Making the most of Medicare NOT FDIC INSURED MAY LOSE VALUE NO BANK - - PowerPoint PPT Presentation

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Making the most of Medicare NOT FDIC INSURED MAY LOSE VALUE NO BANK - - PowerPoint PPT Presentation

Dec 13, 2023 140 likes •453 views

& BCBS Nebraska Sponsor Making the most of Medicare NOT FDIC INSURED MAY LOSE VALUE NO BANK GUARANTEE NOT A DEPOSIT NOT INSURED BY ANY FEDERAL GOVERNMENT AGENCY First Westroads Bank, Inc. is not affiliated with Lincoln Financial

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This information is effective January 1 through December 31, 2011.

& BCBS Nebraska

Sponsor

Making the most of Medicare

First Westroads Bank, Inc. is not affiliated with Lincoln Financial Advisors Corp. Mike Beacom & Brian Kelly are registered representatives of Lincoln Financial Advisors Corp. > Securities and investment advisory services offered through Lincoln Financial Advisors Corp., a broker/dealer (member SIPC) and a registered investment advisor. Insurance

  • ffered through Lincoln affiliates and other fine companies. CRN-934967-052814

> You may want to consult a legal or tax advisor regarding this information as it relates to your personal circumstances. Neither Lincoln Financial Advisors nor its representatives

  • ffer legal or tax advice.

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NOT FDIC INSURED ı MAY LOSE VALUE ı NO BANK GUARANTEE NOT A DEPOSIT ı NOT INSURED BY ANY FEDERAL GOVERNMENT AGENCY

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Making the most of Medicare

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This information is effective January 1 through December 31, 2011.

Today’s Presenter

Matthew Leonard Manager, Consumer Sales

Blue Cross and Blue Shield of Nebraska

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This information is effective January 1 through December 31, 2011.

Today’s topics:

>What is Medicare? >Who’s eligible? >Medicare coverage >Options to fill coverage gaps >When you can enroll >Finding the right plan >Additional help and resources

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This information is effective January 1 through December 31, 2011.

What is Medicare

>Enacted by Congress in 1965, Original Medicare is a health insurance program >Original Medicare has two parts – Medicare Part A and Medicare Part B >The Medicare Modernization Act of 2003 added prescription drug coverage known as Medicare Part D >Medicare is administered by the Centers for Medicare & Medicaid Services (CMS)

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This information is effective January 1 through December 31, 2011.

Who’s eligible

> Must be United States citizen or permanent legal resident who has resided in the United States for five continuous years and are:

– Age 65 or older and eligible to receive Social Security OR – Under age 65, permanently disabled and have received Social Security disability benefits for at least two years – Diagnosed with end-stage renal disease (ESRD)

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This information is effective January 1 through December 31, 2011.

Medicare coverage choices

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Prescription Drugs

Prescription Drug Plan Medicare Advantage + Prescription Drugs

Medical

Original Medicare Medicare Advantage Medicare Supplement Medicare Cost Plans

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This information is effective January 1 through December 31, 2011.

Original Medicare Benefits: Part A

> Coverage for:

– Inpatient hospital care and services – Skilled nursing facility care – Home health care – Hospice care

> Premium: Generally, no cost to beneficiary > Hospital deductible: $1,216 (per benefit period-2014)

– Days 1-60 covered in full after deductible – You pay $304 per day for days 61-90 – You pay $608 per day for additional 60 lifetime reserve days

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This information is effective January 1 through December 31, 2011.

Original Medicare Benefits: Part A (continued)

> Skilled nursing covered up to 100 days after a 3-day hospital stay

– Days 1-20 covered in full, no deductible – You pay $152.00 per day for days 21-100

> Hospice care covered if provided in Medicare-certified facility > Medicare-approved home health care covered in full

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This information is effective January 1 through December 31, 2011.

Original Medicare Benefits: Part B

> Coverage for outpatient care and services as well as durable medical equipment > Premium: $104.90 - $335.70 per month > Annual deductible: $147.00 > After you pay the deductible, you pay 20% and Medicare pays 80% for most covered services > Preventive care:

– Medicare will cover a one-time routine physical exam within the first 12 months that you are enrolled in Part B coverage (“Welcome to Medicare”) – An annual physical exam including lab tests – Certain screenings and immunizations at $0 cost

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This information is effective January 1 through December 31, 2011.

Original Medicare Benefits: Part B (continued)

>Doctor services, including hospital, clinic, office or home visits >Diagnostic X-rays, lab tests, radiation therapy >Medical supplies and services including durable medical equipment >Outpatient diagnosis or treatment services, including ambulatory surgical centers

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This information is effective January 1 through December 31, 2011.

Original Medicare Benefits: Part B (covered)

>Ambulance transportation >Outpatient rehabilitation including physical, speech and

  • ccupational therapy

>Unlimited home health visits when ordered by a doctor

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This information is effective January 1 through December 31, 2011.

What Original Medicare doesn’t pay for:

> Deductibles and coinsurance > Most outpatient prescription drugs > Charges for inpatient hospital and skilled nursing days beyond Medicare’s limits > Services deemed not medically necessary or not allowed by Medicare > Most care received outside of the U.S.

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This information is effective January 1 through December 31, 2011.

Medicare plan options

>Medicare supplement plans (Medigap) >Medicare Advantage plans >Medicare Cost plans >Generally, you will pay an additional monthly plan premium for these products

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This information is effective January 1 through December 31, 2011.

Options to fill coverage gaps: Medicare supplement plans

> Medicare supplement  or Medigap  plans help pay for some of the “gaps” that Medicare doesn’t cover > Different Medicare supplement plans are offered in different states

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This information is effective January 1 through December 31, 2011.

Options to fill coverage gaps: Medicare supplement plans (continued)

> Premiums may change each year > Benefits usually don’t change each year > No longer cover outpatient prescription drugs > Regulated by each state, not Medicare > Must have both Medicare Part A and Part B coverage to be eligible to enroll in a Medigap policy

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This information is effective January 1 through December 31, 2011.

Options to fill coverage gaps: Medicare supplement plans (continued)

> Best time to buy is during initial Medicare supplement plan

  • pen enrollment period

– First six months of Part B enrollment – After open enrollment, may have medical underwriting

> If in a Medigap plan, can try a Medicare Advantage plan for first time and return to Medigap plan within 12 months without providing health history

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This information is effective January 1 through December 31, 2011.

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This information is effective January 1 through December 31, 2011.

Dental Essentials

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This information is effective January 1 through December 31, 2011.

When you can enroll

> Age 65 and/or when you apply for Social Security benefits > Enrollment in Part A is usually automatic when you apply for Social Security > You must choose to enroll in Part B and Part D – enrollment is not automatic > If you’re under 65 and have received Social Security or Railroad Retirement disability benefits for 24 months

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This information is effective January 1 through December 31, 2011.

When you can enroll (continued)

> Medicare Advantage Disenrollment Period (MADP) or Annual Disenrollment Period (ADP)

– Held each year from January 1-February 14 – Specific opportunity to switch coverage from Medicare Advantage to Original Medicare and a Prescription Drug Plan

> Medigap Open Enrollment

– No health history required if you enroll within the first 6 months of your enrollment in Part B

> Special Election Period (SEP)

– Offered to beneficiaries who meet specific eligibility criteria

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This information is effective January 1 through December 31, 2011.

Finding the right plan

>How much are you comfortable paying in premiums each month? >How much do you want to share in the cost of services? >Do you want additional health coverage and/or a prescription drug plan? Or is Original Medicare enough coverage?

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This information is effective January 1 through December 31, 2011.

Finding the right plan (continued)

>Do you plan to move out of state? >Is it important that your benefits remain the same each year? >Are you familiar with the companies who offer the product(s) you want? Choose a company you have faith in.

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This information is effective January 1 through December 31, 2011.

Finding the right plan (continued)

>Do you want to continue seeing your current doctor? Do other providers you use accept the plan? >What about access to doctors and hospitals? Some provider networks are extensive and include providers in nearby states or across the country.

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This information is effective January 1 through December 31, 2011.

Finding the right plan (continued)

> Do you travel? Plans vary in their travel benefits and the length of time you’ll be

  • covered. How often you

travel and for how long should be considered.

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This information is effective January 1 through December 31, 2011.

Additional help and resources

> Social Security

– Monday-Friday, 7 a.m to 7 p.m. – 1-800-772-1213 – TTY 1-800-325-0778 – www.ssa.gov

> Medicare Helpline

– 7 days a week, 24 hours – 1-800-633-4227 – TTY 1-877-486-2048 – www.medicare.gov or www.cms.hhs.gov

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This information is effective January 1 through December 31, 2011.

Additional help and resources (continued)

> For more information about Medicare benefits and services: 1-800-MEDICARE (1-800-633-4227) TTY hearing impaired users call 1-877-486-2048 24 hours a day, seven days a week > State Health Insurance Assist- ance Program for Nebraska (SHIP): 1-800-234-7119

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This information is effective January 1 through December 31, 2011.

Additional help and resources (continued)

> Visit www.medicare.gov:

  • For Medigap policies in your area, select “Health and

Drug Plans,” and then select “Compare Medigap Policies.”

  • For updated phone numbers, select “Help and

Support,” and then select “Useful Phone Numbers and Websites.”

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This information is effective January 1 through December 31, 2011.

Questions?

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