|
Medicare Supplement
Introduction
There are 12 standardized Medicare Supplement Plans, A through L,
currently available in Nebraska. Some insurance companies may offer a
ýhigh deductible optioný on Plans F and J. The following charts show the
benefits offered under each plan. The first step in buying a Medicare
Supplement Policy is to select the plan that both meets your needs and is
affordable. Each Medicare Supplement Plan offers a specific list of benefits. Plan F
from one company must offer the same benefits as Plan F from all other
companies. Since each planýs benefits are identical from company to
company, premium comparison and special conditions are important to
consider when choosing a policy that is right for you.
Be an Informed Consumer
Assess Your Needs. Review your own health profile and decide what
benefits and services you are most likely to need. Choose a policy that
best meets those needs. If a poor decision is made, you may have
more limited choices in the future.
Buy Just ONE. You only need one Medicare Supplement Policy.
You are paying for unnecessary coverage if you own more than one.
Take Your Time. Do not be pressured into buying a policy. If you
have questions or concerns, ask the agent to explain the policy to a
friend or relative whose judgment you trust, or call SHIIP. If you need
more time, tell the agent to return at some future date. Do not fall for
the tactic: ýIým only going to be in town today so youýd better buy
now.ý
Medical Questions May be Important. Do not be misled by the
phrase ýno medical examination required.ý You may not have to go to
a physician for an exam, but medical statements you make on the
application might prevent you from getting coverage after your open
enrollment period.
Remember - during your six-month open enrollment period, all
companies must accept you, regardless of your health history.
Complete the Application Carefully. Before you sign an
application, read the health information recorded by the agent. Do not
sign it until all health information is completed and accurate. If you
omit requested medical information, the insurance company could
deny coverage for that condition or cancel your policy.
Do Not Pay With Cash. Pay by check, money order, or bank draft.
Make it payable to the insurance company only, not the agent.
Completely fill out the check before presenting it to the agent.
It Takes Time to be Approved. You are not insured by a new
Medicare Supplement Policy on the day you apply for it. Generally, it
takes at least 30 days to be approved.
Do Not Immediately Cancel a Current Policy. Wait until you have
been officially accepted by the new insurer and have a policy in-hand
before canceling your current policy.
Expect to Receive the Policy Within a Reasonable Time. A policy
should be delivered within a reasonable time after application. If you
have not received the policy or had your check returned within
approximately 30 days, contact the company and obtain, in writing, a
reason for the delay. If the problem continues, contact the Nebraska
Department of Insurance, Consumer Affairs Division, by calling
1-877-564-7323.
Use Your 30-Day Free Look Period. Your 30-day ýfree looký
period starts when you have a policy in your hand. When you get your
policy, review it carefully. If you decide not to keep it, return it to the
company and request a premium refund. After the free-look period,
insurance companies are not required to return unused premiums if
you decide to drop the policy.
IMPORTANT TIME FRAMES
Open Enrollment When 65
Every new Medicare recipient who is age 65 or older has a guaranteed
right to buy a Medicare Supplement Policy during ýopen enrollment.ý
A company cannot reject you for any policy it sells, and it cannot
charge you more than anyone else your age. Your open enrollment
period starts when you enroll in Medicare Part B. It ends six months
later. During these six months, companies cannot turn you down due
to your health history. If you apply for a policy after the open
enrollment period, some companies may refuse coverage because of
health reasons. You will be eligible for an open enrollment period
when you become 65 if you have had Medicare Part B coverage
before age 65 (e.g., Medicare due to a disability or End-Stage Renal
Disease).
Even though you are guaranteed a policy during open enrollment,
pre-existing conditions may not be covered for up to six months after
the effective date. If you have ýcreditable coverageý earned from your
past health insurance coverage, the pre-existing condition waiting
period can be waived. Creditable coverage includes coverage under an
employer group health plan, Medicaid, or some other types of
insurance. See the ýPre-Exý column on the following charts to see
which companies require a waiting period for pre-existing conditions.
Guarantee Issue Opportunity
After your open enrollment period ends, companies can refuse you
coverage due to your health history. However, there are some limited
circumstances that will give you a ýGuarantee Issue Opportunityý to
buy a Medicare Supplement Policy. You will have the right to buy a
Medicare Supplement Policy A, B, C, F, K or L from any company
selling those plans, as long as you apply within 63 days. These
circumstances include:
ý If you are enrolled in a Medicare Supplement Policy and that
policy ends through no fault of your own (company goes
bankrupt, coverage involuntarily terminated, etc.);
ý If you are enrolled in a Medicare Advantage Plan and you
disenroll because you move from the planýs service area or the
plan terminates;
ý If you are enrolled in an employer group health plan that pays
benefits secondary to Medicare, and the plan ceases to provide
all health benefits;
ý If you disenroll from a Medicare Advantage Plan within the
first twelve months of purchase.*
Important Timeframes (cont.) - Open
Enrollment When Under 65
Persons who receive Social Security Disability benefits can begin
receiving Medicare before they turn 65. However, in Nebraska, they
are not eligible for Medicare Supplement Open Enrollment before
age 65. Companies are not required to sell Medicare Supplement
Policies to persons under 65. SHIIP compiles a list of companies that
may offer a Medicare Supplement Policy to persons under age 65
and on Medicare. Medical questions will be asked and if you meet
the companiesý medical requirements, they may, at that time, offer
you a policy.
Medicare Advantage & Medicare Supplements
Can I Keep My Medicare Supplement Insurance
If I Join a Medicare Advantage Plan?
Those covered under Original Medicare may have a Medicare
Supplement Policy. These plans only work with Original Medicare, so
if you join a Medicare Advantage Plan, you do not need to keep your
supplement policy. If you do elect to keep your Medigap Policy, you
will have to keep paying your premiums and you will receive little or
no benefit from it while you are in a Medicare Advantage Plan.
Guarantee Issue Opportunity
If you are over age 65 and were covered under Original Medicare and
a Medigap Policy, then joined a Medicare Advantage Plan and
cancelled your supplement, you retain the right to cancel your
Medicare Advantage Plan during the first 12 months of enrollment
and return to Original Medicare. If you do this during the 12 month
ýtrial period,ý you are granted a guarantee issue into the same
Medigap Policy in which you were most recently enrolled, if available
from the same issuer, or, if not so available, a benefit package
classified as Plan A, B, C, F (including F with a high deductible), K or
L offered by any issuer. This guarantee issue opportunity only applies
if you cancel your Medicare Supplement Policy while you are enrolled
in a Medicare Advantage Plan.
If you are new to Medicare and elect to join a Medicare Advantage
Plan, you retain the right to cancel your Medicare Advantage Plan
during the first 12 months of enrollment and return to Original
Medicare. If you do this during the 12 month ýtrial period,ý you are
granted a guarantee issue into a benefit package classified as Plan A,
B, C, F (including F with a high deductible), K or L offered by any
issuer.
Please call our office and speak to one of our licensed agents who can best match your medical needs with the appropriate Medicare Supplement Policy. 402.312.7997
| 
Copyright 2008 Advanced Health Plans Inc