Medicare and you will NOT be able to use your Medicare card. What Is Medicare Supplement Insurance? Medicare supplement insurance is offered by private insurance companies. Medicare supplement insurance covers some of the gaps not paid by Original Medicare Parts A and B. With Original Medicare and a Medicare supplement, you are protecting the quality of your healthcare NOW and in the FUTURE. Medicare supplement insurance provides choice, control, freedom, flexibility and value. With a Medicare supplement, there are no network restrictions. That means you can choose any doctors and hospitals, and visit any specialists anywhere in the USA that accept Medicare patients. All Medicare supplement insurance plan benefits are set by the federal government. That means the basic benefit structure for each plan is the same, no matter which insurance company is selling it to you. However, the prices vary widely among the various insurance companies. Plan G is the most popular Medicare Supplement Plan today. Plan G covers 100% of all Medicare-eligible charges, except the coverage of the $183 Medicare Part B calendar-year deductible. The Medicare Part B deductible is only paid ONCE during a calendar year.

3 With Plan G and Medicare you have Freedom. You have the freedom to choose any hospital, doctor or specialist that accepts Medicare patients anywhere in the USA No networks to worry about No doctor referral needed to see a specialist No prior approval required How Plan G works with Original Medicare to cover your Medicare expenses. Plan G is the most popular plan today. With Original Medicare and Plan G, 100% of the following Medicare-eligible charges are covered. You pay $0 for Medicare Part A deductible and co-payments You pay $0 for Medicare Part B coinsurance You pay $0 for all Medicareeligible hospital inpatient and outpatient services You pay $0 for preventive care You pay $0 when you go to an approved skilled nursing facility You pay $0 for any Medicareeligible excess charges You pay $0 for any additional Medicare-eligible medical services THINGS TO LOOK FOR IN A GOOD MEDICARE SUPPLEMENT INSURANCE POLICY What are the important things to look for in a good policy? The first thing to consider is the premium rate of the various insurance companies selling Medicare supplements in North Carolina. Under federal law, all Medicare Supplement Plans have identical benefits the only difference is PRICE. That means Plan G has the same benefits, no matter which insurance company is selling it to you. Plan G is the most popular plan today. However, the premium rates vary widely among the various insurers even though the benefits are the same for each company. In addition, you should consider the company s overall reputation, financial rating, household discounts and number of years the company has been selling Medicare Supplements. When is the best time to buy a Medicare Supplement Plan? The best time to buy a policy is during your Medicare supplement open enrollment period. With most companies, you can lock in the current premium six months before your 65th birthday to six months after your birthday without answering any health questions and no waiting period for pre-existing conditions. Your policy will become effective on the first day of the month you become eligible for Medicare. If you wait until after this deadline to enroll, you may be required to answer health questions to qualify. This is too important to put off. Compare rates and lock in your LOW RATE today! Who has the expert knowledge and experience to help me? Our NCSCA Medicare Specialists have the knowledge and experience to help you compare your Medicare options. We will help you learn the major pitfalls to avoid and help you enroll in the plan of your choice. We have been helping seniors enroll in Medicare Supplement Plans for more than 40 years. Plus, when you enroll with our NCSCA Medicare Specialist, you get additional value-added benefits such as help with your Medicare Prescription Drug Plan; dental and vision protection; free consultation with an elder law attorney, senior financial specialist or long-term care specialist; and access to nursing home and home healthcare referral service. So, let s get started! To make good decisions, you need good information. Asking questions can make the issues surrounding Medicare easier to understand. When you are fully informed, you feel more confident about taking action. And taking the right action is key to saving on healthcare costs. There is NO COST to you for our services. Let us help you. Call us today. Our Medicare Specialist will NOT call you unless requested! ARE YOU OVER AGE 65? Plan F No Longer Available Medicare Supplement Plan F will NO longer be available to newly-eligible Medicare beneficiaries after January 1, What does this mean to you? If you already have Plan F, most experts recommend you switch to Plan G, which has lower premium rates than Plan F and is NOT impacted by the new federal law. Plan G also provides the same exact coverage as Plan F, except covering the $183 Medicare Part B deductible. Most experts agree Plan G is a better value. Lower Your Costs You can apply to switch your current Medicare supplement policy any time during the year to lower your premium rate. You do not have to wait to apply during the Medicare Advantage and Prescription Drug open enrollment period that takes place every year between October 15 and December 7. Switch to a New Policy? If you are over 65 and already have a policy and are reasonably healthy for your age, you can switch to a different Medicare supplement company any time to lower your premium rate. However, it is important to know you may need to go through medical underwriting. If you have health issues that could prevent you from changing your current Medicare Supplement Plan, we recommend you keep your current policy and apply at a later date. Your current policy will NOT be cancelled and will remain active as long as you pay the premium. If you have any questions, please contact us.

4 2019 NORTH CAROLINA PRESCRIPTION DRUG PLANS PLAN NAME Plan Premium Annual Deductible Coverage During Gap/Donut Hole Aetna Life Insurance Company Contract ID & Plan ID Aetna Medicare Rx Saver (PDP) 1,2 $27.20 $275 No S Aetna Medicare Rx Select (PDP) 1 $17.20 $365 Yes S Aetna Medicare Rx Value Plus (PDP) 1 $62.90 $0 Yes S Blue Cross and Blue Shield of NC Blue Medicare Rx Standard (PDP) $69.30 $305 No S Blue Medicare Rx Enhanced (PDP) $96.80 $0 Yes S Cigna-HealthSpring Rx CIGNA-HealthSpring Rx Secure (PDP) 1 $55.70 $415 No S CIGNA-HealthSpring Rx Secure Essential (PDP) 1 $21.90 $415 No S CIGNA-HealthSpring Rx Secure-Extra (PDP) 1 $55.70 $100 Yes S EnvisionRxPlus EnvisionRxPlus (PDP) 1,2 $14.50 $365 No S Express Scripts Medicare Express Scripts Medicare-Value (PDP) 1 $31.10 $415 No S Express Scripts Medicare-Choice (PDP) 1 $95.20 $350 Yes S Express Scripts Medicare-Saver (PDP) 1 $23.90 $415 No S Humana Insurance Company Humana Walmart Rx Plan (PDP) 1 $30.30 $415 No S Humana Preferred Rx Plan (PDP) 1,2 $28.80 $415 No S Humana Enhanced (PDP) 1 $74.60 $0 No S MII Life Insurance, Inc Basic Blue Rx Standard (PDP) 2 $29.00 $415 No S Basic Blue Rx Value (PDP) $24.40 $415 No S Mutual of Omaha Rx Mutual of Omaha Rx Plus (PDP) $45.60 $415 No S Mutual of Omaha Rx Value (PDP) $28.00 $415 No S SilverScript SilverScript Choice (PDP) 1,2 $29.70 $0 No S SilverScript Plus (PDP) 1 $61.20 $0 Yes S SilverScript Allure (PDP) 1 $80.00 $0 No S UnitedHealthcare Insurance Company AARP MedicareRx Saver Plus (PDP) 1,2 $29.20 $415 No S AARP MedicareRx Preferred (PDP) 1 $73.30 $0 No S AARP MedicareRx Walgreens (PDP) 1 $28.00 $415 No S WellCare Health Plans WellCare Classic (PDP) 1,2 $30.30 $415 No S WellCare Extra (PDP) 1 $74.50 $0 No S WellCare Value Script (PDP) 1 $15.00 $415 No S National Plan 2 For those people who are deemed eligible and approved for Extra Help, plan premium should be covered in full. NCSCA-PD-Rates

5 NORTH CAROLINA SENIOR CITIZENS ASSOCIATION 2018 Medicare Part D Prescription Drug Plan Finder Tool The North Carolina Senior Citizens Association will help you find the lowest cost Medicare Prescription Drug Plan that will meet your needs. The following questionnaire will provide the NCSCA staff with the necessary information to prepare a report for your consideration. IMPORTANT Complete this form along with your Official Medicare Supplement Application and return in the enclosed postage-paid envelope to: NCSCA, PO Box 34, Fayetteville, NC A. Please provide us with your name and address as it appears on your Medicare Card: Name: Date of Birth: Address: City: State: Zip: County: Home Phone: ( ) Cell Phone: ( ) B. Do you currently have insurance coverage for prescriptions? Yes No If the answer is yes, please check the type of coverage below. Federal Employee Health Benefit Plan NC State Employee Health Plan TriCare Coverage VA Coverage Other C. Please provide us with your Medicare card information: 1) Name of Beneficiary on card 2) What is YOUR Medicare claim number? 3) What is YOUR effective date for Medicare Part A? 4) What is YOUR effective date for Medicare Part B? Prescription Drug Helpline:

6 NORTH CAROLINA SENIOR CITIZENS ASSOCIATION Medicare Part D Prescription Drug Plan Finder Tool Name of Drug Strength Daily Dosage Example: Lipitor Example: 10 mg. Example: Twice Daily I prefer to have my prescriptions filled at the following pharmacies: First Choice Pharmacy Name: Address: City: State: Zip: Second Choice Pharmacy Name: Address: City: State: Zip: Do you prefer a mail order pharmacy? Yes No For Office Use ONLY Drug List ID #: Password: Prescription Drug Helpline: