Keith Taylor Area Manager

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Presentation transcript:

Keith Taylor Area Manager USA Benefits Group (800) 748-4382 United American Insurance Company is not connected with or endorsed by the U.S. Government or federal Medicare program.

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

1 What is Medicare and what are my CHOICES? Choices Five Questions How do I CHOOSE? How do I determine which plan is right for me? Where do I buy my plan? Which carrier should I use?

2 How do I CHOOSE? Choices Five Questions Five Questions: What is Medicare and what are my CHOICES? How do I CHOOSE? How do I determine which plan is right for me? Where do I buy my plan? Which carrier should I use?

3 How do I determine which plan is right for me? Choices Five Questions 3 How do I determine which plan is right for me? Five Questions: What is Medicare and what are my CHOICES? How do I CHOOSE? How do I determine which plan is right for me? Where do I buy my plan? Which carrier should I use?

4 Where do I buy my plan? Choices Five Questions Five Questions: What is Medicare and what are my CHOICES? How do I CHOOSE? How do I determine which plan is right for me? Where do I buy my plan? Which carrier should I use?

5 Which carrier should I use? Choices Five Questions Five Questions: What is Medicare and what are my CHOICES? How do I CHOOSE? How do I determine which plan is right for me? Where do I buy my plan? Which carrier should I use?

A health insurance program established in 1965 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 A health insurance program established in 1965 Provides health coverage to 44 million people People age 65 + People who are disabled People who are in permanent kidney failure

About United American Insurance Company Med-Supp policies Can apply 3 months prior to turning 65 United American 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 Not currently on a Med-Supp disability policy

The Different Parts of Medicare Medicare Part A (Hospital Insurance) Helps cover inpatient care while in the hospital Helps cover skilled nursing facility, hospice, and home health care Medicare Part A (Hospital Insurance) Helps cover inpatient care while in the hospital Helps cover skilled nursing facility, hospice, and home health care

The Different Parts of Medicare Medicare Part A (Hospital Insurance) Medicare Part B (Medical Insurance) Helps cover doctors' services, hospital outpatient care, and home health care Helps cover some preventive services to help maintain your health and to keep certain illnesses from getting worse Medicare Part B (Medical Insurance) Helps cover doctors' services, hospital outpatient care, and home health care Helps cover some preventive services to help maintain your health and to keep certain illnesses from getting worse

The Different Parts of Medicare Medicare Part A (Hospital Insurance) Medicare Part B (Medical Insurance) Medicare Part D (Medicare Prescription Drug Coverage) A prescription drug option run by Medicare-approved private insurance companies Helps cover the cost of prescription drugs May help lower prescription drug costs and help protect against higher costs in the future Medicare Part D (Medicare Prescription Drug Coverage) A prescription drug option run by Medicare-approved private insurance companies Helps cover the cost of prescription drugs May help lower prescription drug costs and help protect against higher costs in the future

The Different Parts of Medicare Medicare Part A (Hospital Insurance) Medicare Part B (Medical Insurance) Medicare Part D (Medicare Prescription Drug Coverage) Learn more about Medicare including Medicare Part C (Medicare Advantage Plans) at Medicare.gov Learn more about Medicare including Medicare Part C (Medicare Advantage Plans) at Medicare.gov

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

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

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 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/domestic partner 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 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 $1,216 Deductible Day 61-90 $304 per day Day 91-150 $608 per day Skilled Nursing Care Minimum 3 day hospital stay Day 1-20 Covered Day 21-100 $152 per day Hospice Care Terminally ill (with less than 6 months to live) Blood First 3 pints usually covered Hospital Day 1-60 $1,216 Deductible Day 61-90 $304 per day Day 91-150 $608 per day Hospice Care Terminally ill (with less than 6 months to live) Skilled Nursing Care Minimum 3 day hospital stay Day 1-20 Covered Day 21-100 $152 per day 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) $104.90 (income dependent) Enroll 3 months prior to age 65 (excluding month of birthday) Enroll no later than 3 months after birthday – 7 months total Optional Enrollment Can delay Part B enrollment if on Employer Group Medical Plan Monthly Premium (deducted from Social Security check) $104.90 (income dependent) Enroll 3 months prior to age 65 (excluding 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 Medicare Part B – Coverage 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 Medicare Part B – Coverage (continued) Cancer screenings & chemo Diabetes screenings & supplies Durable medical equipment Limited chiropractic, vision, hearing OT/PT and Laboratory Services Source: medicare.gov

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 $104.90 per month deducted from Social Security check Deductible $147 per year Coinsurance 20% of Medicare approved charges PREMIUM: $104.90 per month Deducted from Social Security check ANNUAL DEDUCTIBLE: $147 COINSURANCE 20% Source: medicare.gov

A/B Chart F3095 A/B Chart 2014

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 (continued) Can get Low Income Subsidy (LIS)/Extra Help Assistance: Single Income < $17,235; Resources < $13,440* Couples Income < $23,265; Resources < $26,860* Must Select a Private Drug Plan Choose by Plan Formulary Can get Low Income Subsidy (LIS)/Extra Help assistance: Single Income < $17,235/Yr; Resources < $13,440* Couples Income < $23,265/Yr ; Resources < $26,860* Must select a private drug plan Choose by plan formulary *Income limits are currently based on 2013 income limits at 150% of poverty (all states excluding AK & HI) and will be updated in early 2014. Source: Department of Health & Human Services Centers for Medicare & Medicaid Services

Medicare Part D – Prescription Drug (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 Varies based on which plan and company you choose Deductible $310 per year (some plans have $0 deductible) Coverage Gap (Donut Hole) Annual out-of-pocket exceeds $2,850 up to $4,550 Includes copays, coinsurance, and deductibles Catastrophic Coverage Annual out-of-pocket meets or exceeds $4,550 Small copay for all prescription drugs PREMIUM: Depends which plan and company you choose ANNUAL DEDUCTIBLE: $310 (some plans have $0) COVERAGE GAP (Donut hole): Annual Out-of-Pocket exceeds $2,850 up to $4,550 Includes copays, coinsurance, and deductibles CATASTROPHIC COVERAGE: Annual Out-of-Pocket meets or exceeds $4550 Small copay for all RX Source: medicare.gov

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 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 Source: medicare.gov

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 About Medicare Part C 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 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 About Medicare Part C 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 Supplement Plans (Medigap) Plans available to help cover the ‘gaps’ in Medicare 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) 11 Standardized plans available A B C D F F HDF G K L M N Plan F is the most comprehensive 11 Standardized plans available: Plan F is most comprehensive

United American Medicare Supplement Plans (Medigap) Available Not Available Med-Supp not available in every state Plan availability varies by state and insurer MN NJ MA NY Not available in every state, some states have plans that vary First United American Life Insurance Company markets Med-Supp plans in New York

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 Offered by United American Insurance Company Basic Benefits Skilled Nursing Facility Coinsurance Part A Deductible – $1,216 Part B Deductible – $147 Excess Doctor Charges Foreign Travel Emergency Calendar-Year Deductible, or Out-of-Pocket Annual Limit Hospitalization (Part A Coinsurance) Medical Expenses (Part B Coinsurance) Blood Hospice A  100% B  100% C  100% 80% D  100% 80% F  100% 80% HDF  100% 80% $2,140 G  100% 80% K  50% $4,940 L  75% $2,470 N  Copay 80% Plans offered by UA: A, B, C, D, F, HDF, G, K, L, & N Plan NOT offered by UA: M

Medicare Supplement Plans How are Medicare Supplement plans priced? Community Rated All Ages $ Issue Age Rated 65 $ 66-69 70-75 76-79 80+ Attained Age Rated 65 $ 66 67 68 69 70 Etc. Everyone pays the same premium Premium based on age when policy purchased Community Rated Everyone pays the same premium Issue Age Rated Premium based on age when policy purchased Attained Age Rated Premium changes annually on policyholder’s birth date Premium changes annually on policyholder’s birth date

Medicare Supplement Plans United American’s Medicare Supplement Plans in State Name Community/Attained Age/Issue Age Rated Everyone pays the same premium / Premium changes annually on policyholder’s birth date / Premium based on age when policy purchased Sex Distinct Premium rated on policyholder’s gender Preferred Rates No tobacco use Community/Attained Age/Issue Age Rated Everyone pays the same premium / Premium changes annually on policyholder’s birth date / 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 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 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

A: They raise their deductible … Premium Savings Q: How do people save money on any kind of insurance (health, car, homeowners)? A: They raise their deductible … And Save Premiums $$$

Popular Medicare Supplement Plans Basic Benefits Skilled Nursing Facility Coinsurance Part A Deductible – $1,216 Part B Deductible – $147 Excess Doctor Charges Foreign Travel Emergency Calendar-Year Deductible, or Out-of-Pocket Annual Limit Hospitalization (Part A Coinsurance) Medical Expenses (Part B Coinsurance) Blood Hospice Plan F  100% 80% Plan HDF  100% 80% Foreign Travel $250 deductible $50,000 max $2,140

For Illustrative Purposes Only HDF Claim Example Michelle has an HDF policy What happens when she has a Part B claim? Total approved Part B Doctor Claim $100 Medicare’s 80% of Approved Charge $80 Customer’s 20% of Approved Charge $20 If deductible is reached Senior owes $0 * * Policyholder must meet HDF calendar-year deductible ($2,140 in 2014) before benefits begin, and pay his/her HDF premiums. For Illustrative Purposes Only

Premium Savings Example How HDF may be suitable coverage for Senior health needs AND budget Husband Wife Plan F monthly premium $209 $184 Plan HDF monthly premium * $38 $33 Monthly Premium Savings $171 $151 Current rates as of January 2013 * UA ProCare, Age 65 Nonsmoker, National Average For Illustrative Purposes Only

Premium Savings Example How HDF may be suitable coverage for Senior health needs AND budget Husband Wife Monthly Premium Savings $171 $151 12 Months 12 Annual Premium Savings * $2,052 $1,812 $3,864 Combined Annual Premium Savings * Example assumes no rate increases on either plan; policyholder must meet HDF calendar-year deductible ($2,140 in 2014) before benefits begin For Illustrative Purposes Only

Premium Savings Example Potential premium savings over 10-year period Husband Wife Annual Premium Savings * $2,052 $1,812 10 Years 10 10 Year Premium Savings $20,520 $18,120 $38,640 Combined Premium Savings * Example assumes no rate increases on either plan; policyholder must meet HDF calendar-year deductible ($2,140 in 2014) before benefits begin For Illustrative Purposes Only

Not Available in NY and VT Reserve Fund Annuity Save to pay Med-Supp deductible or copayment Interest rate guaranteed No lock-in time for deposits $50 minimum deposit $5,000 per year maximum deposit No start-up costs, surrender fees, or commission loads Can be purchased along with Medicare Supplement plans A, B, D, HDF, G, K and L 3% Policy Form USFMS Not Available in NY and VT RESERVE FUND ANNUITY UA offers a unique product – RFA assists Med-Supp policyholders with paying HDF calendar- year deductible or copayment RFA’s interest rate is guaranteed at 3% No lock-in time for deposits, open with as little as $50 (up to a maximum of two times the annual deductible or $4,280 initial deposit in 2014) and can deposit up to $5,000 per year No start-up costs, no surrender charges, and no commission loads Can be purchased along with Medicare Supplement plans A, B, D, HDF, G, K and L Not Available in NY and VT

How do I Choose… Which plan is right for me? If turning 65, you have this one-time Open Enrollment Period. The decision you make today affects the quality of your care tomorrow.

YES How do I Choose… Which plan is right for me? Do you want the flexibility and freedom to choose your own Doctors? YES

YES 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

YES How do I Choose… Which plan is right for me? Do you want to choose the best cancer treatment facilities available? YES

MAYBE How do I Choose… Which plan is right for me? Do you want to pay a lower premium to save? MAYBE

YES How do I Choose… Which plan is right for me? Do you want the flexibility, security, and stability of a Guaranteed Renewable Medicare Supplement policy? YES

MAYBE How do I Choose… Which plan is right for me? Do you want a plan that includes foreign travel? MAYBE

MAYBE How do I Choose… Which plan is right for me? I’m not sure what my health will be like 3-5 years from now. Should I consider a lower-cost plan and switch to a better plan down the road? MAYBE

Split into multiple slides -mt How do I Select an Agent? Do your HOMEWORK! Choose an informed local Agent. OKAY Split into multiple slides -mt

Split into multiple slides -mt How do I Select an Agent? Do your HOMEWORK! Ask about their qualifications and designations. OKAY Split into multiple slides -mt

Split into multiple slides -mt How do I Select an Agent? Do your HOMEWORK! Ask how long they’ve been selling insurance/Medicare products. MAYBE Split into multiple slides -mt

Split into multiple slides -mt How do I Select an Agent? Do your HOMEWORK! Ask how long have they been a licensed Agent. MAYBE Split into multiple slides -mt

How do I Select a Carrier? Why choosing a carrier is important Why is an A+ (Superior) rating important to me? How long has the carrier been in the Med-Supp business? Split into multiple slides -mt

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

How do I Select a Carrier? 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

United American Insurance Company Background History Industry Ratings United American in business since 1947 One of the nation's leading writers of individual Medicare Supplements* A+ (Superior), the second highest Financial Strength Rating from A.M. Best Company for more than 35 consecutive years (as of 6/13) A+ “Strong” Financial Strength Rating from Standard & Poor’s (as of 7/13) United American opened its doors in 1947 to provide life, supplemental health, and accident coverage to individuals. Even before Medicare was signed into law in 1966, the Company made the decision to focus its attention on the individual health market with an emphasis on Seniors. This foresight paid off and we gained recognition as one of the nation's leading writers of individual Medicare Supplements. * * NAIC Medicare Supplement Loss Ratios, 2011 Medicare Supplement Insurance Experience Report, July 2012 Industry Ratings * Source: NAIC Medicare Supplement Loss Ratios, 2011 Medicare Supplement Insurance Experience Reports, July 2012

United American Insurance Company is not connected with or endorsed by the U.S. Government or federal Medicare program. Policies and benefits may vary by state and have some limitations and exclusions. Individual Medicare Supplement policy forms MSA10, MSB10, MSC10, MSD10, MSF10, MSHDF10, MSG10, MSK06, MSL06, MSN10, and MC4810 in WI are available from our Company where state approved. Some states require these plans be available to persons eligible for Medicare due to disability. This is a solicitation for Medicare Supplement Insurance policies. You may be contacted by an Agent /Producer representing United American Insurance Company.