South Dakota Consumer s Guide to 2015 Medicare Supplement Insurance Premiums

Transcription

1 South Dakota Consumer s Guide to 2015 Medicare Supplement Insurance Premiums A publication provided by Senior Health Information and Insurance Education (SHIINE), a service of the South Dakota Department of Social Services Division of Adult Services and Aging. Funding for this publication is made possible through a grant from the Administration for Community Living (ACL).

2 4 Steps to Choosing a Medicare Supplement (Medigap) Policy Step 1 Decide which benefits you want, then decide which of the Medigap plans A N meet your needs. Decide which benefits you need and want while considering your current and future health care needs. You might not be able to switch policies later. Select which type of Medigap plan (A N) will meet your needs. Step 2 Find out which insurance companies sell Medigap policies in your state. Do any of the following: Use this guide to view the companies that offer plans in South Dakota. Consider any complaints against the insurance company when deciding which Medigap policy is right for you. To view the complaints filed against insurance companies visit the Consumer Information Source at or call the South Dakota Division of Insurance for assistance (605) Look online for information about the insurance companies. Talk to someone you trust, like: A family member Your insurance agent A friend who has a Medigap policy from the same Medigap insurance company Call the insurance companies. Step 3 Learn about the insurance companies that sell the Medigap policies you re interested in and compare costs. The costs listed in this guide are estimates; companies can change their rates, with Division of Insurance approval, at any time. Plan to contact more than one insurance company that sells the Medigap plan you are interested in. Before you contact any insurance companies, figure out if you're in your Medigap open enrollment period or if you have a guaranteed issue right. Step 4 Buy the Medigap policy. Once you decide on the insurance company and the Medigap policy you want, you should apply. The insurance company must give you a clearly worded summary of your Medigap policy. Make sure you read it carefully. If you don't stand it, ask questions.

3 Medicare Supplement (Medigap) Policies sold in South Dakota Premium Information obtained in January 2015 Premiums listed are for the Initial 6-Month Open Enrollment Period and are subject to change without notice. 10 Things to Know About Medigap Policies 1. You must have Medicare Part A and Part B. During your first six months of enrolling in Medicare Part B you have an Open Enrollment period (also called a Guaranteed Issue Right) where all companies must accept you regardless of your health history. If you are not buying during your Open Enrollment period, companies may ask health questions or require a physical by a physician. The insurance company can deny your application outside of the Open Enrollment period. 2. You pay the private insurance company a monthly premium for your Medigap policy in addition to the monthly Part B premium that you pay to Medicare. 3. A Medigap policy only covers one person. If you and your spouse both want Medigap coverage, you'll each have to buy separate policies. 4. You can buy a Medigap policy from any insurance company that's licensed in South Dakota to sell one. This guide includes a list of all companies that sell Medigap plans in South Dakota. Before signing the application, read the health information, make sure it is complete and accurate. The insurance company could deny coverage for a condition or cancel your policy if you omit requested information. 5. Companies may change their prices at any time. 6. Any standardized Medigap policy is guaranteed renewable even if you have health problems. This means the insurance company can't cancel your Medigap policy as long as you pay the premium. 7. Medigap policies do not cover prescription drugs. If you want prescription drug coverage, you can join a Medicare Prescription Drug Plan (Part D). 8. You are not insured on the day you apply for a Medicare Supplement Insurance policy. It can take up to 30 days for approval. Cancel your current policy only after you have been officially accepted by the new company and have the policy in-hand. 9. If you have a Medicare Advantage Plan, you can apply for a Medigap policy, but make sure you can leave the Medicare Advantage Plan before your Medigap policy begins. 10. You have a 30-day free look period which starts when you have the policy in your hand. When you get it, review it carefully. If you decide not to keep it, return to the company and request a premium refund. After the free look period, insurance companies are not required to return unused premiums if you decide to drop the policy.

4 Explanation of Terms Used in Premium Charts Attained Age Rated The premium is based on your current age (the age you have attained ), so your premium goes up as you get older. Premiums are low for younger buyers but go up as you get older. They may be the least expensive at first, but they can eventually become the most expensive. Premiums may also go up because of inflation and other factors. Issue Age Rated The premium is based on the age you are when you buy (are issued) the Medigap policy. Premiums are lower for people who buy at a younger age and won t change as you get older. Premiums may go up because of inflation and other factors but not because of your age. Community Rated Generally the same monthly premium is charged to everyone who has the Medigap policy, regardless of age. Premiums may go up because of inflation and other factors but not because of your age. Also called No-Age Rated. Crossover Pre-Ex Wait After Medicare reviews and pays a claim, it is automatically submitted to the Medicare Supplement insurance company for processing. The period of time that a pre-existing condition will not be covered by the insurance company. Other Definitions Open Enrollment The six-month period begins on the first day of the month in which you are 65 years of age and enrolled in Medicare Part B. If you have group health coverage based on your (or your spouse s) current employment, your six-month period will start when you sign up for Part B.

5 Standardized Medicare Supplement Plans Available - Monthly Premiums Insurance Company Age A B C D F F (HD) G K L M N Comments Aetna 65 $133 $168 $190 $75 $135 $128 Attained Age $101 $127 $147 $58 $102 $ $114 $143 $165 $65 $116 $109 Crossover American Continental Ins. Co. 75 $133 $168 $190 $75 $135 $ $147 $185 $205 $81 $149 $141 One Time $20 Application Fee 85 $156 $197 $218 $86 $159 $150 Smokers May Pay More Rates for females are lower. 90 $164 $207 $228 $90 $167 $158 American Republic Corp. Ins. 65 $168 $232 $78 $105 $145 Issue Age $123 $171 $57 $77 $ $138 $192 $64 $87 $119 Crossover 75 $168 $232 $78 $105 $ $193 $268 $90 $121 $167 Rates for females and couples 85 $218 $303 $101 $137 $189 Smokers May Pay More are lower. 90 $235 $326 $109 $147 $203 Avera Standard 65 $200 $232 $270 $288 $251 $139 $208 Attained Age $143 $165 $192 $205 $179 $100 $ $165 $191 $222 $237 $207 $115 $171 Crossover 75 $200 $232 $270 $288 $251 $139 $208 Rates for females and couples 80 $236 $274 $319 $340 $297 $165 $246 Smokers May Pay More are lower.

6 Standardized Medicare Supplement Plans Available - Monthly Premiums Insurance Company Age A B C D F F (HD) G K L M N Comments Avera Select 65 $132 $147 $153 $164 $143 $80 $119 Attained Age $80 $89 $93 $100 $87 $48 $ $102 $114 $119 $127 $111 $62 $92 Crossover 75 $132 $147 $153 $164 $143 $80 $ $160 $178 $186 $199 $174 $97 $144 Smokers May Pay More Equitable Life & Casualty Ins. 65 $126 $180 $127 Attained Age $90 $127 $89 70 $109 $155 $109 Crossover 75 $126 $180 $ $138 $215 $ $148 $215 $152 Smokers May Pay More Rates are less for females 90/99 $155 $227 $160 Gerber Life Insurance Co. 65 $166 $246 $21 Attained Age $126 $184 $ $150 $218 $ $166 $246 $201 Crossover 80 $176 $267 $ $184 $285 $235 Smokers May Pay More Rates for females are lower. 90 $190 $303 $250 Globe Life & Accident Ins. Co. 65 $94 $149 $176 $177 $50 Attained Age $65 $102 $120 $120 $ $88 $136 $154 $155 $41 75 $94 $149 $176 $177 $50 2 Month Wait for 80 $95 $152 $191 $192 $55 Pre-Existing Conditions

7 Standardized Medicare Supplement Plans Available - Monthly Premiums Insurance Company Age A B C D F F (HD) G K L M N Comments Government Personnel 65 $135 $187 $191 $139 $122 Attained Age Mutual Life 65 $110 $149 $153 $111 $ $120 $164 $168 $122 $107 Crossover 75 $135 $187 $191 $139 $ $148 $209 $214 $156 $ $157 $227 $233 $170 $151 Smokers May Pay More Rates for females are lower. 90 $164 $243 $249 $183 $162 Humana 65 $215 $257 $301 $307 $110 $137 $197 $217 Attained Age $98 $117 $137 $140 $51 $63 $90 $ $119 $142 $166 $169 $61 $76 $109 $120 Crossover 75 $144 $172 $202 $206 $74 $92 $132 $146 Smokers May Pay More 80+ $170 $203 $239 $244 $87 $108 $156 $172 Physicians Mutual Ins. Co. 65 $115 $119 $57 $163 $146 Attained Age $86 $85 $34 $117 $96 (Issue Age Available) 70 $102 $100 $44 $138 $ $115 $121 $57 $166 $156 Crossover Rates for couples are lower. 80+ $126 $141 $73 $193 $190 Reserve National Insurance 65 $180 $267 $233 $67 $176 $169 Attained Age $129 $191 $167 $48 $126 $ $153 $227 $198 $57 $150 $144 Crossover 75 $180 $267 $233 $67 $176 $ $209 $310 $270 $78 $204 $196 Smokers May Pay More (Plan G) 85 $230 $342 $299 $86 $226 $216 6 Month Wait for Rates for females are lower (Plan G). 90 $236 $351 $306 $88 $231 $222 Pre-Existing Conditions

8 Standardized Medicare Supplement Plans Available - Monthly Premiums Insurance Company Age A B C D F F (HD) G K L M N Comments Thrivent Financial for Lutherans 65 $134 $156 $183 $164 $184 $59 $165 $118 $153 Attained Age $98 $110 $130 $112 $131 $39 $113 $80 $ $117 $132 $154 $136 $155 $48 $136 $97 $128 Crossover 75 $134 $156 $183 $164 $184 $59 $165 $118 $153 (Effective 4/1/2015) 80 $143 $173 $215 $195 $216 $72 $196 $140 $180 Smokers May Pay More Rates for females are lower. 99 $151 $209 $292 $271 $294 $103 $272 $195 $242 United Mutual of Omaha 65 $134 $196 $141 $148 Attained Age $87 $127 $91 $ $105 $154 $111 $116 Crossover 75 $134 $196 $141 $148 Smokers May Pay More 80 $163 $237 $171 $ $186 $271 $195 $206 Rates for females are lower. 90 $208 $303 $218 $229 USAA Life Insurance Co. 65 $174 $161 $153 Attained Age $144 $134 $ $159 $148 $114 Crossover 75 $174 $161 $124 Smokers May Pay More 80 $186 $172 $132 Wellmark Blue Preferred 65 $191 $215 $108 $153 Attained Age $129 $146 $73 $ $161 $182 $91 $129 Crossover 75 $191 $215 $108 $ $211 $238 $119 $169 Smokers May Pay More 85 $229 $258 $129 $183

9 Standardized Medicare Supplement Plans Available - Monthly Premiums Insurance Company Age A B C D F F (HD) G K L M N Comments Wellmark Blue Standard 65 $177 $244 $275 $138 $195 Attained Age $120 $165 $186 $93 $ $150 $206 $232 $116 $165 Crossover 75 $177 $244 $275 $138 $ $196 $270 $304 $152 $216 Smokers May Pay More 85 $212 $293 $330 $165 $234 CONTACT THE FOLLOWING COMPANIES FOR CURRENT RATE INFORMATION: Colonial Penn Life Insurance Co (877) Combined Insurance Company of America (800) Everence Association Inc. (800) Family Life Insurance Company (800) Forethought Life Insurance Company (877) Sanford Health Plan (888) Sentinel Security Life Insurance Company (855) Standard Life and Accident Insurance Company (888) State Farm Mutual Auto Insurance Co (800) State Mutual Insurance Co (888) Sterling Investors Life Insurance (877) United American Insurance Co (800) United Commercial Travelers of America (800) World Insurance Co (866)

10 Standardized Medicare Supplement Plans How to read the Chart: If a check mark appears in a column of this chart, the Medigap policy covers 100% of the described benefit. If a row lists a percentage, the policy covers that percentage of the described benefit. If a row is blank, the policy doesn't cover that benefit. Note: The Medigap policy covers coinsurance only after you have paid the deductible (unless the Medigap policy also covers the deductible). Medigap Benefits 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 up Medicare Part B Coinsurance 50% 75% *** or Copayment Blood (First 3 Pints) 50% 75% Part A Hospice Care Coinsurance 50% 75% or Copayment Skilled Nursing Facility Care 50% 75% Coinsurance Medicare Part A Deductible 50% 75% 50% Medicare Part B Deductible Medicare Part B Excess Charges Foreign Travel Emergency (Up to Plan Limits) Medicare Supplement - Medigap Plans Out-of-Pocket Limit ** $4,940 $2,470 * Plan F(HD) offers a high-deductible plan. If you choose this option, this means you must pay Medicare - covered costs up to the deductible amount of $2,180 in 2015 before your Medigap plan pays anything. **After you meet your out-of-pocket yearly limit and your yearly Part B deductible ($147 in 2015), the Medigap plan pays 100% of covered services for the rest of the calendar year. ***Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to $50 copayment for emergency room visits that don't result in inpatient admission. The Senior Health Information and Insurance Education (SHIINE) program is a service of the South Dakota Department of Social Services, Office of Adult Services and Aging. 700 Governors Drive - Pierre, SD This booklet was produced with financial assistance from the Administration for Community Living. EASTERN SD CENTRAL SD WESTERN SD shiine@activegen.org shiine@centralsd.org shiine@westriversd.org