M E D I C A R E MEDICARE is a federally funded health insurance program established for those age 65 and older, and for the disabled. While MEDICARE may pay a large part of your health care expenses, it does not pay for all of them. Some medical supplies and services are not covered. You must also pay certain amounts called co-pays and deductibles. Medicare only covers about 80% of Part B expenses; the other 20% is up to you.
MEDICARE SUPPLEMENTS 2010 INCREASES The PART B Monthly Premium May Increase For Some MEDICARE SUPPLEMENT/
Reminder: Effective January 1, 2010, Medicare Part A and Part B deductible and daily coinsurance amounts will increase. (These amounts are updated annually with formulas set by law.) For Medicare Supplement plans in 2010, deductibles have increased as follows: Medicare Part A Deductible: $1,100 per benefit period Medicare Part B Deductible: $155 per year Coverage Changes to the Federal Medicare Program and Medicare Supplement Plans
Supplements and Advantage Plans
To help cover your out-of-pocket medical costs, we offer Medicare Supplement insurance policies that help pay for items that Medicare may not cover, such as:
...Medicare deductibles
...Hospital and medical care co-insurance
...Extended hospital care
...Physician's services, hospital outpatient services and supplies
...Ambulance services
AND
...You can choose your own doctors - no need to select a primary care physician
...No referrals needed to see a specialist
...Virtually no claim forms to fill out - we pay your providers directly so you don't need to file claims yourself
...Coverage is GUARANTEED RENEWABLE for life as long as you continue to pay premiums
FOR SOME
MEDICARE SELECT
Deductibles and Coinsurance Amounts
WILL INCREASE
|
Medicare Part A – Hospital Insurance Hospitalization (Per Benefit Period) |
Effective January 1, 2009, Medicare Paid All Except Amount Indicated |
Effective January 1, 2010, Medicare Will Pay All Except Amount Indicated |
Effective January 1, 2010, Medicare Supplement Plans Will Pay (if plan covers the services) |
|
1 to 60 days |
$1,068, the Part A deductible |
$1,100 the Part A deductible |
$1,100, the Part A deductible |
|
61 st to 90th day |
$267 per day |
$275 per day |
$275 per day |
|
91 st to 150th day |
$534 per day |
$550 per day |
$550 per day |
|
Skilled Nursing Facility | |||
|
21 st to 100th day |
$133.50 per day |
$137.50 per day |
$137.50 per day |
|
HEADS UP! |
Many private insurers offer MEDICARE Supplement policies. United Healthcare's AARP MEDICARE Supplement offers many plans (no other carrier offers that many in Florida!) with varying benefits covering some of the benefits not covered by MEDICARE. Included are new plans M and N with co-pays, which will be detailed below when the details are released.
Some of the other companies offering SUPPLEMENT PLANS are MUTUAL OF OMAHA and UNIVERSAL AMERICAN. The plans (A-N) are all alike but extra benefits and premium amounts may vary. If you want more details, call Marilyn Farber Jacobs (561-988-0070). Marilyn is a Licensed Advisor/Independent Insurance Agent.
Instead of a MEDICARE Supplement, you can join a MEDICARE HMO or PPO (see MEDICARE ADVANTAGE section below). See page on this site about MEDICARE ADVANTAGE for more information.
MEDICARE Plan D is for prescription drugs, and several tiers are available (see PLAN D-DRUGS information below).
What the MEDICARE SUPPLEMENT plans offer:
- Additional coverage beyond Original Medicare to help fill in the gaps in Medicare Parts A & B
- Help reduce or eliminate money paid out-of-pocket for care received (deductibles, co-pays, and coinsurance)
- Plans are standardized and are identified by letters - A through N (Massachusetts, Minnesota and Wisconsin have their own standardized plans)
- Are only offered through private insurance companies
What these plans can do for you:
- Help manage out-of-pocket costs
- Freedom to choose any doctor that accepts Medicare
- Virtually no claim forms to file
- National coverage so your client can use benefits anywhere in the U.S. and if they move, their coverage moves with them
- Most plans include foreign travel coverage for emergency services
- Guaranteed renewability meaning the plan automatically renews or is guaranteed to continue from year to year as long as premiums are paid when due
- 30-day "free look" evaluation period. Full refund of premiums if policy is returned within 30 days of policy issuance.
Depending on plan, special extras may be available in Florida: pharmacy savings, vision discounts, and a 24-hour Nurse Hotline.
The Medicare Supplement Insurance Plans are suitable options for Medicare-elegible beneficiaries who:
... are enrolled in Original Medicare, Parts A and B, and are looking for coverage of out-of-pocket expenses not covered by Medicare
... want the freedom to choose their own doctors and hospitals - no referrals or networks
... want coverage when traveling in the US
... want a competitively priced plan allowing for predictable (or limited) out-of-pocket costs (copays and coinsurance)
... are willing to pay a monthly plan premium
For further information go to:
2009 CHOOSING A MEDIGAP POLICY: A Guide to Health Insurance for People with MEDICARE.
If you live in Florida and wish a FREE copy of this booklet, email marilynfjacobs@gmail.com
with your name, address and phone number
(We give away FREE copies as a community service
and provide FREE community service appointments
to discuss and explain Medicare Supplements - also known as Medigap Policies)
MEDICARE SUPPLEMENTS
OVERVIEW OF COVERAGE...
PICK THE BENEFITS MOST IMPORTANT TO YOU
A Medicare Supplement Insurance Plan could save you thousands of dollars in out-of-pocket expenses. Reasons for choosing the only Medicare supplement insurance plans include:
... FREEDOM to choose your own doctors and hospitals
... NO REFERRALS needed - ever - see specialists
... COMPETITIVE PRICES for members (discount if you use electronic funds transfer or pay a year in advance)
... HELP from Personal Health Insurance advisors, your agents
... Virtually NO CLAIM FORMS to fill out
Choose the plan below that suits you best and call Marilyn Farber Jacobs with questions and for pricing in Florida:
|
**NOTE THAT ONLY United Healthcare AARP |
| PLAN A | PLAN B | PLAN C• | PLAN D | PLAN E | ••PLAN F & F+ | PLAN G | PLAN H | PLAN I |
••PLAN J & J+ |
| Basic Benefits |
Basic Benefits |
Basic Benefits |
Basic Benefits |
Basic Benefits |
Basic Benefits |
Basic Benefits |
Basic Benefits |
Basic Benefits |
Basic Benefits |
| Skilled Nursing Facility Coinsur-ance | Skilled Nursing Facility Coinsur-ance | Skilled Nursing Facility Coinsur-ance | Skilled Nursing Facility Coinsur-ance | Skilled Nursing Facility Coinsur-ance | Skilled Nursing Facility Coinsur-ance | Skilled Nursing Facility Coinsur-ance | Skilled Nursing Facility Coinsur-ance | ||
| Part A Deduct-ible | Part A Deduct-ible | Part A Deduct-ible | Part A Deduct-ible | Part A Deduct-ible | Part A Deduct-ible | Part A Deduct-ible | Part A Deduct-ible | Part A Deduct-ible | |
| Part B Deduct- ible | Part B Deduct- ible | Part B Deduct- ible | |||||||
| Part B Excess (100%) | Part B Excess (100%) | Part B Excess (100%) | Part B Excess (100%) | ||||||
| Foreign Travel Emer-gency | Foreign Travel Emer-gency | Foreign Travel Emer-gency | Foreign Travel Emer-gency | Foreign Travel Emer-gency | Foreign Travel Emer-gency | Foreign Travel Emer-gency | Foreign Travel Emer-gency | ||
| At-Home Recovery | At-Home Recovery | At-Home Recovery | At-Home Recovery | ||||||
| Prevent-ive Care Not cov-ered by Medicare | Prevent-ive Care Not cov-ered by Medicare | ||||||||
• Medicare Select Plan C contains same benefits as Standarized Medicare Supplement Plan C, except for restrictions on your use of hospitals.
•• Plans F & J also have an option called a high Deductible plan F and high dectible Plan J. These high deductible plans pay the same benefits as Plans F and J after one has paid a calendar year $1,900 deductible. Benefits from high deductible Plans F and J will not begin until out-of-pocket expenses exceed $1,900. Out-of-pocket expenses for this deductible are expenses that would ordinarily be paid by the policy. These expenses include Medicare dedutibles for Part A and Part B, but do not include the plan's separate foreign travel emergency deductible.
BASIC BENEFITS FOR PLANS K AND L INCLUDE
SIMILAR SERVICES AS PLANS A-J
BUT COST-SHARING FOR BASIC BENEFITS
IS A DIFFERENT
IF YOU ARE LOOKING FOR A MEDICARE SUPPLEMENT PLAN and want PLANS A, C or F, "let's talk" and compare plans!
MEDICARE ADVANTAGE PLANS If your Private-Fee-for-Service (PFFS) MEDICARE ADVANTAGE Plan And already provides healthcare insurance To over 240,000 HMO, PPO and PFFS members And 125,000 Medicare Supplement policyholders. Call Marilyn at 561-988-0070
Offer all of the benefits of HMO Plans plus:
Point of Service Plans allow your client to:
Special Needs Plans are for people with special needs. There are three basic types of plans for:
A Private-Fee-for-Service Plan offers the ability to control out-of-pocket expenses while providing the flexibility of provider selection. Here are some advantages of a PFFS Plan:
PART D: Our insurer is the 3rd largest insurer of Part D beneficiaries With 1,690,000 members CALL MARILYN FARBER JACOBS
This section is here so that you can compare SUPPLEMENT and ADVANTAGE PLANS to see what is most suitable for you.
has been cancelled
Our insurer can give you that coverage
before December 31st, and
We can complete the application
over the phone!
Medicare Advantage Plans
HMO Plans
PPO Plans
POS Plans
Special Needs Plans
Here´s what Special Needs Plans can do for your client:
PFFS Plan
IF YOU WANT A MEDICARE ADVANTAGE PLAN
WE RECOMMEND
the AARP MedicareCompleteChoicePlan 2
...No monthly premium
...$3,350 in-network out-of-pocket limit
...$7500 out-of-network out-of-pocket limit
...All Medicare services covered under out-of-pocket limit
...No referral needed for network doctors, specialists, hospitals
...Prescription Drug Plan to $2,700 with Catastrophic Coverage after you pay $4,350 out-of-pocket, no RX Coverage Gap for $1650
...Vision, Dental and Podiatry Benefits
...You may have to pay a separate copy for certain doctor office visits
...For out-of-network, plan covers for travel in the US
PLEASE CALL MARILYN JACOBS (561-988-0070) FOR FURTHER DETAILS
Medicare Part D Plans
Medicare Part D plans help cover the cost of your prescription drugs. Here are some of the main features of a Part D plan:
Call Marilyn at 561-988-0070
for more information
TOP 5 REASONS to ENROLL in a MEDICARE PART D PLAN
... You've lost your employer coverage
... You are not satisfied with your current plan
... Your drug needs have changed
... You've recently moved
... You want savings, stability and peace of mind
Annual Election Period is from November 15 through December 31. This is the period when you can change, add or remove health and/or drug plans; enrollment begins January 1st.
During the Open Enrollment Period from January 1 to March 31, individuals cannot pick up or drop Medicare Prescription Drug plans but they can join a new MA plan, switch MA plans or choose to be in the Original Medicare plan; changes are effective the month after the plan receives the request to enroll.
Special Enrollment Periods can be at any time for reasons such as enrollee moving out of plans service area; new health plans and options become available; plan leaves Medicare program or reduces its service area; enrollee loses creditable prescription drug coverage; enrollee qualifies for "extra help" from Medicare; enrollee moves into, resides in or moves out of a long-term care faclity such as a nursing home.
NEW ENROLLEES TURNING 65 can generally sign up between 3 months before their 65th birthday up to 3 months after. Check if you qualify for this Initial Election Period, a one time choice.
FOR MORE DETAILS
at 561-988-0070