Important Phone Numbers Medicare: 1-800-633-4227 Social Security: 1-800-772-1213

1. Vince KellyMedicare Insurance SpecialistPhone number 310-625-1837e-mail:vince@medicarebabyboomer.com Important Phone Numbers Medicare: 1-800-633-4227 Social Security: 1-800-772-1213

2. What is Medicare? • Federal health insurance program • Began in 1965, as a result of the “Medicare Act”

3. Medicare Part A – Hospital Insurance Most people do not pay a monthly premium Covers Hospital Stays and Home Health Care/DME $1068 Hospital Deductible days 1-60 each “Benefit Period” additional daily fees for days 61-150. Covers 100 days in a Skilled Nursing Facility $0 per days 1-20 $133.50 per days 21 - 100

4. Medicare Part B – Medical Insurance 2009 Monthly Premium for most people $96.40 ($289.20 quarterly) Covers Doctor Services $135 annual deductible Covers 80% of costs, YOU PAY 20%

5. Medicare Enrollment Periods Initial Enrollment – Begins 3 months before 65th birthday and ends 3 months after. Special Enrollment Period – Anytime, depending upon when the individual stops working and/or coverage from a Group Health Plan is terminated. Annual Election Period – Nov 15th- Dec 31st Open Enrollment Period – Jan1st – March 31st.

6. Medicare Prescription Drug Coverage (Part D) Medicare HMO and PPO plans include Part D Original Medicare only or Medi-Gap should consider enrolling in a “Stand-Alone Drug Plan” Part D Late-Enrollment Penalty – Multiply 1% of the “national base premium” ($30.36) by the number of months you were eligible to join. Example: 12 months equals $3.60/monthly penalty.

7. Medicare Part D Standard Coverage as required by law • TrOOP costs do not include $30.36/month premium • TrOOP costs do not include non-formulary drugs • once $ 4,350 in drug costs have been reached, catastrophic coverage begins:

8. Medicare Does Not Cover Acupuncture Chiropractic services (except to correct a subluxation) Custodial care/Long Term Care (nursing home) Dental care and Dentures Hearing Aids Routine Vision and Glasses (except after cataracts) Prescription drugs Out of Country travel coverage

9. Medicare Health Plan Choices Part C (Medicare Advantage – MA) provides Medicare Parts A & B through private insurance companies approved by Medicare. Medicare Advantage (MAPD)HMO – Includes Rx Medicare Supplement (Medi-Gap) – No Rx MAPD Private Fee-For-Service (PFFS) – Includes Rx MAPD PPO – Includes Rx Original Medicare – 80% Coverage – No Rx

10. Medicare Advantage - HMO Over 10 Medicare HMO’s in the South Bay $0 Monthly premiums Various co-payments for Services and Drugs Need to pick PCP (Primary Care Physician) Need to get referrals and authorizations for services Limited choice of Physicians and Hospitals Low Cost Option, Will save you $$$ SNP (Special Needs Plans), Medi-Medi’s and “Chronic illness” Plans

11. Medicare Advantage –PPO or PFFS $0 Monthly Premium PPO - $1050 Deductible PFFS – Various Copayments Providers bill the insurance company NOT Medicare Includes a Medicare Part D drug plan “Freedom” Choice of Doctors and Hospitals No need to pick a PCP (Primary Care Physician)

12. Medicare Supplement (Medi-Gap) You pay Monthly Premiums, varies by Insurance Co. 12 Medicare Standardized Plans (Plans A through L) Plan “F”- Most Popular - Covers Part B Excess Complete Freedom of Doctors and Providers

13. How Medicare Supplements Plans WorkMedicare pays the Medicare-Approved Amount first, then your Medicare Supplement plan pays all or part of the balance, depending on which plan you choose.EXAMPLE:Total Cost of Physician’s service is: $2000Medicare-approved amount is: $1800Medicare pays 80% of approved amount: $1,440Medicare Supplement pays 20% $360If a physician does not accept Medicare assignment, you must pay the difference between the total amount and the Medicare-approved amount. Legally the physician may not bill for more than 115% of Medicare-approved charges. In this example, you would pay $200, UNLESS you have Plan F, I, or J, which covers the Excess Part B charges.

14. Why Me? • No cost – I’m “Free” • Availability – Includes Annual Insurance Review • Objective Advice –Represent Most Plans • Over 22 Years of Experience • Local Resident and Knowledge • Monthly Meetings – Listed on my website www.MedicareBabyBoomer.com

15. Next Steps Month Medicare Starts_________________ Name: ___________________________________ Address: ___________________________________ Phone: _______________________ E-Mail Address _____________________________ Will continue with Group Health Insurance? YES or NO If NO, circle one or more interested options: HMO PPO Medi-Gap PFFS What date would you like me to call? __________________ COMMENTS: