National Benefits - Medicare Supplements for clients
Isn't the risk worth your attention?
If you have prospective clients who are concerned about their ability to pay expenses not covered by Medicare, you might want to use this example to illustrate how Medicare Supplement insurance can address their concerns:
Sue Padmore, age 67, has a total hospital bill of $28,000 based on the following:
That left Sue to pay the remaining $3,051.
Had Marilyn had Medicare Supplement insurance, the coverage would have paid $3,051 (the amount not covered by Medicare), bringing her total to $0.
If you have prospective clients who are concerned about their ability to pay expenses not covered by Medicare, you might want to use this example to illustrate how Medicare Supplement insurance can address their concerns:
Sue Padmore, age 67, has a total hospital bill of $28,000 based on the following:
- $20,000 hospital expenses
- $5,000 approved physician expenses
- $3,000 skilled nursing care expenses (30 days at $100 per day)
In 2004, Medicare paid $25,044 of the $28,000:
- $19,124 (the hospital expense minus the $876 deductible)
- $3,920 (80 percent of the approved physician expenses)
- $2,000 (all expenses for the first 20 days of skilled nursing care)
- $0 (skilled nursing care expenses in excess of $109.50 for days 21-100)
That left Sue to pay the remaining $3,051.
Had Marilyn had Medicare Supplement insurance, the coverage would have paid $3,051 (the amount not covered by Medicare), bringing her total to $0.
- $876 (Part A deductible)
- $1,080 ($100 Part B deductible and 20 percent of the remaining physician expenses approved by Medicare)
- $1,095 ($100 a day for days 21-30 of skilled nursing care)
Understanding A Medicare Supplemental Plan-
Medicare Supplement Plans are designed to pick up some or all of the costs that Original Medicare does not cover. Examples of these cost costs would be Part A or Part B deductibles, skilled nursing facility co-pays, and the 20% co-insurance for Part B services.
There are 10 basic plan designs outlined by the National Association of Insurance Commissioners (NAIC) that, in most states, are represented by the letters A,B,C,D,F,G,K,L,M, and N. In addition to these, some states also allow the sale of a “high deductible Plan F.”
Medicare Supplements are regulated by individual states. Each state determines which plans will be made available in that state. In turn, carriers wishing to do business in that state will pick from the approved list which plan types they wish to offer for sale. All carriers selling in any given state must offer at least Plan A. If the carrier wishes to offer any plans other than Plan A, it must offer at least either Plan C or Plan F.
Medicare Supplements Plan Options:
None of the Medicare Supplements sold today include Prescription Drug Coverage. A person who chooses to enroll in a Medicare Supplement will need to purchase a stand-alone Medicare Prescription Drug plan in order to meet their “creditable coverage” requirement for Part D.
Medicare Supplements do not provide coverage for services that are not considered eligible Medicare expenses. A couple of exceptions to this would be that some plans (C,D,F,G,M, and N) provide Foreign Travel Emergency coverage for those traveling outside of the US. Medicare itself does not cover services outside of the US. Another example would be that some companies may offer “non-medical” value added services such as discount programs for eyewear, 24 hour nurse help lines, gym membership discounts, etc.
To learn more about our various Medicare Supplement carriers please do not hesitate to contact us.
Medicare Supplement Plans are designed to pick up some or all of the costs that Original Medicare does not cover. Examples of these cost costs would be Part A or Part B deductibles, skilled nursing facility co-pays, and the 20% co-insurance for Part B services.
There are 10 basic plan designs outlined by the National Association of Insurance Commissioners (NAIC) that, in most states, are represented by the letters A,B,C,D,F,G,K,L,M, and N. In addition to these, some states also allow the sale of a “high deductible Plan F.”
Medicare Supplements are regulated by individual states. Each state determines which plans will be made available in that state. In turn, carriers wishing to do business in that state will pick from the approved list which plan types they wish to offer for sale. All carriers selling in any given state must offer at least Plan A. If the carrier wishes to offer any plans other than Plan A, it must offer at least either Plan C or Plan F.
Medicare Supplements Plan Options:
- No Provider Networks - Enrollees can see any provider in the US who accepts Medicare.
- No Primary Care Physician required – This also means that PCP referrals are not required.
- Consistency – Although the NAIC occasionally reviews and adjusts the plan benefits, this is not a common occurrence. The plan designs and benefits do not normally change from year to year.
- Most comprehensive coverage – Plan F which is most popular plan, leaves very little, if any, cost share to the consumer.
None of the Medicare Supplements sold today include Prescription Drug Coverage. A person who chooses to enroll in a Medicare Supplement will need to purchase a stand-alone Medicare Prescription Drug plan in order to meet their “creditable coverage” requirement for Part D.
Medicare Supplements do not provide coverage for services that are not considered eligible Medicare expenses. A couple of exceptions to this would be that some plans (C,D,F,G,M, and N) provide Foreign Travel Emergency coverage for those traveling outside of the US. Medicare itself does not cover services outside of the US. Another example would be that some companies may offer “non-medical” value added services such as discount programs for eyewear, 24 hour nurse help lines, gym membership discounts, etc.
To learn more about our various Medicare Supplement carriers please do not hesitate to contact us.