Webinar: Medicare Supplement Insurance. June 19,

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1 Webinar: Medicare Supplement Insurance June 19,

2 MMW work is supported by grants from: The Chicago Community Trust Michael Reese Health Trust The Retirement Research Foundation 2

3 Who We Are: Leadership AgeOptions Area Agency on Aging (AAA) for suburban Cook County Health & Disability Advocates Policy and advocacy group Progress Center for Independent Living Cross-disability, non-residential suburban Cook County 3

4 What We Do Gather and create practical, accessible information and materials Educate Medicare consumers, service providers and policymakers Problem solving individual and systemic Provide training and technical support for professionals and volunteers Advocate for consumer focused laws and policies Target underserved groups 4

5 You can get Medicare Benefits in 2 different ways: Original Medicare Medicare Advantage Part A Part B Part A & B MedSup or Secondary Part D or Secondary Some will include Part D

6 Original Medicare Part A Part B

7 Original Medicare Red, white and blue card Pay-per-service system Almost any doctor, anywhere in U.S. Limits on doctor and hospital fees Covers most medical needs Medicare Summary Notices (MSN) are sent every three months

8 Original Medicare- Parts A & B Part A o Hospital Insurance o Hospital, skilled nursing facility, home health, hospice Part B o Medical Insurance o Doctors, outpatient services, preventive services, lab tests, ambulance services, equipment and supplies

9 Your Part A Costs Hospital Hospital deductible = $1,260 for first day-for each 60-day benefit period (may be more than once per year) Daily copayment for days 1-60 = $0 Daily copayment for days = $315 per day Daily copayment for days = $630 per day

10 Medicare Part A What is a Benefit Period? Begins the first day you are admitted as an inpatient to a hospital or skilled nursing facility (SNF) Ends when you have not had any inpatient hospital care or skilled care in a SNF for 60 days in a row If you return to a hospital or SNF within the 60 days, you are still in the same benefit period A benefit period is NOT based on a calendar year There is no limit to the number of benefit periods you can have but the Part A deductible applies to each benefit period

11 Skilled Nursing Facility- Costs in 2015 Days 1-20 = $0 Days = $ per day Over 100 days, you pay all To qualify for Medicare coverage of a skilled nursing stay, a prior 3-day inpatient hospital stay is required A typical stay in a skilled nursing facility is about 20 days

12 Home Health Care- Costs in 2015 Medicare pays in full for skilled nursing care in the home, which includes services and care that can only be performed by a licensed nurse. Injections, tube feedings, catheter changes, observation and assessment of a patient s condition, management and evaluation of a patient s care plan, and wound care are examples of skilled nursing care that Medicare may cover Medicare pays in full for a home health aide if you require skilled services. (Provides custodial care services including help with bathing, using the toilet, and dressing) Durable medical equipment-beneficiary pays 20% of Medicare approved amount

13 Hospice Care Costs in 2015 $0 for hospice care No more than $5 for each outpatient prescription drug 5% of the Medicare approved amount for inpatient respite care (this amount may change each year) Can stay in a Medicare-approved hospital or nursing home for up to 5 days each time No limit to the number of times you can get respite care

14 Your Part B Costs in 2015 Monthly premium - you must pay this in addition to any private insurance or Medicare Advantage Plan you buy $ each month for most people with Medicare Higher premium (sliding scale up to $335.70) for those with incomes over $85,000- individual tax return $170,000- married couple

15 Additional Part B Costs Annual Deductible= $147 in this amount will increase every year Medicare usually pays 80% of the Medicare approved amount for doctor s services; you pay the difference (20% coinsurance) Outpatient emergency room, hospital and surgery services are a fixed amount, depending on the service

16 Doctor Charge Limits Doctors who take assignment o agree to take Medicare approved rate as payment in full o Medicare pays 80% of that rate Doctors who don t take assignment o can charge no more than 15% above Medicare s approved rate Doctors who opt out o cannot submit any claim to Medicare o Patient signs private contract to pay in full

17 Medicare Supplement Insurance (also referred to as MediGap Insurance) Medigap

18 MediGap Plans Health insurance sold by private companies to supplement Medicare Use with Original Medicare only (Does not work with Medicare Advantage Plans) o Only pays if Medicare does o Must have Parts A & B Fills in the gaps not covered by Original Medicare o Helps pay some of the costs not covered by Medicare like deductibles, copayments and coinsurance

19 Medigap Plans Pay a premium for a Medigap policy in addition to the Part B premium Polices sold after January 1, 2006 DO NOT include prescription drug coverage o Can buy and enroll in a separate Medicare Part D plan As of June 1, 2010, 10 standardized Medigap Plans are available (A, B, C, D, F, G, K, L, M and N) o Plans with same letter have identical benefits Some individuals may have Medigap plans they bought before June 1, 2010 o Allowed to keep these plans

20 Medigap Changes as of June 1, 2010 Two new plans: M and N Plans E, H, I and J are no longer being sold. People who were already in one of these plans before June may keep that plan At-home recovery no longer included as a benefit with any plan sold after 6/1/10 Preventive care benefits have been removed from plans sold after June 1 st since Medicare began to cover most preventive services in 2011 Hospice co-insurance is included as a core benefit for plans sold after 6/1/10

21 Plan Variations Medicare Select plans- Restricts you to a network in order to receive full Medicare Supplement Benefits (Usually only a hospital network) High deductible plans (F)-Plan F offers a highdeductible plan. You must pay Medicare covered costs up to the deductible amount ($2,180 in 2015) before your plan pays.

22 Medigap Benefits All plans cover: Daily hospital coinsurance (for long stays) An additional 365 days in the hospital 20% coinsurance for Part B services 1 st three pints of blood Part A Hospice coinsurance (included as a core benefit for policies sold after 6/1/2010)

23 Additional Medigap Benefits Additional coverage that you can buy included in certain plans: o Medicare Part A deductible o Medicare Part B deductible o Skilled nursing facility (SNF) coinsurance o Part B excess charges o Emergency care while traveling outside of the USA

24 *Chart developed by the Centers for Medicare & Medicaid Services

25 When is the best time to buy a Medigap policy? Medigap Open Enrollment Period Within 6 months of enrolling in Medicare Part B (over and under age 65) o A Medicare beneficiary under the age of 65 will receive another 6 month Open Enrollment Period once they turn 65 Companies cannot use medical underwriting during the Open Enrollment Period. This means they cannot: o Refuse to sell you a policy o Charge you more for a policy because of health issues o Make you wait for coverage to start for a pre-existing condition if you had at least 6 months of prior continuous creditable coverage before you buy a Medigap policy o Continuous Creditable Coverage-No ore than a 63 day gap in prior creditable coverage Guaranteed Issue Rights & Other Medicare Supplement Rights A company must sell you a policy, must cover all pre-existing conditions, and cannot charge more because of past or present health conditions.

26 Guaranteed Issue Rights Your choices are limited to Medicare Supplement or Medicare Select plans A,B,C,F,K, or L in the following Guaranteed Issue Right situations: Your employer, union, retiree or COBRA plan (either primary or secondary to Medicare) terminates or ceases to provide all such supplemental benefits. If your employer plan is secondary to Medicare and you elect to disenroll, you have no guaranteed issue rights. You must purchase a MediGap policy no later than 63 days after the latest of the following 3 dates: o Date the coverage ends o date on the notice you receive telling you that your coverage is ending o date on a claim denial if this is the only way you know that your coverage ended

27 Guaranteed Issue Rights Continued Your choices are limited to Medicare Supplement or Medicare Select plans A,B,C,F,K, or L in the following Guaranteed Issue Right situations: In a Medicare Advantage plan or Medicare Select plan and your plan leaves Medicare, your service area or you move out of the plan s service area o You must purchase a plan within 63 days after your health coverage ended Your Medicare Supplement plan goes out of business, withdraws from the market or the company or agents misrepresent the plan o You must purchase a plan within 63 days after your health coverage ended

28 Other Special Circumstance Guarantees Federal list of Medicare Supplement Rights & Guarantees, please visit: Illinois Specific Medicare Supplement Rights & Guarantees, please visit:

29 Purchasing Medigap plan outside OEP or without a Guaranteed Issue Right A company is allowed to deny a beneficiary coverage or charge them higher premiums due to medical underwriting o 65 or older may enroll in a Medigap plan any time of the year o Under 65 may only enroll in a Medigap plan between October 15- December 7 th each year In Illinois, BCBS and Health Alliance are currently Guaranteed Issue policies and will issue a policy regardless of their health history o May be charged the highest premium rate on file with the Illinois Department of Insurance, but they will not be denied coverage

30 Medicare Supplement Pricing 3 MediGap Pricing Methods Issue Age- Premium will be based on your age at the time you purchased policy. Premium increases will only be the result of higher medical cots or higher than expected claim costs for the entire category of policyholders you are in. Attained Age- Premium will increase as you grow older. Additional increases possible due to higher medical costs or higher than expected claim costs. If rate increases occur, the increase must apply to entire class of policyholders in which you are categorized No Age Rated- Premium for a policy is the same for everyone over 65, regardless of age.

31 Medicare Supplement Premium Comparison Guide Can view estimated premium costs on Medicare Supplement Premium Comparison Guide-developed by the Illinois Department on Aging o To view guide: o Prices may change during the year after guide was printed o Contact company for personalized premium information

32 Medicare Supplement Terms 30 Day Free Look Policy Guaranteed Renewable Crossover Application Fee

33 Medicare Supplement Premium Comparison Guide-Illinois Department on Aging

34 Comparing MediGap Policies Decide which benefit is right for you (A-N) Choose between a standard Medicare Supplement plan, Medicare Select plan or high deductible plan F option Compare prices with plans that offer that benefit Call company and request personalized premium quote

35 Questions? 35

36 MMW Website Please visit our website at to... Sign up for our list to receive registration information for our webinars, trainings, and meetings and to receive our alerts, bulletins, and other healthcare related materials Access our materials on Medicare, Medicaid, and the Affordable Care Act View our Calendar of Events 36

37 Thank You! If you have questions, please contact an MMW staff at AgeOptions by calling (708) or ing us at: 37

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