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For authorized agent use only. Not for public use. Standard Life and Accident Insurance Company.

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Presentation on theme: "For authorized agent use only. Not for public use. Standard Life and Accident Insurance Company."— Presentation transcript:

1 For authorized agent use only. Not for public use. Standard Life and Accident Insurance Company

2 For authorized agent use only. Not for public use. Medicare Supplement vs Medicare Advantage

3 For authorized agent use only. Not for public use. Did you know that you can sell Medicare Supplement as easily as you can sell Medicare Advantage?

4 For authorized agent use only. Not for public use. Did you know that selling Medicare Supplement isn’t as complicated as you think?

5 What you need to know about Medicare Supplement and Medicare Advantage For authorized agent use only. Not for public use.

6 Medicare Supplement vs Medicare Advantage In 2008, Medicare beneficiaries have two basic options for healthcare coverage; traditional Medicare and supplemental insurance (also known as Medigap policies) and Medicare Advantage policies. For authorized agent use only. Not for public use.

7 Medicare Supplement vs Medicare Advantage It is important to note that there is a significant difference between Medicare Advantage plans and Medicare Supplement insurance. For authorized agent use only. Not for public use.

8 The following slides will give you a point by point product comparison of Medicare Supplement and Medicare Advantage.

9 Medicare Supplement vs Medicare Advantage Medicare Supplement plans:  provide coverage for the “gaps” of original Medicare Parts A and B,  were standardized in 1992,  are carefully regulated to control the quality of coverage, and  work in conjunction with original Medicare to provide healthcare coverage. For authorized agent use only. Not for public use.

10 Medicare Supplement vs Medicare Advantage Medicare Advantage plans:  is a new name for Medicare+Choice (M+C),  are private healthcare plans subsidized by Medicare,  may take the form of an: o HMO (Health Maintenance Organization), o PFFS (Private Fee-For-Service) plan, or o PPO (Preferred Provider Organization). For authorized agent use only. Not for public use.

11 Medicare Supplement vs Medicare Advantage Medicare Supplement plans:  are available through private insurance companies,  12 standardized plans available – Plans A through L,  each plan offers varying levels of coverage,  benefits of each plan are the same from any insurance company across the industry. For authorized agent use only. Not for public use.

12 Medicare Supplement vs Medicare Advantage Medicare Advantage plans:  are available through private insurance companies,  unique to the company offering them,  usually take the form of “Basic” or “Premium” plans,  varying levels of coverage for each plan,  no two plans are alike,  companies are encouraged to compete for pricing and plans. For authorized agent use only. Not for public use.

13 Medicare Supplement vs Medicare Advantage Medicare Supplement plans:  enrollees may use the doctor or hospital of their choice,  according to the Centers for Medicare and Medicaid Services, 99.7% of physicians and hospitals in the U.S. accept Medicare assignment,  beneficiaries may also travel the United States with little worry of coverage being available. For authorized agent use only. Not for public use. US Department of Health and Human Services. Data Compendium. Online 2007 Edition of US Department of Health and Human Services. Centers for Medicare and Medicaid Services. http://www.cms.hhs.gov/DataCompendium/17_2007_Data_Compendium.asp#TopOfPage http://www.cms.hhs.gov/DataCompendium/17_2007_Data_Compendium.asp#TopOfPage

14 Medicare Advantage plans:  enrollees may be restricted to the use of certain doctors and hospitals in a network of providers,  depending on the plan, only those approved providers may be covered in the event of treatment. Medicare Supplement vs Medicare Advantage For authorized agent use only. Not for public use.

15 Medicare Supplement plans:  are guaranteed renewable,  as long as premium payments are made in a timely manner, beneficiaries cannot be denied coverage,  laws are in place to provide beneficiaries the ability to seamlessly enroll with another company, should the company providing the supplemental policy go out of business. Medicare Supplement vs Medicare Advantage For authorized agent use only. Not for public use.

16 Medicare Advantage plans:  must sign contracts with Medicare to provide covered benefits,  contracts are reviewed annually and are subject to termination,  if the contract is not renewed, the plan may simply disenroll its Medicare beneficiaries,  laws are in place to provide beneficiaries the ability to re-enroll with traditional Medicare and a Medicare Supplement, should the company providing the Medicare Advantage plan go out of business. Medicare Supplement vs Medicare Advantage For authorized agent use only. Not for public use.

17 Medicare Supplement vs Medicare Advantage Medicare Supplement plans:  the 12 plans available vary in level of coverage and cost,  because the plans are standardized across the industry, the level of coverage is the same from any insurance company across the industry. For authorized agent use only. Not for public use.

18 Medicare Supplement vs Medicare Advantage Medicare Advantage plans:  may charge little or no initial premiums to their members,  enrollees may frequently be charged co-pays and co-insurance for any number of healthcare treatments. For authorized agent use only. Not for public use.

19 Medicare Supplement vs Medicare Advantage Medicare Supplement plans:  do not come with built-in prescription drug coverage,  seniors may shop private companies for affordable Medicare Part D Prescription Drug Plans,  different types of Part D plans are available with varying levels of cost and coverage. For authorized agent use only. Not for public use.

20 Medicare Supplement vs Medicare Advantage Medicare Advantage plans:  many come with prescription drug coverage built-in,  “Basic” plans usually have lower levels of drug coverage,  “Premium” plans usually have higher levels of drug coverage. For authorized agent use only. Not for public use.

21 There are also differences in the enrollment periods for Medicare Supplement and Medicare Advantage Plans For authorized agent use only. Not for public use.

22 Medicare Supplement vs Medicare Advantage Medicare Supplement plans:  qualifying clients have the flexibility to enroll or change plans at any time throughout the year. For authorized agent use only. Not for public use.

23 Medicare Supplement vs Medicare Advantage Medicare Advantage plans:  clients may enroll or change plans only during the two enrollment periods each year  Annual Open Enrollment: November 15 through December 31, and  Special Enrollment: January 1st through March 31 For authorized agent use only. Not for public use.

24 Commission payouts also differ. Because commissions for Medicare Supplements are levelized, you have the potential to earn significantly more in renewal commission with traditional Medicare Supplement products. *Commission varies by state and contract level. For authorized agent use only. Not for public use.

25 With a Medicare Supplement, you will typically make one sale per client, but earn a healthy renewal commission for a number of years from that one sale. *Commission varies by state and contract level. For authorized agent use only. Not for public use.

26 Commission Payout Example Medicare Supplement Sell just two $1,000 annual premium Medicare Supplement policies per month for one year and receive $3,600 in commission*. You will then receive $150 in commission* per year for the next five years for each in force policy. That could mean $3,600 in commission per year for six years. Some policies pay a service fee for each in force policy after the sixth year. *Commission varies by state and contract level. For authorized agent use only. Not for public use.

27 Commission Payout Example Medicare Advantage Sell two Medicare Advantage policies per month for one year and receive $9,600 in commission*. After the first year, you will receive approximately $9.00 per month in commission for each plan sold for only one year. *Commission varies by company and state. For authorized agent use only. Not for public use.

28 Commission Payout Comparison* $1,000 annual premium Med Supp policy at 15% commission = $150* Year 1:Sell 2 policies / month x 12 months = $3,600 Year 2:$3,600 commission from year 1 sales Year 3:$3,600 commission from year 1 sales Year 4:$3,600 commission from year 1 sales Year 5:$3,600 commission from year 1 sales Year 6:$3,600 commission from year 1 sales TOTAL:$21,600 commission from year 1 sales $400 commission from Med Adv plan sale* Year 1:Sell 2 plans / month x 12 months = $9,600 Year 2:$18.00 commission / month = $216 from year 1 sales Year 3:$0 commission from year 1 sales Year 4:$0 commission from year 1 sales Year 5:$0 commission from year 1 sales Year 6:$0 commission from year 1 sales TOTAL:$9,816 commission from year 1 sales *Commission varies by state and contract level. For authorized agent use only. Not for public use.

29 “So, where can I find the answers to common questions about Medicare Supplement plans, rules and enrollment, etc.?” For authorized agent use only. Not for public use.

30  You can find the answers to any questions you may have about Medicare Supplement plans, rules, enrollment, etc. in the Guide to Health Insurance for People with Medicare, or the company’s underwriting guide. Medicare Supplement For authorized agent use only. Not for public use.

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32 “What if I have reviewed this presentation and still have questions?” For authorized agent use only. Not for public use.

33 Medicare Supplement  Standard Life and Accident Insurance Company has highly trained Marketing Specialists available to give you personalized service from 8:00 am – 4:30 pm CT, Monday through Friday. They can help you with any questions you may have regarding Medicare Supplements.  Call: 888.290.1085 or Email: standard.marketing@slaico.com For authorized agent use only. Not for public use.

34 The following slides will give you a more detailed overview of the Federal Medicare program. For authorized agent use only. Not for public use.

35 Federal Medicare Supplement Overview  Medicare is the nation’s largest health insurance program, covering approximately 42 million Americans  Administered by the Centers for Medicare & Medicaid Services (CMS)  The Medicare Program has four parts: oPart A – Hospital Insurance oPart B – Medical Insurance oPart C – Medicare Advantage Plans oPart D – Prescription Drug Insurance For authorized agent use only. Not for public use.

36 Federal Medicare Supplement Overview: Part A  Hospital Insurance: Pays benefits for: oInpatient hospital care oSkilled Nursing Facility Care oHome Health Care oHospice Care  No Premiums  Deductibles and co-insurances do apply per length of stay For authorized agent use only. Not for public use.

37 Federal Medicare Supplement Overview: Part B  Medical Insurance: Pays benefits for: oPhysician services oOutpatient hospital care oOutpatient mental health services oLaboratory fees oDurable Medical Equipment oBlood glucose meters, test strips and lancets oSome drugs in certain cases oOutpatient Physical/Occupational/ Speech therapy  Voluntary Benefit  Premium for 2008 is $96.40* *May be higher dependent on your tax return. For authorized agent use only. Not for public use.

38 Federal Medicare Supplement Cost “Gaps” in Original Medicare *May be higher dependent on your tax return.  Part B premium $96.40*/month  $1,024 deductible/ hospital stay days 1-60  $256/day coinsurance for hospital days 61-90  $512/day coinsurance for hospital days 90+ (60-day maximum over lifetime)  All costs over 150 days  All costs first 3 pints blood in inpatient stay  $128/day for days 21-100 in skilled nursing facility  All costs past 100 days in skilled nursing facility  $135 annual Part B deductible  20% coinsurance for Medicare approved cost of physician services  50% of cost for outpatient mental health services  All cost first 3 pints of blood as outpatient, then 20% of cost  20% coinsurance for other medical services For authorized agent use only. Not for public use.

39 The Standard Life and Accident Insurance Company Medicare Supplement Field Underwriting Manual The Standard Life and Accident Insurance Company Medicare Supplement Field Underwriting Manual For authorized agent use only. Not for public use.

40 The underwriting manual is designed in a simple and easy to understand format, and provides you with the procedures for completing and submitting an application for both the traditional Medicare Supplement and Medicare SELECT health insurance policies. Medicare Supplement Field Underwriting Manual For authorized agent use only. Not for public use.

41 The following slides give examples of the type of detailed information you will find in the Medicare Supplement Field Underwriting Manual. For authorized agent use only. Not for public use.

42 Under Completing the Application, each section of the application is broken down and each question thoroughly explained. For example, Page 5 of the manual contains an explanation of Section B, Question 4: Medicare Supplement Field Underwriting Manual “Question 4: Indicate whether the application is for a new policy or for reinstatement. Please indicate the plan being applied for by filling in the proper letter designation and whether the client wants the traditional Medicare Supplement form or the Medicare SELECT version. The application also asks for the gender type and whether the Applicant has used tobacco products. Please check the appropriate boxes.” For authorized agent use only. Not for public use.

43 The Special Enrollment States section, contains current state rules for open enrollment. For example: Medicare Supplement Field Underwriting Manual CALIFORNIA All standardized Medicare Supplement Plans offered by SLAICO are available to California Medicare Supplement policy owners during an annual open enrollment period for a period of 30 days after their birthday. During this time period an insured is eligible to apply for any carrier’s policy providing the same or lesser benefits as their current coverage. All standardized Medicare Supplement Plans offered by SLAICO are available on an open enrollment basis to California residents who are under age 65 and are disabled Medicare beneficiaries and who became covered by Part B due to disability during the past six months. This eligibility does not apply if the individual qualified by reason of End Stage Renal Disease. Special premium rates will be used for these individuals who are under age 65. Refer to the outline of coverage. For authorized agent use only. Not for public use.

44 The Unacceptable Health Conditions Section gives an extensive list of reasons and unacceptable medical conditions. There is no need to guess whether or not your client will be denied coverage. Medicare Supplement Field Underwriting Manual For authorized agent use only. Not for public use.

45 The Standard Life and Accident Insurance Company Pocket-sized Easy Medicare Supplement Underwriting Guide The Standard Life and Accident Insurance Company Pocket-sized Easy Medicare Supplement Underwriting Guide

46 Medicare Supplement Pocket-sized Field Underwriting Guide The purpose of this handy pocket-sized guide is to make the underwriting process as easy as possible. You know where you and your Applicant stand with Standard Life and Accident Insurance Company (SLAICO) from start to finish.

47 Medicare Supplement Pocket-sized Field Underwriting Guide The pocket-sized field underwriting guide puts vital information at-a-glance, such as the weight chart, application submission guidelines and state specific special enrollment information.

48 Standard Life and Accident Insurance Company has a Medicare Supplement plan to fit most every client’s budget and needs. For authorized agent use only. Not for public use.

49 The following slides will introduce you to some of our most popular Medicare Supplement plans – E, F, F(HD) and G For authorized agent use only. Not for public use.

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51 Some of the Plan E benefits include: Medicare Supplement Outline of Coverage – Plan E * See Outline of Coverage or Policy for details.  Part A Deductible coverage*  Coinsurance payment coverage for Medicare approved stays in a Skilled Nursing Facility for days 21 through 100*  Foreign Travel emergency care services not covered by Medicare* For authorized agent use only. Not for public use.

52 In addition, Plan E benefits include the first $120* each calendar year of preventive medical care not covered by Medicare such as some annual physical and preventive tests and services administered or ordered by your doctor.** Medicare Supplement Outline of Coverage – Plan E ** See Outline of Coverage or Policy for details. * Benefit subject to change. For authorized agent use only. Not for public use.

53 Some of the Plan F and F(HD) benefits include: Medicare Supplement Outline of Coverage – Plans F and F(HD) * See Outline of Coverage or Policy for details.  Part A Deductible coverage*  Part B Deductible coverage*  100% coverage of Part B Excess charges above Medicare approved amounts*  Coinsurance payment coverage for Medicare approved stays in a Skilled Nursing Facility for days 21 through 100* For authorized agent use only. Not for public use.

54 In addition: * See Outline of Coverage or Policy for details.  Foreign Travel emergency care services not covered by Medicare* Medicare Supplement Outline of Coverage – Plans F and F(HD) For authorized agent use only. Not for public use.

55 * See Outline of Coverage or Policy for details.  In 2008, the deductible for High Deductible Plan F $1,900. However, the premium for these plans are a fourth, sometimes even a fifth of the cost of other Medicare Supplement plans, depending on the state and other varying factors Medicare Supplement Outline of Coverage – Plan F(HD) For authorized agent use only. Not for public use.

56 Some of the Plan G benefits include: Medicare Supplement Outline of Coverage – Plan G * See Outline of Coverage or Policy for details.  Part A Deductible coverage*  80% coverage of Part B Excess charges above Medicare approved amounts*  Coinsurance payment coverage for Medicare approved stays in a Skilled Nursing Facility for days 21 through 100* For authorized agent use only. Not for public use.

57 In addition: Medicare Supplement Outline of Coverage – Plan G * See Outline of Coverage or Policy for details.  Foreign Travel emergency care services not covered by Medicare*  At-Home Recovery services not covered by Medicare, up to $40 per visit and up to $1,600 per calendar year* For authorized agent use only. Not for public use.

58 Standard Life and Accident Insurance Company is a hands on company.

59 For authorized agent use only. Not for public use. We take pride in offering you all the tools necessary to make selling Medicare Supplement plans simple and easy.

60 For authorized agent use only. Not for public use. Call us today to find out how easy it is for you to get started.

61 For authorized agent use only. Not for public use. Standard Life and Accident Insurance Company 888.290.1085 standard.marketing@slaico.com


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