HealthPartners Medicare Supplement Outline of Coverage and Disclosure of Information
|
|
- Lester O’Connor’
- 5 years ago
- Views:
Transcription
1 HealthPartners Medicare Supplement Outline of Coverage and Disclosure of Information HEALTHPARTNERS EXTENDED BASIC MEDICARE SUPPLEMENT PLAN Use this document to get to know the HealthPartners Extended Basic Medicare Supplement plan. It outlines what the plan covers and what you pay for those services. This booklet doesn't list everything the plan covers, or every limitation or exclusion. For a full list of covered services contact us for a copy of the policy. For more information about the plan, call Medicare Sales at or If you re a current member and have questions, call us at or From Oct. 1 through March 31, we take calls from 8 a.m. to 8 p.m. CT seven days a week. You ll speak with a representative. From April 1 to Sept. 30, call us 8 a.m. to 8 p.m. Monday through Friday to speak with a representative. On Saturdays, Sundays and Federal holidays, you can leave a message and we ll get back to you within one business day. TTY users can call 711. HealthPartners is required to disclose the following information to you. The Commissioner of Commerce of the state of Minnesota has established two categories of Medicare Supplement insurance and minimum standards for each, with the Extended Basic Medicare Supplement being the most comprehensive and the Basic Medicare Supplement being the least comprehensive. NOTICE: THESE POLICIES DO NOT COVER ALL MEDICAL EXPENSES BEYOND THOSE COVERED BY MEDICARE. THESE POLICIES DO NOT COVER ALL SKILLED NURSING HOME CARE EXPENSES AND DOES NOT COVER CUSTODIAL OR RESIDENTIAL NURSING CARE. READ YOUR POLICY CAREFULLY TO DETERMINE WHICH NURSING HOME FACILITIES AND EXPENSES ARE COVERED BY YOUR POLICY. Supp_ IR 9/2018 Outline of Coverage_Extended Basic
2 Plan options HealthPartners offers Basic and Extended Basic policies in all 87 counties in Minnesota. Minnesota law also permits the purchase of additional riders with the Basic policy. Below is an overview of the plans and premiums effective Jan. 1, 2019 Dec. 31, Basic Benefits included in Medicare Supplement policies Inpatient Hospital Care: Covers the Medicare Part A coinsurance Medical Costs: Covers the Medicare Part B coinsurance (generally 20% of the Medicare-approved payment amount) Blood: Covers the first three pints of blood each year for Medicare Parts A and B Hospice: Covers Part A coinsurance Home Health Care and Medical Supplies: Covers Medicare Part A or B cost sharing The check marks mean the benefit is covered 100%. Medicare Supplement Benefits Basic Plan * Basic Benefits Part A Skilled Nursing Facility Coinsurance Part A Inpatient Hospital Deductible Optional benefit rider Part B Deductible Optional benefit rider Part B Excess Charges Optional benefit rider Preventive Care (Not Covered by Medicare) Optional benefit rider Coverage While in a Foreign Country 80% Emergencies only 80% Additional Benefits (Not Covered by Medicare) 80% 80% or 100%; refer to State-mandated benefits policy for more information *100% after you spend $1,000 of out-of-pocket costs for a calendar year. Premium information 80% or 100%; refer to policy for more information Basic Plan Monthly rate Standard rate Tobacco rate Basic plan $ $ Optional benefit riders Rider 1: Part A Inpatient Hospital Deductible $36.30 $42.20 Rider 2: Part B Deductible $16.25 $16.25 Rider 3: Part B Excess Charges $1.00 $1.20 Rider 4: Preventive Care $2.50 $2.90 Total $220 $253 Monthly rate Standard rate Extended Basic plan $ Total $263.02
3 HealthPartners Extended Basic Medicare Supplement Plan The following summarizes the HealthPartners Extended Basic Medicare Supplement coverage and the coverage under Original Medicare. It s not to be read or considered as a contract. Original Medicare Inpatient hospital services 60 days of hospital inpatient care at 100% after your Medicare Part A deductible. Days and your 60 day lifetime reserve days at 100% after a daily Part A coinsurance Skilled nursing care The first 20 days at 100% Days at 100% after Part A daily coinsurance amount per NO COVERAGE after the 100 th day per Hospice and Respite care All but very limited copayment/coinsurance for outpatient drugs and inpatient respite care Home health care 100% of Medicare Part A eligible expenses and 80% of Part B eligible expenses PLAN PAYS YOU PAY Medicare Part A deductible 100% of the Medicare Part A daily coinsurance for days per benefit period 100% of the Medicareeligible services after Medicare benefits are exhausted 100% of the Medicare Part A daily coinsurance through the 100 th day per 80% of eligible charges for days per 100% of the Medicare copayments and coinsurance for all Part A Medicare-eligible expenses Part A services covered in full by Medicare 20% of Medicare Part B approved charges Part B Deductible 20% of eligible charges for days per benefit period All charges after the 121 st day You must get care from a Medicare-certified hospice
4 Original Medicare Covers PLAN PAYS YOU PAY Medical services, outpatient services and medical supplies 80% of Medicare s approved Part B deductible 20% for additional charges after annual Part B deductible 20% of Medicare s approved charges benefits not covered by Medicare Remaining balances on Part B excess charges 80% for additional benefits not covered by Medicare Emergency care 80% of Medicare approved charges after annual Part B 20% of Medicare s approved charges deductible. Part B deductible Not covered outside the U.S. Foreign medical services Not covered, except under limited circumstances Preventive services (screening exams) 100% of Medicare-covered services and screenings such as colorectal screening exams, screening mammograms, pap smears and pelvic exams, prostate cancer screening exam, Welcome to Medicare visit, and Annual Wellness Visit. 80% of medically necessary services and supplies when traveling outside the U.S. 100% of non-medicare covered preventive services, up to a benefit limit of $120 per year Services may include annual routine physical exam, routine eye exam, and routine hearing exam 20% and any remaining charges above the allowed amount Any remaining charges above the benefit limit
5 Rules and disclosures about HealthPartners Medicare Supplement plans READ YOUR POLICY OR CERTIFICATE VERY CAREFULLY This outline of coverage is a summary of the policy issued or applied for and the policy should be consulted to determine governing contractual provisions. Additionally, it does not give all the details of Medicare coverage. Contact your local Social Security office or consult the Medicare & You handbook (sent by Medicare) for more details. You must read the policy itself to understand all of the rights and duties of both you and your insurance company. Carefully read your policy that you receive with your new member materials. LOSS RATIO This policy provides an anticipated loss ratio of 77.3%. This means that, on the average, policyholders may expect that $77.30 of every $100 in premium will be returned as benefits to the policyholders over the life of the contract. PREMIUMS AND RENEWABILITY HealthPartners guarantees to renew this policy as long as the premium is paid on or before the due date or within the grace period. This policy will not be cancelled or non-renewed on the grounds of the deterioration of your health. If you send the policy back to us within 30 days after you receive it, we will treat the contract as if it has never been issued and return all of your payments within ten days. POLICY OR CERTIFICATE REPLACEMENT If you are replacing another health insurance policy or certificate, do NOT cancel it until you have actually received your new policy or certificate and are sure you want to keep it. Notice: The policy may not fully cover all your medical costs. Neither HealthPartners nor its agents are connected with Medicare. COMPLETE ANSWERS ARE VERY IMPORTANT When you fill out the application for the new policy or certificate, be sure to answer truthfully and completely all questions about your medical and health history. The company may cancel your policy or certificate and refuse to pay any claims if you leave out or falsify important medical information. If you are eligible for guaranteed issue, (including the six (6)-month openenrollment window following your Part B effective date) you may not need to provide health history information. EXCLUSIONS Certain services are excluded from coverage. Please refer to the policy for more information. MEDICARE COST-SHARING AMOUNTS Benefits under this policy that are designed to cover cost-sharing amounts under Medicare will be changed automatically to coincide with any changes in the applicable Medicare deductible and coinsurance percentage factors. RIGHT TO RETURN POLICY OR CERTIFICATE If you find that you are not satisfied with your policy or certificate for any reason, you may return it to: HealthPartners Riverview Membership Accounting MS 21103R P.O. Box 9463 Minneapolis, MN
HealthPartners Medicare Supplement Outline of Coverage and Disclosure of Information
HealthPartners Medicare Supplement Outline of Coverage and Disclosure of Information HEALTHPARTNERS BASIC MEDICARE SUPPLEMENT PLAN Use this document to get to know the HealthPartners Basic Medicare Supplement
More informationGERBER LIFE INSURANCE COMPANY WHITE PLAINS, NEW YORK OUTLINE OF MEDICARE SUPPLEMENT COVERAGE - COVER PAGE
GERBER LIFE INSURANCE COMPANY WHITE PLAINS, NEW YORK OUTLINE OF MEDICARE SUPPLEMENT COVERAGE - COVER PAGE BASIC AND EXTENDED BASIC PLANS The Commissioner of Insurance of the State of Minnesota has established
More informationRegence Bridge. Medicare Supplement (Medigap) Plans
OUTLINE OF COVERAGE Regence Bridge Medicare Supplement (Medigap) Plans Regence BlueShield serves select counties in the state of Washington and is an Independent Licensee of the Blue Cross and Blue Shield
More informationBasic, including 100% Part B Coinsurance, except up to $20 copayment for office visit, and up to $50 copayment for ER Skilled Nursing.
MUTUAL OF OMAHA INSURANCE COMPANY OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE BENEFIT PLANS A, F, AND G This chart shows the benefits included in each of the standard Medicare supplement plans.
More informationOutline of Medicare Supplement Coverage
Tufts Medicare Preferred SUpplement PLANS 2014 Outline of Medicare Supplement Coverage Tufts Medicare Preferred Supplement Core Tufts Medicare Preferred Supplement One Effective January 1, 2014 December
More information2019 Outline of Coverage McLaren Medicare Supplement Plans A, C, D, F, High Deductible-F, G & N Effective April 1, 2019
2019 Outline of Coverage McLaren Medicare Supplement Plans A, C, D, F, High Deductible-F, G & N Effective April 1, 2019 McLarenHealthPlan.org/MedicareSupplement Call us toll-free (888) 327-0671, Monday
More informationWPS Medicare Companion. 25% Cost-Sharing Plan / 50% Cost-Sharing Plan. Medicare Supplement Rates and Plan Information
WPS Medicare Companion 25% Cost-Sharing Plan / 50% Cost-Sharing Plan Medicare Supplement Rates and Plan Information Effective January 1, 2012 To Be Eligible for WPS Medicare Companion Cost-Sharing Plans
More informationPlan A Plan B Plan C Plan D Plan F F* Plan G Plan K Plan L Plan M Plan N. Hospitalization: 100%; other basic benefits paid at 50%
UNITED WORLD LIFE INSURANCE COMPANY OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE BENEFIT PLANS A, F, HIGH DEDUCTIBLE F, G, AND N This chart shows the benefits included in each of the standard Medicare
More informationBasic, including 100% Part B Coinsurance, except up to $20 copayment for office visit, and up to $50 copayment for ER Skilled Nursing.
MUTUAL OF OMAHA INSURANCE COMPANY OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE BENEFIT PLANS A, C, D, F, AND G This chart shows the benefits included in each of the standard Medicare supplement plans.
More informationOutline of Coverage. Medicare Supplement Insurance BENEFIT PLANS. AAA Medicare Supplement Plans. Insured by Aetna Health and Life Insurance Company
American Automobile Association (AAA) Medicare Supplement Insurance Office 800 Crescent Centre Dr. Suite 200 Franklin, TN 37067 855 663.2201 aetnaseniorproducts.com Outline of Coverage Medicare Supplement
More informationA B C D F / F* G K L M N Basic including 100% Part B Coinsurance. Coinsurance. Coinsurance. Skilled Nursing Facility
This chart show the benefits included in each of the standard Medicare Supplement plans. Every insurer must make available Plan A. Some plans may not be available in your state. See Outlines of Coverage
More informationbasic benefits paid at 50% 50% Skilled Nursing Facility Skilled Nursing 50% Part A Part A Deductible Part B Part B Excess (100%)
UNITED OF OMAHA LIFE INSURANCE COMPANY A Mutual of Omaha Company OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE BENEFIT PLANS A, F, HIGH DEDUCTIBLE F, G AND N This chart shows the benefits included
More informationBasic, including 100% Part B Coinsurance, except up to $20 copayment for office visit, and up to $50 copayment for ER Skilled Nursing.
MUTUAL OF OMAHA INSURANCE COMPANY OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE BENEFIT PLANS A, F, AND G This chart shows the benefits included in each of the standard Medicare supplement plans.
More informationBasic, including. Hospitalization and preventive care paid. 50% Skilled Nursing. Part A Deductible. 50% Part A. Deductible
United World Life Insurance Company A Mutual of Omaha Company OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE BENEFIT PLANS A, F, HIGH DEDUCTIBLE F, G AND N This chart shows the benefits included in
More informationUNITED WORLD LIFE INSURANCE COMPANY A Mutual of Omaha Company OUTLINE OF MEDICARE SUPPLEMENT COVERAGE - COVER PAGE 1 BENEFIT PLANS A, B, C, D, F AND G
UNITED WORLD LIFE INSURANCE COMPANY A Mutual of Omaha Company OUTLINE OF MEDICARE SUPPLEMENT COVERAGE - COVER PAGE 1 BENEFIT PLANS A, B, C, D, F AND G These charts show the benefits included in each of
More informationA B C D F F* G K L M N. coinsurance. Skilled Nursing Facility. 75% Skilled Nursing Facility coinsurance 75% Part A Deductible.
Shenandoah Life Insurance Company Administrative Office: P.O. Box 14558, Clearwater, FL 33766-4558 (855) 406-9085 Outline of Medicare Supplement Coverage Cover Page Benefit Plans A, F, G and N Benefit
More informationBasic, including. Hospitalization and preventive care paid. 50% Skilled Nursing. Part A Deductible. 50% Part A. Deductible
Mutual of Omaha Insurance Company OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE BENEFIT PLANS A, F, HIGH DEDUCTIBLE F, G AND N This chart shows the benefits included in each of the standard Medicare
More informationBasic, including. Hospitalization and preventive care paid. 50% Skilled Nursing. Part A Deductible. 50% Part A. Deductible
Omaha Insurance Company A Mutual of Omaha Company OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE BENEFIT PLANS A, F, HIGH DEDUCTIBLE F, G AND N This chart shows the benefits included in each of the
More informationBasic, including 100% Part B coinsurance, except up to $20 copayment for office visit, and up to $50 copayment for ER Skilled
GOVERNMENT PERSONNEL MUTUAL LIFE INSURANCE COMPANY OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE BENEFIT PLANS A, C, F, G, AND N These charts show the benefits included in each of the standard Medicare
More informationAnnual Notice of Changes for 2019
HealthPartners Journey Stride (PPO) offered by HealthPartners, Inc. (HPI) Annual Notice of Changes for 2019 You are currently enrolled as a member of HealthPartners Journey Stride. Next year, there will
More informationSTONEBRIDGE LIFE INSURANCE COMPANY OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE BENEFIT PLANS A, F, G AND N
STONEBRIDGE LIFE INSURANCE COMPANY OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE BENEFIT PLANS A, F, G AND N These charts show the benefits included in each of the standard Medicare supplement plans.
More informationBasic, including 100% Part B Coinsurance, except up to $20 copayment for office visit, and up to $50 copayment for ER Skilled Nursing.
MUTUAL OF OMAHA INSURANCE COMPANY OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE BENEFIT PLANS A, F, AND G This chart shows the benefits included in each of the standard Medicare supplement plans.
More informationAetna Life Insurance Company Outline of Medicare Supplement Coverage
Aetna Life Insurance Company Outline of Medicare Supplement Coverage Benefit Plans A, B, F, G and N are Offered To be eligible for coverage under an Individual Medicare Supplement you must be at least
More informationBasic, including. Hospitalization and preventive care paid. 50% Skilled Nursing. Part A Deductible. 50% Part A. Deductible
United World Life Insurance Company A Mutual of Omaha Company OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE BENEFIT PLANS A, C, D, F, HIGH DEDUCTIBLE F, G AND N This chart shows the benefits included
More information2019 Alliance Medicare Supplement Brochure
2019 Supplement Brochure MED SUPP 2019 PRODUCT BROCHURE Find the right plan for you. Supplement offers a choice of plans Plan A, Plan C, Plan F, Plan G and Plan N. The benefits of each of these plans are
More informationBasic, including 100% Part B coinsurance. Foreign Travel Emergency
BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA An Independent Licensee of the Blue Cross and Blue Shield Association OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE 1 of 2: BENEFIT PLANS A, C, L and N
More informationBasic, Including 100% Part B Coinsurance. Part B Coinsurance. Coinsurance* 50% Skilled Nursing Facility Coinsurance. Skilled Nursing Facility
AMERICAN RETIREMENT LIFE INSURANCE COMPANY P. O. BOX 26580 AUSTIN, TX 78755-0580 866-459-4272 Outline of Medicare Supplement Coverage - Benefit Plans A, F, G and N This chart shows the benefits included
More informationto $20 co-payment for office Basic, including 100% Part B Co-insurance, except up visit, and up to $50copayment Co-insurance Part A Deductible
STONEBRIDGE LIFE INSURANCE COMPANY OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE BENEFIT PLANS A, F, G AND N These charts show the benefits included in each of the standard Medicare supplement plans.
More informationUNITED WORLD LIFE INSURANCE COMPANY 2019 Mutual of Omaha Rates 2019
UNITED WORLD LIFE INSURANCE COMPANY 2019 Mutual of Omaha Rates 2019 A Mutual of Omaha Company OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE BENEFIT PLANS A, F, HIGH DEDUCTIBLE F, G AND N This chart
More informationOutline of Medicare Supplement Coverage
Outline of Medicare Supplement Coverage Cover page 1 of 2 Benefit Chart of Medicare Supplement Plans Sold on or After June 1, 2010 Plans A, F, G, N These charts show the benefits included in each of the
More informationK L M N Basic, including 100% Part B. Basic, including 100% Part B Co- Insurance; other basic benefits paid at 50%
Companion Life Insurance Company Administrative Office PO Box 14158 Clearwater, Florida 33766-4158 (888) 220-0466 Outline of Medicare Supplement Coverage Cover Page Benefit Plans A, B, F and G - See Outlines
More informationcopayment for ER Skilled Nursing Facility Coinsurance Skilled Nursing Facility Coinsurance Part A Deductible Part B 50% Part A
BANKERS FIDELITY LIFE INSURANCE COMPANY 4370 Peachtree Road, NE; PO Box 105185, Atlanta, GA 30348-5185 Benefit Chart of Medicare Supplement Plans Sold for Effective Dates On or After 06-01-2010 This chart
More informationPlan A Plan B Plan C Plan D Plan F F* Plan G Plan K Plan L Plan M Plan N. Hospitalization: Skilled Nursing. 50% Skilled Nursing. Facility Coinsurance
Omaha Insurance Company A Mutual of Omaha Company OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE BENEFIT PLANS A, C, F, HIGH DEDUCTIBLE F, G AND N This chart shows the benefits included in each of
More informationHospitalization and preventive care paid at 100%; other basic benefits paid at 50% Skilled Nursing. 50% Skilled Nursing. Facility Coinsurance
Omaha Insurance Company A Mutual of Omaha Company OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE BENEFIT PLANS A, F, HIGH DEDUCTIBLE F, G AND N This chart shows the benefits included in each of the
More informationBasic, including. Hospitalization and preventive care paid. 50% Skilled Nursing. Part A Deductible. 50% Part A. Deductible
Mutual of Omaha Insurance Company OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE BENEFIT PLANS A, F, HIGH DEDUCTIBLE F, G AND N This chart shows the benefits included in each of the standard Medicare
More informationto $20 co-payment for office visit, and up to $50 copayment Skilled B Co-insurance, except up Basic, including 100% Part Co-insurance Deductible
STONEBRIDGE LIFE INSURANCE COMPANY OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE BENEFIT PLANS A, F, G AND N These charts show the benefits included in each of the standard Medicare supplement plans.
More informationMedicare Supplement Outline of Coverage. Plans A, F, G & N Anthem Blue Cross and Blue Shield Missouri 2018
March 2, 2018 12:01 PM OOC18_MS_MO-T_DUAL-AFGN-AOOC001M(18)-MO-T_03-01-2018 Medicare Supplement Outline of Coverage Plans A, F, G & N Anthem Blue Cross and Blue Shield Missouri 2018 This booklet includes
More informationOUTLINE OF COVERAGE AND RATES FOR CONNECTICUT RESIDENTS
OUTLINE OF COVERAGE AND RATES FOR CONNECTICUT RESIDENTS Medicare Supplement benefit plans A, F, High-Deductible F, G, and N Cigna Medicare Supplement Insurance Cigna Health and Life Insurance Company CHLIC-HHD-OC.v2-CR-CT
More informationBasic, including. Hospitalization and preventive care paid. 50% Skilled Nursing. Part A Deductible. 50% Part A. Deductible
Mutual of Omaha Insurance Company OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE BENEFIT PLANS A, B, C, D, F, HIGH DEDUCTIBLE F, G AND N This chart shows the benefits included in each of the standard
More informationBasic, including 100% Part B coinsurance, except up to $20 copayment for office visit, and up to $50 copayment for ER Skilled Nursing.
ASSURED LIFE ASSOCIATION A Fraternal Benefit Society OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE BENEFIT PLANS A, B, C, D, F AND G These charts show the benefits included in each of the standard
More informationBasic, including 100% Part B coinsurance. Skilled Nursing Facility Coinsurance Part A Deductible Part B. 50% Part A
BANKERS FIDELITY LIFE INSURANCE COMPANY 4370 Peachtree Road, NE; PO Box 105185, Atlanta, GA 30348-5185 Benefit Chart of Medicare Supplement Plans Sold for Effective Dates On or After 06-01-2010 This chart
More informationSTONEBRIDGE LIFE INSURANCE COMPANY OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE BENEFIT PLANS A, C, F, G AND N
STONEBRIDGE LIFE INSURANCE COMPANY OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE BENEFIT PLANS A, C, F, G AND N These charts show the benefits included in each of the standard Medicare supplement
More informationMedicare Supplement Outline of Coverage
2019 Anthem Rates - Indiana Medicare Supplement Outline of Coverage Plans A, F, G & N Anthem Blue Cross and Blue Shield Indiana 2019 This booklet includes premium rates, Medicare deductibles, copays and
More informationBasic, including 100% Part B coinsurance. Coinsurance Part A Deductible Part A Deductible Part A Deductible Part A Deductible Part A Deductible
BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA An Independent Licensee of the Blue Cross and Blue Shield Association OUTLINE OF BLUECARE COVERAGE COVER PAGE 1 of 2: BENEFIT PLANS A, F with High Deductible,
More informationA B C D F F* G K L M N. Basic, including 100% Part B. coinsurance. at 50% Skilled Nursing Facility coinsurance Part A Deductible.
Shenandoah Life Insurance Company Administrative Office: P.O. Box 14558, Clearwater, FL 33766-4558 (855) 406-9085 Outline of Medicare Supplement Coverage Cover Page Benefit Plans A, F, G and N Benefit
More informationMedicare Supplement Outline of Coverage
Medicare Supplement Outline of Coverage Plans A, F & N Anthem Blue Cross and Blue Shield New Hampshire 2016 This booklet includes premium rates, Medicare deductibles, copays and maximum out-of-pocket costs.
More informationOutline of Coverage. Medicare Supplement Insurance BENEFIT PLANS: A, B, F, G, & N. AAA Medicare Supplement Plans
American Automobile Association (AAA) Medicare Supplement Insurance Office 800 Crescent Centre Dr. Suite 200 Franklin, TN 37067 855 663.2201 aetnaseniorproducts.com Outline of Coverage Medicare Supplement
More informationAnnual Notice of Changes for 2018
HealthPartners Freedom Balance with Rx (Cost) offered by Group Health Plan, Inc. (GHI) Annual Notice of Changes for 2018 You are currently enrolled as a member of HealthPartners Freedom Balance with Rx.
More informationBasic, Including 100% Part B Coinsurance. Part B Coinsurance. Coinsurance* 50% Skilled Nursing Facility Coinsurance. Skilled Nursing Facility
AMERICAN RETIREMENT LIFE INSURANCE COMPANY P. O. BOX 26580 AUSTIN, TX 78755-0580 866-459-4272 Outline of Medicare Supplement Coverage - Benefit Plans A, F, G and N This chart shows the benefits included
More informationBENEFIT PLANS A, B, F, G & N
American Automobile Association (AAA) Medicare Supplement Insurance Office 800 Crescent Centre Dr. Suite 200 Franklin, TN 37067 855 663.2201 aetnaseniorproducts.com Outline of Coverage Medicare Supplement
More information2010 Medicare Supplement Insurance Plans
United of Omaha Life Insurance Company A Mutual of Omaha Company 2010 Medicare Supplement Insurance Plans Plans with coverage effective dates on and after June 1. Indiana U8183_IN_0010R UNITED OF OMAHA
More information2018 Outline of Coverage McLaren Medicare Supplement Plans A, C, F, High Deductible-F, G & N
2018 Outline of Coverage McLaren Medicare Supplement Plans A, C, F, High Deductible-F, G & N McLarenHealthPlan.com/MedicareSupplement Call us toll-free (888) 327-0671, Monday - Friday from 8 a.m. 6 p.m.
More informationBasic, including 100% Part B coinsurance. Skilled Nursing Facility Coinsurance Part A Deductible Part B. Part B Excess (100%) Foreign Travel Emergency
Texas OLD SURETY LIFE INSURANCE COMPANY ** 2016 ** ( effective 03/01/2016 ) Outline of Medicare Supplement Coverage Benefit Plans A and F Only are being offered by the company at this time. Benefit Plan
More informationBasic, including 100% Part B coinsurance, except up to $20 copayment for office visit, and up to $50 copayment for ER Skilled Nursing
MUTUAL OF OMAHA INSURANCE COMPANY OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE BENEFIT PLANS A, B, C, D, F AND G These charts show the benefits included in each of the standard Medicare supplement
More informationOmaha Insurance Company Application Packet
Omaha Insurance Company Application Packet Thank you for your interest in the Omaha Insurance Company Medicare Supplement plan! This application packet provides you with a link to the Online Application
More informationIMPORTANT NOTICE PLEASE READ 2016 Medicare Cost-Sharing Amounts
IMPORTANT NOTICE PLEASE READ 2016 Medicare Cost-Sharing Amounts Dear Prospective Member: The Centers for Medicare & Medicaid Services (CMS) have not released the 2016 Medicare cost-sharing amounts as of
More informationOmaha Insurance Company Application Packet
Omaha Insurance Company Application Packet Thank you for your interest in the Omaha Insurance Company Medicare Supplement plan! This application packet provides you with a link to the Online Application
More informationFeatures that Add Value. Freedom of Choice. Quality Service Is Part of Quality Care
For Retirees of Loudoun County School Board Features that Add Value The Cigna Medicare Surround indemnity medical plan helps pay some of the health care costs that your Medicare Part A or Part B do not
More informationMutual of Omaha Application Packet
Mutual of Omaha Application Packet Thank you for your interest in applying for the Mutual of Omaha Medicare Supplement plan! This application packet provides you with a link to the Online Application to
More informationRegence Bridge Medicare Supplement (Medigap) Plans
IDAHO Regence Bridge Medicare Supplement (Medigap) Plans Overview Includes Senior Selection (Modified Plan F) Regence BlueShield of Idaho is an Independent Licensee of the BCBSA 06210rep06029-id Information
More informationBasic, including 100% Part B coinsurance, except up to $20 copayment for office visit, and up to $50 copayment for ER Skilled Nursing.
UNITED OF OMAHA LIFE INSURANCE COMPANY A Mutual of Omaha Company OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE BENEFIT PLANS A, F, G, AND M These charts show the benefits included in each of the standard
More informationUnited of Omaha Application Packet
United of Omaha Application Packet Thank you for your interest in applying for the United of Omaha Medicare Supplement plan! This application packet provides you with a link to the Online Application to
More informationBasic, including. Hospitalization and preventive care paid. 50% Skilled Nursing. Part A Deductible. 50% Part A. Deductible
United of Omaha Life Insurance Company A Mutual of Omaha Company OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE BENEFIT PLANS A, F, HIGH DEDUCTIBLE F, G AND N This chart shows the benefits included
More informationBasic, including 100% Part B Coinsurance, except up to $20 copayment for office visit, and up to $50 copayment for ER Skilled Nursing.
GERBER LIFE INSURANCE COMPANY OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE STANDARDIZED BENEFIT PLAN A AND SELECT BENEFIT PLANS F AND G This chart shows the benefits included in each of the standard
More informationA B C D F l F* G K L M N
Aetna Life Insurance Company Outline of Medicare Supplement Coverage Benefit Plans A, B, F, G and N are Offered Benefit Chart of Medicare Supplement Plans Sold for Effective Dates on or After June 1, 2010
More information2019 MEDICAL PLAN SUMMARY Arlington County Government/AmWINS Medicare Plan
Out of Pocket Maximum: $1,500 Lifetime Maximum: Unlimited MEDICARE (PART A) HOSPITAL SERVICES PER BENEFIT PERIOD HOSPITALIZATION * Semiprivate room and board, general nursing, and miscellaneous services
More information2013 Outline of Medicare Supplement Coverage
Anthem Blue Cross and Blue Shield Ohio Administrative Office: P.O. Box 659806, San Antonio, TX 78265-9106 Toll Free Telephone Number: 1-866-803-5169 Benefit Chart of Medicare Supplement Plans Sold for
More informationBasic, including 100% Part B coinsurance
BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA An Independent Licensee of the Blue Cross and Blue Shield Association OUTLINE OF BLUE SELECT COVERAGE COVER PAGE 1 of 2: BENEFIT PLANS TRADITIONAL A and BLUE
More informationA B C D F F* G K L M N. coinsurance. Skilled Nursing Facility. 75% Skilled Nursing Facility coinsurance 75% Part A Deductible.
Shenandoah Life Insurance Company Administrative Office: P.O. Box 14558, Clearwater, FL 33766-4558 (855) 406-9085 Outline of Medicare Supplement Coverage Cover Page Benefit Plans A, F, G and N Benefit
More informationAmeriHealth Medigap Plans Information. Individual health plan options for people with Medicare
2016 AmeriHealth Medigap Plans Information Individual health plan options for people with Medicare AM6830 (5/15) 5823(10/15)BKV1 Thank you. We appreciate your interest in AmeriHealth New Jersey. We look
More informationA B C D F F* G K L M N. coinsurance. Skilled Nursing Facility. 75% Skilled Nursing Facility coinsurance 75% Part A Deductible.
Shenandoah Life Insurance Company Administrative Office: P.O. Box 14558, Clearwater, FL 33766-4558 (855) 406-9085 Outline of Medicare Supplement Coverage Cover Page Benefit Plans A, F, G and N Benefit
More informationRegence Bridge. Medicare Supplement (Medigap) Plans DECISION GUIDE
DECISION GUIDE Regence Bridge Medicare Supplement (Medigap) Plans Regence BlueCross BlueShield of Utah is an Independent Licensee of the Blue Cross and Blue Shield Association REG-36414-17/05-17-UT Learn
More informationMED SUPP 2018 PROD BRO Alliance Medicare Supplement Brochure
MED SUPP 2018 PROD BRO 2018 Supplement Brochure Supplement helps f ill the gaps in Original. With Original, you are covered for many hospital and medical expenses, but there are some gaps in that coverage
More informationOUTLINE OF COVERAGE AND RATES FOR LOUISIANA RESIDENTS
OUTLINE OF COVERAGE AND RATES FOR LOUISIANA RESIDENTS Medicare Supplement benefit plans A, F, High-Deductible F, G, and N Cigna Medicare Supplement Insurance Cigna Health and Life Insurance Company CHLIC-HHD-OC-AA-LA
More informationOUTLINE OF COVERAGE AND RATES FOR TENNESSEE RESIDENTS
OUTLINE OF COVERAGE AND RATES FOR TENNESSEE RESIDENTS Medicare Supplement benefit plans A, F, High-Deductible F, G, and N Cigna Medicare Supplement Insurance Cigna Health and Life Insurance Company CHLIC-HHD-OC-AA-TN
More informationOutline of Coverage. Medicare Supplement Insurance BENEFIT PLANS A, B, F, G, N. AAA Medicare Supplement Plans
American Automobile Association (AAA) Medicare Supplement Insurance Office 800 Crescent Centre Dr. Suite 200 Franklin, TN 37067 855 663.2201 aetnaseniorproducts.com Outline of Coverage Medicare Supplement
More informationBasic, including 100% Part B coinsurance. Basic, including. coinsurance. coinsurance* 50% Skilled Nursing Facility. Deductible
LOYAL AMERICAN LIFE INSURANCE COMPANY P. O. BOX 26580 AUSTIN, TX 78755-0580 866-459-4272 Outline of Medicare Supplement Coverage - Benefit Plans A, F, G, and N This chart shows the benefits included in
More informationBasic, including 100% Part B coinsurance, except up to $20 copayment for office visit, and up to $50 copayment for.
UNITED WORLD LIFE INSURANCE COMPANY A Mutual of Omaha Company OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE BENEFIT PLANS A, B, C, D, F, G, and M These charts show the benefits included in each of
More informationTHE MANHATTAN LIFE INSURANCE COMPANY Outline of Medicare Supplement Coverage-Cover Page Benefit Plans A, C, F, G, AND N
THE MANHATTAN LIFE INSURANCE COMPANY Outline of Medicare Supplement Coverage-Cover Page Benefit Plans A, C, F, G, AND N These charts show the benefits included in each of the standard Medicare supplement
More informationCigna Application Packet
Cigna Application Packet Thank you for your interest in applying for the Cigna Medicare Supplement plan! This application packet provides you with access to a printable copy of the Enrollment Form and
More informationOutline of Group Medicare Supplement Coverage
Outline of Group Medicare Supplement Coverage Effective January 1, 2018 301 S. Vine St., Urbana, IL 61801-3347 1-877-933-0028 TTY 711 HealthAlliance.org med-msgrpoutcov-11 med-msgrpoutcov18-1117 November
More information2018 Medicare Program Overview
2018 Medicare Program Overview State College of Florida Florida College System Risk Management Consortium #78800 Retirees Eligible for Medicare Florida Blue is an Independent Licensee of the Blue Cross
More informationK L M N # Basic, including 100% Part B co-insurance. Basic, including 100% Part B. co-insurance. Skilled Nursing Facility co-insurance.
Forethought Life Insurance Company Administrative Office P.O. Box 14659, Clearwater, FL 33766-4659 (877) 492-5870 Outline of Medicare Supplement Coverage Cover Page Benefit Plans A, C #, F #, G # and N
More informationPLAN SUMMARY. UnitedHealthcare Senior Supplement. Plan F
PLAN SUMMARY UnitedHealthcare Senior Supplement Underwritten by UnitedHealthcare Insurance Company In New York, Underwritten by UnitedHealthcare Insurance Company of New York Plan F All covered amounts
More informationAnnual Notice of Changes for 2019
Annual Notice of Changes for 2019 BlueCross TotalSM Upstate (PPO) Jan. 1, 2019 Dec. 31, 2019 855-204-2744 TTY 711 Seven Days a Week, 8 a.m. to 8 p.m. (Oct. 1, 2018, to Mar. 31, 2019) Monday-Friday, 8 a.m.
More informationone full year from your effective date of the respond by date, these rates are Direct Notice Bank Account Credit Card payments ahead.
Issue Age Medicare Supplement Insurance s Offered in Wisconsin Underwritten by Transamerica Life Insurance Company Monthly Rate For Non-Tobacco 1 2 3 4 5 6 7 Under 65 $99.68 $154.66 $134.43 $153.56 $155.90
More informationBasic, including 100% Part B coinsurance
BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA An Independent Licensee of the Blue Cross and Blue Shield Association OUTLINE OF BLUE SELECT COVERAGE COVER PAGE 1 of 2: BENEFIT PLANS TRADITIONAL A and BLUE
More informationBasic, including 100% Part B coinsurance
BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA An Independent Licensee of the Blue Cross and Blue Shield Association OUTLINE OF BLUE SELECT COVERAGE COVER PAGE 1 of 2: BENEFIT PLANS TRADITIONAL A and BLUE
More informationOutline of Coverage. Medicare Supplement Insurance BENEFIT PLANS A,B,F, HIGH DEDUCTIBLE F, G, N. American Continental Insurance Company
American Continental Insurance Company 800 Crescent Centre Dr. Suite 200 Franklin, TN 37067 800 264.4000 aetnaseniorproducts.com Outline of Coverage Medicare Supplement Insurance BENEFIT S A,B,F, HIGH
More informationA B C D F F* G K L M N. Basic, including 100% Part B coinsurance. Basic, including 100% Part B coinsurance
Independence Blue Cross and Highmark Blue Shield Outline of Medicare Supplement Coverage MedigapSecurity Plans A, B, and C Benefit Chart of Medicare Supplement Plans sold on or After June 1, 2010 This
More informationAETNA HEALTH AND LIFE INSURANCE COMPANY 800 Crescent Centre Dr., Suite 200, Franklin, Tennessee, Telephone:
AETNA HEALTH AND LIFE INSURANCE COMPANY 800 Crescent Centre Dr., Suite 200, Franklin, Tennessee, 37067 Telephone: 800 264.4000 OUTLINE OF MEDICARE SUPPLEMENT INSURANCE OUTLINE OF COVERAGE FOR POLICY FORM
More informationSupplement. Medicare. Disclosure Packet. Included in this disclosure packet:
Americo Medicare Supplement Disclosure Packet Thank you for your interest in purchasing an Americo Financial Life and Annuity Insurance Company Medicare Supplement insurance policy. Below are the forms
More informationHealthPartners Freedom (Cost) Group Plan with Rx
HealthPartners Freedom (Cost) Group Plan with Rx 2018 Summary of Benefits Minnesota Jan. 1, 2018 Dec. 31, 2018 Hennepin County #3096 Use this summary document to get to know the Freedom plan. It shows
More informationPHILADELPHIA AMERICAN LIFE INSURANCE COMPANY
P.O. Box 4884, Houston, Texas 77210-4884 BENEFIT CHART OF MEDICARE SUPPLEMENT PLANS SOLD ON OR AFTER JANUARY 1, 2014 This chart shows the benefits included in each of the Medicare supplement plans. Every
More informationMedicare Supplement Coverage Options
A Division of HealthNow New York Inc. An Independent Licensee of the BlueCross BlueShield Association Medicare Supplement Coverage Options Thank you for your interest in our Medicare Supplemental coverage
More informationYour Plan Explained Insurance Trust for Delta Retirees 2013 Medical Benefit Plan
Your Plan Explained Insurance Trust for Delta Retirees 2013 Medical Benefit Plan UnitedHealthcare Senior Supplement Plan Introducing the Insurance Trust for Delta Retirees Senior Supplement plan insured
More informationSupplement. Medicare. Disclosure Packet. Included in this disclosure packet:
Americo Medicare Supplement Disclosure Packet Thank you for your interest in purchasing an Americo Financial Life and Annuity Insurance Company Medicare Supplement insurance policy. Below are the forms
More information2012 Outline of Medigap coverage and option change form Plans A, F, M and N
Medicare Supplement Coverage offered by Blue Care Network of Michigan MyBlue Medigap SM 2012 Outline of Medigap coverage and option change form Plans A, F, M and N My life, My health plan www.bcbsm.com/mybluemedicare
More informationMutual of Omaha Application Packet
Mutual of Omaha Application Packet Thank you for your interest in applying for the Mutual of Omaha Medicare Supplement plan! This application packet provides you with a link to the Online Application to
More informationBasic, including 100% Part B coinsurance
BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA An Independent Licensee of the Blue Cross and Blue Shield Association OUTLINE OF BLUE SELECT COVERAGE COVER PAGE 1 of 2: BENEFIT PLANS TRADITIONAL A and BLUE
More information