Medicare Supplements; The Who, What & Why

1. Medicare Supplements; The Who, What & Why Presented by: Mary Anne Francis, RHU, LUTCF Brown & Brown of Washington

2. MedicareSupplements: What is available? • Original Medicare Supplements- “Medigap”- Plans A to J 2. MedAdvantage / Alternative Plans 3. Part D Drug Plans

3. Medicare Supplements: Plans A to J

4. Medicare Supplements: A to J Premiums

5. Medicare Supplement: Alternative Plans Called MedAdvantage Plans- Examples: • Pacificare Secure Horizons • Group Health HMO Plan • Regence MedAdvantage Plan

6. Med Supp Alternatives: MedAdvantage Plans Regence MedAdvantage offers- • Low Premiums • Choice of Provider Network • With or without drug coverage • Supplemental services not included in A to J Med Supplements

7. Medicare Supplements: MedAdvantage Plans Regence MedAdvantage PPO Plan - In Network: • $5 Copay for Office Visits • $100 per day Hospital Copay 3X max. • Dental Cleanings & X-rays to $500 Annual • Discounts on other services • $1,000 Annual Maximum Out-of-Pocket

8. Medicare Supplements: MedAdvantage Plans Regence MedAdvantage Out-of-Network Benefits: • $250 Annual Deductible • 20% Coinsurance for Services • $100 per day Hospital Copay • $3,000 Annual Maximum Out-of-Pocket

9. Medicare Supplement: MedAdvantage Plans Premiums – 2007 • MedAdvantage no Rx $ 99.00 monthly • MedAdvantage + Rx $127.00 monthly • MedAdvantage + Rx Enhanced $137.00 monthly

10. Medicare Supplements: Part D Drug Plans How they Work: • You pay annual deductible- $0 to $265 • Then copays, depending on type of RX- generic, preferred brand name, non-preferred brand name • Copays range $5 to $55 until . . .

11. Medicare Supplements: Part D Drug Plans • Until total cost of drugs reach $2,250 • At that point plan stops paying until total drug costs exceed $3,600 for the year • This is called the “Donut Hole” or “Gap” • Plan pays 95% of drug costs after Gap for remainder of year

12. Medicare Supplements: Part D Drug Plans How do I locate Plans? • www.medicare.gov • Agents • SHIBA Volunteers • Local pharmacies will compare based on your RX • Over 70 Plans in WA offered

13. Medicare Supplements: Part D Drug Plans What needs to be considered? • Service Area of Plan • Copays • Formulary – Do they carry my drugs? • Premium Costs • Preferred/nonpreferred Pharmacy

14. Medicare Supplements: Part D Drug Plans Must I sign up? • Penalties apply later for failure to enroll • Can I change if I don’t like my Plan? • November 15 to December 31 Open Enrollment • Change effective January 1

15. Medicare Supplements: What are my resources? Local: • SHIBA Volunteers - 253-596-0918 or 1- 800-562-6900 • Medicare Help line 1-800-633-4227 • Social Security Office 1-800-772-1213

16. Medicare Supplements: Web Based: • www.medicare.gov • Order Publications • Use Drug Finder • Get Updated information

17. Medicare Supplements: Web Continued: • www.ssa.gov Social Security Administration • www.insurance.wa.gov Insurance Commissioners office

18. Medicare Supplements: • Questions?