Medicare

Please contact 877-734-3884 for more information about Medicare Supplement (also called “Medigap”), Medicare Advantage (Part C) and Medicare Prescription Drug (Part D) plans. We are appointed to sell AARP Medicare Supplement (also called “Medigap”)  Insurance and the AARP Medicare Rx Plans (both insured by United HealthCare Insurance Company) as well as policies offered in Florida by several other major carriers including Avmed, Blue Cross Blue Shield of Florida, Coventry, Mutual of Omaha, American Pioneer, Summit/Vista and United American.

In accordance with federal law, you must complete a Sales Appointment Confirmation Form before an agent  can discuss Medicare Advantage (Part C) or Part D prescription drug coverage with you. Forms differ by carrier, but you can download a copy of the form used for the AARP plans here and either scan and email it to us at pcholak@earthlink.net or fax it to us at 561-734-3886.  You can also call us at 877-734-3884 to receive a copy of a form (also called Scope of Appointment) for any other insurance carrier (each carrier uses a different form).

In addition, we offer a policy for those between 64 1/2 and age 85. This is NOT a Medicare Supplement or Medicare Advantage plan but it can be used to help defray out-of-pocket costs for deductibles, co-payments and coverage limits. This policy comes with optional coverage levels. Please call 877-734-3884 for additional details and to obtain information about any requirements that must be met before an agent can discuss this plan with you.

You can learn more about Medicare at www.medicare.gov, which is the official site of the Center for Medicare and Medicaid Services (the agency that administers Medicare). You can also use this site to apply for Medicare online.

Please click here for a copy of Medicare & You 2010, which is the official government handbook with information about the following:

• What’s new
• Medicare costs
• What Medicare covers
• Health and prescription drug plans
• Your Medicare rights
• Health Information Technology  

Click here for information about how Health Care Reform (the recently passed Patient Protection and Affordable Care Act) affects Medicare recipients. You’ll see these improvements in Medicare right away:

• More affordable prescription drugs [if you’ve reached the Medicare Part D coverage gap (also called the “doughnut-hole”) in 2010 you’ll be receiving a $250 rebate check and if you reach the coverage gap in 2011 you’ll receive a 50% discount when buying Part D-covered brand name prescription drugs.]  Click here to download a special government publication about the rebate check
  
• Important new preventive care benefits
• Better access to care
• Better chronic care

There will also be significant changes to Medicare Advantage plans.  Partly in response to new laws, some carriers (for example, CIGNA for PFFS plans) will no longer be offering Medicare Advantage plans and will be notifying subscribers by November that they will not have coverage for 2011 and must pick a new plan.  These individuals will have the right to go into any available Medicare Supplement or Medicare Advantage plan on a guaranteed issue basis during the annual election period which runs from November 15 to December 31.

New laws have brought many changes to Medicare Supplement (Medigap) insurance policies, and individuals buying Medigap policies on or after June 1, 2010 will have new choices.  The former plans E, H, I and J will no longer be sold. Plans D and G bought on or after June 1,2010 have different benefits than D or G plans bought before that date.  Note:  you can keep your old Plan D, E, G, H or I supplement bought before June 1, 2010 and in many cases there should be no need for you to change plans.  Plans M and N are new choices not previously offered.

The new plans cover these hospice care benefits that are not covered by Medicare:

• $5  for prescription drugs
• Inpatient respite care

Medicare Supplement Plans Available After June 1, 2010
Click here for a chart that compares all of the Medicare Supplement policies available after June 1, 2010.

Click here to obtain the 2010 version of Choosing a Medigap Policy:  A Guide to Health Insurance for People with Medicare, the official government publication that explains Medigap policies.  This guide includes the following information:

• What a Medigap (Medicare Supplement Insurance) policy is
• What’s new in 2010
• What Medigap policies cover
• Your rights to buy a Medigap policy
• How to buy a Medigap policy

Medicare Supplement Plans A, B, C, D, and F

In our experience Plans A, B, C, D and F have been the most commonly purchased Medicare Supplement (Medigap) plans.   Please note that with any Medicare Supplement plan, individuals are required to continue paying their Medicare Part B premium.  Also note that AARP Medicare Supplements do not include Plan D in Florida, but these plans are available through other carriers  (We can offer any Medicare supplement available in Florida but not all supplements are offered by all carriers).  Please refer to the 2010 version of Choosing a Medigap Policy for more complete information.

What are the benefits of Plan A?

Plan A is the most basic and lowest cost  of  these plans.  It pays:

• Medicare Part A Coinsurance and Hospital Benefits
• Medicare B Coinsurance or Copayment
• Blood (First Three Pints)
• Hospice Care Coinsurance or Copayment
• Preventive Care Coinsurance

What are the benefits of Plan B?

Plan B pays the above Plus:

• Medicare Part A Deductible

What are the benefits of Plan C?

Plan C pays what is listed for Plans A and B Plus:

• Medicare Part B Deductible
• Foreign Travel Emergency (beneficiaries must pay a separate deductible of $250 per year for a foreign travel emergency)
• Skilled Nursing Facility Coinsurance

What are the benefits of Plan D?

Plan D pays what is listed for Plan C but does not pay the Medicare Part B deductible.

What are the benefits of Part F?

Plan F is most comprehensive Medicare Supplement.  It pays what is listed for Plan C Plus:

• Excess Charges (Note: “excess charges” are the difference between the Medicare-approved amount and what a doctor who does not accept Medicare assignment actually charges you  for the service.  Individuals or their insurer must pay the difference.  By law their doctor cannot charge them more than 15% about what Medicare allows.)

Medicare Supplement plans aren’t Original Medicare (Part A or B) or a Medicare Advantage plan (Part C) because they’re not a way to get Medicare benefits, and prescription drug plans (Part D) must be purchased separately. Medicare Supplement plans are identified by letters (such as Plan C) except in Massachusetts, Minnesota, and Wisconsin. Each Medicare Supplement plan (e.g. Plan C) must offer the same basic benefits, no matter what insurance company sells it.  Medicare supplement policies sold by insurance companies  differ by cost, underwriting criteria, extra services (value added), and customer service.  Medicare supplement insurance companies must follow federal and state laws.  A Medicare Supplement policy covers only one person.  If a married couple wants Medicare Supplement coverage, they must buy separate Medicare Supplement policies.

Medicare Supplement Plans M and N

Plans M and N were introduced effective June 1, 2010 and are lower in cost than most of the other plans but offer less coverage. Plan N, in particular, has proven to be quite popular.

Plan N has these differences from Plan F:

• Does not cover Part B deductible
• After you meet the Part B deductible, the plan requires $20 copayment for doctor’s office visits and $50 for emergency room visits
• Does not pay Medicare Part B Excess Charges
  

Healthy individuals who rarely go to the doctor and understand that the Part B deductible requirement is not covered, that office visits and emergency rooms have copays after the deductible, and are not concerned about Excess Charges (see above for description under Plan F) may find this plan particularly attractive. Premiums for this plan can be significantly lower than those for some other Medicare Supplements. Mutual of Omaha has very attractive rates for this plan.

Part D Prescription Drug Plans

Although they must meet minimum Federal guidelines, Part D plans differ markedly between carriers, and one of the most important differences is which drugs are covered and which are not. This is a particularly important consideration for individuals who have been prescribed expensive medications. Each carrier provides a formulary that lists which drugs are covered under the offered plan and which copay tier the drug falls into. Subscribers should always check the formulary to determine if their drugs are covered—and at which copay—before purchasing a plan.

Medicare publishes a formulary finder that permits you to enter your medications and then lists the carriers that cover these medications in their formulary. Click here to access the formulary finder.

American Pioneer has a very expansive formulary and often covers medications not covered by other carriers.