Understanding Medicare

What is Medicare? Medicare is the federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD). Medicare was created in 1965 when people over 65 found it virtually impossible to get private health insurance coverage. Medicare has made access to health care a universal right for Americans once they reach age 65. This has helped improve the health and longevity of older Americans.

The Different Parts of Medicare There are 5 different parts to Medicare Medicare Part A (Hospital) Medicare Part B (Physician) Medicare Part C (Medicare Advantage) Medicare Part D (Prescription Drug) Medigap (Medicare Supplement) Depending on a clients current coverage and household income will determine what parts they need to enroll into.

Medicare Part A Medicare Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care. Medicare pays 80% of all Medicare Approved Charges. Client’s are liable for 20% Coinsurance. Most clients are automatically enrolled by Social Security when they turn 65. Unless found eligible for a Special Enrollment Period, clients over the age of 65 must enroll during the General Enrollment Period between Jan 1st – March 31st. Coverage begins July 1st. Clients under 65 may qualify after filing Disability.

Medicare Part A (Continued) If you paid Medicare taxes while working or had Medicare-covered government employment, receive retirement benefits from Social Security or the Railroad Retirement Board, or if your disability benefits last 24 months your Medicare Part A premiums are generally free. If not, you could pay up to $407.00 per month

Medicare Part B Medicare Part B covers certain doctors' services, outpatient care, medical supplies, and preventive services. Medicare Pays 80% of all Medicare Approved Charges. Clients are liable for 20% Coinsurance. Medicare Part B is optional and client’s may manually enroll by calling Social Security when they receive their Medicare Part A Card. Unless found eligible for a Special Enrollment Period, clients over the age of 65 must enroll during the General Enrollment Period between January 1st – March 31st. Coverage begins July 1st. Clients under 65 may qualify after filing Disability.

Medicare Part B (Continued) Most people pay the Standard Medicare Part B Premium of $104.50 a month. Some people with higher incomes pay more. Less than 5% of Medicare Beneficiaries pay more than the Standard Medicare Part B Premium. Medicare Beneficiaries may be fined a Late Enrollment Penalty for as long as they have Medicare if they don’t sign up when they’re first eligible or if they drop their Medicare Part B and then get it later. Medicare Part B premiums can go up 10% for each full 12 month period they could have had Medicare Part B, but didn’t.

Medicare Part C A Medicare Part C Plan or otherwise known as a Medicare Advantage Plan is a type of Medicare health plan offered by a private company that contracts with Medicare to provide you with all your Part A and Part B benefits. Medicare Advantage Plans include Health Maintenance Organizations (HMO), Preferred Provider Organizations (PPO), Private Fee-for-Service Plans, Special Needs Plans, and Medicare Medical Savings Account Plans. Some Medicare Part C plans Include Medicare Part D Coverage. Limited Networks. Doctors can change at anytime. $0.00-37.00 Monthly Premiums (FL).

Medicare Part C (Continued) Annual Enrollment Period October 15th – December 7th. Annual Disenrollment Period January 1st – February 14th.

Medicare Part D Medicare Part D adds prescription drug coverage to Original Medicare, some Medicare Cost Plans, some Medicare Private-Fee-for-Service Plans, and Medicare Medical Savings Account Plans. These plans are offered by insurance companies and other private companies approved by Medicare. And Again, Medicare Advantage Plans may also offer Prescription Drug coverage that follows the same rules as Medicare Prescription Drug Plans. A clients Prescribed Drug List will determine their monthly premiums depending on the type of Drug Coverage they prefer.

Medigap (Medicare Supplement) A Medicare Supplement Insurance (Medigap) policy, sold by private companies, can help pay some of the health care costs that Original Medicare doesn't cover, like copayments, coinsurance, and deductibles. Some Medigap policies also offer coverage for services that Original Medicare doesn't cover, like medical care when you travel outside the U.S. If you have Original Medicare and you buy a Medigap Policy, Medicare will pay it’s share of the Medicare Approved amount for covered health care costs. Then your Medigap policy pays it’s share. (Ex. 80%/20%) Annual Enrollment Period Jan 1st – December 31st.

8 Things to know about Medigap You must have Medicare Part A and B. 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. 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. A Medigap policy only covers one person. If you and your spouse both want Medigap coverage, you'll each have to buy separate policies.

8 Things to know about Medigap You can buy a Medigap policy from any insurance company that's licensed in your state to sell one. 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. Some Medigap policies sold in the past cover prescription drugs, but Medigap policies sold after January 1, 2006 aren't allowed to include prescription drug coverage. It's illegal for anyone to sell you a Medigap policy if you have a Medicare Medical Savings Account (MSA) Plan.

Work a Warm Market! 10,000 people turn 65 each day. They have 2 decisions to make turning 65 concerning their healthcare options. Either keep their current Private Health Insurance or Employer Sponsored Plan in conjunction with Medicare Part A & B to cover some of the 20% Coinsurance. Or terminate their current coverage for a Medicare Part C or Medigap Plan to cover some or all of the 20% Coinsurance due from Medicare Part A & B.

United American Insurance Company Our go to Medigap/Medicare Supplement Carrier. In business since 1947 Providing Medigap/Medicare Supplements since 1966, the year they were created. Low, Competitive Rates. 16% Level Lifetime Commissions.

Plan F Essentially Full Coverage for a set Premium. A B C D F HDF G K Part A Coinsurance ✓ Part B Coinsurance 100% 50% 75% Blood Hospice Nursing Facility Coinsurance Part A Deductible Part B Deductible Excess Doctor Charges Foreign Travel Emergency Out of Pocket Annual Limit 2,180 4,940 2,470 Essentially Full Coverage for a set Premium.

Plan HDF A B C D F HDF G K L N Part A Coinsurance ✓ Part B Coinsurance 100% 50% 75% Blood Hospice Nursing Facility Coinsurance Part A Deductible Part B Deductible Excess Doctor Charges Foreign Travel Emergency Out of Pocket Annual Limit 2,180 4,940 2,470 Provides all the Plan F benefits after a $2,180 Deductible has been met. For Agent Use Only | Not For Use With General Public

Plan N A B C D F HDF G K L N Part A Coinsurance ✓ Part B Coinsurance 100% 50% 75% Blood Hospice Nursing Facility Coinsurance Part A Deductible Part B Deductible Excess Doctor Charges Foreign Travel Emergency Out of Pocket Annual Limit 2,180 4,940 2,470 Allows clients to switch to Plan F in the future with no underwriting. For Agent Use Only | Not For Use With General Public

United American Medigap Selling Points When we service a client we always pitch Plan HDF first. Reason be is because it comes with the RFA and the RFA gets us in the door for Life and Annuity Sales! If your client doesn’t like Plan HDF it’s most likely because of the Deductible. At this point you would turn her toward Plan F. However, if they like the idea of Plan HDF and the optional RFA, they should almost immediately ask you what they’re allowed to put into the RFA. When they do you’ll gather information on their goals, wrap up your Med Supp sale, and schedule another appointment to go back after you find a suitable product for their needs.