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1 Understanding your Medicare options. Medicare Made Clear TM Get Answers Series Y0066_120629_ CMS Accepted

2 learning about Medicare Choices. Eligibility Coverage options When to enroll Next steps and resources

3 learning about Medicare Choices. Eligibility

4 eligibility for Original Medicare (Parts A and B). 4 You re eligible to join Original Medicare (Parts a and B) if: You re 65 years old, or you re under 65 and qualify on the basis of disability or other special situation AND You re a U.S. citizen or a legal resident who has lived in the U.S. for at least five consecutive years Some things to know about the age 65 rule: Even if you re already collecting Social Security, you must wait until you re 65 You must be 65 your spouse s age doesn t count Even if you re not collecting Social Security yet, you re eligible at age 65

5 understanding Medicare. Medicare Choices

6 Keep Original Medicare and add: Medicare Choices Step 1 Enroll in Original Medicare when you become eligible. Covers hospital stays Original MediCare + Government-provided Covers doctor and outpatient visits Step 2 If you need more coverage, you have choices. Option 1 or Option 2 Covers some or all of the costs not covered by Parts A & B Combines Parts A & B Most plans cover 6

7 understanding Medicare. Original Medicare (Parts A and B)

8 What Original Medicare (Parts A and B) covers. Part a Hospital costs and skilled nursing services after a hospital stay, plus some other skilled care: Inpatient hospital care Inpatient mental health care Home health care Hospice care Some blood for transfusions during inpatient care Part B doctor s office visits and other medical services that do not require a hospital stay: Physician services Outpatient hospital services (minor surgeries) Ambulance Outpatient mental health Laboratory services Durable medical equipment (wheelchairs, oxygen, etc.) * Outpatient physical, occupational and speech-language therapy Some preventive care 8 * Services and supplies must be medically necessary.

9 Original Medicare (Parts A and B). What to keep in mind. Part a Costs: Most people don t pay a monthly premium You only pay your deductible the first $1,156 in 2012 for a hospital stay of less than 60 days enrollment: Enrollment is easy. You can t be turned down because of your medical history or pre-existing condition Coverage: Long hospitalizations can be expensive. Stays of more than 60 days require a daily copayment Multiple stays may mean multiple deductibles You can go to any qualified hospital in the U.S. that accepts new Medicare patients. Hospital care outside the U.S. isn t usually covered Part B Costs: There is no maximum out-of-pocket For coinsurance, in general, you pay 20% of the Medicare-approved cost If you wait to join until after your initial enrollment period, you may have to pay a higher premium enrollment: Enrollment is easy. Your medical history or pre-existing condition doesn t matter Coverage: Part B works the same way throughout the U.S. You can get care wherever you are. Generally, care outside the U.S. is not covered You can receive care from any participating physician who accepts new Medicare patients Preventive care is limited 9

10 Original Medicare (Parts A and B). What it doesn t cover. Medicare Part A deductibles and coinsurance premiums Medicare Part B deductibles and coinsurance premiums Medicare Part B excess charges (amount billed over what Medicare agrees to pay) Medicare Part D prescription drug coverage 10

11 understanding Medicare. Medicare supplement insurance plans

12 Medicare supplement insurance plans eligibility. You re eligible if you: Are enrolled in Medicare Parts A and B at the time your Medicare supplement insurance coverage will begin Are a resident of the state in which you are applying for coverage Are age 65 or older (or under age 65 with certain disabilities in some states) 12

13 Medicare supplement insurance plans. Private health insurance designed to supplement Original Medicare (Parts a and B). also known as Medigap plans. Plans are for people on Medicare Parts A and B who want help paying for some of the health care costs not paid by Medicare, like coinsurance, copayments and deductibles Plans are named with letters of the alphabet (A, B, C, D, F, G, K, L, M and N), and benefit levels vary by plan Typically, the more comprehensive the coverage, the higher the monthly premium for the Medicare supplement plan Medicare supplement plans are regulated according to federal and state laws and are required to offer the same coverage 13

14 Medicare supplement insurance plans. What to keep in mind. Costs: Depending on the Medicare supplement plan, some or all of your out-of-pocket costs for care under Original Medicare (Parts A and B) are covered Premium prices with different insurance companies can vary sharply for the same coverage. In some plans, premiums rise as your age increases enrollment: You are guaranteed the right to buy a Medigap plan during your open enrollment period In some states, if you apply after your open enrollment period, you can be denied coverage based on your health Coverage: No network restrictions and no referrals required Coverage may go with you when you move or travel anywhere in the U.S. With some plans, you have foreign travel coverage for emergency services Coverage is guaranteed to continue as long as you pay your premium on time 14

15 understanding Medicare. Medicare Advantage (Part C)

16 Medicare advantage (Part C) eligibility. You re eligible if you: Are enrolled in Medicare Parts A and B Live in the plan service area Do not have end-stage renal disease (ESRD) 16

17 Medicare advantage (Part C). A single plan offered by private insurance companies that combines coverage for Original Medicare (Parts A and B) and sometimes prescription drug coverage (Part D). all the benefits of Part a, except hospice care Hospital stays Skilled nursing Home health all the benefits of Part B Doctor s visits Outpatient care Screenings and shots Lab tests Prescription drug coverage Included in many Medicare Advantage plans, but not all additional benefits May be bundled with the plan tip: Additional benefits may include eye care, hearing, wellness services and nurse phoneline. 17

18 Medicare advantage (Part C). What to keep in mind. Costs: Plan premiums and terms can change from year to year enrollment: Your eligibility for enrollment is not affected by your health or financial status (special rules for end-stage renal disease ESRD) 18 Coverage: Convenience of a single plan Many plans may include prescription drug coverage (Part D) In most plans, you receive your coverage in a service area unless it s an emergency For some plans, you re required to see doctors and hospitals that are included in the plan s network Many plans may offer additional benefits not covered by Medicare (e.g., dental, vision, hearing and preventive care)

19 Five types of Part C plans. Coordinated Care Plans Health Maintenance Organization (HMO) Plans Preferred Provider Organization (PPO) Plans Special Needs Plans (SNP) Other Plans Private Fee-For-Service (PFFS) Plans Medical Savings Account (MSA) Plans 19

20 types of Part C plans: HMO. What s an HMO plan? HMO stands for Health Maintenance Organization A Medicare Advantage plan with a network of physicians, hospitals and other health care professionals Generally, you must get routine care from an approved network of doctors and hospitals Your primary care physician oversees your care and may refer you to specialists, if applicable Care received outside the network unless it s in an emergency is not covered Many plans include prescription drug coverage and additional benefits In all types of Medicare plans, if you have an emergency or need urgent care, you can go to the nearest 20 doctor or hospital. Coverage varies by plan. Not all plans are available in every state or county.

21 types of Part C plans: PPO. What s a PPO plan? PPO stands for Preferred Provider Organization Hospital costs, doctor and outpatient care in one plan No referral needed to see a specialist Have more freedom to choose your doctor or hospital Can choose to use doctors and hospitals inside the network and receive the maximum benefit Can go outside the network, but usually at a higher cost Many plans include prescription drug coverage and additional benefits 21

22 types of Part C plans: Special needs. Coordinated care plans: Are designed for people with special and often complex health care needs Residents of nursing homes People eligible for both Medicare and Medicaid People with certain chronic diseases such as diabetes or heart disease Focus on helping members receive well-coordinated care Holistic, proactive approach Specialized care team Enhanced education and communication 22

23 types of Part C plans: Private Fee-For-Service. Offered by private insurance companies Many plans may offer prescription drug coverage Many plans may offer additional benefits beyond Original Medicare (Parts A and B) No restrictions on which doctors or hospitals you can use Keep in mind: Doctors and hospitals must accept the payment terms and conditions of the private insurance company. Payment comes from the Private Fee-For-Service plan, not Medicare Important to make sure your doctor or hospital will accept payment from a specific plan each time before receiving services 23

24 understanding n Medicare. Prescription drug plans (Part D)

25 Prescription drug plans (Part D). Plans offered through private insurance companies that help with the cost of prescription drugs. Helps with prescription drug costs Works differently from Medicare Part A and Part B. You can only get Medicare Part D through a private insurance company Must continue to pay Part B premium 25

26 Medicare Part d (prescription drug). What to keep in mind. Costs: Helps with the cost of your prescription drugs Total costs of a plan can vary significantly from plan to plan Catastrophic coverage protects you from very high drug costs Plan benefits including premium, deductible and copayments can change each year enrollment: You must enroll in a Part D plan. Coverage is not automatic If you do not sign up for a Part D plan when you become eligible, you may have to pay a late-enrollment penalty unless you qualify for an exception 26 Coverage: Each plan has a list of drugs that it covers Make sure your drugs are covered before you enroll in a plan The list of drugs can potentially change each year

27 What about the coverage gap? AARP"I MedicareRx Plans insuredthrough UnitedHealthcare Most people don't enter the coverage gap, but if you do this is what you need to know. Start here Initial Coverage Stage During this stage you pay a flat fee (copay) or a percentage of a drug's total cost (coinsurance) for each prescription you fill. The plan pays the rest until both you and the insurance have paid $2,960 in TOTAL drug costs. Coverage Gap Stage (Donut Hole) During this stage you pay 65% of the price for generic drugs, 45% of the price (plus the dispensing fee) for brand name drugs (2015). In the coverage gap you pay only a percentage of the drug cost. However, 100% of the drug cost is applied toward your out-of-pocket costs. Once your total out-of-pocket costs reach $4,750 during this GAP period, you move to catastrophic coverage. Catastrophic Coverage Stage During this stage you pay only a small copay ($2) or coinsurance amount for each filled prescription. The plan pays the rest until the end of the calendar year 27

28 Options Consideration Pros Cons Retain Employer Group Insurance ORIGINAL MEDICARE Medicare A & B A=Hospital B=Physician New coverage D=addition of drug coverage. Must sign up for a part D plan 1% penalty for every year you delay. Consider GAP or donut hole issues Medicare A & B plus a Supplement Fills GAPS in Medicare Plan F/N most common NEW MEDICARE - C Each plan is unique and has special offerings such as hearing aids, dentures, higher RX coverage etc. as incentives to join each plan Open enrollment for carrier and plan change Is it an option? What is the cost? Must have A & B to stay in most plans Part A deductible(s) $ days $304 per day $608 per day Part B premium $ annual deductible of $147, then 20% of physician charges Part D drug plan $30 on average Average of $300 per month on top of Part B $ premium Need Part D drug plan also Advantage Plans Might need to change doctors network driven Usually $0 premium in addition to your part B amount. PPO plans charge a premium and have no referrals. Nothing changes from what you have been doing Costs less than Employer plan as Medicare becomes primary and you only pay for part B and D 90% of doctors in US take Medicare. Can travel in any state no network most freedom for a price. NO REFERRALS All inclusive medical, some dental, vision, drugs Cost can be significant No dental, vision, LTC No dental, vision, gym memberships etc. Network driven by state and location. No national network. Plans change benefits every year just like your plan 28

29 each year on October 7 Dec 7 Higher out of pocket Questions to ask yourself GET ON GENERIC MEDICINES!!! Eliminate the DONUT HOLE starts when you and your plan have paid out $2960. Most plans cover generics in the donut hole now, and in 2015 brand name is covered at 45%, generic covered at 65%. Gap closes Is cost the factor or your doctors? If cost then Medicare Advantage plans are most likely the right choice - $0 premium. If doctor Ask your doctor if he takes Medicare or what Medicare Advantage plans he takes. Do you plan on traveling a lot nationally, multiple homes should consider Supplement and part D. UHC has a passport option when living in separate homes for extended periods of time with their national network under a their Regional PPO Plan. Lots of consolidation in the industry. Hopefully we will have less confusion in plans in the future. OCTOBER 7 the advertising is allowed to start each year. AGENTS ARE NOT ALLOWED TO CALL YOU OR SHOW UP AT YOUR HOME, UNLESS YOU HAVE CALLED THEM FIRST! 29

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