USC Senior Care A Supplemental Plan to Medicare Revised: 11/13/2015

Overview What is Senior Care? Who is Eligible? How does Senior Care Interact with Original Medicare? Frequently Asked Questions USC Senior Care | 1

USC Senior Care | 2 What is Senior Care and Who is Eligible? A sponsored supplemental plan to Original Medicare for former employees of the University of Southern California, their spouses, mutual financial dependents or registered domestic partners. You must have both Medicare Parts A and B before enrolling in Senior Care Senior Care is an affordable solution to bridge the gaps in Original Medicare coverage: –Medicare covers 80% of the Medicare Allowable –Senior Care will help cover the 20% that you are responsible for –No out-of pocket physician services expense when you see a doctor at USC –Since Senior Care is a supplemental plan to Medicare, it only covers the services that Medicare covers

What is Original Medicare? Original Medicare Includes: –Part A (Hospital Insurance) - Inpatient hospital services, skilled nursing facility care, home health care, and at-home recovery services –Part B (Medical Insurance) – Outpatient care, physician services, laboratory services, x-ray, ambulance services Original Medicare provides this coverage directly Once enrolled you do not need to re-enroll Gives/provides choice of doctors, hospitals and other providers who accept Medicare USC Senior Care | 3

Why would I need USC Senior Care or other supplemental coverage in addition to Original Medicare Part A and B? Because both Part A and Part B have deductibles –Part B $166/annual (2016) –Part A $1,288/benefit period (2016) Because both Part A (see below) and Part B (20% of Medicare- approved amount) co-insurance after the deductible has been met USC Senior Care | 4 Days in HospitalPart A Coinsurance after Deductible Days 1-60$0 for each benefit period Days 61-90$322/day of each benefit period Days 91 and beyond$644 per each lifetime reserve day after day 90 for each benefit period up to 60 days over your lifetime Beyond lifetime reserve daysAll costs

USC Senior Care | 5 Senior Care Benefits You have no co-payments or deductibles ($200) if you receive services exclusively from USC physicians and USC affiliated hospitals No authorizations or pre-approvals required No physical exam required for membership Premium is not dependent on age, locality or health condition You can choose any doctor in the nation as long as he/she accepts Medicare assignment. After you have met your $200 deductible, you will pay 2% of Medicare Allowable for non-USC providers Plan provides foreign travel emergency medical coverage

USC Senior Care | 6 Senior Care Benefits (continued) Participants will be automatically enrolled for dental and vision benefits at no additional cost –Delta Dental PPO You can continue to see your current dentist as long as they are Delta Dental providers. –VSP Coverage includes eye exams, corrective lenses and eyeglass frames. Prescription drugs NOT included –You must enroll in Medicare Part D plan for drug coverage

USC Senior Care | 7 Medical Benefit Example $100 Allowable Medicare Pays Senior Care Pays Your Cost USC Providers $80$20 $0 Non-USC Providers (After $200 Deductible) $80$18 $2

USC Senior Care | 8 FAQ Q: How does USC Senior Care differ from Medicare HMOs such as Kaiser Senior Advantage or Secure Horizons? –There are distinct advantages to USC Senior Care over Medicare HMOs: You can choose to see any Medicare provider Pre-approvals or referrals are not necessary You can be treated in any Medicare-approved hospital

USC Senior Care | 9 FAQ Q: Does USC Senior Care coverage extend to my family members? –Spouses, mutual financial dependents or registered domestic partners that are enrolled in Medicare parts A and B are eligible for USC Senior Care. Q: Is my eligibility for the plan determined by my health status? –No. Your eligibility is not impacted by health status or pre-existing conditions.

USC Senior Care | 10 FAQ Q: Am I eligible for this program if I don’t live in Southern California? –Yes. You do not have to live in Southern California to be eligible for this program. You may seek care from any Medicare provider, anywhere in the U.S.

USC Senior Care | 11 FAQ Q: Can I dis-enroll from Senior Care and re-enroll later? –Yes. You may re-enroll even if you have dis- enrolled from Senior Care.

USC Senior Care | 12 FAQ Q: What are the enrollment periods for Medicare Part A and B? –Initial enrollment period During the 7-month period that starts 3 months before the month you turn 65 Coverage starts the first day of your birth month, unless your birthday is on the first day of the month, then your coverage starts the first day of the prior month –Special enrollment period 8-month period that starts the month after the employment ends or group health plan insurance based on current employment ends, whichever happens first Coverage first day of month after enrollment –General enrollment period for Medicare January 1 through March 31 Coverage starts July 1

USC Senior Care | 13 FAQ Q: What are the enrollment periods for Medicare Part C and D? –Initial enrollment period During the 7-month period that starts 3 months before the month you turn 65 Coverage starts the first day of the month after you ask to join a plan. If you join during one of the 3 months before you turn 65, your coverage will begin the first day of the month you turn 65. –Special enrollment period 2 full months after prior coverage ends Coverage starts first day of next month, or you can delay up to 3 months after enrolling –General enrollment period for Medicare October 15 – December 7 Coverage starts January 1

USC Senior Care | 14 FAQ Q: What are the monthly Part B Premiums for 2016? File individual tax return (for 2014 yearly income) File joint tax returnFile married & separate tax return You pay the following if you enroll in Part B for the first time, you don’t get SS benefits, or Medicaid pays your premium If you collect Social Security benefits and your Part B premium is deducted from those benefits $85,000 or less$170,000 or less$85,000 or less$121.80$ $85,000 – 107,000$170,000 – 214,000N/A$ $107,000 – 160,000$214,000 – 320,000N/A$ $160, ,000$320, ,000$85, ,000$ $214,000+$428,000+$129,000+$389.80

USC Senior Care | 15 FAQ Q: What are the monthly Part D Premiums for 2016? File individual tax return (for 2014 yearly income) File joint tax returnFile married & separate tax return You pay (in 2016) $85,000 or less$170,000 or less$85,000 or lessYour plan premium $85,000 – 107,000$170,000 – 214,000N/A$ your plan premium $107,000 – 160,000$214,000 – 320,000N/A$ your plan premium $160, ,000$320, ,000$85, ,000$ your plan premium $214,000+$428,000+$129,000+$ your plan premium

Quiz Q: What will it cost (at minimum) to enroll in Medicare + Senior Care per person per month? A.$195/month for Senior Care and nothing else B.Senior Care ($195) + Medicare Part A Premium ($0) = $195/month C.Senior Care ($195) + Medicare Part A Premium ($0) + Medicare Part B Premium ($121.80) = $316.80/month D.Senior Care ($195) + Medicare Part A Premium ($0) + Medicare Part B Premium ($121.80) + Medicare Part D Premium ($0) + Part D Plan Premium ($60) = $376.80/month/person USC Senior Care | 16

Quiz Q: What will it cost (at minimum) to enroll in Medicare + Senior Care per person per month? A.$195/month for Senior Care and nothing else B.Senior Care ($195) + Medicare Part A Premium ($0) = $195/month C.Senior Care ($195) + Medicare Part A Premium ($0) + Medicare Part B Premium ($121.80) = $316.80/month D.Senior Care ($195) + Medicare Part A Premium ($0) + Medicare Part B Premium ($121.80) + Medicare Part D Premium ($0) + Part D Plan Premium ($60) = $376.80/month/person USC Senior Care | 17

FAQ Q: What is an estimate of monthly premiums to enroll in Medicare + Senior Care per person per month in 2016? USC Senior Care | 18 Estimate Based on 2014 Income Tax Filing CalculationTotal Minimum CostSenior Care ($195) + Medicare Part A Premium ($0) + Medicare Part B Premium ($121.80) + Medicare Part D Premium ($0) + Part D Plan Premium ($60) = $376.80/month/person Mid-RangeSenior Care ($195) + Medicare Part A Premium ($0) + Medicare Part B Premium ($243.60) + Medicare Part D Premium ($32.80) + Part D Plan Premium ($80) = $551.40/month/person Upper-RangeSenior Care ($195) + Medicare Part A Premium ($0) + Medicare Part B Premium ($389.80) + Medicare Part D Premium ($72.90) + Part D Plan Premium ($100) = $757.70/month/person

Senior Care is not a substitute for Medicare Part A and Part B You must have Medicare Part A and B to enroll in Senior Care Senior Care does not provide drug coverage so you need to also enroll in Medicare Part D Your Part B and Part D premiums are means tested so total costs will vary by person Part D Plan premiums vary based upon plan design and coverage levels and can range from $60 - $100/month for a highest rated Part D Plan Medicare Part D also has a $360 deductible and co-insurance that you will be responsible for USC Senior Care | 19 Important things to remember when estimating total cost of being on Original Medicare plus a commercial supplemental plan or Senior Care

USC Senior Care | 20 USC Senior Care Member Enrollment

How do you enroll? Call USC Health Plans at for an application An application and credit card deduction form will be mailed to you You return the application to USC Health Plans Premiums will be paid for by credit card deduction USC Senior Care | 21

USC Senior Care | 22 USC Senior Care Member Services Call: (213)