Senior Retirement Service Presenting Medicare and You For your Future Presented By Senior Advisor A. Cherie Kolinski

Understand your Medicare choices We Will Help You … Understand your Medicare choices Unravel the mysteries of Medicare Understand your options and make the right choice

What is Medicare? A health insurance program established in 1965 Provides health coverage to millions of people People age 65 and over People who are disabled People who are in Permanent Kidney Failure Tf the Social Security Act was in 1935 by Franklin D Roosevelt and then the Medicare health insurance program was established in 1965 by Lynden B Johnson and in 1972 it was expanded to cover Disability. Now Providing health coverage to over 44 million people People age 65 + People who are disabled People who are in permanent kidney failure

About Medicare Insurance Company's Med-Supp policies Can apply 3 months prior to turning 65 Medicare Insurance Insurance Company applications to be taken up to six months in advance of Medicare effective date if, First-time Med-Supp applicants age 64½ and above Not currently on a Med-Supp disability policy CMS regulation allows applicants to apply 3 months prior to turning 65 United American allows advance dating Up to six months in advance of Medicare effective date. For first-time Med-Supp applicants age 64½ and above or Not currently on a Med-Supp disability policy

Medicare Basics – Medicare Advantage (Part C) Optional Part D Part A Part B Usually Part D Can not join a Medicare Advantage Plan (Part C) and purchase a Medicare Supplement Insurance (Medigap) policy

Medicare Basics – Original Medicare Optional Part D Part A Part B Optional Medicare Supplement Insurance (Medigap)

Medicare Part A – Hospital Automatic Enrollment (if receiving Social Security benefits) Eligible at age 65, or 2 years on disability Premium-free for most people, if Eligible for Social Security or Railroad benefits You or your spouse had Medicare-covered government employment Source: medicare.gov

Medicare Part A – Hospital Medicare Part A – Coverage Inpatient Hospital Room and Board Skilled Nursing Facility (not Long Term Care) Hospice and Respite Care services Some Home Health Care services Blood Source: medicare.gov

Medicare Part A – Hospital (Out-of-Pocket Costs) Day 1-60 $1156 Deductible Day 61-90 $289 per day Day 91-150 $578 per day SKILLED NURSING CARE: Minimum 3 day hospital stay Day 1-20 Covered Day 21-100 $144.50 per day BLOOD First 3 pints usually covered HOSPICE CARE Terminally ill with less than 6 months to live Hospital Day 1-60 $1,364 Deductible Day 61-90 $341 per day Day 91-150 $682 per day Skilled Nursing Care Minimum 3 day hospital stay Day 1-20 Covered Day 21-100 $170.50 per day Hospice Care Terminally ill (with less than 6 months to live) Blood First 3 pints usually covered Source: medicare.gov

Medicare Part B – Medical Optional Enrollment Can delay Part B enrollment if on Employer Group Medical Plan Monthly Premium (deducted from Social Security check) $135.50 (income dependent) Enroll 3 months prior to age 65 (including month of birthday) Enroll no later than 3 months after birthday – 7 months total Source: medicare.gov

Medicare Part B – Medical Medicare Part B – Coverage Doctor Services Outpatient Care ‘Welcome to Medicare’ visit Preventive Services (flu shots) Ambulance Services Doctor services Outpatient care ‘Welcome to Medicare’ visit Preventative services (flu shots) Ambulance services Source: medicare.gov

Medicare Part B – Medical Medicare Part B – Coverage (continued) Cancer Screenings and Chemo Diabetes Screenings and Supplies Durable Medical Equipment Limited Chiropractic, Vision, Hearing OT/PT and Laboratory Services Cancer screenings & chemo Diabetes screenings & supplies Durable medical equipment Limited chiropractic, vision, hearing OT/PT and Laboratory Services

Medicare Part B – Medical [ Out-of-Pocket Costs ] HOSPITAL: Day 1-60 $1156 Deductible Day 61-90 $289 per day Day 91-150 $578 per day SKILLED NURSING CARE: Minimum 3 day hospital stay Day 1-20 Covered Day 21-100 $144.50 per day BLOOD First 3 pints usually covered HOSPICE CARE Terminally ill with less than 6 months to live Premium $135.50 per month deducted from Social Security check Deductible $185 per year Coinsurance 20% of Medicare approved charges PREMIUM: $104.90 per month Deducted from Social Security check ANNUAL DEDUCTIBLE: $166 COINSURANCE 20% Source: medicare.gov

Medicare Part D – Prescription Drug Enroll After Parts A and B Guaranteed Acceptance Can get with a Medicare Advantage Plan Can get as a Stand Alone Prescription Drug Plan (PDP) May pay penalty if not enrolled when first eligible Enroll after Parts A/B Guaranteed acceptance Can get with a Medicare Advantage Plan Can purchase stand alone Prescription Drug Plan (PDP) May pay penalty if not enrolled when first eligible * NEED SOURCE

Medicare Part D – Prescription Drug (d) Can get Low Income Subsidy (LIS)/Extra Help Assistance: Single Income < $17,655; Resources < $13,640* Couples Income < $23,895; Resources < $27,250* Must Select a Private Drug Plan Choose by Plan Formulary *Income limits are currently based on 2015 income limitHealth & Human Services Centers for Medicare s at 150% of poverty and will be updated in early 2016. Source: Department of & Medicaid Services Can get Low Income Subsidy (LIS)/Extra Help assistance: Single Income < $17,655/Yr; Resources < $13,640* Couples Income < $23,895/Yr ; Resources < $27,250* Must select a private drug plan Choose by plan formulary Etc.

Medicare Part C – Medicare Advantage About Medicare Part C Can join or switch plans only during certain times of the year Must cover at least what Medicare covers Some plans charge small monthly premiums, others do not The Maximum out-of-pocket (MOOP) costs vary by plan and can go up to $10,000 Can join or switch plans only during certain times of the year Must cover at least what Medicare covers Some plans charge small monthly premiums, others do not The Maximum Out-of-Pocket (MOOP) costs vary by plan and can go up to $10,000

Medicare Part C – Medicare Advantage About Medicare Part C Benefits and Premiums can change annually You cannot own a Medicare Supplement and a Medicare Advantage plan NOT Guaranteed Renewable You cannot own a Medicare Supplement with a Medicare Advantage (PD) plan Benefits and Premiums can change annually Over last few years, MOOP expenses have climbed exponentially Advantage plans are NOT guaranteed renewable (plan member)

Medicare Part C – Medicare Advantage About Medicare Part C Some plans have certain rules to follow, like referrals, etc. You may have to use providers who belong to the plan Insurers can opt out of these plans Doctors can opt out of these plans Hospitals can opt out of these plans Some plans have certain rules to follow, like referrals, etc. You may have to use certain providers who belong to the plan Insurers can opt out of these plans Doctors can opt out of these plans Hospitals can opt out of these plans

Medicare Supplement Plans (Medigap) Plans available to help cover the Gap Medicare Approved Charges Excess Charges GAP Senior Pays Excess Charges Senior Pays 20% Medicare Pays 80% Senior Pays Deductibles, Coinsurance, and Copays Helps covers the “gaps” in Medicare: Deductibles Coinsurance Copays Excess Charges These amounts change each year but Medigap plans cover it

Medicare Supplement Plans (Medigap) All Med-Supp Plans are Guaranteed Renewable Flexibility and Freedom to Choose Any Doctor * NO referrals Any Hospital * NO networks Any Specialist * All Medicare Supplement plans are GUARANTEED RENEWABLE Flexibility and Freedom to choose any Doctor, Hospital, or Specialist that takes Medicare with NO referrals and NO networks * That accepts Medicare

Medicare Supplement Plans (Medigap) All Companies Must Follow Federal and State Laws Costs Vary By Companies Vary By Company Ratings Where you Live Stability Plan Selected All companies must follow Federal and State laws Costs vary by company, where you live, and by the plan Financial ratings and stability vary by com

Medicare Supplement Plans How are Medicare Supplement plans priced? Issue Age Rated 65 $ 66-69 70-75 76-79 80+ Premium based on age when policy purchased Issue Age Rated Premium based on age when policy purchased

Medicare Supplement Plans United American’s Medicare Supplement Plans in Florida Issue Age Rated Premium based on age when policy purchased Sex Distinct Premium rated on policyholder’s gender Preferred Rates No tobacco use

Medicare Supplement Plans Rate Adjustments Helps keep pace with Rising Medicare claim trends Changes in annual deductibles

Medicare Supplement Open Enrollment Qualifiers Enrolled in Medicare Parts A and B Within 6 months before and after you turn age 65 Cannot be denied during the Open Enrollment period Cannot be charged more because of health Medicare Supplement Guaranteed Issue Qualifiers Must be on Original Medicare and Involuntarily Disenrolled from your Employer’s Group Health Plan Involuntarily Disenrolled from your Medicare Advantage Plan Must go through underwriting if outside Open Enrollment Must be enrolled in Medicare PARTS A & B 6 months before and 6 months after you turn 65 Cannot be denied during this Guaranteed Issue period Cannot be charged more because of health If replacing an existing Medigap plan (creditable coverage) No waiting period No pre-existing limitations NOTE: Must go through underwriting if outside Open Enrollment or Guaranteed Issue Periods Involuntarily disenrolled from your employer’s plan Involuntarily disenrolled from your employer’s Medicare Advantage (PD) plan No pre-exisitng NOTE: Must go through underwriting if outside Open Enrollment or Guaranteed Issue Period Source: medicare.gov

Medicare Advantage 2014 Pre-Enrollment Period October 1 – October 14 Annual Election Period (AEP) October 15 – December 7 Annual Disenrollment Period January 1 – February 14 Pre-Enrollment Period Annual Election Period (AEP) Annual Disenrollment Period Oct 1 – Oct 14 Oct 15 – Dec 7 Jan 1 – Feb 14 Pre-Enrollment Period October 1 – October 14 Annual Election Period (AEP) October 15 – December 7 Annual Disenrollment Period January 1 – February 14 Source: medicare.gov

Today’s Medicare Environment Includes more Coverage Options for You! Includes all the benefits of: Original Medicare (Part A-Hospital) (Part B-Medicare) Or Medicare Advantage health plan only (MA only) MA only with stand-alone Part D MAPD-MA health plan with Part D included

How do I Choose… Which plan is right for me? Do you want to choose your own specialists without referrals and not worry about networks? YES

How do I Select a Carrier ? Why choosing a carrier is important How quickly do they issue policies and pay claims? Split into multiple slides -mt

Split into multiple slides -mt Why choosing a carrier is important Do they outsource their Customer Service call center or is it here in the USA? Split into multiple slides -mt

Thank You Cherie Kolinski SENIOR RETIREMENT SERVICES 1-800-588-1798