2016 Medicare Supplement (Medigap) Plans Under Age 65

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1 Standard Medigap Plan Benefits A B C D F HOSPITALIZATION F High Deductible G K L M N Hospital deductible: days 1-6 P P P P P P 5% 75% 5% P Hospital coinsurance: days 61-15, plus 365 extra days P P P P P P P P P P P Skilled Nursing coinsurance days 21-1 P P P P P 5% 75% P P Hospice - Inpatient respite care coinsurance P P P P P P P 5% 75% Blood - First 3 pints as inpatient P P P P P P P 5% 75% P P OUTPATIENT Part B Deductible P P P Part B medical coinsurance or copays (2%) P P P P P P P 5% 75% P * Partial - see below Part B Excess P P P Preventive Care P P P P P P P P P P P Blood - First 3 pints as outpatient P P P P P P P 5% 75% Basic P Mental Health Services P P P P P P P 5% 5% Basic P NON-MEDICARE BENEFITS Foreign travel Emergency Care (Up to plan limit ) 8% 8% 8% 8% 8% 8% 8% OTHER COSTS 216 Medicare Supplement (Medigap) Plans Under Age 65 Deductible you pay first, then paid at 1% $2,18 Maximum you pay, then paid at 1% $4,96 $2,48 * Plan N: Includes copays of $2 per office visit and $5 for emergency room visits. (ER visit copay is waived if admitted to hospital.) Plan N pays all other 2% coinsurance in full. This chart is provided as a convenience. The Health Insurance Counseling and Advocacy Program (HICAP) makes no claims to the listed insurers financial status, reputation, sales practices or status in the market place. These SAMPLE premiums were extracted from the California Department of Insurance website at / interactive.web.insurance.ca.gov/ apex/ f?p=111:3. The rates shown on this chart are for non-smokers in the zip code. Premiums can vary by zip code. Always check with the insurance company for complete information. HICAP does not endorse any specific health insurer. Call HICAP for free assistance with Medicare and supplemental insurance at: or Medigap Benefits Chart

2 A B C D F High F G K L M N Wait Period Days Rate Method Comments Aetna Life Insurance (get local agent number at website) $218 $262 $32 $ Anthem Blue Cross Life & Health Ins. Co $221 $397 $249 6 Blue Shield of California Life & Health Ins $559 $761 $638 $82 $298 $342 $522 Colonial Penn Life $2 $256 $363 $67 $19 $197 $253 $24 Combined Insurance of America $194 $278 Continental Life of Brentwood, TN $218 $275 $32 $227 Everence Association Inc $248 $276 $21 Fraternal Benefit Society: Policies available only to those eligible for membership Medigap Rates Under 65

3 A B C D F High F G K L M N Wait Period Days Rate Method Comments Gerber Life Insurance $2 $299 Globe Life & Accident $128 $19 $215 $217 6 Health Net Life Insurance $29 $298 $298 $125 $274 $158 $215 $25 Health Net Life Insurance $223 $274 $319 $29 $319 $134 $293 $169 $23 $268 Group Policy: Available to Employers/Groups of 5 or more Humana Insurance $245 $263 $322 $326 $12 $141 $25 $198 9 IA Individual Assurance Life, Health & Accident $392 $444 $32 Liberty National $195 $281 $345 $69 $ IA Medigap Rates Under 65

4 A B C D F High F G K L M N Wait Period Days Rate Method Comments Loyal American Life $24 $279 $23 18 Mutual of Omaha $219 $288 Oxford Life Insurance $222 $274 $21 Physicians Mutual $234 $539 $135 $367 $341 IA Physicians Mutual $234 $539 $135 $367 $342 Sentinel Security Life $222 $255 $322 $33 Standard Life and Accident Insurance $261 $271 $32 $34 $322 $42 $35 $ Medigap Rates Under 65

5 A B C D F High F G K L M N Wait Period Days Rate Method Comments State Farm Mutual Automobile Ins $134 $241 $243 Sterling Life Insurance $272 $364 $166 $282 Stonebridge Life option 2 $144 $245 $224 $ Thrivent Financial for Lutherans [email protected] $18 $223 $255 $295 $319 $92 $29 $212 $26 IA Applicants must be eligible for membership Thrivent Financial for Lutherans [email protected] $177 $211 $294 $265 $288 $83 $261 $195 $235 Applicants must be eligible for membership Transamerica Life $247 $32 $373 $371 $17 $252 $311 $ IA Group Policy: Product is marketed to members of affiliated association groups Medigap Rates Under 65

6 A B C D F High F G K L M N Wait Period Days Rate Method Comments US Life Insurance $195 $253 $166 United American $159 $23 $37 $284 $63 $154 $ IA United Healthcare Insurance /RP $161 $218 $258 $259 $9 9 CR Group Policy: RP membership required ($16/year); other restrictions may apply Medigap Rates Under 65

7 Medicare Supplement (Medigap) Plans Basic Benefits All Medigap plans include the following Basic Benefits: Hospitalization: Part A coinsurance for days 61 to 15, plus 365 extra days Medical expenses: Part B coinsurance generally 2% of the Medicare approved amount Blood: First 3 pints of blood each year The amount of coverage may vary with the plan you choose. For example, some plans pay 1% toward the Basic Benefits and other plans may pay less. What types of Medigap policies will insurance companies sell? Insurance companies selling Medigap policies are required to make Plan A available. If they offer any other Medigap plan, they must also offer either Plan C or Plan F. Insurance companies that sell Medigap policies don t have to offer every letter policy. Each insurance company decides which Medigap policies it wants to sell. Rating Methodology Each insurance company decides how it will set the price, or premium for its Medigap policies. Medigap policies can be priced or rated in three ways: Attained Age (): The premium is based on the current age and automatically increases, as the person grows older. Typically, these plans appear less expensive at younger ages but can cost considerably more in later years. Issue Age (IA): The premium is based upon the age of the person when the policy is purchased but does not increase automatically as the person ages. The premiums can only increase if it is raised for all similar plans in the geographic area. Community- Rated (CR): There is no age rating. The premium can only increase if it is raised for all similar plans in the geographic area. Definitions Open Enrollment: A period during which the insurance company cannot impose health screening. Guarantee Issue: A period during which the insurance company cannot impose health screening or a waiting period for pre-existing conditions. Waiting Period for Pre-Existing Condition: A period of six months or less during which a company can refuse to pay claims for a health condition that was treated in the six months prior to purchasing a policy. In most cases a person can use previous health coverage to shorten or eliminate the waiting period. For more Medigap information, please see the California Health Advocates website - Medicare s website - and the California Department of Insurance site - Page 7