Stonebridge Life Insurance Company Home Office: Rutland, VT A Transamerica company This program is not connected This program with or endorsed is not connected by the U.S. with Government or endorsed or by the the Federal U.S. Government Medicare Program. or the Federal Medicare Program.
Medicare Basics This This program is is not not connected with or or endorsed by by the the U.S. U.S. Government or or the the Federal Medicare Program.
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) *www.hhs.gov/about/whatwedo.html (23 April 2012).
ABC s (and D) of Medicare.
Part A: Hospital Insurance Covers the following: Inpatient hospital care Skilled nursing facility care Home health care Hospice care
Part A: Hospital Insurance
Part B: Medical Insurance Standard monthly premium of $104.90 in 2013 Covers the following: Doctor s and other health care providers services Hospital outpatient care Durable medical equipment Home health care Many preventative services
Part B: Medical Insurance You must also continue to pay your Part B premium
Part C: Medicare Advantage Offers health plan options run by Medicareapproved 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
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
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 coinsurance Original Medicare does not offer coverage for prescription drugs in most cases One can enroll in Part D
Medicare Supplement Insurance Plan Basics
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
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
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
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
Medicare Supplement Plans Some of the plans also cover Part A deductible Part B deductible At-home recovery Medicare Part B excess charges Other services
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
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
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
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
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
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.
Medicare Supplement Plans from Stonebridge Life Insurance Company
Medicare Supplement Plans From Stonebridge Life 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
Medicare Supplement Plans From Stonebridge Life Standardized Plan G All the features of Plan F, EXCEPT does not cover Part B deductible of $147 Standardized Plan N Covers 100% of Part A $20 co-pay for Doctors $50 co-pay for emergency room Does not cover excess
Why Choose Stonebridge Life Competitive Pricing Goal is rate stability by reasonable initial pricing and modest rate increases Commitment to Service Predictable underwriting Efficient new business & claims process Commitment to the Senior Market Already leader in Final Expense
Why Choose Stonebridge Life Strong History & Name Recognition Stonebridge Life is a Transamerica Company Serving Policyholders for over 100 years Approximately 12,000 employees in the US
New Business for Stonebridge Medicare Supplement Sending in Business to Home Office: Agents can fax or mail apps to Home Office Faxing is preferred method If app is faxed, do not mail original Always Include Express Issue Cover Sheet
New Business for Stonebridge Service Levels Medicare Supplement All new app s when received prior to 3:00 pm CST to be submitted same business day Approval s to be processed within 2 business days
Underwriting for Stonebridge Service Levels Medicare Supplement Initial review on new cases within 1 business day Additional requirements, PHI s and any UW requirements: reviewed within 2 business days of receipt
Underwriting for Stonebridge Medicare Supplement Personal History Interviews (If Needed) Performed by Unavita Contact Number 866-890-0368 Hours Weekdays: 8:00AM 7:00PM (CST) Weekends: 7:00AM 1:00PM (CST)
Stonebridge Medicare Supplement Claims Processing 87% of claims processed electronically with next day turnaround time 90% of claims handled electronically 99.3% Accuracy on claims handling
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