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2010 Modernized Plans Overview

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Presentation on theme: "2010 Modernized Plans Overview"— Presentation transcript:

1 2010 Modernized Plans Overview
Hi I am [Name], [Title], with Mutual of Omaha. Please join me as we walk through the 2010 Medicare supplement modernized plans. Feb-19 For Producer Use Only

2 Overview Following the Medicare, Prescription Drug, Improvement and Modernization Act of 2003 (MMA), the NAIC was encouraged to modernize the Medigap market Following the Medicare, Prescription Drug, Improvement and Modernization Act of 2003, the NAIC was encouraged to modernize the Medigap market. Feb-19 For Producer Use Only

3 2010 Medigap Modernization
Summary of Changes effective June 1, 2010 Action Benefit Affected Plans Notes Eliminate Plan E Becomes identical to Plan D once the preventive care and at-home recovery benefits are removed Plans H, I & J Duplicates Plan F & G once the preventive and at-home recovery benefits are removed Remove At –home recovery D, G (I and J) Plans I and J are eliminated Preventive care (E and J) Plans E and J are eliminated Increase Part B Excess charges coverage from 80% to 100% Plan G Create Hospice All Plans: A, B,C, D, F, G, K, L and high deductible F Becomes part of the basic (core) benefits Plans M and N Offer higher cost-sharing at lower premiums Changes to the 2010 Medigap modernization plans take effect June 1, The changes that will take affect are shown here…..[read the chart out loud]. Feb-19 For Producer Use Only

4 Availability Standardized plans available for sale with coverage effective dates through May 31, 2010 Modernized plans available for sale with coverage effective dates on or after June 1, 2010 NOTE: Carriers are required to file with the states the new Modernized plans. You can not sell any plan with effective dates June 1, 2010 and after until the state has approved these filed new plans. The standardized plans are available for sale with coverage effective dates through May 31, 2010 while the Modernized plans are available for sale with coverage effective dates on or after June 1, 2010. Please Note: Carriers are required to file with the states the new Modernized plans. You can not sell any plan with effective dates June 1, 2010 and after until the state has approved these filed new plans. Feb-19 For Producer Use Only

5 2010 Plans Outline of Coverage
Notice that Plan E is no longer available Notice that Plans H, I , J are no longer available Plans M & N New Basic now includes a Hospice Benefit Here, we can see the changes to the 2010 Outline of Coverage….[read the arrows on the chart]. At home recovery removed Excess Part B 100% up from 80% Feb-19 For Producer Use Only

6 Q & A on Plan Changes Question Answer
Why is At-Home Recovery being eliminated? Underutilized and outdated benefit given the limited availability of the benefit in the old plans. Why is the Preventive Care Benefit being eliminated? Underutilized and outdated benefit given the enhanced benefits that are now available under Medicare Part B. What is the change with the Hospice benefit? Will be added as a Basic (core) benefit. The new benefit covers cost sharing for all Part A eligible hospice and respite care expenses. Today, if individual has Medicare they pay: $0 for hospice care Copay of $5 per outpatient prescription for outpatient prescription drugs for pain and symptom management 5% of the Medicare-approved amount for inpatient respite care (short-term care given by another caregiver, so the usual caregiver can rest). This does not include room and board. Here we can see some of the more popular questions we often get on plan changes. Lets go through and answer each of these questions….First, [read the slide]. Feb-19 For Producer Use Only

7 Q & A on Offerings and Transition
Question Answer Can carriers still continue to offer only Plan A? Yes Must companies offer both Plan C and Plan F with the new changes? No. If a carrier wants to offer more than just Plan A, then it must also offer either Plan C or Plan F. It does not have to offer both. What if a beneficiary in an existing Medigap policy would like to get a new 2010 standardized policy? Revised model allows but does not require companies to offer existing policyholders the opportunity to exchange their current policy for a new policy without medical underwriting. Can the new plans be marketed prior to June 1, 2010? Yes, however they can not have an effective date prior to June 1, 2010. How will the rates be in comparison to the old plans? Unless a state passes regulations more stringent than the new model, it appears that carriers will have the opportunity to re-price all plans. In addition, possibly consider the 2010 plans to be a separate block of business. Shown here are some additional questions on offerings and transition of plans. Lets go through these questions as well and answer each of these….First, [read the slide]. Feb-19 For Producer Use Only

8 Plans M and N NEW PLANS EFFECTIVE JUNE 1, 2010 Basic Benefit Includes:
Inpatient hospital care- Part A coinsurance Medical costs- Part B coinsurance First 3 pints of blood each year Part A hospice coinsurance or copayment (New effective June 1, 2010) X-indicates covered NEW PLANS EFFECTIVE JUNE 1, 2010 Medicare Supplement Benefit Plan M Plan N Basic Benefits X Skilled Nursing Facility Coinsurance Part A Deductible 50% Part B Deductible Part B Coinsurance 100% 100% Except for Up to $20 copay for Doctor visit Up to $50 copay for ER visit Foreign Travel Emergency As I mentioned earlier, Plans M and N are both new plans that are effective on June 1, The basic benefits of these plans are shown here, and include: -Inpatient hospital care – Part A coinsurance -Medical costs – Part B coinsurance -First three pints of blood each year; and -Part A hospice coinsurance or copayment (this is new and effective June 1, 2010) Feb-19 For Producer Use Only

9 Questions on Mutual’s Medicare Supplement
Answer Will my clients have to switch to the new plans? For example, they have a Plan F today , must they convert to the new modernized Plan F? No, your client is not required to convert to a current modernized plan. Your client may keep these current plans as long as they pay their premiums-coverage is guaranteed renewable for life. Will my clients lose their Plan J? No. Individuals may keep their current plans. Plan J does have a Guarantee Issue conversion privilege that allows them to replace it anytime with another Medicare supplement plan we offer in the state including the new modernized plans with an effective date of June 1st or after. What plans are you offering? The current plans we offer today in each of our states. Here are some questions we often get on Mutual’s Medicare Supplement….[read slide]. Feb-19 For Producer Use Only

10 Questions on Mutual’s Medicare Supplement
Answer When can I market your new modernized plans? On December 1, 2009, contingent on state approvals, you may market a 2010 modernized plans to consumers who are turning age 65 in the month of June Individuals may apply during their 6 month open enrollment period. However, in these states, applications maybe taken during this period before the applicant turns 65: Connecticut: Days New York: Days West Virginia: Days Wisconsin: Days You may take underwritten applications up to 60 days before the requested effective date. How will compensation be handled on these new plans? The same as it is today. We have not changed commissions. …..[read slide]. Feb-19 For Producer Use Only

11 Plan F Comparison Medicare Supplement Benefit Plan F sold with
Effective date thru May 31, 2010 Effective date on or after June 1, 2010 Basic Benefits X X-Includes Hospice Benefit* Skilled Nursing Facility Coinsurance Part A Deductible Part B Deductible Part B Excess Charge 100% Foreign Travel Emergency Shown here is a comparison of Plan F sold with effective date through May 31, 2010 versus sold with effective date on or after June 1, We can see here the major difference in that Plan F sold with effective date or or after June 1, 2010 includes a hospice benefit in the basic benefits. *Co pay of $5 per outpatient prescription for outpatient prescription drugs for pain and symptom management and 5% of the Medicare-approved amount for inpatient respite care (short-term care given by another caregiver, so the usual caregiver can rest). This does not include room and board Feb-19 For Producer Use Only

12 Plan G Comparison Medicare Supplement Benefit Plan G sold with
Effective date thru May 31, 2010 Effective date on or after June 1, 2010 Basic Benefits X X-Includes Hospice Benefit* Skilled Nursing Facility Coinsurance Part A Deductible Part B Excess Charge 80% 100% Foreign Travel Emergency At Home Recovery Care certified by your doctor for personal care during recovery from injury or sickness which Medicare approved the treatment plan. Covers $40 a visit up to the number of Medicare approved visits, not to exceed 7 each week. Calendar year maximum $1,600 Not available Plan G, much like Plan F includes the hospice benefit in the basic benefit when sold with effective date on or after June 1, 2010 as well as a 100 percent Part B excess charge rather than 80 percent. Lastly, the at home recovery care is not available when Plan G is sold with an effective date on or after June 1, 2010. *Covers co pay of $5 per outpatient prescription for outpatient prescription drugs for pain and symptom management and 5% of the Medicare-approved amount for inpatient respite care (short-term care given by another caregiver, so the usual caregiver can rest). This does not include room and board Feb-19 For Producer Use Only

13 Plan J Comparison Medicare Supplement Benefit Plan J sold with Effective date thru May 31, 2010 Comparable Plan with Effective date after June 1, 2010-PLAN F Basic Benefits X X-Includes Hospice Benefit* Skilled Nursing Facility Coinsurance Part A Deductible Part B Deductible Part B Excess Charge Foreign Travel Emergency Not available At Home Recovery Care certified by your doctor for personal care during recovery from injury or sickness which Medicare approved the treatment plan. Covers $40 a visit up to the number of Medicare approved visits, not to exceed 7 each week. Calendar year maximum $1,600 Preventive Care that is not covered by Medicare-$120 a calendar yr A comparable plan with an effective date after June 1, 2010 includes the hospice benefit in the basic benefits just like Plans F and G. The comparable plan sold after June 1 will also include a Foreign Travel Emergency benefit but will not include the at home recovery benefit or the preventive care that is not covered by Medicare. *Covers co pay of $5 per outpatient prescription for outpatient prescription drugs for pain and symptom management and 5% of the Medicare-approved amount for inpatient respite care (short-term care given by another caregiver, so the usual caregiver can rest). This does not include room and board Feb-19 For Producer Use Only

14 Minnesota Basic Benefit Includes: Medicare Supplement Benefit
Plans sold with Effective dates thru May 1, 2010 Plans sold with Effective dates on or after June 1, 2010 Basic Benefits (included in Basic & Extended Basic Plans*) X X-Includes Hospice Benefit Basic Benefit Includes: Inpatient hospital care- Part A coinsurance Medical costs- Part B coinsurance First 3 pints of blood each year Skilled Nursing Facility Care-coinsurance Foreign Travel Emergency Part A hospice coinsurance or copayment (New effective June 1, 2010) RIDERS* Optional Riders to add to Basic Riders included in Extended Basic Plans sold with Effective dates thru May 1, 2010 Plans sold with Effective dates on or after June 1, 2010 Part A Deductible X Part B Deductible Preventive Health Services Part B Excess Rider X –covers 80% X-covers 100% At-home Recovery No longer available The basic benefits of Medicare Supplement in Minnesota shown here include -Inpatient hospital care – Part A coinsurance -Medical costs – Part B coinsurance -First three pints of blood each year -Skilled Nursing and Facility Care – coinsurance -Foreign Travel Emergency; and -Part A hospice coinsurance or copayment (this is new and effective June 1, 2010) X= indicates covered/available Feb-19 For Producer Use Only

15 Wisconsin Basic Benefit Includes:
Inpatient hospital care- Part A coinsurance Medical costs- Part B coinsurance First 3 pints of blood each year Preventive Care not Covered by Medicare Part A hospice coinsurance or copayment (New effective June 1, 2010) (X-indicates covered) Medicare Supplement Benefit Basic Plans sold with Effective dates thru May 1, 2010 Plans sold with Effective dates on or after June 1, 2010 Basic Benefits X X-includes Hospice benefit Medicare Part A Skilled Nursing Facility Coinsurance Inpatient Mental Health Coverage (175 days per lifetime in addition to Medicare) Home Health Care (40 visits in addition to those paid by Medicare) Outpatient Mental Health The basic benefits of Medicare Supplement in Wisconsin shown here include -Inpatient hospital care – Part A coinsurance -Medical costs – Part B coinsurance -First three pints of blood each year -Preventive Care not covered by Medicare; and -Part A hospice coinsurance or copayment (this is new and effective June 1, 2010) For more information on the 2010 modernized plans, contact sales support at (877) Optional Riders (these remain the same) Basic Plans sold with Effective dates thru May 1, 2010 Plans sold with Effective dates on or after June 1, 2010 Medicare Part A deductible X Medicare Part B deductible Medicare Part B excess charges 100% Additional Home Health Care Foreign Travel Feb-19 For Producer Use Only

16 Call Sales Support at (800) 693-6083
Additional Information For additional information, please refer to Sales Professional Access (SPA) at OR Call Sales Support at (800) For additional information on the 2010 Modernized Plans, please refer to Sales Professional Access at or contact our Sales Support area at (800) Feb-19 For Producer Use Only

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