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Published byBrittany Elaine Benson Modified over 6 years ago
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Sentinel Plan® Hospital Advantage™ Protecting Your Health and Maximizing Your Potential
Sentinel Security Life is pleased to introduce Sentinel Plan® Hospital Advantage™ .
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Reviewing Your Current Coverage
Take the opportunity to review your current Medicare coverage or the option you are considering. These Medicare coverage options may include: Original Medicare Medicare Supplements Plan M High Deductible Plan F Medicare Advantage Medicare Medical Savings Account (MSA) Plans Review your most commonly used benefits. Key benefits and costs that you would be responsible for with your current or prospective Medicare coverage: Co-pays and/or co-insurance Deductibles The Sentinel Plan® Hospital Advantage™ will help reduce or eliminate many of those costs. As is important with any insurance product, please make sure and review your current insurance coverage needs, which may include: Original Medicare Medicare Supplements Medicare Advantage Medicare Medical Savings Account (MSA) Plans Take note of your most commonly used benefits that can result in out of pocket costs such as: Co-pays and/or co-insurance Deductibles The Sentinel Plan® Hospital Advantage™ was designed to help reduce or eliminate many of these costs.
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Reviewing Some of Your Healthcare Options Key Benefits
Now let’s look at some of the key benefits of this plan.
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Medical Services & Benefits
Original Medicare1 Medicare Supplement High Deductible Plan F Medicare Advantage Plans2 Sentinel Plan® Hospital Advantage™ Premier Plan You must pay: Pays You a benefit amount of: Inpatient Hospital Care: You must first pay your Part A deductible of $1,156 plus your Part B deductible of $140 for a total out-of-pocket cost of $1,296. Then you must pay co-insurance for many services: Must pay Part A deductible for days 1-60 A monthly premium plus an annual deductible of $2,070 before any benefits will be covered. (Monthly premiums are subject to annual increases and can not be applied towards meeting your annual deductible) $250 per day for days 1-5 Ambulance Services: 20% co-insurance $125 per trip $125 per trip for up to 3 trips per year Emergency Room Care: $60 per visit $50 per visit for up to 4 visits per year Outpatient Surgical Services: 20% co-insurance 10% - 30% 10% of the fee schedule up to $2,500 per year Diagnostic Tests – Laboratory Services & Radiology Services: 20% co-insurance for diagnostic tests and x-rays $25 per test/service $30 per visit for up to $900 per year Primary Care Physician Dr. Office Visits: $20 per visit $25 per visit for up to 8 visits per year Skilled Nursing Facility: $0 for days 1-20 $40 per day for days 1-20 $60 per day for days 1-20 per year Welcome to Medicare Visit: No cost to you $25 paid to you Annual Medicare Wellness Visit: Additional Preventive Care Services: $10 per test/service up to 5 tests/services per year 12012 Medicare deductibles and co-insurance amounts listed. 2Amounts are based off a sampling of current 2012 Medicare Advantage Plans and are not meant to represent any one contract. Here is a side-by-side comparison of some of the key out of pocket costs you might incur with Original Medicare, Medicare Supplement Plan F, and Medicare Advantage Plans. The far right column outlines the corresponding benefit provided to you by the Sentinel Plan® Hospital Advantage™ . As you will notice, the Sentinel Plan benefit that is paid to you closely resembles the actual costs you incur with other coverage.
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Three Levels of Coverage
Sentinel offers three levels of coverage so you can find the plan that fits you best. STANDARD PLAN PREFERRED PLAN PREMIER PLAN The Standard Plan is our basic coverage level. This plan is for those who expect fewer hospital stays and require less preventative care, but still want coverage when need be. The Preferred Plan has a higher premium and more comprehensive coverage. It is the level for those who want to make sure they have enough coverage, but also want to be cost conscious. The Premier Plan is the most comprehensive level of coverage. It is the plan with the lowest out-of-pocket cost to you. This ensures you will have the coverage you need when you need it. Sentinel offers 3 levels of coverage so you can find the plan that fits you best. The Standard plan offers basic coverage levels at a reduced premium. The Preferred Plan offers higher benefits to you while still being cost conscious. The Premier Plan is the most comprehensive plan available and offers the least out of pocket costs. Now let’s take a look at how some of the benefits of the Sentinel Plan work
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Inpatient Hospital Care
Have you, or anyone you know, gone to the hospital for five days? Coverage Type Benefit cost to YOU Sentinel Plan® Hospital Advantage™ Premier Plan Benefit Payment Amount Original Medicare: $1,156 Part A deductible1 $250 per day for days 1-5 Total benefit paid to you for a five-day hospital confinement is $1,250 Medicare Advantage: $250 per days for days 1-52 Have you, or anyone you know, gone to the hospital for five days? If so, you could be responsible for $1,156 under the Original Medicare part A deductible. If you have Medicare Advantage, you would be responsible for $250 per day. The Sentinel Plan® Hospital Advantage™ pays up to $250 for days 1-5 for a total benefit of up to $1,250. 12012 Medicare deductibles and co-insurance amounts listed. 2Amounts are based off a sampling of current 2012 Medicare Advantage Plans and are not meant to represent any one contract. How much did you or your friend have to pay for a five day hospital stay?
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Benefit Payment Amount
Ambulance Services If you had to go to the hospital in an emergency due to an unforeseen health condition or accident, you would most likely be taken by ambulance. Coverage Type Benefit cost to YOU Sentinel Plan® Hospital Advantage™ Premier Plan Benefit Payment Amount Original Medicare: 20% co-insurance1 $125 per trip paid to you and coverage of up to three trips per year Medicare Advantage: $125 per trip2 If you had to go to the hospital in an emergency due to an unforeseen health condition or accident, you would most likely be taken by ambulance. If you have Original Medicare you could be responsible for a 20% coinsurance. With Medicare Advantage you could incur a $125 per trip charge. The Sentinel Plan® Hospital Advantage™ pays up to $125 per trip for up to 3 trips per year. 12012 Medicare deductibles and co-insurance amounts listed. 2Amounts are based off a sampling of current 2012 Medicare Advantage Plans and are not meant to represent any one contract. With the Sentinel Plan® Hospital Advantage™ you have coverage options to help meet or entirely cover those costs.
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Benefit Payment Amount
Emergency Room Care Many hospital confinements start with a trip to the emergency room, often by ambulance, and result in yet another charge to you for emergency room care. Coverage Type Benefit cost to YOU Sentinel Plan® Hospital Advantage™ Premier Plan Benefit Payment Amount Original Medicare: 20% co-insurance1 $50 per admission paid to you if you are admitted to the hospital for one or more days Medicare Advantage: $60 per admission2 Many hospital confinements start with a trip to the emergency room, often by ambulance, and result in yet another charge to you for emergency room care. With Original Medicare you could incur up to a 20% co-insurance amount. With Medicare Advantage you could incur a $60 admission charge. The Sentinel Plan® Hospital Advantage™ pays up to $50 per admission if you admitted to the hospital for one or more days. 12012 Medicare deductibles and co-insurance amounts listed. 2Amounts are based off a sampling of current 2012 Medicare Advantage Plans and are not meant to represent any one contract. The Sentinel Plan® Hospital Advantage™ helps reduce or eliminate these costs to you.
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Outpatient Surgical Services
Suppose you are on Original Medicare and have $1,000 surgical procedure. Medicare would cover all but $ of those costs. The remaining $200 would be your responsibility to pay. Coverage Type Benefit cost to YOU Sentinel Plan® Hospital Advantage™ Premier Plan Benefit Payment Amount Original Medicare: 20% co-insurance1 Pays 10% of the Medicare fee schedule amount up to $2,500 per calendar year for all medically necessary procedures. Benefits cannot be applied toward elective or cosmetic procedures. Medicare Advantage: 10% - 30% co-insurance2 Suppose you are on Original Medicare and have $1,000 surgical procedure. Medicare would cover all but $ of those costs, while the remaining $200 would be your responsibility to pay. With the Sentinel Plan® Hospital Advantage™ you would only be responsible for half of that $100 and the plan would pay you the other half. If you have a Medicare Advantage plan with a 10% co-insurance, the plan would reimburse you 100% of those charges. 12012 Medicare deductibles and co-insurance amounts listed. 2Amounts are based off a sampling of current 2012 Medicare Advantage Plans and are not meant to represent any one contract. With the Sentinel Plan® Hospital Advantage™ you would only be responsible for half of that $100 and the plan would pay you the other half. If you have a Medicare Advantage plan with a 10% co-insurance, the plan would reimburse you 100% of those charges.
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Primary Care Physician Doctor Office Visits
What about your everyday and routine doctor’s office visits? The Sentinel Plan® Hospital Advantage™ helps cover these visits. Coverage Type Benefit cost to YOU Sentinel Plan® Hospital Advantage™ Premier Plan Benefit Payment Amount Original Medicare: $140 Part B deductible, then 20% co-insurance thereafter1 $25 paid to you per office visit for up to 8 visits per year for a total of $200 in benefits paid to you Medicare Advantage: $20 per office visit2 The Sentinel Plan® Hospital Advantage™ helps cover your everyday and routine doctor’s office visits by paying $25 per office visit for up to 8 visits per year. While making health care both affordable and accessible, the Plan helps you maintain your quality of health. 12012 Medicare deductibles and co-insurance amounts listed. 2Amounts are based off a sampling of current 2012 Medicare Advantage Plans and are not meant to represent any one contract. Regular visits to your primary care physician can help maintain your quality of health as well as detect and even prevent serious health complications. The Sentinel Plan® Hospital Advantage™ helps make health care both affordable and accessible.
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Additional Wellness & Preventive Care Benefits
Sentinel Security Life Insurance Company believes in helping you stay happy and healthy with proactive and preventive health benefits. Below are some of these benefits provided by the Sentinel Plan® Hospital Advantage™. Benefit Coverage Type Benefit cost to YOU Sentinel Plan® Hospital Advantage™ Premier Plan Benefit Payment Amount Welcome to Medicare Initial Wellness Visit & Ongoing Annual Medicare Wellness Visit Original Medicare: No cost to you1 $25 paid to you every year for each visit Medicare Advantage: No cost to you2 Benefit Coverage Type Benefit cost to YOU Sentinel Plan® Hospital Advantage™ Premier Plan Benefit Payment Amount Preventive Health Care Services & Screenings Original Medicare: No cost to you1 $10 per preventive service or health screening paid to you. You are eligible to complete up to five covered services/ screenings per year and receive $50 in reimbursements. Medicare Advantage: No cost to you2 Sentinel Security Life Insurance Company believes in helping you stay happy & healthy with proactive and preventive health benefits. These benefits include $25 for your initial and annual Medicare Wellness visits. The plan also pays $10 per preventative service or health screening for up to 5 covered service/screenings. 12012 Medicare deductibles and co-insurance amounts listed. 2Amounts are based off a sampling of current 2012 Medicare Advantage Plans and are not meant to represent any one contract.
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Questions and Review of the Outline of Coverage
A couple common questions to consider: “If I have to... go to the hospital for 5 days how much will this plan pay me to cover my costs, or if I need to go see my doctor does this plan help cover my co-pays or co-insurance?” Take the time to review each benefit in question and how the Sentinel Plan® Hospital Advantage™ fits with your existing type of Medicare coverage. Be sure to consider any benefit maximums or limitations. As with any insurance policy, we highly suggest you review the Outline of Coverage. Consider your out of pocket costs for services such as Hospital Stays and Physician Visits. Make sure and understand how the Sentinel Plan® Hospital Advantage™ fits with your exiting Medicare and Medicare Supplement coverage.
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Reviewing the Three Levels of Coverage Options
Now let’s take a look at the 3 different plan levels available to you
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Why Choose the Sentinel Plan® Hospital Advantage™ ?
The Sentinel Plan® Hospital Advantage™ was specifically created to help provide coverage for people in situations like those we just reviewed. We have designed three plan options to better meet your individual needs and those circumstances that might unexpectedly arise. We wish you great health as well as a long and happy life. This is why we have included proactive, preventative health and wellness programs in your coverage. The Sentinel Plan® Hospital Advantage™ was specifically created to help provide coverage for people in situations like those we just reviewed. The plan offers three levels of benefit to most closely fit your individual coverage needs and cost considerations.
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Sentinel Plan® Hospital Advantage™
OVERVIEW OF PLAN BENEFITS STANDARD PLAN PREFERED PLAN PREMIER PLAN Daily Hospital Confinement Indemnity Benefit $100 per day $125 per day $250 per day Maximum 5 days per calendar year Ambulance Transportation Benefit $75 per trip $100 per trip $125 per trip Maximum 3 ambulance trips per calendar year Emergency Room Services Benefit $25 per event $50 per event Maximum benefit payable up to 4 times per calendar year Hospital Inpatient or Ambulatory Surgical Center Surgical Services Benefit 10% of the Medicare fee schedule amount, maximum $500 per calendar year 10% of the Medicare fee schedule amount, maximum $1,000 per calendar year 10% of the Medicare fee schedule amount, maximum $2,500 per calendar year Hospital Outpatient or Ambulatory Surgical Center Laboratory and Radiology Services Benefit $20 per outpatient visit, maximum of $500 per calendar year $25 per outpatient visit, maximum of $700 per calendar year $30 per outpatient visit, maximum of $900 per calendar year Primary Care Physician Office Visit Benefit $15 per visit, maximum of 4 visits per calendar year $20 per visit, maximum of 6 visits per calendar year $25 per visit, maximum of 8 visits per calendar year Skilled Nursing Facility Confinement Benefit $20 per day $25 per day $60 per day Maximum 20 days per calendar year Welcome to Medicare Benefit $25 for initial Medicare preventive physical exam Annual Medicare Wellness Visit Benefit $25 for one annual Medicare wellness visit Maximum 1 benefit per calendar year Additional Preventive Care Services Benefit Limited to 5 preventive screenings per calendar year $10 annually per each completed Medicare-covered preventive service Please take a few moments to review the 3 plan levels and the corresponding coverages they provide.
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Please contact us with any questions you might have, or to learn more about this great new product. Sentinel Security Life Insurance Company • We wish you great health as well as a long and happy life. This is why we have built in proactive, preventative health and wellness programs into your coverage. Please contact us with any questions you might or to learn more about this great new product. Sentinel Security Life Insurance Company • •
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