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David Crotts & Associates “Agent Support Services”
Today’s Agenda• The ABC’s of Medicare & Gaps In Coverage• What Is A Medicare Supplement
Medicare ABC’S• Part A: -Eligible at age 65 & most people automatically enroll -Covers most costs for inpatient Hospital Care -Initial deductible of $1,132 with $283 & $566 co-payments -Covers skilled nursing facilities for up to 100 days• Part B: -Must sign up for it &most pay a monthly premium -Deductible of $162 in 2011 -Helps cover doctors’ visits & outpatient hospital care expenses• Part C: -Medicare Advantage health plans options approved by Medicare -Run by private companies & usually offer additional benefits -May provide specialized care for people in need -Replaces Medicare Parts A and B.• Part D: -Prescription Drug Plans for Medicare A&B clients’ -Charge a monthly premium that varies by plan -Allows clients to get the coverage needed at the best price possible.
Gaps In Coverage Original Medicare “Parts A&B” -Covers a portion of approved medical expenses -Individual is reasonable for the remaining share Part A Part B – $1,132 deductible for daysHospital Stays 1 – 60 Deductible $162 per year – $283 per day for days 61 – 90 – $566 per day for days 91 – 150 – $0 for first 20 daysSkilled Nursing – Up to $141.50 per day for Facility days 21 – 100 20% coinsurance Doctor & – 100% after day 100 Copayments for Care Outpatient Services hospital outpatient services – 100% for first 3 pints – 20% for additional pintsBlood
Covering The Gaps• Medicare Supplement Polices -Helps individuals reduce financial liability. - May give discounts on vision. -Coverage level depends on the plan you buy. - Costs are in addition to original Medicare premiums.
Additional No Coverage Gaps• Not covered under Medicare Supplement or Medicare - Dental - Vision - Long Term Care - Eyeglasses - Private – Duty Nursing
Medicare Supplements Glance• Supplement Basics - Sometimes called Medigap - Offered through Private Companies - Follows Federal & State Laws - Most states only offer “standardized” - All plans regardless of company must offer same benefits - Price & customer service “Only” difference
Medicare Plans• Plan Identification Letters - A,B,C,D,E,F,G,H,I,J,K,L,M,N• Plans No Longer Available - E,H,I,J Note;• New Plans In 2010 Carries May - N and M Choose To Offers Select Plans
Plan Premiums • Factors That Effect Costs; 1. Plan 2.*Company 3.Where you live “zip code” 4.**Age * Benefits remain the same regardless of company. ** Individuals can’t be single out for an increase based on age. The increase must be given to entire age group in that zip code.
Important Changes To Know• Policies effective on-after June 1st 2010 - Hospice Part A “Covered” - K- covers 50% and L- covers 75%• Plans K,L,N - May require cost share in Part B Coinsurance• Plans D and G - Sold before June 1, 2010 “Old Benefits” - Purchased after June 1, 2010 “New Benefits”• All Medicare Supplement Carriers - Must offer plan A - Also have to carry either plan C or F as option.
Enrollment Denied• * People On Medicare Under 65 - Generally can’t purchase medigap “If offered it’s costly” - End-Stage Renal Disease• Individuals over 65 not in GI under certain situations -That can’t pass medical underwriting. * Some states require carries to sell to under 65 Medicare beneficiaries such as “North Carolina”.
Understanding The Individuals Needs Medicare Supplement Additional Products• Confused about healthcare options? - Page 5 “2010 Medigap Book” • Are you concerned about the cost involved in recuperating from a sickness• Can you explain the changes CMS made in or injury? 2010 - New Plans - Benefit Changes • Do you know anyone with cancer? - 59.4% cancer cost are non-medical• Is their coverage guaranteed renewable? - Page 36 “2010 Medigap Book”. • Have you consider paying for Final• Is a network important? Expenses? - Do they travel? - If so, what do you have set aside?• Are out-of-pocket costs a concern? • Ask about other concerns or questions. - Hospital stays - Doctor visits• What would they change about current insurance carrier?• What do they look for in an insurance company? - Price - Service - Financial Security
Who Can Buy & When When?? Who?? Individuals enrolling in Individuals with Medicare Parts A and B Medicare Parts A and B - 65th Birthday - Generally only people 65 and older • During Guaranteed issue period Medicare members in - Up to 6 month before your open enrollment birthday period - Up to 6 months after birthday People covered under a guaranteed issue right • If on Medicare Advantage Plan - Leaving service area.
Questions You May Get Asked• Can I get a Medicare Supplement with drugs? - No! Page 7 “2010 Medigap Book”.• What plans can I get during guaranteed issue? - Page 23-26 “2010 Medigap Book”.• What documents will the company ask for during guaranteed issue period? - Page 26 “2010 Medigap Book”.• Can I switch Medicare supplement plans? “Yes” - Although, companies do NOT have to appect you outside “GI” - *Some cases allow you to switch from Medicare Select to regular plan if relocated outside service area. * Plan must have same benefits.
Additional Options• Medicare Advantage Plans - Can be issued to individuals under 65 - Some come with Rx coverage - Costs as little as 0 in addition to Part B - Flexible underwriting
Why David Crotts Agent Support• One-day turnaround on all individual and group quotes.• The most up-to-date market information• Product and sales training, personalized to meet your agencys needs.• Professional representative will work with you to close your business accounts across the state.• Interactive on-line agent tools.
Our Commitment ToYou….As your General Agency’ is to bring youthe best the insurance industry has tooffer, including unsurpassed personalizedservice and the latest in online interactiveagent tools.
Agent Support Staff David Crotts “President” Kara Chastain Kathy Clarke “Marketing Manager” “Support Specialist” Chris Johnson LaNelle Grubbs“Marketing Representative” “Senior Products Specialist”
The Extra Mile For YouAt our Agency we understand the value of deepclient relationship. The more you can assist aclient the better the value your offering. With thatin mind we developed an investment divisiondedicated to providing you the agent with atrusted source to refer your clients to help themwith all their financial planning needs. Thisincludes helping them understand how toorganize, control and accumulate their wealth.
Products• Health “Group & • Medicare Advantage Individual” • Medicare Supplements• Life “Group & Individual” • Prescription Drug Plans• Short Term Disability • Long Term Care• Long Term Disability • Critical Illness
The Next Step As your Agent Support Liaison team, we will partner with you to develop a marketing strategy that will enhance and grow your current organization. No matter the size or stage of your business, we will enhance your product portfolio, solidify your client relationships, and lock out the competition, maximizing your profit potential. Call: 1-(800)-803-7873 Ext: 237 422 Montague Avenue, Suite #7 ● Greenwood, SC 29649-1961 864-223-8788 ● 1-800-803-7873 ● Fax: 864-229-7392Email: firstname.lastname@example.org ● Web Page: www.dacagentsupport.com