Medicare Supplement (Medigap) Coverage for Medicare Beneficiaries
|
|
|
- Juniper Short
- 10 years ago
- Views:
Transcription
1 Medicare Supplement (Medigap) Coverage for Medicare Beneficiaries Brian Webb Manager, Health and Life Policy Nat l Assoc. of Insurance Commissioners February 6, 2009
2 Original Medicare Created in 1965, Medicare provides coverage to over 35 million Americans over the age of 65. Structure of Original Medicare plan is based on typical coverage in There are two basic parts to Original Medicare Part A (inpatient hospital) and Part B (doctor/outpatient)
3 Part A Coverage Key benefits: Inpatient Blood (you pay: first 3 pints + 20%) Home Health (you pay: 20% for durable medical equipment) Hospice (you pay: $5 copay for Rx; 5% for respite) Inpatient Hospital (you pay: $992 for first 60 days; $248 per day for days 61-90; $496 per day for days ; all for 150+, excluding 60 lifetime reserve days) Skilled Nursing Facility (you pay: $124 per day for days this is NOT long-term care)
4 Part B Coverage Key Benefits: Outpatient Blood (you pay: first 3 pints + 20%) Clinical Lab Services (you pay: nothing) Preventive Services and Screenings (you pay: typically 20% of approved amount) Physician Services (you pay: $131 deductible + 20%) Outpatient Mental Health (you pay: 50%) Outpatient Hospital (you pay: typically 20%)
5 Part B Coverage Additional Benefits: Ambulance and Other Transportation Approved Transplants Dialysis Prosthetics and Orthotics Diabetic Testing Supplies Various Outpatient Therapies Emergency Room Services Cost-sharing required for most
6 Medicare Supplement Coverage Due to coverage gaps in the Original Medicare plan, most seniors have some kind of supplemental coverage Over 10 million seniors have Medigap coverage through private plans that offer standardized options.
7 History of Medigap Medigap standardized plans were developed by the National Assoc. of Insurance Commissioners through unique delegation by U.S. Congress under OBRA 90 The NAIC s model for state law was approved by the federal government States (other than WI, MA, MN) are required to adopt the NAIC model to retain regulatory authority of these plans
8 Medigap Coverage Currently 14 standardized plans up from 10 in 1990 (including, two high deductible options) All carriers must offer at least the Basic (A) plan: Medicare Part A hospital coinsurance (days and ) Medicare Part B coinsurance Blood deductible (3 pints) 365 Additional inpatient days
9 Medigap Coverage Plans B-L include additional coverage options: Medicare deductibles and coinsurance Preventive screening services Emergency care while traveling outside US Excess charges Limited at-home recovery Skilled Nursing Facility (SNF) coinsurance Until 2005, plans H, I and J also offered limited outpatient prescription drug coverage
10 Medigap Coverage Plans F and J have a high-deductible option set at $2,000 for 2009 Plans K and L are prescribed by federal law (MMA) They require cost sharing for Part A and B expenses at 50% and 75%, respectively They include an annual Out-of-Pocket limit of $4,620 for K and $2,310 for L (2009) - indexed for inflation and coverage for hospice cost-sharing They do not cover the Part B deductible or the cost of the first 3 pints of blood
11 New Coverage Options for 2010 On September 24, 2008, the NAIC adopted changes to the Medigap model updating the standardized plans and including GINA and MIPAA requirements States must adopt the GINA provisions by July 1, 2009 States must adopt the updated benefit plans by September 24, 2009 Updated plans may be effective June 1, 2010
12 Key Changes to Medigap Plans Overall = Reduces number of plans from 14 to 11 Eliminates Plans H, I, and J, which became duplicative after drug benefits were eliminated Eliminates Plan E which became duplicative after other changes made Creates new plans M and N which have higher beneficiary cost-sharing options Eliminates outdated At-Home Recovery benefit Creates a new Hospice benefit, which is added to every plan as part of Basic (Core) benefits Eliminates outdated and underutilized Preventive Care benefit
13 Most Popular Medigap Plans Beneficiaries overwhelmingly choose plans that cover all deductibles and coinsurance Manageable costs budgeted over 12 months Less hassle no doctors bills
14 Medigap Consumer Protections If enrolled during the open enrollment period (a six-month window beginning at age 65 or older AND enrollment in Part B) a person cannot: Be denied coverage for health reasons Be charged more because of health history or medical conditions premium can vary based on age Be excluded coverage due to a preexisting condition for more than 6 months less if have creditable coverage Same protections if a person loses creditable coverage, if gap does not exceed 63 days (examples) Coverage must be renewed
15 Other Supplemental Coverage Medicare Select Same 14 standardized plans, but use network providers and negotiate charges Result is less flexibility, but lower premiums Medicare Advantage Private HMO, PPO or fee-for-service plans Typically have low cost-sharing and additional benefits May have Rx coverage States only regulate licensure and solvency plus brokers and agents who sell the products Not guaranteed renewable Medicare Medical Savings Accounts
16 Contact Information Brian Webb Jane Sung Manager Senior Health Policy Analyst Health and Life Policy and Health Counsel NAIC NAIC
MUTUAL OF OMAHA INSURANCE COMPANY OUTLINE OF MEDICARE SUPPLEMENT COVERAGE - COVER PAGE BENEFIT PLANS A, C AND F
MUTUAL OF OMAHA INSURANCE COMPANY OUTLINE OF MEDICARE SUPPLEMENT COVERAGE - COVER PAGE BENEFIT PLANS A, C AND F Medicare supplement insurance can be sold in only 10 standard plans plus two high deductible
2006 Choosing a Medigap Policy:
CENTERS FOR MEDICARE & MEDICAID SERVICES 2006 Choosing a Medigap Policy: A Guide to Health Insurance for People With Medicare This official government guide can help you Learn what a Medigap (Medicare
Getting Started with Medicare Beginning Medicare Training
Getting Started with Medicare Beginning Medicare Training This Medicare Counselor Training program was developed under a grant from UnitedHealthcare through a joint project with the National Association
STEPPING INTO MEDICARE. Invaluable help from the name you know and trust Blue Cross and Blue Shield of Illinois
STEPPING INTO MEDICARE Invaluable help from the name you know and trust Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Illinois offers a great array of plans that pick up where Medicare
How To Get A Medicare Supplement Plan From Aetna Insurance Company
Aetna Individual Medicare Supplement PlanSM Aetna Life Insurance Company Outline of Medicare Supplement Coverage Benefit Plans A, B and F OOC-MD 18.02.312.1 MD (8/04) Outline of Medicare Supplement Coverage
I wanted to understand the Medicare program basics. This presentation really helped.
Welcome to Medicare 101! I wanted to understand the Medicare program basics. This presentation really helped. What is Medicare? What benefits does Medicare cover? What benefits doesn t Medicare cover?
Understanding your. Medicare options. Medicare Made Clear TM. Get Answers Series. Y0066_120629_084915 CMS Accepted
Understanding your Medicare options. Medicare Made Clear TM Get Answers Series Y0066_120629_084915 CMS Accepted learning about Medicare Choices. Eligibility Coverage options When to enroll Next steps and
What is Medicare? The Different Parts of Medicare
Medicare and You The Different Parts of Medicare A Medicare Part A Hospital Insurance Inpatient care at hospitals, skilled nursing facility*, hospice and home health care. What is Medicare? Medicare is
2015 Outline of Coverage Security 65 Medicare Supplement Plans. Plan A Plan B Plan C Plan H Plan H with Drug
2015 Outline of Coverage Security 65 Medicare Supplement Plans Plan A Plan B Plan C Plan H Plan H with Drug Independence Blue Cross and Highmark Blue Shield Outline of Medicare Supplement Coverage Security
Guide to Medicare MEDICARE BASICS. Presented by
Guide to Medicare MEDICARE BASICS Presented by 14 Medicare Basics What Is Medicare? Medicare is health insurance for the following: People 65 or older People under 65 with certain disabilities People of
For issues on or after June 1, 2010, Medicare Supplement Basic Benefit Plans A, B, C, D, F, G, M, and N coverage includes:
1. What are the basic benefits on a Medicare Supplement Policy? For issues on or after June 1, 2010, Medicare Supplement Basic Benefit Plans A, B, C, D, F, G, M, and N coverage includes: a.) First 3 Pints
Medicare has four components, Part A, Part B Part C and Part D:
Medicare What is Medicare? Medicare is a National Health Insurance Program for people 65 years of age and older Certain persons with disabilities under the age of 65 People with end stage renal disease
MediGap Plans A, C, F, & N 2016 OUTLINE OF MEDICARE SUPPLEMENT COVERAGE
MediGap Plans A, C, F, & N 2016 OUTLINE OF MEDICARE SUPPLEMENT COVERAGE This page was intentionally left blank. BENEFIT CHART OF MEDICARE SUPPLEMENT PLANS SOLD FOR EFFECTIVE DATES ON OR AFTER JUNE 1, 2010
How To Get More Coverage With A Medicare Supplement Insurance Policy
Understanding Your Medicare Coverage Options With information on how to increase your coverage with a Medicare Supplement insurance policy We are not connected with or endorsed by the U.S. Government or
Medicare Supplement Coverage Options
Medicare Supplement Coverage Options Thank you for your interest in our Medicare Supplemental coverage options, also known as Traditional Blue (Medigap) policies. The Medicare Supplement Plans, when combined
Service AvMed Cigna Leon Cares Humana HMO Humana PPO UnitedHealthcare. Out-of- Network
2016 Medicare Advantage Plans Comparison Chart This comparison chart is a side-by-side representation of services offered through the AvMed, Cigna, UHC, and Humana Medicare Advantage Plans for both in-network
How To Buy A Medigap Policy
CENTERS FOR MEDICARE & MEDICAID SERVICES 2009 Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare This official government guide has important information about the following:
MUTUAL OF OMAHA INSURANCE COMPANY OUTLINE OF MEDICARE SUPPLEMENT COVERAGE - COVER PAGE 1 BENEFIT PLANS A, C, D, F AND G
OUTLINE OF MEDICARE SUPPLEMENT COVERAGE - COVER PAGE 1 BENEFIT PLANS A, C, D, F AND G These charts show the benefits included in each of the standard Medicare supplement plans. Every company must make
Choosing a Medigap Policy:
CENTERS FOR MEDICARE & MEDICAID SERVICES 2010 Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare This official government guide has important information about the following:
In general, Medicare Part A covers Hospital Care, Skilled Nursing Facility Care, Hospice and Home Health Services.
CSB-9-0051-MS101 MEDICARE PART A In general, Medicare Part A covers Hospital Care, Skilled Nursing Facility Care, Hospice and Home Health Services. $1,260 Deductible Hospital Inpatient Days 1-60: $0 coinsurance
2015 Benefit Chart of Medicare Supplement Plans Outline of Coverage 1-888-708-0123 mhinsurance.com
2015 Benefit Chart of Medicare Supplement Plans Outline of Coverage 1-888-708-0123 mhinsurance.com MEMBERS HEALTH INSURANCE COMPANY Home Office: P.O. Box 1424, Columbia, TN 38402-1424 1-888-708-0123;
2007 Choosing a Medigap Policy:
CENTERS FOR MEDICARE & MEDICAID SERVICES 2007 Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare This is the official government guide with important information about what
Medicare Supplement Insurance
Helping Older Persons With Legal & Long-Term Care Problems Medicare Supplement Insurance 1. What Is Medicare Supplement Insurance? Medicare Supplement Insurance, also known as MedSupp or MediGap is designed
It s Time for Medicare
It s Time for Medicare med-waageinbook-1214 Medicare What you need to know. You re turning 65. Or you re already 65 and getting ready to retire and lose your healthcare coverage. You re almost ready for
Outline of Medicare Supplement Coverage Cover Page: 1 of 2 Benefit Plan A, Plan D, Plan F, Plan K and Plan L
Outline of Medicare Supplement Coverage Cover Page: 1 of 2 Benefit Plan A, Plan D, Plan F, Plan K and Plan L Medicare Supplement insurance can be sold in only 12 standard plans plus two high-deductible
Medigap Insurance 54110-0306
Medigap Insurance Overview A summary of the insurance policies to supplement and fill gaps in Medicare coverage. How to be a smart shopper for Medigap insurance Medigap policies Medigap and Medicare prescription
The Pennsylvania Insurance Department s. Your Guide to Choosing a MEDIGAP POLICY. Understanding Medigap
Your Guide to Choosing a MEDIGAP POLICY Understanding Medigap Medigap is private health insurance designed to help pay healthcare costs that aren t covered by Medicare. Each Medigap plan covers different
Choosing A Medigap Policy
Choosing A Medigap Policy 2002 Guide To Health Insurance For People With Medicare For People in the Original Medicare Plan This Guide has easy steps to help you buy Medicare Supplement Insurance. Developed
Introducing OneExchange.
RETIREE BENEFITS Introducing OneExchange. OneExchange provides you with plan advice and enrollment assistance to choose Medicare supplemental healthcare and prescription drug coverage that s right for
Understanding Medicare and How It Works
Understanding Medicare and How It Works Get the facts about your Medicare insurance options 1 What Is Medicare? 2 Medicare is a health insurance program for people 65 or older or under 65 and with certain
OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE BENEFIT STANDARD PLANS A, B, C, D, F, J AND HIGH DEDUCTIBLE PLAN F
Anthem Blue Cross Blue Shield Connecticut Administrative Office: PO Box 1014 North Haven, CT 06473 Toll Free Telephone Number: 1-800-238-1143 OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE BENEFIT
Trends in Medigap Enrollment and Coverage Options, 2013
November 2014 Trends in Medigap Enrollment and Coverage Options, 2013 www.ahipresearch.org LIST OF TABLES AND FIGURES TABLE 1. TABLE 2. TABLE 3. TABLE 4. Distribution of Medigap Companies with Standardized
Basic, including 100% Part B coinsurance. Skilled Nursing Facility Coinsuranc e Part A Deductible Part B
Benefit Chart of Medicare Supplement Plans Sold for Effective Dates on or After June 1, 2010 This chart shows the benefits included in each of the standard Medicare supplement plans. Every company must
Once you have an understanding of your health needs, you need to understand your Medicare options so you can decide which one best suits your needs.
Medicare Options It is important for you to think about your particular health care needs. Do you have a doctor you prefer to see? Do you have a condition that requires frequent doctor visits? How many
Solutions for Today Flexibility for Tomorrow.
Solutions for Today Flexibility for Tomorrow. Medicare Products and Services For More Information call our Senior Care Specialist, Raun Lynch at 856.380.5079 Or visit us on the web at www.cbdi-inc.com
Plan F* Plan G. Basic, including 100% Basic, including 100% Basic, including 100% Part B coinsurance. Skilled nursing facility coinsurance
Outline of Coverage UnitedHealthcare Insurance Company Overview of Available s Benefit Chart of Medicare Supplement s Sold on or After June 1, 2010 This chart shows the benefits included in each of the
UNITED OF OMAHA LIFE INSURANCE COMPANY A Mutual of Omaha Company
UNITED OF OMAHA LIFE INSURANCE COMPANY A Mutual of Omaha Company OUTLINE OF MEDICARE S UPPLEMENT COVERAGE COVER PAGE BENEFIT PLANS A, F AND G These charts show the benefits included in each of the standard
About to Retire: Preparing for Medicare Patient Financial Services Agenda Medicare Enrollment Covered Services Medicare-covered covered Preventive Services Agenda, continued Advance Beneficiary Notice
Regence Bridge Medigap (Medicare Supplement) Plans
Information Brochure Regence Bridge Medigap (Medicare Supplement) Plans Making sure you have the coverage that is right for you. Regence BlueShield of Idaho is an Independent Licensee of the Blue Cross
Benefit Chart of Medicare Supplement Plans Sold On or After June 1, 2015
Outline of Medicare Supplement Coverage Benefit Chart of Medicare Supplement Plans Sold On or After June 1, 2015 This chart shows the benefits included in each of the standard Medicare Supplement plans.
Wisconsin Guide to Health Insurance for People with Medicare
Wisconsin Guide to Health Insurance for People with Medicare 2015 For more information on health insurance call: MEDIGAP HELPLINE 1-800-242-1060 This is a statewide toll-free number set up by the Wisconsin
How Medicare Works. Helping you make the most of Medicare. MedicareBlue SM Rx (PDP) S5743_101415_B02_RE Internal Approval 11/12/2015
How Medicare Works Helping you make the most of Medicare 2016 MedicareBlue SM Rx (PDP) S5743_101415_B02_RE Internal Approval 11/12/2015 About Medicare Whether you re new to Medicare or want a refresher,
Making the most of Medicare
Making the most of Medicare S5743_102714_K04_RE Internal Approval 10/27/2014 Today s Topics What is Medicare Who s eligible Medicare coverage Options to fill coverage gaps When you can enroll Finding the
Basic, 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, B, D and F
Medicare Advantage 101. Michael Taylor, PhD Medicare Advantage Branch Manager Centers for Medicare & Medicaid Services Atlanta Regional Office
Medicare Advantage 101 Michael Taylor, PhD Medicare Advantage Branch Manager Centers for Medicare & Medicaid Services Atlanta Regional Office Objectives General Overview of Medicare Advantage CMS 5 Star
How to be a smart shopper for Medigap Insurance
info sheet Medicare is the basic federal health insurance for older persons and for younger people with disabilities. Because Medicare has gaps in coverage, many people also buy a Medigap policy to supplement
MEDICARE SUPPLEMENT INSURANCE
Illinois Insurance Facts Illinois Department of Insurance Rev Feb 2014 MEDICARE SUPPLEMENT INSURANCE What is Medicare? Medicare is a federal health insurance program for people 65 or older, some people
OUTLINE OF COVERAGE. Regence Bridge. Medicare Supplement (Medigap) Plans
OUTLINE OF COVERAGE Regence Bridge Medicare Supplement (Medigap) Plans Regence BlueCross BlueShield of Utah is an Independent Licensee of the Blue Cross and Blue Shield Association 09713rep07355-ut UT
Medicare Basics and Medicare Advantage
Medicare Basics and Medicare Advantage Medicare The federal health insurance program for people age 65 and over, some disabled people under 65 years of age, and people with End-Stage Renal Disease (permanent
Medicare Factsheet What is Medicare? Original Medicare (Part A and Part B) Medicare Advantage Plan (Part C) Prescription Drug Plans (Part D),
Medicare Factsheet If you are enrolled in Medicare, you do not need to do anything with Covered California. If you have Medicare you are covered. No matter how you receive your Medicare benefits, whether
BlueCross65. Medicare Supplement Plans
BlueCross65 Medicare Supplement Plans Medicare Supplement Coverage Filling the Gaps of Your Medicare Coverage With Medicare Part A and Part B alone, you are required to pay deductibles and coinsurance
Regence Bridge. Medicare Supplement (Medigap) Plans
OUTLINE OF COVERAGE Regence Bridge Medicare Supplement (Medigap) Plans Regence BlueCross BlueShield of Oregon is an Independent Licensee of the Blue Cross and Blue Shield Association 07355rep06630-or OR
THE A,B,C,D S OF MEDICARE
THE A,B,C,D S OF MEDICARE An important resource for understanding your healthcare in retirement What you need to know for 2014 How Medicare works What Medicare covers How much Medicare costs INTRODUCTION
What is a Medicare Advantage Plan?
CENTERS FOR MEDICARE & MEDICAID SERVICES What is a Medicare Advantage Plan? A Medicare Advantage Plan (like an HMO or PPO) is a way to get your Medicare benefits. Unlike Original Medicare, in which the
Medicare Factsheet. September 2, 2015 Page 1 of 6
Medicare Factsheet If you are enrolled in Medicare, you do not need to do anything with Covered California. If you have Medicare you are covered. No matter how you receive your Medicare benefits, whether
OUTLINE OF MEDICARE SUPPLEMENT COVERAGE
OUTLINE OF MEDICARE SUPPLEMENT COVERAGE Tufts Medicare Preferred Supplement Core Tufts Medicare Preferred Supplement One Outline of Medicare Supplement Coverage Cover Page: Benefit Plans Medicare Supplement
Hospitalization and preventive care paid at 100%; other basic benefits paid at 50% Basic, including 100% Part B coinsurance. 100% Part B coinsurance
Health First Insurance, Inc. OUTLINE OF COVERAGE 2014 Benefit Plans A, F, N Benefit Chart of Medicare Supplement Plans Sold on or After June 1, 2010 This chart shows the benefits included in each of the
Part B. Coinsurance. Skilled Nursing Facility. 50% Skilled Nursing Facility. Coinsurance. Coinsurance 75% Part A Deductible.
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
Vermont Blue 65. Coverage for Vermonters with Medicare. 2016 Medicare Supplemental Products. Group Brochure. An independent, local Vermont company
Vermont Blue 65 SM Coverage for Vermonters with Medicare 2016 Medicare Supplemental Products Group Brochure An independent, local Vermont company Three smart steps to quality health care after retirement:
HeritagePlanning. Medicare Supplemental Insurance. Courtesy of: Mandatory Standardization. Enrollment
HeritagePlanning SM Helping Yourself Helping Your Parents Helping Your Children Courtesy of: SM Medicare Supplemental Insurance Although Medicare is the basic federal health insurance for older people,
What Federal Employees Need to Know About Their Health Insurance and Medicare
What Federal Employees Need to Know About Their Health Insurance and Medicare Federal employees have been paying the Medicare Part A (hospital insurance) payroll tax since Jan. 1, 1983. That means all
MEDICARE BASICS WHAT TO KNOW AND WHAT TO EXPECT WITH MEDICARE
MEDICARE BASICS WHAT TO KNOW AND WHAT TO EXPECT WITH MEDICARE AGENDA What is original Medicare? The A, B, C, and D s of Medicare Enrollment periods Medicare Advantage star rating system Where you can find
Basic, including 100% Part B coinsurance* Basic, including 100% Part B coinsurance. Skilled Nursing Facility Coinsurance Part A Deductible
(Agency Note: Proposed new N.J.A.C. 11:4-23 Appendix Exhibit D reproduced below is not depicted in boldface, as would be the standard format for proposed new text, in order for the permanent boldfacing
Wisconsin Guide to Health Insurance for People with Medicare
Wisconsin Guide to Health Insurance for People with Medicare 2015 For more information on health insurance call: MEDIGAP HELPLINE 1-800-242-1060 This is a statewide toll-free number set up by the Wisconsin