Medicare Supplements; The Who, What & Why Presented by: Mary Anne Francis, RHU, LUTCF Brown & Brown of Washington.

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Presentation transcript:

Medicare Supplements; The Who, What & Why Presented by: Mary Anne Francis, RHU, LUTCF Brown & Brown of Washington

Medicare Supplements: What is available? 1.Original Medicare Supplements- “Medigap”- Plans A to J 2. MedAdvantage / Alternative Plans 3. Part D Drug Plans

Medicare Supplements: Plans A to J

Medicare Supplements: A to J Premiums

Medicare Supplement: Alternative Plans Called MedAdvantage Plans- Examples:  Pacificare Secure Horizons  Group Health HMO Plan  Regence MedAdvantage Plan

Med Supp Alternatives: MedAdvantage Plans Regence MedAdvantage offers-  Low Premiums  Choice of Provider Network  With or without drug coverage  Supplemental services not included in A to J Med Supplements

Medicare Supplements: MedAdvantage Plans Regence MedAdvantage PPO Plan - In Network:  $5 Copay for Office Visits  $100 per day Hospital Copay 3X max.  Dental Cleanings & X-rays to $500 Annual  Discounts on other services  $1,000 Annual Maximum Out-of-Pocket

Medicare Supplements: MedAdvantage Plans Regence MedAdvantage Out-of-Network Benefits:  $250 Annual Deductible  20% Coinsurance for Services  $100 per day Hospital Copay  $3,000 Annual Maximum Out-of-Pocket

Medicare Supplement: MedAdvantage Plans Premiums – 2007  MedAdvantage no Rx$ monthly  MedAdvantage + Rx $ monthly  MedAdvantage + Rx Enhanced $ monthly

Medicare Supplements: Part D Drug Plans How they Work: How they Work:  You pay annual deductible- $0 to $265  Then copays, depending on type of RX- generic, preferred brand name, nonpreferred brand name  Copays range $5 to $55 until...

Medicare Supplements: Part D Drug Plans  Until total cost of drugs reach $2,250  At that point plan stops paying until total drug costs exceed $3,600 for the year  This is called the “Donut Hole” or “Gap”  Plan pays 95% of drug costs after Gap for remainder of year

Medicare Supplements: Part D Drug Plans How do I locate Plans?   Agents  SHIBA Volunteers  Local pharmacies will compare based on your RX  Over 70 Plans in WA offered

Medicare Supplements: Part D Drug Plans What needs to be considered?  Service Area of Plan  Copays  Formulary – Do they carry my drugs?  Premium Costs  Preferred/nonpreferred Pharmacy

Medicare Supplements: Part D Drug Plans Must I sign up?  Penalties apply later for failure to enroll  Can I change if I don’t like my Plan?  November 15 to December 31 Open Enrollment  Change effective January 1

Medicare Supplements: What are my resources? Local:  SHIBA Volunteers or or  Medicare Help line  Social Security Office

Medicare Supplements: Web Based:   Order Publications  Use Drug Finder  Get Updated information

Medicare Supplements: Web Continued:  Social Security Administration  Insurance Commissioners office

Medicare Supplements:  Q uestions?