MEDICARE MEDICARE SUPPLEMENT INSURANCE PLANS These plans are sold by private insurance companies to help cover some of the expenses Medicare Parts A and B don t. You can apply for a Medicare Supplement insurance plan year-round as long as you are eligible. You have Medicare questions? We have answers. NETWORK The facilities, providers and suppliers your health insurer or plan has contracted with to provide health-care services. These providers include doctors, hospitals, and other health-care professionals and facilities. LET S DO THIS TOGETHER. usaa.com/medicare 800-515-8687 OUT-OF-POCKET COSTS Expenses you pay for medical care, prescriptions and other health-care services that are not reimbursed. This includes deductibles, coinsurance and copayments. TTY users, dial 711. Call us Monday Friday, 7:30 a.m. 8 p.m. CT. When you call, you ll be directed to a licensed sales agent/producer. PREFERRED PROVIDER ORGANIZATION (PPO) A type of health plan that contracts with medical providers, such as hospitals and doctors, to create a network of participating providers. You usually pay less if you use providers that belong to the plan s network. You can use doctors, hospitals and providers outside of the network for an additional cost. PREMIUM To get information for free in other languages, call 800-515-8687 (TTY: 711). Para obtener esta información gratuitamente en otros idiomas, llame al 800-515-8687 (TTY: 711). 要獲得本資訊的免費其他語言版本 請致電 800-515-8687 (聽障專線 711). The periodic amount you pay Medicare or a health plan for health insurance or prescription drug coverage. PRIVATE FEE-FOR-SERVICE PLAN (PFFS) With this type of plan, you must find doctors, hospitals and other types of providers that accept Medicare and the plan s payment terms. Some PFFS plans have a network of providers; you can still see out-of-network providers that accept the plan s payment terms, but you may pay more. usaa.com/medicare l 800-515-8687 GUIDEBOOK 31 This Medicare Guidebook is for informational purposes and subject to change without notice. We believe the websites and resources we used to gather this information are reliable; however, we cannot guarantee the accuracy or timeliness of the information. Neither USAA nor any affiliates are associated with or endorsed by these websites and resources. Medicare solutions provided by USAA Life Insurance Company, San Antonio, TX, and through USAA Life General Agency, Inc. (LGA) (known in CA and NY as USAA Health and Life Insurance Agency), which acts as an agent for select insurance companies to provide products to USAA members. LGA representatives are salaried and receive no commissions. However, LGA receives commissions from those companies, which can include compensation based on the total quantity and quality of insurance coverage purchased through LGA. Plans not available in all states. Each company has sole financial responsibility for its own products. Medicare Supplement insurance, USAA Life Insurance Company and USAA Life General Agency are not connected with or endorsed by the U.S. government or the federal Medicare program. 2017 USAA. 219327-0317 YOU AND YOUR CHOICES
What s inside: Medicare Basics... 3 Learning the basics When am I eligible? A word about penalties When do I enroll? Explore Plans...11 Your Medicare choices Factors to consider: benefits and costs What is Medicare Part C? What is Medicare Part D: Prescription Drug Coverage? Inside the coverage gap Medicare Special Needs Plans Medicare Supplement Insurance Plans... 21 Why would I need a supplemental plan? Resources... 25 Find more help Glossary... 29 Before You Enroll, Ask Yourself... 32 33
WHAT IS MEDICARE?
Learning the basics Medicare is a government health insurance program that helps millions of people age 65 and older (and some individuals younger than 65 with certain disabilities) get the health care they need. MEDICARE BASICS It consists of four parts, each covering different benefits: Parts and. Medicare Parts A and B cover a wide range of health services, but they don t cover everything. You can combine certain Medicare parts and plans to meet your specific health and budget needs. But first you have to understand the differences. Understanding your Medicare benefits can help you save on health-care expenses and avoid costly mistakes. Let s get started. usaa.com/medicare l Call a licensed sales agent: 800-515-8687 3
MEDICARE BASICS Here s a quick view: PART PROVIDER BENEFITS Medicare Part A: Hospital Insurance Government Helps pay the costs of inpatient care in a hospital, a skilled nursing facility, home health care (but not long-term care), and hospice care Medicare Part B: Medical Insurance Government Helps pay bills for doctor visits, outpatient care such as rehab therapy and some preventive services. It also covers doctors services in the hospital and most medicines administered in a doctor s office Medicare Part C: Medicare Advantage Private Insurance Companies Combines coverage for most services of Medicare Parts A and B except hospice care in a single plan. Many of these plans also include prescription drug coverage Medicare Part D: Prescription Drug Plan Private Insurance Companies A plan that may help pay for prescription drugs Medicare Supplement Insurance Private Insurance Companies A plan that may help reduce your annual out-of-pocket expenses 4 usaa.com/medicare l 800-515-8687
When am I eligible? In general, you re eligible for Medicare Parts A and B if you are: Age 65 (can complete application the month when you will be 64 years and nine months old) Younger than 65 with a qualifying disability Any age and have end-stage renal disease Enrollment in Part A is automatic if you already receive Social Security benefits. If not, you must enroll on your own at Medicare.gov or go to socialsecurity.gov. You can also visit your local Social Security office or contact it at 800-772-1213 (TTY 800-325-0778), Mondays Fridays, 7 a.m. - 7 p.m. ET. Do this well before your 65th birthday so you can start getting benefits as soon as you re eligible. In general, anyone enrolled in Part A is also eligible for Part B. To enroll in Medicare Advantage (Part C), you must be enrolled in Parts A and B. To enroll in a Medicare Prescription Drug Plan, you must be entitled to Part A and/or be enrolled in Part B. Please note: Part B is voluntary. However, many people with Part A also enroll in Part B to make sure their basic health-care needs are covered. To enroll in a Medicare Supplement plan, you must be enrolled in Parts A and B. You ll pay a monthly premium in addition to the Part B premium you pay, but supplemental plans can help pay some or most of the health-care costs that Medicare doesn t pay. usaa.com/medicare l 800-515-8687 5
A word about penalties If you don t sign up for Part B and Medicare prescription drug coverage (Part D) when you re first eligible, you may pay a higher monthly fee when you sign up later. NO PENALTY You qualify for delaying your enrollment if: PENALTY If you delay and aren t qualified to delay: Part B You have group health insurance You may have to pay a higher monthly premium for the life of your Part B coverage Part D You have creditable coverage for prescription drugs You qualify for a low-income subsidy You may pay a lateenrollment penalty each month as long as you have Part D coverage If you qualify, you can delay your sign-up without a penalty. To find out more about delayed Part B and Part D, visit Medicare.gov or call 800-MEDICARE 24 hours a day/7 days a week (TTY users, dial 877-486-2048). 6 usaa.com/medicare l 800-515-8687
When do I enroll? JAN FEB MAR APR MAY JUN (ADP) Annual Disenrollment Period (SEP) Special Enrollment Period When you become eligible for Medicare If selecting a Medicare Supplement insurance plan Initial Enrollment Period (IEP) Medicare Supplement Open Enrollment Period lasts for six Three months before the month months. you turn 65 The month you turn 65 Starts on the first day of the month in which you turn age 65 and are Three months after the month enrolled in Medicare Part B. If your you turn 65 birthday is on the first day of the month, Medicare will begin the first day of the prior month. You can purchase a Medicare Supplement insurance plan at any time during the year. The best time to purchase one is during your Medicare Supplement Open Enrollment Period. Some states have additional open enrollment periods, including those for people under age 65. There are also several situations that may guarantee a Medicare Supplement plan is available to you if certain criteria are met. During these periods, an insurance company can t use medical underwriting. 8 usaa.com/medicare l 800-515-8687
Pre-Enrollment Period JUL AUG SEP OCT NOV DEC (AEP) Annual Election Period Every year after you first become eligible Pre-Enrollment Period Oct. 1 Oct. 14 During this period, people with Medicare can find out about the products that will be offered during the Annual Election Period. Annual Election Period (AEP) From Oct. 15 to Dec. 7, you can enroll in a Medicare Advantage plan and/or a Medicare Prescription Drug Plan for the next calendar year. Annual Disenrollment Period (ADP), Jan. 1 Feb. 14 During this time, people who have a Medicare Advantage plan can disenroll and return to Medicare Parts A and B. These people can also enroll in a stand-alone prescription drug plan. If you qualify for Medicare Advantage or a Medicare Prescription Drug Plan because of an exception Special Enrollment Period If you meet certain conditions, you may qualify for a Special Enrollment Period. Some conditions* include moving from your plan s service area or having Medicaid coverage. If you qualify for a Special Enrollment Period, you can enroll in a Medicare Advantage or a Medicare Prescription Drug plan even between Feb. 15 and Oct. 14. * For a listing of those Special Enrollment Periods, visit Medicare.gov. Lock-in Period, Feb. 15 Oct. 14 End of the Medicare enrollment season, during which time you must stay with your plan election. Generally, you can only make changes if you qualify for a Special Enrollment Period. usaa.com/medicare l 800-515-8687 9
WHICH MEDICARE PLAN IS RIGHT FOR ME?
Your Medicare choices Your coverage, your choice You can get your Medicare coverage in one of two ways: Medicare Parts A and B or Medicare Advantage (Part C). No matter which way you go, you first have to enroll in Medicare Parts A and B. Once you enroll, there may be additional coverage options. Use this chart to help you decide which route you want to take: Enroll in Medicare for Part A (Hospital Insurance) and Part B (Medical Insurance) AND EXPLORE PLANS Then choose to receive your Medicare benefits by selecting a Medicare Advantage plan (Part C), like an HMO or PPO from a private insurance company. This works in place of Part A and Part B and often includes prescription drug coverage as well as extra benefits and services for an additional cost. + Select a stand-alone prescription drug plan (Part D) offered by a private company that can be used with Medicare Parts A and B or plans like a Medicare Advantage Private Fee-For-Service plan that does not have prescription drug coverage included. OR Enroll in Medicare for Part A (Hospital Insurance) and Part B (Medical Insurance) AND Select Medicare Supplement insurance offered through a private insurance company that can help pay some of the health-care costs that Medicare doesn t pay, like copayments, coinsurance and deductibles. + Select a stand-alone prescription drug plan (Part D) offered by a private company. usaa.com/medicare l 800-515-8687 11
Factors to consider: benefits and costs EXPLORE PLANS Medicare Parts A and B don t cover everything. Even when they do cover a service, you generally have to pay deductibles, coinsurance and copayments, unless you have a Medicare Supplement insurance or a prescription drug plan to help cover those costs. With all the choices you have for your health-care coverage, it s important to understand how each plan works, the benefits it offers and your share of the plan s costs. Here s a brief look at your potential out-of-pocket costs by plan: Part A: Hospital Insurance Part B: Medical Insurance Deductible $1,340 $183 Monthly premium Many people don t pay a Part A premium. If you don t meet qualifications for premium-free Part A, you ll have to buy it ($422 each month in 2018) Standard monthly premium is $134 in 2018 Coinsurance/ copayments After meeting your deductible, you pay nothing for up to 60 days in the hospital in any one benefit period, but additional days may have daily copays You are responsible for 20% of Medicare-approved expenses Yearly limit for out-ofpocket costs* None None *Annual out-of-pocket amount does not include monthly premiums or any amounts paid during catastrophic coverage. 12 usaa.com/medicare l 800-515-8687
Doctor and hospital choices. Do your doctors, hospitals, pharmacies and other providers accept the Medicare plan you ve chosen? Do you need to get referrals from the primary care physician? Benefits. Does the plan you want include all benefits in Parts A and B? If you take prescription drugs regularly, does it include prescription drug coverage? Costs. Understanding costs is an important part of choosing the right Medicare coverage for you. How much are your premiums, deductibles, coinsurance and copayments? How much can you afford? Is there a yearly limit on what you pay out of pocket? Part C: Medicare Advantage Part D: Prescription Drug Plan Medicare Supplement Insurance None Varies by plan and provider Varies by plan and provider Premiums for Parts B and D Premiums for Part B and Medicare Supplement policy (many also purchase Part D coverage), which vary by plan and provider Varies by plan and provider Varies by plan and provider Varies by plan and provider Plan includes a yearly limit on how much you pay for Part A and Part B covered services. After you reach that limit, you pay $0 for covered services** $5,000 (Depending on Part D Prescription Drug Plan selected) **Amount may vary based on your income. usaa.com/medicare l 800-515-8687 13
What is Medicare Part C? Medicare Part C, also called Medicare Advantage, works in place of Medicare Parts A and B. With it, you get hospital, medical and preventive care services all in a single plan. Some of these private, Medicare-approved health plans also include prescription drug coverage. To be eligible for a Medicare Advantage plan, you must be enrolled in Parts A and B. You could pay a monthly premium for Part C, in addition to your Part B premium. Zero premium Part C plans may be available in your area, but you would still have to pay your Part B premium. A single plan may give you everything you need People choose Medicare Advantage plans because they can reduce out-of-pocket costs and may offer additional benefits you don t get with Medicare Parts A and B. For example: Fitness programs Gym membership Mail-order pharmacy A nurse helpline Health-education programs
Please note: This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments and restrictions may apply. Benefits, premium and member cost share may change on January 1 of each year. You must continue to pay your Medicare Part B premium. There are different types of Medicare Advantage plans designed to give you more choices about how to get your health care. Each type defines what providers you can see: Health Maintenance Organization (HMO) You ll be required to choose a primary care physician who is responsible for managing and coordinating all of your health care. Preferred Provider Organization (PPO) * Some carriers may ask you to select a primary care physician, but you are not required to see them or get referrals to see other providers in the network. You can see providers outside the network, but generally you ll pay less if you stay inside your network. Private Fee-For-Service (PFFS) Plans You have the freedom to go to any Medicare-approved doctor or hospital that accepts Medicare and the plan s payment terms and agrees to treat you. Not all providers will. You can also choose out-of-network providers who accept the plan s terms, but you may have to pay more. * Out of-network/non-contracted providers are under no obligation to treat you except in emergency situations. For a decision about whether your plan sponsor will cover an out-of-network service, we encourage you or your provider to ask the plan sponsor for a pre-service organization determination before you receive the service. Please call your plan sponsor s customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services. usaa.com/medicare l 800-515-8687 15
What is Medicare Part D: Prescription Drug Coverage? Medicare Parts A and B do not include prescription drug coverage. However, as a Medicare recipient you can get a Medicare-approved plan that helps cover the cost of the medicines your doctor prescribes. It s called Medicare Part D Prescription Drug Plan. Part D plans are sold by private insurance companies. Each Part D plan covers a specific list of medicines, called a formulary. By law, these plans must cover the kinds of drugs most commonly prescribed. Choose your plan carefully to make sure it covers medicines that you take regularly. Two ways to get Prescription drug coverage: 1. Buy a separate, stand-alone Part D Prescription Drug Plan in addition to Medicare Parts A or B. Can also be purchased with Medicare Supplement insurance but would require enrollment in Medicare Part B. OR 2. Choose a Medicare Advantage (Part C) plan with prescription drug coverage. If you enroll in a Medicare Advantage plan with prescription drug coverage, you don t need to enroll in a stand-alone prescription drug plan. If the Medicare Advantage plan you want doesn t include prescription drug coverage, choose one that does or enroll in a Primary Fee-For-Service MA Only and stand-alone prescription drug plan. 16 usaa.com/medicare l 800-515-8687
The law requires all Part D plans to offer at least the basic benefits required by Medicare. Plans can offer more benefits, but they must meet the minimum requirements listed below. Part D 2018 Coverage & Gaps 1 You Pay Until you meet your deductible Deductible $400 Deductible 2 You Pay 25% 75% Paid by Your Plan Initial Coverage 3 Initial Coverage Limit Cost-Share Until $3,750 Brand Name Drugs You Pay 40% of Cost Generic Drugs You Pay 51% of Cost Out-of-Pocket Threshold Paid by Individual $5,000 Coverage Gap also known as the Donut Hole 4 You Pay 15% Paid by Your Plan Catastrophic 5%* 80% Paid by Medicare Coverage True out-of-pocket costs during the initial deductible and initial coverage period can vary by Part D plan. *Cost-sharing for the catastrophic portion of the benefit is set at the greater of 5% coinsurance or fixed copayments set by CMS. usaa.com/medicare l 800-515-8687 17
Inside the coverage gap Most Medicare Prescription Drug Plans have a coverage gap, also called the donut hole. This means that after you and your drug plan have spent a predetermined amount of money for covered drugs, you have entered the coverage gap. You then have to pay a percentage of your drug costs up to a certain limit for the year. For 2018, that amount is $5,000 and subject to change every plan year. Here s how it works: You and your drug plan pay for covered drugs until your total drug costs reach $3,750 Then you pay a percentage until your out-of-pocket costs reach $5,000 After that, you re out of the coverage gap It s called the coverage gap because the plan provides no coverage between $3,750 and $5,000 After you leave the coverage gap, you ve entered the catastrophic coverage phase. Here, you ll only pay a small copayment or coinsurance for your medications for the rest of the calendar year. Your insurer covers the balance.* Keep in mind: Your costs will vary based on the drugs you use and the plan you choose. Help paying for prescriptions If you qualify for extra help, the amount you pay for brand-name and generic drugs does not change in the coverage gap. *Rates and costs are subject to change yearly. 18 usaa.com/medicare l 800-515-8687
Medicare Special Needs Plans (SNPs) These privately run Medicare Advantage plans offer benefits, provider choices and drug lists to best meet the needs of the groups they serve. Who can join a Medicare SNP? To join a Medicare-approved SNP, you must have Parts A and B and one of the following must apply: You have a chronic illness, such as diabetes or a heart condition, which is diagnosed and verified by a physician You live in a nursing home facility or require nursing care at home You are eligible for Medicare, and you receive Medicaid assistance from the state What do SNPs cover? SNPs include all Part A and Part B benefits, as well as: Access to clinical programs focused on the type of health-care services you need Extra benefits and services tailored to people with the same condition or diagnosis Help paying for Medicare if you qualify for both Medicare and Medicaid usaa.com/medicare l 800-515-8687 19
DO I NEED A MEDICARE SUPPLEMENT INSURANCE PLAN?
Why would I need a supplemental plan? Medical expenses can put your retirement savings at risk. Medicare Supplement insurance policies can help protect you from those costs, which can add up fast even in good health. These private, supplemental health insurance plans work hand in hand with Medicare Parts A and B. This means they help pay some of the health-care costs that Medicare doesn t cover, such as deductibles, copayments and coinsurance, and provide you with more insurance coverage. Plus, you can visit doctors and providers of your choice that accept Medicare patients including specialists and specialty hospitals. How do supplemental plans work? If you buy a plan, you ll continue to be covered by Medicare Parts A and B. After Medicare pays your claims, it will automatically forward your claims to your plan, which then pays its share of your claim. Sign up early You ll pay a monthly premium in addition to the Part B premium you pay, but plans can help reduce your annual out-ofpocket expenses. SUPPLEMENTS If you buy a Medicare Supplement insurance policy during your six-month Open Enrollment Period, you can t be refused a policy or charged more than someone else with no health problems. This period starts automatically the month you turn 65 and enroll in Medicare Part B. Some plans are also available to qualified consumers under age 65 in certain states. You can add a Medicare Supplement insurance policy anytime during the year if you are over age 65 and have already enrolled in Medicare Parts A and B. But you may be subject to medical underwriting standards if you sign up outside of your enrollment period. usaa.com/medicare l 800-515-8687 21
Choosing the right plan for you There are ten standardized Medicare Supplement insurance plans, labeled letters A through N. By law, the plans offered by each company cover the same benefits, so cost is usually the only difference. Here are the benefits included with each plan: SUPPLEMENTS
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) Medicare Part B coinsurance or copayment 50% 75% ** Blood (first three pints) 50% 75% Medicare Part A hospice care coinsurance or copayment 50% 75% Skilled nursing facility care coinsurance 50% 75% Medicare Part A deductible 50% 75% 50% Medicare Part B deductible Medicare Part B excess charges Foreign travel emergency (up to plan limits) 80% 80% 80% 80% 80% 80% Out-of-pocket limit in 2018*** K $5,240 L $2,620 *Plan F may also be available as a high-deductible plan by some insurers. ** Plan N pays of the Part B coinsurance, except for copayments of up to $20 for office visits and $50 for emergency room visits. *** For Plans K and L, once you meet your out-of-pocket yearly limit and Part B deductible, the plan pays of covered services for the rest of the calendar year. usaa.com/medicare l 800-515-8687 23
WHERE CAN I FIND OUT MORE?
Find more help Take advantage of all your Medicare resources The information in this guidebook is just a starting point. There are many resources where you can find more help, including through your USAA membership. USAA has been helping members with their Medicare choices for more than 25 years. So you can be confident that you re getting knowledgeable guidance from someone you can count on. Find everything you need to know about your Medicare options at usaa.com/medicare or get one-on-one guidance by calling a licensed sales agent at 800-515-8687. State Health Insurance Assistance Program Every state has a State Health Insurance Assistance Program (SHIP). This program provides free personalized insurance counseling to people with Medicare, or family and friends who have authorization to choose for you. You can speak with a SHIP counselor face-to-face or over the phone about benefits, claims and supplemental policies. If you want to know more about your state s SHIP or you want to contact a SHIP counselor in your area, visit shiptacenter.org. SHIP counselors don t provide legal advice. They also won t sell, recommend or endorse any specific insurance product, agent or insurance company. They simply provide information and guidance so you can make your own decisions. RESOURCES usaa.com/medicare l 800-515-8687 25
Medicare also offers a number of resources to help you make the right decision for you. Medicare The Medicare & You handbook gives detailed information about Medicare. People with Medicare receive this booklet in the mail each fall. To get a copy, visit Medicare.gov. Medicare Supplement Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare, a publication developed by the Centers for Medicare & Medicaid Services and the National Association of Insurance Commissioners. To view a copy, visit Medicare.gov. Help with Medicare costs Have limited income and resources? You may be able to get extra help paying for Medicare, a Medicare Part D Prescription Drug Plan, or both. RESOURCES To find out if you qualify, contact your state Medicaid office or the Social Security Administration at 800-772-1213 (TTY users, dial 800-325-0778). Hours are 7 a.m. to 7 p.m., Monday through Friday. 26 usaa.com/medicare l 800-515-8687
Caregivers Many people trust someone else to help make health-care decisions. That person can be a spouse, sibling, grown child or close friend. Insurers call this person a caregiver. But to share your health-plan information with your caregiver, insurers first need your permission. You ll need to read and sign a consent form that allows insurers to share your health-plan information with your caregiver. StaySmartStayHealthy.com The goal of Stay Smart Stay Healthy is simple: to educate you about the health-care system by removing the usual hurdles and replacing them with an informative and engaging video series. Medicare videos in the series include: What is the Medicare process and how does it work? What does Medicare cost? Medicare and health screenings For help understanding the health-care industry, visit StaySmartStayHealthy.com today. usaa.com/medicare l 800-515-8687 27
Glossary ANNUAL ELECTION PERIOD (AEP) From Oct. 15 through Dec. 7, people who are Medicare-eligible can enroll in, disenroll from, or change to the Medicare Advantage or Medicare Prescription Drug Plan of their choice for the following year. CAREGIVER A person who helps meet another person s needs and perform the activities of daily living. CENTERS FOR MEDICARE & MEDICAID SERVICES (CMS) The federal agency that runs the Medicare and Medicaid programs. COINSURANCE The percentage of costs for covered medical services or prescriptions that you pay out of pocket. COPAYMENT The fixed amount you pay for a covered health-care service when you receive medical services or have a prescription filled. COVERAGE GAP OR DONUT HOLE In some plans, after your total drug costs for the year reach the defined limit, you may pay more of your drug costs until you reach catastrophic coverage. DEDUCTIBLE The amount you owe for medical services or prescriptions before your plan begins to pay for your benefits. usaa.com/medicare l 800-515-8687 29 GLOSSARY
FORMULARY A list of drugs your plan covers. HEALTH MAINTENANCE ORGANIZATION (HMO) A type of plan that requires you to choose a primary care physician in the plan s network to coordinate your care. INITIAL ENROLLMENT PERIOD (IEP) You can sign up for Medicare when you re first eligible for Part A and/or Part B during your Initial Enrollment Period. For example, if you re eligible when you turn 65, you can sign up during the seven-month period that begins three months before the month you turn 65, including the month you turn 65, and ends three months after the month you turn 65. MEDICALLY NECESSARY Health-care services or supplies needed to prevent, diagnose or treat an illness, injury, condition, disease or its symptoms and that meet accepted standards of medicine. MEDICARE PARTS A AND B Fee-for-service coverage under which the government pays your healthcare providers directly for your Part A (Hospital Insurance) and/or Part B (Medical Insurance) benefits. MEDICARE ADVANTAGE (MEDICARE PART C) PLANS These Medicare-approved plans are offered by private companies. They provide you with all of your Part A (Hospital Insurance) and Part B (Medical Insurance) coverage. Medicare Advantage plans often offer extra coverage such as vision, hearing, dental, or health and wellness programs. Many include prescription drug coverage. GLOSSARY 30 usaa.com/medicare l 800-515-8687
MEDICARE MEDICARE SUPPLEMENT INSURANCE PLANS These plans are sold by private insurance companies to help cover some of the expenses Medicare Parts A and B don t. You can apply for a Medicare Supplement insurance plan year-round as long as you are eligible. You have Medicare questions? We have answers. NETWORK The facilities, providers and suppliers your health insurer or plan has contracted with to provide health-care services. These providers include doctors, hospitals, and other health-care professionals and facilities. LET S DO THIS TOGETHER. usaa.com/medicare 800-515-8687 OUT-OF-POCKET COSTS Expenses you pay for medical care, prescriptions and other health-care services that are not reimbursed. This includes deductibles, coinsurance and copayments. TTY users, dial 711. Call us Monday Friday, 7:30 a.m. 8 p.m. CT. When you call, you ll be directed to a licensed sales agent/producer. PREFERRED PROVIDER ORGANIZATION (PPO) A type of health plan that contracts with medical providers, such as hospitals and doctors, to create a network of participating providers. You usually pay less if you use providers that belong to the plan s network. You can use doctors, hospitals and providers outside of the network for an additional cost. PREMIUM To get information for free in other languages, call 800-515-8687 (TTY: 711). Para obtener esta información gratuitamente en otros idiomas, llame al 800-515-8687 (TTY: 711). 要獲得本資訊的免費其他語言版本 請致電 800-515-8687 (聽障專線 711). The periodic amount you pay Medicare or a health plan for health insurance or prescription drug coverage. PRIVATE FEE-FOR-SERVICE PLAN (PFFS) With this type of plan, you must find doctors, hospitals and other types of providers that accept Medicare and the plan s payment terms. Some PFFS plans have a network of providers; you can still see out-of-network providers that accept the plan s payment terms, but you may pay more. usaa.com/medicare l 800-515-8687 GUIDEBOOK 31 This Medicare Guidebook is for informational purposes and subject to change without notice. We believe the websites and resources we used to gather this information are reliable; however, we cannot guarantee the accuracy or timeliness of the information. Neither USAA nor any affiliates are associated with or endorsed by these websites and resources. Medicare solutions provided by USAA Life Insurance Company, San Antonio, TX, and through USAA Life General Agency, Inc. (LGA) (known in CA and NY as USAA Health and Life Insurance Agency), which acts as an agent for select insurance companies to provide products to USAA members. LGA representatives are salaried and receive no commissions. However, LGA receives commissions from those companies, which can include compensation based on the total quantity and quality of insurance coverage purchased through LGA. Plans not available in all states. Each company has sole financial responsibility for its own products. Medicare Supplement insurance, USAA Life Insurance Company and USAA Life General Agency are not connected with or endorsed by the U.S. government or the federal Medicare program. 2017 USAA. 219327-0317 YOU AND YOUR CHOICES
MEDICARE MEDICARE SUPPLEMENT INSURANCE PLANS These plans are sold by private insurance companies to help cover some of the expenses Medicare Parts A and B don t. You can apply for a Medicare Supplement insurance plan year-round as long as you are eligible. You have Medicare questions? We have answers. NETWORK The facilities, providers and suppliers your health insurer or plan has contracted with to provide health-care services. These providers include doctors, hospitals, and other health-care professionals and facilities. LET S DO THIS TOGETHER. usaa.com/medicare 800-515-8687 OUT-OF-POCKET COSTS Expenses you pay for medical care, prescriptions and other health-care services that are not reimbursed. This includes deductibles, coinsurance and copayments. TTY users, dial 711. Call us Monday Friday, 7:30 a.m. 8 p.m. CT. When you call, you ll be directed to a licensed sales agent/producer. PREFERRED PROVIDER ORGANIZATION (PPO) A type of health plan that contracts with medical providers, such as hospitals and doctors, to create a network of participating providers. You usually pay less if you use providers that belong to the plan s network. You can use doctors, hospitals and providers outside of the network for an additional cost. PREMIUM To get information for free in other languages, call 800-515-8687 (TTY: 711). Para obtener esta información gratuitamente en otros idiomas, llame al 800-515-8687 (TTY: 711). 要獲得本資訊的免費其他語言版本 請致電 800-515-8687 (聽障專線 711). The periodic amount you pay Medicare or a health plan for health insurance or prescription drug coverage. PRIVATE FEE-FOR-SERVICE PLAN (PFFS) With this type of plan, you must find doctors, hospitals and other types of providers that accept Medicare and the plan s payment terms. Some PFFS plans have a network of providers; you can still see out-of-network providers that accept the plan s payment terms, but you may pay more. usaa.com/medicare l 800-515-8687 GUIDEBOOK 31 This Medicare Guidebook is for informational purposes and subject to change without notice. We believe the websites and resources we used to gather this information are reliable; however, we cannot guarantee the accuracy or timeliness of the information. Neither USAA nor any affiliates are associated with or endorsed by these websites and resources. Medicare solutions provided by USAA Life Insurance Company, San Antonio, TX, and through USAA Life General Agency, Inc. (LGA) (known in CA and NY as USAA Health and Life Insurance Agency), which acts as an agent for select insurance companies to provide products to USAA members. LGA representatives are salaried and receive no commissions. However, LGA receives commissions from those companies, which can include compensation based on the total quantity and quality of insurance coverage purchased through LGA. Plans not available in all states. Each company has sole financial responsibility for its own products. Medicare Supplement insurance, USAA Life Insurance Company and USAA Life General Agency are not connected with or endorsed by the U.S. government or the federal Medicare program. 2018 USAA. 219327-0118 YOU AND YOUR CHOICES