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Ray mac medicare education presentation long version

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Jacob MacArthur
Jacob MacArthur
1 of 75
2 Ways To Get Medicare Use only by permission from Senior Insurance Services of NCW, LLC. VRM
2 Ways To Get Medicare Original Medicare Federal Gov’t Use only by permission from Senior Insurance Services of NCW, LLC. VRM
2 Ways To Get Medicare Original Medicare Federal Gov’t Use only by permission from Senior Insurance Services of NCW, LLC. VRM Medicare ADVANTAGE Part C
Inpatient Hospital Ins.Part A Original Medicare Federal Gov’t 2 Ways To Get Medicare Use only by permission from Senior Insurance Services of NCW, LLC. VRM Medicare ADVANTAGE Part C
Inpatient Hospital Ins.Part A [Hospital, Hospice, Homecare, Skilled Nursing, etc.] Original Medicare Federal Gov’t 2 Ways To Get Medicare Use only by permission from Senior Insurance Services of NCW, LLC. VRM Medicare ADVANTAGE Part C
Inpatient Hospital Ins. Ded. $1260/Stay (Benefit Period Day 1-60) Part A [Hospital, Hospice, Homecare, Skilled Nursing, etc.] Original Medicare Federal Gov’t 2 Ways To Get Medicare Use only by permission from Senior Insurance Services of NCW, LLC. VRM Medicare ADVANTAGE Part C
Outpatient Medical Ins.Part B Use only by permission from Senior Insurance Services of NCW, LLC. VRM Inpatient Hospital Ins. Ded. $1260/Stay (Benefit Period Day 1-60) Part A [Hospital, Hospice, Homecare, Skilled Nursing, etc.] Original Medicare Federal Gov’t 2 Ways To Get Medicare Medicare ADVANTAGE Part C
Outpatient Medical Ins. [Doctor, Outpatient Surgery, Ambulance, etc.] Part B Use only by permission from Senior Insurance Services of NCW, LLC. VRM Inpatient Hospital Ins. Ded. $1260/Stay (Benefit Period Day 1-60) Part A [Hospital, Hospice, Homecare, Skilled Nursing, etc.] Original Medicare Federal Gov’t 2 Ways To Get Medicare Medicare ADVANTAGE Part C
Outpatient Medical Ins. [Doctor, Outpatient Surgery, Ambulance, etc.] Part B Use only by permission from Senior Insurance Services of NCW, LLC. VRM Inpatient Hospital Ins. Ded. $1260/Stay (Benefit Period Day 1-60) Part A [Hospital, Hospice, Homecare, Skilled Nursing, etc.] Original Medicare Federal Gov’t 2 Ways To Get Medicare Medicare ADVANTAGE Part C Prem: $104.90/mo.
Outpatient Medical Ins. [Doctor, Outpatient Surgery, Ambulance, etc.] Part B Use only by permission from Senior Insurance Services of NCW, LLC. VRM Inpatient Hospital Ins. Ded. $1260/Stay (Benefit Period Day 1-60) Part A [Hospital, Hospice, Homecare, Skilled Nursing, etc.] Original Medicare Federal Gov’t 2 Ways To Get Medicare Medicare ADVANTAGE Part C Prem: $104.90/mo. Ded: $147/yr.
Outpatient Medical Ins. [Doctor, Outpatient Surgery, Ambulance, etc.] Part B Use only by permission from Senior Insurance Services of NCW, LLC. VRM Inpatient Hospital Ins. Ded. $1260/Stay (Benefit Period Day 1-60) Part A [Hospital, Hospice, Homecare, Skilled Nursing, etc.] Original Medicare Federal Gov’t 2 Ways To Get Medicare Medicare ADVANTAGE Part C Prem: $104.90/mo. Ded: $147/yr. Co-Ins. You – 20% & Medicare – 80%
Use only by permission from Senior Insurance Services of NCW, LLC. VRM A B Inpatient Hospital Ins. Outpatient Medical Ins. Ded. $1260/Stay (Benefit Period Day 1-60) Prem: $104.90/mo. Ded: $147/yr. Co-Ins. You – 20% & Medicare – 80% [Doctor, Outpatient Surgery, Ambulance, etc.] Part A Part B [Hospital, Hospice, Homecare, Skilled Nursing, etc.] [Network: Any provider that accepts Medicare]Medi-Gaps Original Medicare Federal Gov’t 2 Ways To Get Medicare Medicare ADVANTAGE Part C
Use only by permission from Senior Insurance Services of NCW, LLC. VRM A B Inpatient Hospital Ins. Outpatient Medical Ins. Ded. $1260/Stay (Benefit Period Day 1-60) Prem: $104.90/mo. Ded: $147/yr. Co-Ins. You – 20% & Medicare – 80% [Doctor, Outpatient Surgery, Ambulance, etc.] Part A Part B [Hospital, Hospice, Homecare, Skilled Nursing, etc.] [Monthly Changeable] [Network: Any provider that accepts Medicare]Medi-Gaps Original Medicare Federal Gov’t 2 Ways To Get Medicare Medicare ADVANTAGE Part C
Use only by permission from Senior Insurance Services of NCW, LLC. VRM A B Inpatient Hospital Ins. Outpatient Medical Ins. Ded. $1260/Stay (Benefit Period Day 1-60) Prem: $104.90/mo. Ded: $147/yr. Co-Ins. You – 20% & Medicare – 80% [Doctor, Outpatient Surgery, Ambulance, etc.] Part A Part B [Hospital, Hospice, Homecare, Skilled Nursing, etc.] [Monthly Changeable] [Network: Any provider that accepts Medicare]Medi-Gaps 10 Letter Plans in Washington Original Medicare Federal Gov’t 2 Ways To Get Medicare Medicare ADVANTAGE Part C
Use only by permission from Senior Insurance Services of NCW, LLC. VRM
F 100% $179-$188 100% Use only by permission from Senior Insurance Services of NCW, LLC. VRM A B Inpatient Hospital Ins. Outpatient Medical Ins. Ded. $1260/Stay (Benefit Period Day 1-60) Prem: $104.90/mo. Ded: $147/yr. Co-Ins. You – 20% & Medicare – 80% [Doctor, Outpatient Surgery, Ambulance, etc.] Part A Part B [Hospital, Hospice, Homecare, Skilled Nursing, etc.] [Monthly Changeable] [Network: Any provider that accepts Medicare]Medi-Gaps Original Medicare Federal Gov’t 2 Ways To Get Medicare Medicare ADVANTAGE Part C
F 100% $179-$188 100% Use only by permission from Senior Insurance Services of NCW, LLC. VRM A B Inpatient Hospital Ins. Outpatient Medical Ins. Ded. $1260/Stay (Benefit Period Day 1-60) Prem: $104.90/mo. Ded: $147/yr. Co-Ins. You – 20% & Medicare – 80% [Doctor, Outpatient Surgery, Ambulance, etc.] Part A Part B [Hospital, Hospice, Homecare, Skilled Nursing, etc.] G $158 Pt. B $147 [Monthly Changeable] [Network: Any provider that accepts Medicare]Medi-Gaps Original Medicare Federal Gov’t 2 Ways To Get Medicare Medicare ADVANTAGE Part C
NF 100% $179-$188 100% $128 Pt. B $147 Doc/$20 - ER/$50 Use only by permission from Senior Insurance Services of NCW, LLC. VRM A B Inpatient Hospital Ins. Outpatient Medical Ins. Ded. $1260/Stay (Benefit Period Day 1-60) Prem: $104.90/mo. Ded: $147/yr. Co-Ins. You – 20% & Medicare – 80% [Doctor, Outpatient Surgery, Ambulance, etc.] Part A Part B [Hospital, Hospice, Homecare, Skilled Nursing, etc.] G $158 Pt. B $147 [Monthly Changeable] [Network: Any provider that accepts Medicare]Medi-Gaps Original Medicare Federal Gov’t 2 Ways To Get Medicare Medicare ADVANTAGE Part C
NF 100% $179-$188 100% K 50% $57 $4940 MOOP $128 Pt. B $147 Doc/$20 - ER/$50 Use only by permission from Senior Insurance Services of NCW, LLC. VRM A B Inpatient Hospital Ins. Outpatient Medical Ins. Ded. $1260/Stay (Benefit Period Day 1-60) Prem: $104.90/mo. Ded: $147/yr. Co-Ins. You – 20% & Medicare – 80% [Doctor, Outpatient Surgery, Ambulance, etc.] Part A Part B [Hospital, Hospice, Homecare, Skilled Nursing, etc.] G $158 Pt. B $147 [Monthly Changeable] [Network: Any provider that accepts Medicare]Medi-Gaps Original Medicare Federal Gov’t 2 Ways To Get Medicare Medicare ADVANTAGE Part C
Use only by permission from Senior Insurance Services of NCW, LLC. VRM Rx – Prescription Drugs [Stand Alone Plans] Part D Inpatient Hospital Ins. Outpatient Medical Ins. Ded. $1260/Stay (Benefit Period Day 1-60) Prem: $104.90/mo. Ded: $147/yr. Co-Ins. You – 20% & Medicare – 80% NF 100% $179-$188 100% K 50% $57 $4940 MOOP $128 Pt. B $147 Doc/$20 - ER/$50 [Doctor, Outpatient Surgery, Ambulance, etc.] Part A Part B A B [Hospital, Hospice, Homecare, Skilled Nursing, etc.] G $158 Pt. B $147 [Monthly Changeable] [Network: Any provider that accepts Medicare]Medi-Gaps Original Medicare Federal Gov’t 2 Ways To Get Medicare Medicare ADVANTAGE Part C
Use only by permission from Senior Insurance Services of NCW, LLC. VRM Rx – Prescription Drugs [Stand Alone Plans] Part D Avg. $33.13/ mo. Inpatient Hospital Ins. Outpatient Medical Ins. Ded. $1260/Stay (Benefit Period Day 1-60) Prem: $104.90/mo. Ded: $147/yr. Co-Ins. You – 20% & Medicare – 80% NF 100% $179-$188 100% K 50% $57 $4940 MOOP $128 Pt. B $147 Doc/$20 - ER/$50 [Doctor, Outpatient Surgery, Ambulance, etc.] Part A Part B A B [Hospital, Hospice, Homecare, Skilled Nursing, etc.] G $158 Pt. B $147 [Monthly Changeable] [Network: Any provider that accepts Medicare]Medi-Gaps Original Medicare Federal Gov’t 2 Ways To Get Medicare Medicare ADVANTAGE Part C
Use only by permission from Senior Insurance Services of NCW, LLC. VRM Rx – Prescription Drugs [Stand Alone Plans] Part D Avg. $33.13/ mo. Formulary – Rx List Tiers 1 -5 Inpatient Hospital Ins. Outpatient Medical Ins. Ded. $1260/Stay (Benefit Period Day 1-60) Prem: $104.90/mo. Ded: $147/yr. Co-Ins. You – 20% & Medicare – 80% NF 100% $179-$188 100% K 50% $57 $4940 MOOP $128 Pt. B $147 Doc/$20 - ER/$50 [Doctor, Outpatient Surgery, Ambulance, etc.] Part A Part B A B [Hospital, Hospice, Homecare, Skilled Nursing, etc.] G $158 Pt. B $147 [Monthly Changeable] [Network: Any provider that accepts Medicare]Medi-Gaps Original Medicare Federal Gov’t 2 Ways To Get Medicare Medicare ADVANTAGE Part C
Use only by permission from Senior Insurance Services of NCW, LLC. VRM Rx – Prescription Drugs [Stand Alone Plans] Part D 1% Penalty Avg. $33.13/ mo. Formulary – Rx List Tiers 1 -5 Inpatient Hospital Ins. Outpatient Medical Ins. Ded. $1260/Stay (Benefit Period Day 1-60) Prem: $104.90/mo. Ded: $147/yr. Co-Ins. You – 20% & Medicare – 80% NF 100% $179-$188 100% K 50% $57 $4940 MOOP $128 Pt. B $147 Doc/$20 - ER/$50 [Doctor, Outpatient Surgery, Ambulance, etc.] Part A Part B A B [Hospital, Hospice, Homecare, Skilled Nursing, etc.] G $158 Pt. B $147 [Monthly Changeable] [Network: Any provider that accepts Medicare]Medi-Gaps Original Medicare Federal Gov’t 2 Ways To Get Medicare Medicare ADVANTAGE Part C
Use only by permission from Senior Insurance Services of NCW, LLC. VRM Rx – Prescription Drugs [Stand Alone Plans] Part D 1% Penalty Avg. $33.13/ mo. 1. Formulary - a list of prescription drugs covered by a Plan. Formulary – Rx List Tiers 1 -5
Use only by permission from Senior Insurance Services of NCW, LLC. VRM Rx – Prescription Drugs [Stand Alone Plans] Part D 1% Penalty Avg. $33.13/ mo. 1. Formulary - a list of prescription drugs covered by a Plan. 2. Tier level determines what your copay will be for a given drug. Higher tier = higher cost. Formulary – Rx List Tiers 1 -5
Use only by permission from Senior Insurance Services of NCW, LLC. VRM Rx – Prescription Drugs [Stand Alone Plans] Part D 1% Penalty Avg. $33.13/ mo. 1. Formulary - a list of prescription drugs covered by a Plan. 2. Tier level determines what your copay will be for a given drug. Higher tier = higher cost 3. 90-Day Supply Formulary – Rx List Tiers 1 -5
Use only by permission from Senior Insurance Services of NCW, LLC. VRM Rx – Prescription Drugs [Stand Alone Plans] Part D 1% Penalty Avg. $33.13/ mo. 1. Formulary - a list of prescription drugs covered by a Plan. 2. Tier level determines what your copay will be for a given drug. Higher tier = higher cost 3. 90-Day Supply 4. Step Therapy – Some drugs require you to try another drug first. Formulary – Rx List Tiers 1 -5
Use only by permission from Senior Insurance Services of NCW, LLC. VRM Rx – Prescription Drugs [Stand Alone Plans] Part D 1% Penalty Avg. $33.13/ mo. 1. Formulary - a list of prescription drugs covered by a Plan. 2. Tier level determines what your copay will be for a given drug. Higher tier = higher cost 3. 90-Day Supply 4. Step Therapy – Some drugs require you to try another drug first. 5. Exceptions Formulary – Rx List Tiers 1 -5
Use only by permission from Senior Insurance Services of NCW, LLC. VRM Rx – Prescription Drugs [Stand Alone Plans] Part D 1% Penalty Avg. $33.13/ mo. 1. Formulary - a list of prescription drugs covered by a Plan. 2. Tier level determines what your copay will be for a given drug. Higher tier = higher cost 3. 90-Day Supply 4. Step Therapy – Some drugs require you to try another drug first. 5. Exceptions 6. Network Pharmacies – unless emergency Formulary – Rx List Tiers 1 -5
Use only by permission from Senior Insurance Services of NCW, LLC. VRM Rx – Prescription Drugs [Stand Alone Plans] Part D 1% Penalty Avg. $33.13/ mo. 1. Formulary - a list of prescription drugs covered by a Plan. 2. Tier level determines what your copay will be for a given drug. Higher tier = higher cost 3. 90-Day Supply 4. Step Therapy – Some drugs require you to try another drug first. 5. Exceptions 6. Network Pharmacies – unless emergency 7. Low Income Subsidy Formulary – Rx List Tiers 1 -5
(Monthly Premiums are in addition to cost shown below.)Part D – Standard Benefit, what you pay for drugs.
Stage 1. Yearly Deductible (Monthly Premiums are in addition to cost shown below.)Part D – Standard Benefit, what you pay for drugs.
Stage 1. Yearly Deductible You Pay 100% $0 to $320 (Monthly Premiums are in addition to cost shown below.)Part D – Standard Benefit, what you pay for drugs.
Stage 2. Initial Benefit Period Copays Stage 1. Yearly Deductible You Pay 100% $0 to $320 (Monthly Premiums are in addition to cost shown below.)Part D – Standard Benefit, what you pay for drugs.
Stage 2. Initial Benefit Period Copays You Pay Copays Stage 1. Yearly Deductible You Pay 100% $0 to $320 (Monthly Premiums are in addition to cost shown below.)Part D – Standard Benefit, what you pay for drugs.
Stage 2. Initial Benefit Period Copays Insurance Pays Balance You Pay Copays Stage 1. Yearly Deductible You Pay 100% $0 to $320 (Monthly Premiums are in addition to cost shown below.)Part D – Standard Benefit, what you pay for drugs.
Stage 1. Yearly Deductible You Pay 100% $0 to $320 Stage 2. Initial Benefit Period Copays Insurance Pays Balance You Pay Copays (Monthly Premiums are in addition to cost shown below.)Part D – Standard Benefit, what you pay for drugs. When You
Stage 1. Yearly Deductible You Pay 100% $0 to $320 Stage 2. Initial Benefit Period Copays Insurance Pays Balance You Pay Copays (Monthly Premiums are in addition to cost shown below.)Part D – Standard Benefit, what you pay for drugs. When You + Insurance Pays
Stage 1. Yearly Deductible You Pay 100% $0 to $320 Stage 2. Initial Benefit Period Copays Insurance Pays Balance You Pay Copays (Monthly Premiums are in addition to cost shown below.)Part D – Standard Benefit, what you pay for drugs. When You + Insurance Pays = $2960
Stage 3. Coverage Gap – “Donut Hole” (Monthly Premiums are in addition to cost shown below.)Part D – Standard Benefit, what you pay for drugs. Stage 1. Yearly Deductible You Pay 100% $0 to $320 Stage 2. Initial Benefit Period Copays Insurance Pays Balance You Pay Copays When You + Insurance Pays = $2960
Stage 3. Coverage Gap – “Donut Hole” Brand-name You Pay 45% Of Drug Value (Monthly Premiums are in addition to cost shown below.)Part D – Standard Benefit, what you pay for drugs. Stage 1. Yearly Deductible You Pay 100% $0 to $320 Stage 2. Initial Benefit Period Copays Insurance Pays Balance You Pay Copays When You + Insurance Pays = $2960
Stage 3. Coverage Gap – “Donut Hole” Brand-name Manufacturer Provides 50% discount You Pay 45% Of Drug Value (Monthly Premiums are in addition to cost shown below.)Part D – Standard Benefit, what you pay for drugs. Stage 1. Yearly Deductible You Pay 100% $0 to $320 Stage 2. Initial Benefit Period Copays Insurance Pays Balance You Pay Copays When You + Insurance Pays = $2960
Stage 3. Coverage Gap – “Donut Hole” Brand-name Manufacturer Provides 50% discount Insurance Pays 5% You Pay 45% Of Drug Value (Monthly Premiums are in addition to cost shown below.)Part D – Standard Benefit, what you pay for drugs. Stage 1. Yearly Deductible You Pay 100% $0 to $320 Stage 2. Initial Benefit Period Copays Insurance Pays Balance You Pay Copays When You + Insurance Pays = $2960
Stage 3. Coverage Gap – “Donut Hole” You Pay 65% Of Drug Value Generic (Monthly Premiums are in addition to cost shown below.)Part D – Standard Benefit, what you pay for drugs. Stage 1. Yearly Deductible You Pay 100% $0 to $320 Brand-name Stage 2. Initial Benefit Period Copays Insurance Pays Balance You Pay Copays Manufacturer Provides 50% discount Insurance Pays 5% You Pay 45% Of Drug Value When You + Insurance Pays = $2960
Stage 3. Coverage Gap – “Donut Hole” You Pay 65% Of Drug Value Insurance Pays 35% Of Drug Value Generic (Monthly Premiums are in addition to cost shown below.)Part D – Standard Benefit, what you pay for drugs. Stage 1. Yearly Deductible You Pay 100% $0 to $320 Brand-name Stage 2. Initial Benefit Period Copays Insurance Pays Balance You Pay Copays Manufacturer Provides 50% discount Insurance Pays 5% You Pay 45% Of Drug Value When You + Insurance Pays = $2960
TrOOP When YOU have paid $4700 (including Mfg. 50% disc.) then… (Monthly Premiums are in addition to cost shown below.)Part D – Standard Benefit, what you pay for drugs. Stage 1. Yearly Deductible You Pay 100% $0 to $320 Stage 3. Coverage Gap – “Donut Hole” Brand-name Stage 2. Initial Benefit Period Copays Insurance Pays Balance You Pay Copays Manufacturer Provides 50% discount Insurance Pays 5% You Pay 45% Of Drug Value You Pay 65% Of Drug Value Insurance Pays 35% Of Drug Value Generic When You + Insurance Pays = $2960 In 2015, when in Stage 3 Coverage Gap, 95 percent of the full price of a brand name and 65 percent of the full price of a generic goes toward True Out of Pocket expense (TrOOP). Once this amount reaches $4700, then Stage 4 – Catastrophic coverage is reached.
Stage 4. Catastrophic Coverage (Monthly Premiums are in addition to cost shown below.)Part D – Standard Benefit, what you pay for drugs. Stage 1. Yearly Deductible You Pay 100% $0 to $320 Stage 3. Coverage Gap – “Donut Hole” Brand-name Stage 2. Initial Benefit Period Copays Insurance Pays Balance You Pay Copays Manufacturer Provides 50% discount Insurance Pays 5% You Pay 45% Of Drug Value You Pay 65% Of Drug Value Insurance Pays 35% Of Drug Value Generic TrOOP When YOU have paid $4700 (including Mfg. 50% disc.) then… In 2015, when in Stage 3 Coverage Gap, 95 percent of the full price of a brand name and 65 percent of the full price of a generic goes toward True Out of Pocket expense (TrOOP). Once this amount reaches $4700, then Stage 4 – Catastrophic coverage is reached. When You + Insurance Pays = $2960
Stage 4. Catastrophic Coverage You pay Greater of | 5% or $2.65 generic / $6.60 Brand (Monthly Premiums are in addition to cost shown below.)Part D – Standard Benefit, what you pay for drugs. Stage 1. Yearly Deductible You Pay 100% $0 to $320 Stage 3. Coverage Gap – “Donut Hole” Brand-name Stage 2. Initial Benefit Period Copays Insurance Pays Balance You Pay Copays Manufacturer Provides 50% discount Insurance Pays 5% You Pay 45% Of Drug Value You Pay 65% Of Drug Value Insurance Pays 35% Of Drug Value Generic TrOOP When YOU have paid $4700 (including Mfg. 50% disc.) then… In 2015, when in Stage 3 Coverage Gap, 95 percent of the full price of a brand name and 65 percent of the full price of a generic goes toward True Out of Pocket expense (TrOOP). Once this amount reaches $4700, then Stage 4 – Catastrophic coverage is reached. When You + Insurance Pays = $2960
Stage 4. Catastrophic Coverage You pay Greater of | 5% or $2.65 generic / $6.60 Brand Medicare Pays 80% Of Drug Value (Monthly Premiums are in addition to cost shown below.)Part D – Standard Benefit, what you pay for drugs. Stage 1. Yearly Deductible You Pay 100% $0 to $320 Stage 3. Coverage Gap – “Donut Hole” Brand-name Stage 2. Initial Benefit Period Copays Insurance Pays Balance You Pay Copays Manufacturer Provides 50% discount Insurance Pays 5% You Pay 45% Of Drug Value You Pay 65% Of Drug Value Insurance Pays 35% Of Drug Value Generic TrOOP When YOU have paid $4700 (including Mfg. 50% disc.) then… In 2015, when in Stage 3 Coverage Gap, 95 percent of the full price of a brand name and 65 percent of the full price of a generic goes toward True Out of Pocket expense (TrOOP). Once this amount reaches $4700, then Stage 4 – Catastrophic coverage is reached. When You + Insurance Pays = $2960
Stage 4. Catastrophic Coverage You pay Greater of | 5% or $2.65 generic / $6.60 Brand Medicare Pays 80% Of Drug Value Insurance Pays 15% of Drug Value (Monthly Premiums are in addition to cost shown below.)Part D – Standard Benefit, what you pay for drugs. Stage 1. Yearly Deductible You Pay 100% $0 to $320 Stage 3. Coverage Gap – “Donut Hole” Brand-name Stage 2. Initial Benefit Period Copays Insurance Pays Balance You Pay Copays Manufacturer Provides 50% discount Insurance Pays 5% You Pay 45% Of Drug Value You Pay 65% Of Drug Value Insurance Pays 35% Of Drug Value Generic TrOOP When YOU have paid $4700 (including Mfg. 50% disc.) then… In 2015, when in Stage 3 Coverage Gap, 95 percent of the full price of a brand name and 65 percent of the full price of a generic goes toward True Out of Pocket expense (TrOOP). Once this amount reaches $4700, then Stage 4 – Catastrophic coverage is reached. When You + Insurance Pays = $2960
Use only by permission from Senior Insurance Services of NCW, LLC. VRM [Network: Any provider that accepts Medicare] 2 Ways To Get Medicare Part A Inpatient Hospital Ins. Outpatient Medical Ins. Ded. $1260/Stay (Benefit Period Day 1-60) Prem: $104.90/mo. Ded: $147/yr. Co-Ins. You – 20% & Medicare – 80% NF 100% $188/mo. 100% K 50% $57-mo. $4940 MOOP $128/mo. Pt. B $147 Doc/$20 - ER/$50 [Doctor, Outpatient Surgery, Ambulance, etc.] Part B A B [Hospital, Hospice, Homecare, Skilled Nursing, etc.] G $158/mo. Pt. B $147 Rx – Prescription Drugs [Stand Alone Plans] Part D 1% Penalty Avg. $33.13/ mo. Formulary – Rx List Tiers 1 -5 [Monthly Changeable] Medi-Gaps Original Medicare Federal Gov’t Medicare ADVANTAGE Part C Part A
Use only by permission from Senior Insurance Services of NCW, LLC. VRM Part A [Network: Any provider that accepts Medicare] 2 Ways To Get Medicare Part A Inpatient Hospital Ins. Outpatient Medical Ins. Ded. $1260/Stay (Benefit Period Day 1-60) Prem: $104.90/mo. Ded: $147/yr. Co-Ins. You – 20% & Medicare – 80% NF 100% $188/mo. 100% K 50% $57-mo. $4940 MOOP $128/mo. Pt. B $147 Doc/$20 - ER/$50 [Doctor, Outpatient Surgery, Ambulance, etc.] Part B A B [Hospital, Hospice, Homecare, Skilled Nursing, etc.] G $158/mo. Pt. B $147 Rx – Prescription Drugs [Stand Alone Plans] Part D 1% Penalty Avg. $33.13/ mo. Formulary – Rx List Tiers 1 -5 [Monthly Changeable] Medi-Gaps Original Medicare Federal Gov’t Medicare ADVANTAGE Part C Part A
Use only by permission from Senior Insurance Services of NCW, LLC. VRM Part A Part B [Network: Any provider that accepts Medicare] 2 Ways To Get Medicare Inpatient Hospital Ins. Outpatient Medical Ins. Ded. $1260/Stay (Benefit Period Day 1-60) Prem: $104.90/mo. Ded: $147/yr. Co-Ins. You – 20% & Medicare – 80% NF 100% $188/mo. 100% K 50% $57-mo. $4940 MOOP $128/mo. Pt. B $147 Doc/$20 - ER/$50 [Doctor, Outpatient Surgery, Ambulance, etc.] Part A Part B A B [Hospital, Hospice, Homecare, Skilled Nursing, etc.] G $158/mo. Pt. B $147 Rx – Prescription Drugs [Stand Alone Plans] Part D 1% Penalty Avg. $33.13/ mo. Formulary – Rx List Tiers 1 -5 [Monthly Changeable] Medi-Gaps Original Medicare Federal Gov’t Medicare ADVANTAGE Part C
$104.90/mo. Use only by permission from Senior Insurance Services of NCW, LLC. VRM Part A Part B [Network: Any provider that accepts Medicare] 2 Ways To Get Medicare Inpatient Hospital Ins. Outpatient Medical Ins. Ded. $1260/Stay (Benefit Period Day 1-60) Prem: $104.90/mo. Ded: $147/yr. Co-Ins. You – 20% & Medicare – 80% NF 100% $188/mo. 100% K 50% $57-mo. $4940 MOOP $128/mo. Pt. B $147 Doc/$20 - ER/$50 [Doctor, Outpatient Surgery, Ambulance, etc.] Part A Part B A B [Hospital, Hospice, Homecare, Skilled Nursing, etc.] G $158/mo. Pt. B $147 Rx – Prescription Drugs [Stand Alone Plans] Part D 1% Penalty Avg. $33.13/ mo. Formulary – Rx List Tiers 1 -5 [Monthly Changeable] Medi-Gaps Original Medicare Federal Gov’t Medicare ADVANTAGE Part C
$104.90/mo. Use only by permission from Senior Insurance Services of NCW, LLC. VRM Part A Part B Most often included Part D [Network: Any provider that accepts Medicare] 2 Ways To Get Medicare Inpatient Hospital Ins. Outpatient Medical Ins. Ded. $1260/Stay (Benefit Period Day 1-60) Prem: $104.90/mo. Ded: $147/yr. Co-Ins. You – 20% & Medicare – 80% NF 100% $188/mo. 100% K 50% $57-mo. $4940 MOOP $128/mo. Pt. B $147 Doc/$20 - ER/$50 [Doctor, Outpatient Surgery, Ambulance, etc.] Part A Part B A B [Hospital, Hospice, Homecare, Skilled Nursing, etc.] G $158/mo. Pt. B $147 Rx – Prescription Drugs [Stand Alone Plans] Part D 1% Penalty Avg. $33.13/ mo. Formulary – Rx List Tiers 1 -5 [Monthly Changeable] Medi-Gaps Original Medicare Federal Gov’t Medicare ADVANTAGE Part C
HMO – Get your care in Network $104.90/mo. Use only by permission from Senior Insurance Services of NCW, LLC. VRM Part A Part B Most often included Part D 2 Ways To Get Medicare Inpatient Hospital Ins. Outpatient Medical Ins. Prem: $104.90/mo. Part A Part B A B Rx – Prescription Drugs [Stand Alone Plans] Part D Medi-Gaps Original Medicare Federal Gov’t Medicare ADVANTAGE Part C
HMO – Get your care in Network You choose your doctor $104.90/mo. Use only by permission from Senior Insurance Services of NCW, LLC. VRM Part A Part B Most often included Part D 2 Ways To Get Medicare Inpatient Hospital Ins. Outpatient Medical Ins. Prem: $104.90/mo. Part A Part B A B Rx – Prescription Drugs [Stand Alone Plans] Part D Medi-Gaps Original Medicare Federal Gov’t Medicare ADVANTAGE Part C
HMO – Get your care in Network You choose your doctor Low to No Monthly Premiums $104.90/mo. Use only by permission from Senior Insurance Services of NCW, LLC. VRM Part A Part B Most often included Part D 2 Ways To Get Medicare Inpatient Hospital Ins. Outpatient Medical Ins. Prem: $104.90/mo. Part A Part B A B Rx – Prescription Drugs [Stand Alone Plans] Part D Medi-Gaps Original Medicare Federal Gov’t Medicare ADVANTAGE Part C
HMO – Get your care in Network You choose your doctor Low to No Monthly Premiums Copays more predictable PCP copays Specialist copays Outpatient Surgery $104.90/mo. Use only by permission from Senior Insurance Services of NCW, LLC. VRM Part A Part B Most often included Part D 2 Ways To Get Medicare Inpatient Hospital Ins. Outpatient Medical Ins. Prem: $104.90/mo. Part A Part B A B Rx – Prescription Drugs [Stand Alone Plans] Part D Medi-Gaps Original Medicare Federal Gov’t Medicare ADVANTAGE Part C
HMO – Get your care in Network You choose your doctor Low to No Monthly Premiums Copays more predictable PCP copays Specialist copays Outpatient Surgery Worldwide Emergency Care$104.90/mo. Use only by permission from Senior Insurance Services of NCW, LLC. VRM Part A Part B Most often included Part D 2 Ways To Get Medicare Inpatient Hospital Ins. Outpatient Medical Ins. Prem: $104.90/mo. Part A Part B A B Rx – Prescription Drugs [Stand Alone Plans] Part D Medi-Gaps Original Medicare Federal Gov’t Medicare ADVANTAGE Part C
HMO – Get your care in Network You choose your doctor Low to No Monthly Premiums Copays more predictable PCP copays Specialist copays Outpatient Surgery Worldwide Emergency Care Additional Benefits - Dental - Vision - Health Club $104.90/mo. Use only by permission from Senior Insurance Services of NCW, LLC. VRM Part A Part B Most often included Part D 2 Ways To Get Medicare Inpatient Hospital Ins. Outpatient Medical Ins. Prem: $104.90/mo. Part A Part B A B Rx – Prescription Drugs [Stand Alone Plans] Part D Medi-Gaps Original Medicare Federal Gov’t Medicare ADVANTAGE Part C
HMO – Get your care in Network You choose your doctor Low to No Monthly Premiums Copays more predictable PCP copays Specialist copays Outpatient Surgery Worldwide Emergency Care Additional Benefits - Dental - Vision - Health Club 1. Review maximum cost exposure $104.90/mo. Use only by permission from Senior Insurance Services of NCW, LLC. VRM Part A Part B Most often included Part D 2 Ways To Get Medicare Inpatient Hospital Ins. Outpatient Medical Ins. Prem: $104.90/mo. Part A Part B A B Rx – Prescription Drugs [Stand Alone Plans] Part D Medi-Gaps Original Medicare Federal Gov’t Medicare ADVANTAGE Part C
HMO – Get your care in Network You choose your doctor Low to No Monthly Premiums Copays more predictable PCP copays Specialist copays Outpatient Surgery Worldwide Emergency Care Additional Benefits - Dental - Vision - Health Club 1. Review maximum cost exposure Accumulation of copays $104.90/mo. Use only by permission from Senior Insurance Services of NCW, LLC. VRM Part A Part B Most often included Part D 2 Ways To Get Medicare Inpatient Hospital Ins. Outpatient Medical Ins. Prem: $104.90/mo. Part A Part B A B Rx – Prescription Drugs [Stand Alone Plans] Part D Medi-Gaps Original Medicare Federal Gov’t Medicare ADVANTAGE Part C
HMO – Get your care in Network You choose your doctor Low to No Monthly Premiums Copays more predictable PCP copays Specialist copays Outpatient Surgery Worldwide Emergency Care Additional Benefits - Dental - Vision - Health Club 1. Review maximum cost exposure Accumulation of copays 2. Review Recurring Costs $104.90/mo. Use only by permission from Senior Insurance Services of NCW, LLC. VRM Part A Part B Most often included Part D 2 Ways To Get Medicare Inpatient Hospital Ins. Outpatient Medical Ins. Prem: $104.90/mo. Part A Part B A B Rx – Prescription Drugs [Stand Alone Plans] Part D Medi-Gaps Original Medicare Federal Gov’t Medicare ADVANTAGE Part C
HMO – Get your care in Network You choose your doctor Low to No Monthly Premiums Copays more predictable PCP copays Specialist copays Outpatient Surgery Worldwide Emergency Care Additional Benefits - Dental - Vision - Health Club 1. Review maximum cost exposure Accumulation of copays 2. Review Recurring Costs Doctor Visits Lab Visits Physical Therapy RX Costs Monthly Premium $104.90/mo. Use only by permission from Senior Insurance Services of NCW, LLC. VRM Part A Part B Most often included Part D 2 Ways To Get Medicare Inpatient Hospital Ins. Outpatient Medical Ins. Prem: $104.90/mo. Part A Part B A B Rx – Prescription Drugs [Stand Alone Plans] Part D Medi-Gaps Original Medicare Federal Gov’t Medicare ADVANTAGE Part C
HMO – Get your care in Network You choose your doctor Low to No Monthly Premiums Copays more predictable PCP copays Specialist copays Outpatient Surgery Worldwide Emergency Care Additional Benefits - Dental - Vision - Health Club 1. Review maximum cost exposure Accumulation of copays 2. Review Recurring Costs Doctor Visits Lab Visits Physical Therapy RX Costs Monthly Premium 3. Trial Right $104.90/mo. Use only by permission from Senior Insurance Services of NCW, LLC. VRM Part A Part B Most often included Part D 2 Ways To Get Medicare Inpatient Hospital Ins. Outpatient Medical Ins. Prem: $104.90/mo. Part A Part B A B Rx – Prescription Drugs [Stand Alone Plans] Part D Medi-Gaps Original Medicare Federal Gov’t Medicare ADVANTAGE Part C
HMO – Get your care in Network You choose your doctor Low to No Monthly Premiums Copays more predictable PCP copays Specialist copays Outpatient Surgery Worldwide Emergency Care Additional Benefits - Dental - Vision - Health Club 1. Review maximum cost exposure Accumulation of copays 2. Review Recurring Costs Doctor Visits Lab Visits Physical Therapy RX Costs Monthly Premium 3. Trial Right Formulary – Rx List Tiers 1 -5 $104.90/mo. Use only by permission from Senior Insurance Services of NCW, LLC. VRM Part A Part B Most often included Part D 2 Ways To Get Medicare Inpatient Hospital Ins. Outpatient Medical Ins. Prem: $104.90/mo. Part A Part B A B Rx – Prescription Drugs [Stand Alone Plans] Part D Medi-Gaps Original Medicare Federal Gov’t Medicare ADVANTAGE Part C
HMO – Get your care in Network You choose your doctor Low to No Monthly Premiums Copays more predictable PCP copays Specialist copays Outpatient Surgery Worldwide Emergency Care Additional Benefits - Dental - Vision - Health Club 1. Review maximum cost exposure Accumulation of copays 2. Review Recurring Costs Doctor Visits Lab Visits Physical Therapy RX Costs Monthly Premium 3. Trial Right Formulary – Rx List Tiers 1 -5 $104.90/mo. Use only by permission from Senior Insurance Services of NCW, LLC. VRM Part A Part B Most often included Part D ELIGIBILITY Part A & B 2 Ways To Get Medicare Inpatient Hospital Ins. Outpatient Medical Ins. Prem: $104.90/mo. Part A Part B A B Rx – Prescription Drugs [Stand Alone Plans] Part D Medi-Gaps Original Medicare Federal Gov’t Medicare ADVANTAGE Part C
HMO – Get your care in Network You choose your doctor Low to No Monthly Premiums Copays more predictable PCP copays Specialist copays Outpatient Surgery Worldwide Emergency Care Additional Benefits - Dental - Vision - Health Club 1. Review maximum cost exposure Accumulation of copays 2. Review Recurring Costs Doctor Visits Lab Visits Physical Therapy RX Costs Monthly Premium 3. Trial Right Formulary – Rx List Tiers 1 -5 $104.90/mo. Use only by permission from Senior Insurance Services of NCW, LLC. VRM Part A Part B Most often included Part D ELIGIBILITY Part A & B ESRD 2 Ways To Get Medicare Inpatient Hospital Ins. Outpatient Medical Ins. Prem: $104.90/mo. Part A Part B A B Rx – Prescription Drugs [Stand Alone Plans] Part D Medi-Gaps Original Medicare Federal Gov’t Medicare ADVANTAGE Part C
HMO – Get your care in Network You choose your doctor Low to No Monthly Premiums Copays more predictable PCP copays Specialist copays Outpatient Surgery Worldwide Emergency Care Additional Benefits - Dental - Vision - Health Club 1. Review maximum cost exposure Accumulation of copays 2. Review Recurring Costs Doctor Visits Lab Visits Physical Therapy RX Costs Monthly Premium 3. Trial Right Formulary – Rx List Tiers 1 -5 $104.90/mo. Use only by permission from Senior Insurance Services of NCW, LLC. VRM Part A Part B Most often included Part D ELIGIBILITY Part A & B ESRD 6 months in service area 2 Ways To Get Medicare Inpatient Hospital Ins. Outpatient Medical Ins. Prem: $104.90/mo. Part A Part B A B Rx – Prescription Drugs [Stand Alone Plans] Part D Medi-Gaps Original Medicare Federal Gov’t Medicare ADVANTAGE Part C
HMO – Get your care in Network You choose your doctor Low to No Monthly Premiums Copays more predictable PCP copays Specialist copays Outpatient Surgery Worldwide Emergency Care Additional Benefits - Dental - Vision - Health Club 1. Review maximum cost exposure Accumulation of copays 2. Review Recurring Costs Doctor Visits Lab Visits Physical Therapy RX Costs Monthly Premium 3. Trial Right Formulary – Rx List Tiers 1 -5 $104.90/mo. Use only by permission from Senior Insurance Services of NCW, LLC. VRM Part A Part B Most often included Part D ELIGIBILITY Part A & B ESRD 6 months in service area Election Periods AEP: Oct 15 – Dec 7 2 Ways To Get Medicare Inpatient Hospital Ins. Outpatient Medical Ins. Prem: $104.90/mo. Part A Part B A B Rx – Prescription Drugs [Stand Alone Plans] Part D Medi-Gaps Original Medicare Federal Gov’t Medicare ADVANTAGE Part C
HMO – Get your care in Network You choose your doctor Low to No Monthly Premiums Copays more predictable PCP copays Specialist copays Outpatient Surgery Worldwide Emergency Care Additional Benefits - Dental - Vision - Health Club 1. Review maximum cost exposure Accumulation of copays 2. Review Recurring Costs Doctor Visits Lab Visits Physical Therapy RX Costs Monthly Premium 3. Trial Right Formulary – Rx List Tiers 1 -5 $104.90/mo. Use only by permission from Senior Insurance Services of NCW, LLC. VRM Part A Part B Most often included Part D ELIGIBILITY Part A & B ESRD 6 months in service area Election Periods AEP: Oct 15 – Dec 7 MADP: Jan 1 – Feb 14 2 Ways To Get Medicare Inpatient Hospital Ins. Outpatient Medical Ins. Prem: $104.90/mo. Part A Part B A B Rx – Prescription Drugs [Stand Alone Plans] Part D Medi-Gaps Original Medicare Federal Gov’t Medicare ADVANTAGE Part C
HMO – Get your care in Network You choose your doctor Low to No Monthly Premiums Copays more predictable PCP copays Specialist copays Outpatient Surgery Worldwide Emergency Care Additional Benefits - Dental - Vision - Health Club 1. Review maximum cost exposure Accumulation of copays 2. Review Recurring Costs Doctor Visits Lab Visits Physical Therapy RX Costs Monthly Premium 3. Trial Right Formulary – Rx List Tiers 1 -5 $104.90/mo. Use only by permission from Senior Insurance Services of NCW, LLC. VRM Part A Part B Most often included Part D ELIGIBILITY Part A & B ESRD 6 months in service area Election Periods AEP: Oct 15 – Dec 7 MADP: Jan 1 – Feb 14 SEP: common examples Leave employer coverage Moving out of area 2 Ways To Get Medicare Inpatient Hospital Ins. Outpatient Medical Ins. Prem: $104.90/mo. Part A Part B A B Rx – Prescription Drugs [Stand Alone Plans] Part D Medi-Gaps Original Medicare Federal Gov’t Medicare ADVANTAGE Part C
HMO – Get your care in Network You choose your doctor Low to No Monthly Premiums Copays more predictable PCP copays Specialist copays Outpatient Surgery Worldwide Emergency Care Additional Benefits - Dental - Vision - Health Club 1. Review maximum cost exposure Accumulation of copays 2. Review Recurring Costs Doctor Visits Lab Visits Physical Therapy RX Costs Monthly Premium 3. Trial Right Formulary – Rx List Tiers 1 -5 $104.90/mo. Use only by permission from Senior Insurance Services of NCW, LLC. VRM Part A Part B Most often included Part D ELIGIBILITY Part A & B ESRD 6 months in service area Election Periods AEP: Oct 15 – Dec 7 MADP: Jan 1 – Feb 14 SEP: common examples Leave employer coverage Moving out of area LIS 2 Ways To Get Medicare Inpatient Hospital Ins. Outpatient Medical Ins. Prem: $104.90/mo. Part A Part B A B Rx – Prescription Drugs [Stand Alone Plans] Part D Medi-Gaps Original Medicare Federal Gov’t Medicare ADVANTAGE Part C
Inpatient Hospital Ins. Outpatient Medical Ins. Ded. $1260/Stay (Benefit Period Day 1-60) Prem: $104.90/mo. Ded: $147/yr. Co-Ins. You – 20% & Medicare – 80% NF 100% HMO – Get your care in Network You choose your doctor Low to No Monthly Premiums Copays more predictable PCP copays Specialist copays Outpatient Surgery Worldwide Emergency Care Additional Benefits - Dental - Vision - Health Club 1. Review maximum cost exposure Accumulation of copays 2. Review Recurring Costs Doctor Visits Lab Visits Physical Therapy RX Costs Monthly Premium 3. Trial Right Formulary – Rx List Tiers 1 -5 $188/mo. 100% K 50% $57-mo. $4940 MOOP $128/mo. Pt. B $147 Doc/$20 - ER/$50 [Doctor, Outpatient Surgery, Ambulance, etc.] Part A Part B $104.90/mo. Use only by permission from Senior Insurance Services of NCW, LLC. VRM A B [Hospital, Hospice, Homecare, Skilled Nursing, etc.] G $158/mo. Pt. B $147 Part A Part B Most often included Part DRx – Prescription Drugs [Stand Alone Plans] Part D 1% Penalty Avg. $33.13/ mo. Formulary – Rx List Tiers 1 -5 [Monthly Changeable] [Network: Any provider that accepts Medicare]Medi-Gaps Original Medicare Federal Gov’t 2 Ways To Get Medicare Medicare ADVANTAGE Part C

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Ray mac medicare education presentation long version

  • 1. 2 Ways To Get Medicare Use only by permission from Senior Insurance Services of NCW, LLC. VRM
  • 2. 2 Ways To Get Medicare Original Medicare Federal Gov’t Use only by permission from Senior Insurance Services of NCW, LLC. VRM
  • 3. 2 Ways To Get Medicare Original Medicare Federal Gov’t Use only by permission from Senior Insurance Services of NCW, LLC. VRM Medicare ADVANTAGE Part C
  • 4. Inpatient Hospital Ins.Part A Original Medicare Federal Gov’t 2 Ways To Get Medicare Use only by permission from Senior Insurance Services of NCW, LLC. VRM Medicare ADVANTAGE Part C
  • 5. Inpatient Hospital Ins.Part A [Hospital, Hospice, Homecare, Skilled Nursing, etc.] Original Medicare Federal Gov’t 2 Ways To Get Medicare Use only by permission from Senior Insurance Services of NCW, LLC. VRM Medicare ADVANTAGE Part C
  • 6. Inpatient Hospital Ins. Ded. $1260/Stay (Benefit Period Day 1-60) Part A [Hospital, Hospice, Homecare, Skilled Nursing, etc.] Original Medicare Federal Gov’t 2 Ways To Get Medicare Use only by permission from Senior Insurance Services of NCW, LLC. VRM Medicare ADVANTAGE Part C
  • 7. Outpatient Medical Ins.Part B Use only by permission from Senior Insurance Services of NCW, LLC. VRM Inpatient Hospital Ins. Ded. $1260/Stay (Benefit Period Day 1-60) Part A [Hospital, Hospice, Homecare, Skilled Nursing, etc.] Original Medicare Federal Gov’t 2 Ways To Get Medicare Medicare ADVANTAGE Part C
  • 8. Outpatient Medical Ins. [Doctor, Outpatient Surgery, Ambulance, etc.] Part B Use only by permission from Senior Insurance Services of NCW, LLC. VRM Inpatient Hospital Ins. Ded. $1260/Stay (Benefit Period Day 1-60) Part A [Hospital, Hospice, Homecare, Skilled Nursing, etc.] Original Medicare Federal Gov’t 2 Ways To Get Medicare Medicare ADVANTAGE Part C
  • 9. Outpatient Medical Ins. [Doctor, Outpatient Surgery, Ambulance, etc.] Part B Use only by permission from Senior Insurance Services of NCW, LLC. VRM Inpatient Hospital Ins. Ded. $1260/Stay (Benefit Period Day 1-60) Part A [Hospital, Hospice, Homecare, Skilled Nursing, etc.] Original Medicare Federal Gov’t 2 Ways To Get Medicare Medicare ADVANTAGE Part C Prem: $104.90/mo.
  • 10. Outpatient Medical Ins. [Doctor, Outpatient Surgery, Ambulance, etc.] Part B Use only by permission from Senior Insurance Services of NCW, LLC. VRM Inpatient Hospital Ins. Ded. $1260/Stay (Benefit Period Day 1-60) Part A [Hospital, Hospice, Homecare, Skilled Nursing, etc.] Original Medicare Federal Gov’t 2 Ways To Get Medicare Medicare ADVANTAGE Part C Prem: $104.90/mo. Ded: $147/yr.
  • 11. Outpatient Medical Ins. [Doctor, Outpatient Surgery, Ambulance, etc.] Part B Use only by permission from Senior Insurance Services of NCW, LLC. VRM Inpatient Hospital Ins. Ded. $1260/Stay (Benefit Period Day 1-60) Part A [Hospital, Hospice, Homecare, Skilled Nursing, etc.] Original Medicare Federal Gov’t 2 Ways To Get Medicare Medicare ADVANTAGE Part C Prem: $104.90/mo. Ded: $147/yr. Co-Ins. You – 20% & Medicare – 80%
  • 12. Use only by permission from Senior Insurance Services of NCW, LLC. VRM A B Inpatient Hospital Ins. Outpatient Medical Ins. Ded. $1260/Stay (Benefit Period Day 1-60) Prem: $104.90/mo. Ded: $147/yr. Co-Ins. You – 20% & Medicare – 80% [Doctor, Outpatient Surgery, Ambulance, etc.] Part A Part B [Hospital, Hospice, Homecare, Skilled Nursing, etc.] [Network: Any provider that accepts Medicare]Medi-Gaps Original Medicare Federal Gov’t 2 Ways To Get Medicare Medicare ADVANTAGE Part C
  • 13. Use only by permission from Senior Insurance Services of NCW, LLC. VRM A B Inpatient Hospital Ins. Outpatient Medical Ins. Ded. $1260/Stay (Benefit Period Day 1-60) Prem: $104.90/mo. Ded: $147/yr. Co-Ins. You – 20% & Medicare – 80% [Doctor, Outpatient Surgery, Ambulance, etc.] Part A Part B [Hospital, Hospice, Homecare, Skilled Nursing, etc.] [Monthly Changeable] [Network: Any provider that accepts Medicare]Medi-Gaps Original Medicare Federal Gov’t 2 Ways To Get Medicare Medicare ADVANTAGE Part C
  • 14. Use only by permission from Senior Insurance Services of NCW, LLC. VRM A B Inpatient Hospital Ins. Outpatient Medical Ins. Ded. $1260/Stay (Benefit Period Day 1-60) Prem: $104.90/mo. Ded: $147/yr. Co-Ins. You – 20% & Medicare – 80% [Doctor, Outpatient Surgery, Ambulance, etc.] Part A Part B [Hospital, Hospice, Homecare, Skilled Nursing, etc.] [Monthly Changeable] [Network: Any provider that accepts Medicare]Medi-Gaps 10 Letter Plans in Washington Original Medicare Federal Gov’t 2 Ways To Get Medicare Medicare ADVANTAGE Part C
  • 15. Use only by permission from Senior Insurance Services of NCW, LLC. VRM
  • 16. F 100% $179-$188 100% Use only by permission from Senior Insurance Services of NCW, LLC. VRM A B Inpatient Hospital Ins. Outpatient Medical Ins. Ded. $1260/Stay (Benefit Period Day 1-60) Prem: $104.90/mo. Ded: $147/yr. Co-Ins. You – 20% & Medicare – 80% [Doctor, Outpatient Surgery, Ambulance, etc.] Part A Part B [Hospital, Hospice, Homecare, Skilled Nursing, etc.] [Monthly Changeable] [Network: Any provider that accepts Medicare]Medi-Gaps Original Medicare Federal Gov’t 2 Ways To Get Medicare Medicare ADVANTAGE Part C
  • 17. F 100% $179-$188 100% Use only by permission from Senior Insurance Services of NCW, LLC. VRM A B Inpatient Hospital Ins. Outpatient Medical Ins. Ded. $1260/Stay (Benefit Period Day 1-60) Prem: $104.90/mo. Ded: $147/yr. Co-Ins. You – 20% & Medicare – 80% [Doctor, Outpatient Surgery, Ambulance, etc.] Part A Part B [Hospital, Hospice, Homecare, Skilled Nursing, etc.] G $158 Pt. B $147 [Monthly Changeable] [Network: Any provider that accepts Medicare]Medi-Gaps Original Medicare Federal Gov’t 2 Ways To Get Medicare Medicare ADVANTAGE Part C
  • 18. NF 100% $179-$188 100% $128 Pt. B $147 Doc/$20 - ER/$50 Use only by permission from Senior Insurance Services of NCW, LLC. VRM A B Inpatient Hospital Ins. Outpatient Medical Ins. Ded. $1260/Stay (Benefit Period Day 1-60) Prem: $104.90/mo. Ded: $147/yr. Co-Ins. You – 20% & Medicare – 80% [Doctor, Outpatient Surgery, Ambulance, etc.] Part A Part B [Hospital, Hospice, Homecare, Skilled Nursing, etc.] G $158 Pt. B $147 [Monthly Changeable] [Network: Any provider that accepts Medicare]Medi-Gaps Original Medicare Federal Gov’t 2 Ways To Get Medicare Medicare ADVANTAGE Part C
  • 19. NF 100% $179-$188 100% K 50% $57 $4940 MOOP $128 Pt. B $147 Doc/$20 - ER/$50 Use only by permission from Senior Insurance Services of NCW, LLC. VRM A B Inpatient Hospital Ins. Outpatient Medical Ins. Ded. $1260/Stay (Benefit Period Day 1-60) Prem: $104.90/mo. Ded: $147/yr. Co-Ins. You – 20% & Medicare – 80% [Doctor, Outpatient Surgery, Ambulance, etc.] Part A Part B [Hospital, Hospice, Homecare, Skilled Nursing, etc.] G $158 Pt. B $147 [Monthly Changeable] [Network: Any provider that accepts Medicare]Medi-Gaps Original Medicare Federal Gov’t 2 Ways To Get Medicare Medicare ADVANTAGE Part C
  • 20. Use only by permission from Senior Insurance Services of NCW, LLC. VRM Rx – Prescription Drugs [Stand Alone Plans] Part D Inpatient Hospital Ins. Outpatient Medical Ins. Ded. $1260/Stay (Benefit Period Day 1-60) Prem: $104.90/mo. Ded: $147/yr. Co-Ins. You – 20% & Medicare – 80% NF 100% $179-$188 100% K 50% $57 $4940 MOOP $128 Pt. B $147 Doc/$20 - ER/$50 [Doctor, Outpatient Surgery, Ambulance, etc.] Part A Part B A B [Hospital, Hospice, Homecare, Skilled Nursing, etc.] G $158 Pt. B $147 [Monthly Changeable] [Network: Any provider that accepts Medicare]Medi-Gaps Original Medicare Federal Gov’t 2 Ways To Get Medicare Medicare ADVANTAGE Part C
  • 21. Use only by permission from Senior Insurance Services of NCW, LLC. VRM Rx – Prescription Drugs [Stand Alone Plans] Part D Avg. $33.13/ mo. Inpatient Hospital Ins. Outpatient Medical Ins. Ded. $1260/Stay (Benefit Period Day 1-60) Prem: $104.90/mo. Ded: $147/yr. Co-Ins. You – 20% & Medicare – 80% NF 100% $179-$188 100% K 50% $57 $4940 MOOP $128 Pt. B $147 Doc/$20 - ER/$50 [Doctor, Outpatient Surgery, Ambulance, etc.] Part A Part B A B [Hospital, Hospice, Homecare, Skilled Nursing, etc.] G $158 Pt. B $147 [Monthly Changeable] [Network: Any provider that accepts Medicare]Medi-Gaps Original Medicare Federal Gov’t 2 Ways To Get Medicare Medicare ADVANTAGE Part C
  • 22. Use only by permission from Senior Insurance Services of NCW, LLC. VRM Rx – Prescription Drugs [Stand Alone Plans] Part D Avg. $33.13/ mo. Formulary – Rx List Tiers 1 -5 Inpatient Hospital Ins. Outpatient Medical Ins. Ded. $1260/Stay (Benefit Period Day 1-60) Prem: $104.90/mo. Ded: $147/yr. Co-Ins. You – 20% & Medicare – 80% NF 100% $179-$188 100% K 50% $57 $4940 MOOP $128 Pt. B $147 Doc/$20 - ER/$50 [Doctor, Outpatient Surgery, Ambulance, etc.] Part A Part B A B [Hospital, Hospice, Homecare, Skilled Nursing, etc.] G $158 Pt. B $147 [Monthly Changeable] [Network: Any provider that accepts Medicare]Medi-Gaps Original Medicare Federal Gov’t 2 Ways To Get Medicare Medicare ADVANTAGE Part C
  • 23. Use only by permission from Senior Insurance Services of NCW, LLC. VRM Rx – Prescription Drugs [Stand Alone Plans] Part D 1% Penalty Avg. $33.13/ mo. Formulary – Rx List Tiers 1 -5 Inpatient Hospital Ins. Outpatient Medical Ins. Ded. $1260/Stay (Benefit Period Day 1-60) Prem: $104.90/mo. Ded: $147/yr. Co-Ins. You – 20% & Medicare – 80% NF 100% $179-$188 100% K 50% $57 $4940 MOOP $128 Pt. B $147 Doc/$20 - ER/$50 [Doctor, Outpatient Surgery, Ambulance, etc.] Part A Part B A B [Hospital, Hospice, Homecare, Skilled Nursing, etc.] G $158 Pt. B $147 [Monthly Changeable] [Network: Any provider that accepts Medicare]Medi-Gaps Original Medicare Federal Gov’t 2 Ways To Get Medicare Medicare ADVANTAGE Part C
  • 24. Use only by permission from Senior Insurance Services of NCW, LLC. VRM Rx – Prescription Drugs [Stand Alone Plans] Part D 1% Penalty Avg. $33.13/ mo. 1. Formulary - a list of prescription drugs covered by a Plan. Formulary – Rx List Tiers 1 -5
  • 25. Use only by permission from Senior Insurance Services of NCW, LLC. VRM Rx – Prescription Drugs [Stand Alone Plans] Part D 1% Penalty Avg. $33.13/ mo. 1. Formulary - a list of prescription drugs covered by a Plan. 2. Tier level determines what your copay will be for a given drug. Higher tier = higher cost. Formulary – Rx List Tiers 1 -5
  • 26. Use only by permission from Senior Insurance Services of NCW, LLC. VRM Rx – Prescription Drugs [Stand Alone Plans] Part D 1% Penalty Avg. $33.13/ mo. 1. Formulary - a list of prescription drugs covered by a Plan. 2. Tier level determines what your copay will be for a given drug. Higher tier = higher cost 3. 90-Day Supply Formulary – Rx List Tiers 1 -5
  • 27. Use only by permission from Senior Insurance Services of NCW, LLC. VRM Rx – Prescription Drugs [Stand Alone Plans] Part D 1% Penalty Avg. $33.13/ mo. 1. Formulary - a list of prescription drugs covered by a Plan. 2. Tier level determines what your copay will be for a given drug. Higher tier = higher cost 3. 90-Day Supply 4. Step Therapy – Some drugs require you to try another drug first. Formulary – Rx List Tiers 1 -5
  • 28. Use only by permission from Senior Insurance Services of NCW, LLC. VRM Rx – Prescription Drugs [Stand Alone Plans] Part D 1% Penalty Avg. $33.13/ mo. 1. Formulary - a list of prescription drugs covered by a Plan. 2. Tier level determines what your copay will be for a given drug. Higher tier = higher cost 3. 90-Day Supply 4. Step Therapy – Some drugs require you to try another drug first. 5. Exceptions Formulary – Rx List Tiers 1 -5
  • 29. Use only by permission from Senior Insurance Services of NCW, LLC. VRM Rx – Prescription Drugs [Stand Alone Plans] Part D 1% Penalty Avg. $33.13/ mo. 1. Formulary - a list of prescription drugs covered by a Plan. 2. Tier level determines what your copay will be for a given drug. Higher tier = higher cost 3. 90-Day Supply 4. Step Therapy – Some drugs require you to try another drug first. 5. Exceptions 6. Network Pharmacies – unless emergency Formulary – Rx List Tiers 1 -5
  • 30. Use only by permission from Senior Insurance Services of NCW, LLC. VRM Rx – Prescription Drugs [Stand Alone Plans] Part D 1% Penalty Avg. $33.13/ mo. 1. Formulary - a list of prescription drugs covered by a Plan. 2. Tier level determines what your copay will be for a given drug. Higher tier = higher cost 3. 90-Day Supply 4. Step Therapy – Some drugs require you to try another drug first. 5. Exceptions 6. Network Pharmacies – unless emergency 7. Low Income Subsidy Formulary – Rx List Tiers 1 -5
  • 31. (Monthly Premiums are in addition to cost shown below.)Part D – Standard Benefit, what you pay for drugs.
  • 32. Stage 1. Yearly Deductible (Monthly Premiums are in addition to cost shown below.)Part D – Standard Benefit, what you pay for drugs.
  • 33. Stage 1. Yearly Deductible You Pay 100% $0 to $320 (Monthly Premiums are in addition to cost shown below.)Part D – Standard Benefit, what you pay for drugs.
  • 34. Stage 2. Initial Benefit Period Copays Stage 1. Yearly Deductible You Pay 100% $0 to $320 (Monthly Premiums are in addition to cost shown below.)Part D – Standard Benefit, what you pay for drugs.
  • 35. Stage 2. Initial Benefit Period Copays You Pay Copays Stage 1. Yearly Deductible You Pay 100% $0 to $320 (Monthly Premiums are in addition to cost shown below.)Part D – Standard Benefit, what you pay for drugs.
  • 36. Stage 2. Initial Benefit Period Copays Insurance Pays Balance You Pay Copays Stage 1. Yearly Deductible You Pay 100% $0 to $320 (Monthly Premiums are in addition to cost shown below.)Part D – Standard Benefit, what you pay for drugs.
  • 37. Stage 1. Yearly Deductible You Pay 100% $0 to $320 Stage 2. Initial Benefit Period Copays Insurance Pays Balance You Pay Copays (Monthly Premiums are in addition to cost shown below.)Part D – Standard Benefit, what you pay for drugs. When You
  • 38. Stage 1. Yearly Deductible You Pay 100% $0 to $320 Stage 2. Initial Benefit Period Copays Insurance Pays Balance You Pay Copays (Monthly Premiums are in addition to cost shown below.)Part D – Standard Benefit, what you pay for drugs. When You + Insurance Pays
  • 39. Stage 1. Yearly Deductible You Pay 100% $0 to $320 Stage 2. Initial Benefit Period Copays Insurance Pays Balance You Pay Copays (Monthly Premiums are in addition to cost shown below.)Part D – Standard Benefit, what you pay for drugs. When You + Insurance Pays = $2960
  • 40. Stage 3. Coverage Gap – “Donut Hole” (Monthly Premiums are in addition to cost shown below.)Part D – Standard Benefit, what you pay for drugs. Stage 1. Yearly Deductible You Pay 100% $0 to $320 Stage 2. Initial Benefit Period Copays Insurance Pays Balance You Pay Copays When You + Insurance Pays = $2960
  • 41. Stage 3. Coverage Gap – “Donut Hole” Brand-name You Pay 45% Of Drug Value (Monthly Premiums are in addition to cost shown below.)Part D – Standard Benefit, what you pay for drugs. Stage 1. Yearly Deductible You Pay 100% $0 to $320 Stage 2. Initial Benefit Period Copays Insurance Pays Balance You Pay Copays When You + Insurance Pays = $2960
  • 42. Stage 3. Coverage Gap – “Donut Hole” Brand-name Manufacturer Provides 50% discount You Pay 45% Of Drug Value (Monthly Premiums are in addition to cost shown below.)Part D – Standard Benefit, what you pay for drugs. Stage 1. Yearly Deductible You Pay 100% $0 to $320 Stage 2. Initial Benefit Period Copays Insurance Pays Balance You Pay Copays When You + Insurance Pays = $2960
  • 43. Stage 3. Coverage Gap – “Donut Hole” Brand-name Manufacturer Provides 50% discount Insurance Pays 5% You Pay 45% Of Drug Value (Monthly Premiums are in addition to cost shown below.)Part D – Standard Benefit, what you pay for drugs. Stage 1. Yearly Deductible You Pay 100% $0 to $320 Stage 2. Initial Benefit Period Copays Insurance Pays Balance You Pay Copays When You + Insurance Pays = $2960
  • 44. Stage 3. Coverage Gap – “Donut Hole” You Pay 65% Of Drug Value Generic (Monthly Premiums are in addition to cost shown below.)Part D – Standard Benefit, what you pay for drugs. Stage 1. Yearly Deductible You Pay 100% $0 to $320 Brand-name Stage 2. Initial Benefit Period Copays Insurance Pays Balance You Pay Copays Manufacturer Provides 50% discount Insurance Pays 5% You Pay 45% Of Drug Value When You + Insurance Pays = $2960
  • 45. Stage 3. Coverage Gap – “Donut Hole” You Pay 65% Of Drug Value Insurance Pays 35% Of Drug Value Generic (Monthly Premiums are in addition to cost shown below.)Part D – Standard Benefit, what you pay for drugs. Stage 1. Yearly Deductible You Pay 100% $0 to $320 Brand-name Stage 2. Initial Benefit Period Copays Insurance Pays Balance You Pay Copays Manufacturer Provides 50% discount Insurance Pays 5% You Pay 45% Of Drug Value When You + Insurance Pays = $2960
  • 46. TrOOP When YOU have paid $4700 (including Mfg. 50% disc.) then… (Monthly Premiums are in addition to cost shown below.)Part D – Standard Benefit, what you pay for drugs. Stage 1. Yearly Deductible You Pay 100% $0 to $320 Stage 3. Coverage Gap – “Donut Hole” Brand-name Stage 2. Initial Benefit Period Copays Insurance Pays Balance You Pay Copays Manufacturer Provides 50% discount Insurance Pays 5% You Pay 45% Of Drug Value You Pay 65% Of Drug Value Insurance Pays 35% Of Drug Value Generic When You + Insurance Pays = $2960 In 2015, when in Stage 3 Coverage Gap, 95 percent of the full price of a brand name and 65 percent of the full price of a generic goes toward True Out of Pocket expense (TrOOP). Once this amount reaches $4700, then Stage 4 – Catastrophic coverage is reached.
  • 47. Stage 4. Catastrophic Coverage (Monthly Premiums are in addition to cost shown below.)Part D – Standard Benefit, what you pay for drugs. Stage 1. Yearly Deductible You Pay 100% $0 to $320 Stage 3. Coverage Gap – “Donut Hole” Brand-name Stage 2. Initial Benefit Period Copays Insurance Pays Balance You Pay Copays Manufacturer Provides 50% discount Insurance Pays 5% You Pay 45% Of Drug Value You Pay 65% Of Drug Value Insurance Pays 35% Of Drug Value Generic TrOOP When YOU have paid $4700 (including Mfg. 50% disc.) then… In 2015, when in Stage 3 Coverage Gap, 95 percent of the full price of a brand name and 65 percent of the full price of a generic goes toward True Out of Pocket expense (TrOOP). Once this amount reaches $4700, then Stage 4 – Catastrophic coverage is reached. When You + Insurance Pays = $2960
  • 48. Stage 4. Catastrophic Coverage You pay Greater of | 5% or $2.65 generic / $6.60 Brand (Monthly Premiums are in addition to cost shown below.)Part D – Standard Benefit, what you pay for drugs. Stage 1. Yearly Deductible You Pay 100% $0 to $320 Stage 3. Coverage Gap – “Donut Hole” Brand-name Stage 2. Initial Benefit Period Copays Insurance Pays Balance You Pay Copays Manufacturer Provides 50% discount Insurance Pays 5% You Pay 45% Of Drug Value You Pay 65% Of Drug Value Insurance Pays 35% Of Drug Value Generic TrOOP When YOU have paid $4700 (including Mfg. 50% disc.) then… In 2015, when in Stage 3 Coverage Gap, 95 percent of the full price of a brand name and 65 percent of the full price of a generic goes toward True Out of Pocket expense (TrOOP). Once this amount reaches $4700, then Stage 4 – Catastrophic coverage is reached. When You + Insurance Pays = $2960
  • 49. Stage 4. Catastrophic Coverage You pay Greater of | 5% or $2.65 generic / $6.60 Brand Medicare Pays 80% Of Drug Value (Monthly Premiums are in addition to cost shown below.)Part D – Standard Benefit, what you pay for drugs. Stage 1. Yearly Deductible You Pay 100% $0 to $320 Stage 3. Coverage Gap – “Donut Hole” Brand-name Stage 2. Initial Benefit Period Copays Insurance Pays Balance You Pay Copays Manufacturer Provides 50% discount Insurance Pays 5% You Pay 45% Of Drug Value You Pay 65% Of Drug Value Insurance Pays 35% Of Drug Value Generic TrOOP When YOU have paid $4700 (including Mfg. 50% disc.) then… In 2015, when in Stage 3 Coverage Gap, 95 percent of the full price of a brand name and 65 percent of the full price of a generic goes toward True Out of Pocket expense (TrOOP). Once this amount reaches $4700, then Stage 4 – Catastrophic coverage is reached. When You + Insurance Pays = $2960
  • 50. Stage 4. Catastrophic Coverage You pay Greater of | 5% or $2.65 generic / $6.60 Brand Medicare Pays 80% Of Drug Value Insurance Pays 15% of Drug Value (Monthly Premiums are in addition to cost shown below.)Part D – Standard Benefit, what you pay for drugs. Stage 1. Yearly Deductible You Pay 100% $0 to $320 Stage 3. Coverage Gap – “Donut Hole” Brand-name Stage 2. Initial Benefit Period Copays Insurance Pays Balance You Pay Copays Manufacturer Provides 50% discount Insurance Pays 5% You Pay 45% Of Drug Value You Pay 65% Of Drug Value Insurance Pays 35% Of Drug Value Generic TrOOP When YOU have paid $4700 (including Mfg. 50% disc.) then… In 2015, when in Stage 3 Coverage Gap, 95 percent of the full price of a brand name and 65 percent of the full price of a generic goes toward True Out of Pocket expense (TrOOP). Once this amount reaches $4700, then Stage 4 – Catastrophic coverage is reached. When You + Insurance Pays = $2960
  • 51. Use only by permission from Senior Insurance Services of NCW, LLC. VRM [Network: Any provider that accepts Medicare] 2 Ways To Get Medicare Part A Inpatient Hospital Ins. Outpatient Medical Ins. Ded. $1260/Stay (Benefit Period Day 1-60) Prem: $104.90/mo. Ded: $147/yr. Co-Ins. You – 20% & Medicare – 80% NF 100% $188/mo. 100% K 50% $57-mo. $4940 MOOP $128/mo. Pt. B $147 Doc/$20 - ER/$50 [Doctor, Outpatient Surgery, Ambulance, etc.] Part B A B [Hospital, Hospice, Homecare, Skilled Nursing, etc.] G $158/mo. Pt. B $147 Rx – Prescription Drugs [Stand Alone Plans] Part D 1% Penalty Avg. $33.13/ mo. Formulary – Rx List Tiers 1 -5 [Monthly Changeable] Medi-Gaps Original Medicare Federal Gov’t Medicare ADVANTAGE Part C Part A
  • 52. Use only by permission from Senior Insurance Services of NCW, LLC. VRM Part A [Network: Any provider that accepts Medicare] 2 Ways To Get Medicare Part A Inpatient Hospital Ins. Outpatient Medical Ins. Ded. $1260/Stay (Benefit Period Day 1-60) Prem: $104.90/mo. Ded: $147/yr. Co-Ins. You – 20% & Medicare – 80% NF 100% $188/mo. 100% K 50% $57-mo. $4940 MOOP $128/mo. Pt. B $147 Doc/$20 - ER/$50 [Doctor, Outpatient Surgery, Ambulance, etc.] Part B A B [Hospital, Hospice, Homecare, Skilled Nursing, etc.] G $158/mo. Pt. B $147 Rx – Prescription Drugs [Stand Alone Plans] Part D 1% Penalty Avg. $33.13/ mo. Formulary – Rx List Tiers 1 -5 [Monthly Changeable] Medi-Gaps Original Medicare Federal Gov’t Medicare ADVANTAGE Part C Part A
  • 53. Use only by permission from Senior Insurance Services of NCW, LLC. VRM Part A Part B [Network: Any provider that accepts Medicare] 2 Ways To Get Medicare Inpatient Hospital Ins. Outpatient Medical Ins. Ded. $1260/Stay (Benefit Period Day 1-60) Prem: $104.90/mo. Ded: $147/yr. Co-Ins. You – 20% & Medicare – 80% NF 100% $188/mo. 100% K 50% $57-mo. $4940 MOOP $128/mo. Pt. B $147 Doc/$20 - ER/$50 [Doctor, Outpatient Surgery, Ambulance, etc.] Part A Part B A B [Hospital, Hospice, Homecare, Skilled Nursing, etc.] G $158/mo. Pt. B $147 Rx – Prescription Drugs [Stand Alone Plans] Part D 1% Penalty Avg. $33.13/ mo. Formulary – Rx List Tiers 1 -5 [Monthly Changeable] Medi-Gaps Original Medicare Federal Gov’t Medicare ADVANTAGE Part C
  • 54. $104.90/mo. Use only by permission from Senior Insurance Services of NCW, LLC. VRM Part A Part B [Network: Any provider that accepts Medicare] 2 Ways To Get Medicare Inpatient Hospital Ins. Outpatient Medical Ins. Ded. $1260/Stay (Benefit Period Day 1-60) Prem: $104.90/mo. Ded: $147/yr. Co-Ins. You – 20% & Medicare – 80% NF 100% $188/mo. 100% K 50% $57-mo. $4940 MOOP $128/mo. Pt. B $147 Doc/$20 - ER/$50 [Doctor, Outpatient Surgery, Ambulance, etc.] Part A Part B A B [Hospital, Hospice, Homecare, Skilled Nursing, etc.] G $158/mo. Pt. B $147 Rx – Prescription Drugs [Stand Alone Plans] Part D 1% Penalty Avg. $33.13/ mo. Formulary – Rx List Tiers 1 -5 [Monthly Changeable] Medi-Gaps Original Medicare Federal Gov’t Medicare ADVANTAGE Part C
  • 55. $104.90/mo. Use only by permission from Senior Insurance Services of NCW, LLC. VRM Part A Part B Most often included Part D [Network: Any provider that accepts Medicare] 2 Ways To Get Medicare Inpatient Hospital Ins. Outpatient Medical Ins. Ded. $1260/Stay (Benefit Period Day 1-60) Prem: $104.90/mo. Ded: $147/yr. Co-Ins. You – 20% & Medicare – 80% NF 100% $188/mo. 100% K 50% $57-mo. $4940 MOOP $128/mo. Pt. B $147 Doc/$20 - ER/$50 [Doctor, Outpatient Surgery, Ambulance, etc.] Part A Part B A B [Hospital, Hospice, Homecare, Skilled Nursing, etc.] G $158/mo. Pt. B $147 Rx – Prescription Drugs [Stand Alone Plans] Part D 1% Penalty Avg. $33.13/ mo. Formulary – Rx List Tiers 1 -5 [Monthly Changeable] Medi-Gaps Original Medicare Federal Gov’t Medicare ADVANTAGE Part C
  • 56. HMO – Get your care in Network $104.90/mo. Use only by permission from Senior Insurance Services of NCW, LLC. VRM Part A Part B Most often included Part D 2 Ways To Get Medicare Inpatient Hospital Ins. Outpatient Medical Ins. Prem: $104.90/mo. Part A Part B A B Rx – Prescription Drugs [Stand Alone Plans] Part D Medi-Gaps Original Medicare Federal Gov’t Medicare ADVANTAGE Part C
  • 57. HMO – Get your care in Network You choose your doctor $104.90/mo. Use only by permission from Senior Insurance Services of NCW, LLC. VRM Part A Part B Most often included Part D 2 Ways To Get Medicare Inpatient Hospital Ins. Outpatient Medical Ins. Prem: $104.90/mo. Part A Part B A B Rx – Prescription Drugs [Stand Alone Plans] Part D Medi-Gaps Original Medicare Federal Gov’t Medicare ADVANTAGE Part C
  • 58. HMO – Get your care in Network You choose your doctor Low to No Monthly Premiums $104.90/mo. Use only by permission from Senior Insurance Services of NCW, LLC. VRM Part A Part B Most often included Part D 2 Ways To Get Medicare Inpatient Hospital Ins. Outpatient Medical Ins. Prem: $104.90/mo. Part A Part B A B Rx – Prescription Drugs [Stand Alone Plans] Part D Medi-Gaps Original Medicare Federal Gov’t Medicare ADVANTAGE Part C
  • 59. HMO – Get your care in Network You choose your doctor Low to No Monthly Premiums Copays more predictable PCP copays Specialist copays Outpatient Surgery $104.90/mo. Use only by permission from Senior Insurance Services of NCW, LLC. VRM Part A Part B Most often included Part D 2 Ways To Get Medicare Inpatient Hospital Ins. Outpatient Medical Ins. Prem: $104.90/mo. Part A Part B A B Rx – Prescription Drugs [Stand Alone Plans] Part D Medi-Gaps Original Medicare Federal Gov’t Medicare ADVANTAGE Part C
  • 60. HMO – Get your care in Network You choose your doctor Low to No Monthly Premiums Copays more predictable PCP copays Specialist copays Outpatient Surgery Worldwide Emergency Care$104.90/mo. Use only by permission from Senior Insurance Services of NCW, LLC. VRM Part A Part B Most often included Part D 2 Ways To Get Medicare Inpatient Hospital Ins. Outpatient Medical Ins. Prem: $104.90/mo. Part A Part B A B Rx – Prescription Drugs [Stand Alone Plans] Part D Medi-Gaps Original Medicare Federal Gov’t Medicare ADVANTAGE Part C
  • 61. HMO – Get your care in Network You choose your doctor Low to No Monthly Premiums Copays more predictable PCP copays Specialist copays Outpatient Surgery Worldwide Emergency Care Additional Benefits - Dental - Vision - Health Club $104.90/mo. Use only by permission from Senior Insurance Services of NCW, LLC. VRM Part A Part B Most often included Part D 2 Ways To Get Medicare Inpatient Hospital Ins. Outpatient Medical Ins. Prem: $104.90/mo. Part A Part B A B Rx – Prescription Drugs [Stand Alone Plans] Part D Medi-Gaps Original Medicare Federal Gov’t Medicare ADVANTAGE Part C
  • 62. HMO – Get your care in Network You choose your doctor Low to No Monthly Premiums Copays more predictable PCP copays Specialist copays Outpatient Surgery Worldwide Emergency Care Additional Benefits - Dental - Vision - Health Club 1. Review maximum cost exposure $104.90/mo. Use only by permission from Senior Insurance Services of NCW, LLC. VRM Part A Part B Most often included Part D 2 Ways To Get Medicare Inpatient Hospital Ins. Outpatient Medical Ins. Prem: $104.90/mo. Part A Part B A B Rx – Prescription Drugs [Stand Alone Plans] Part D Medi-Gaps Original Medicare Federal Gov’t Medicare ADVANTAGE Part C
  • 63. HMO – Get your care in Network You choose your doctor Low to No Monthly Premiums Copays more predictable PCP copays Specialist copays Outpatient Surgery Worldwide Emergency Care Additional Benefits - Dental - Vision - Health Club 1. Review maximum cost exposure Accumulation of copays $104.90/mo. Use only by permission from Senior Insurance Services of NCW, LLC. VRM Part A Part B Most often included Part D 2 Ways To Get Medicare Inpatient Hospital Ins. Outpatient Medical Ins. Prem: $104.90/mo. Part A Part B A B Rx – Prescription Drugs [Stand Alone Plans] Part D Medi-Gaps Original Medicare Federal Gov’t Medicare ADVANTAGE Part C
  • 64. HMO – Get your care in Network You choose your doctor Low to No Monthly Premiums Copays more predictable PCP copays Specialist copays Outpatient Surgery Worldwide Emergency Care Additional Benefits - Dental - Vision - Health Club 1. Review maximum cost exposure Accumulation of copays 2. Review Recurring Costs $104.90/mo. Use only by permission from Senior Insurance Services of NCW, LLC. VRM Part A Part B Most often included Part D 2 Ways To Get Medicare Inpatient Hospital Ins. Outpatient Medical Ins. Prem: $104.90/mo. Part A Part B A B Rx – Prescription Drugs [Stand Alone Plans] Part D Medi-Gaps Original Medicare Federal Gov’t Medicare ADVANTAGE Part C
  • 65. HMO – Get your care in Network You choose your doctor Low to No Monthly Premiums Copays more predictable PCP copays Specialist copays Outpatient Surgery Worldwide Emergency Care Additional Benefits - Dental - Vision - Health Club 1. Review maximum cost exposure Accumulation of copays 2. Review Recurring Costs Doctor Visits Lab Visits Physical Therapy RX Costs Monthly Premium $104.90/mo. Use only by permission from Senior Insurance Services of NCW, LLC. VRM Part A Part B Most often included Part D 2 Ways To Get Medicare Inpatient Hospital Ins. Outpatient Medical Ins. Prem: $104.90/mo. Part A Part B A B Rx – Prescription Drugs [Stand Alone Plans] Part D Medi-Gaps Original Medicare Federal Gov’t Medicare ADVANTAGE Part C
  • 66. HMO – Get your care in Network You choose your doctor Low to No Monthly Premiums Copays more predictable PCP copays Specialist copays Outpatient Surgery Worldwide Emergency Care Additional Benefits - Dental - Vision - Health Club 1. Review maximum cost exposure Accumulation of copays 2. Review Recurring Costs Doctor Visits Lab Visits Physical Therapy RX Costs Monthly Premium 3. Trial Right $104.90/mo. Use only by permission from Senior Insurance Services of NCW, LLC. VRM Part A Part B Most often included Part D 2 Ways To Get Medicare Inpatient Hospital Ins. Outpatient Medical Ins. Prem: $104.90/mo. Part A Part B A B Rx – Prescription Drugs [Stand Alone Plans] Part D Medi-Gaps Original Medicare Federal Gov’t Medicare ADVANTAGE Part C
  • 67. HMO – Get your care in Network You choose your doctor Low to No Monthly Premiums Copays more predictable PCP copays Specialist copays Outpatient Surgery Worldwide Emergency Care Additional Benefits - Dental - Vision - Health Club 1. Review maximum cost exposure Accumulation of copays 2. Review Recurring Costs Doctor Visits Lab Visits Physical Therapy RX Costs Monthly Premium 3. Trial Right Formulary – Rx List Tiers 1 -5 $104.90/mo. Use only by permission from Senior Insurance Services of NCW, LLC. VRM Part A Part B Most often included Part D 2 Ways To Get Medicare Inpatient Hospital Ins. Outpatient Medical Ins. Prem: $104.90/mo. Part A Part B A B Rx – Prescription Drugs [Stand Alone Plans] Part D Medi-Gaps Original Medicare Federal Gov’t Medicare ADVANTAGE Part C
  • 68. HMO – Get your care in Network You choose your doctor Low to No Monthly Premiums Copays more predictable PCP copays Specialist copays Outpatient Surgery Worldwide Emergency Care Additional Benefits - Dental - Vision - Health Club 1. Review maximum cost exposure Accumulation of copays 2. Review Recurring Costs Doctor Visits Lab Visits Physical Therapy RX Costs Monthly Premium 3. Trial Right Formulary – Rx List Tiers 1 -5 $104.90/mo. Use only by permission from Senior Insurance Services of NCW, LLC. VRM Part A Part B Most often included Part D ELIGIBILITY Part A & B 2 Ways To Get Medicare Inpatient Hospital Ins. Outpatient Medical Ins. Prem: $104.90/mo. Part A Part B A B Rx – Prescription Drugs [Stand Alone Plans] Part D Medi-Gaps Original Medicare Federal Gov’t Medicare ADVANTAGE Part C
  • 69. HMO – Get your care in Network You choose your doctor Low to No Monthly Premiums Copays more predictable PCP copays Specialist copays Outpatient Surgery Worldwide Emergency Care Additional Benefits - Dental - Vision - Health Club 1. Review maximum cost exposure Accumulation of copays 2. Review Recurring Costs Doctor Visits Lab Visits Physical Therapy RX Costs Monthly Premium 3. Trial Right Formulary – Rx List Tiers 1 -5 $104.90/mo. Use only by permission from Senior Insurance Services of NCW, LLC. VRM Part A Part B Most often included Part D ELIGIBILITY Part A & B ESRD 2 Ways To Get Medicare Inpatient Hospital Ins. Outpatient Medical Ins. Prem: $104.90/mo. Part A Part B A B Rx – Prescription Drugs [Stand Alone Plans] Part D Medi-Gaps Original Medicare Federal Gov’t Medicare ADVANTAGE Part C
  • 70. HMO – Get your care in Network You choose your doctor Low to No Monthly Premiums Copays more predictable PCP copays Specialist copays Outpatient Surgery Worldwide Emergency Care Additional Benefits - Dental - Vision - Health Club 1. Review maximum cost exposure Accumulation of copays 2. Review Recurring Costs Doctor Visits Lab Visits Physical Therapy RX Costs Monthly Premium 3. Trial Right Formulary – Rx List Tiers 1 -5 $104.90/mo. Use only by permission from Senior Insurance Services of NCW, LLC. VRM Part A Part B Most often included Part D ELIGIBILITY Part A & B ESRD 6 months in service area 2 Ways To Get Medicare Inpatient Hospital Ins. Outpatient Medical Ins. Prem: $104.90/mo. Part A Part B A B Rx – Prescription Drugs [Stand Alone Plans] Part D Medi-Gaps Original Medicare Federal Gov’t Medicare ADVANTAGE Part C
  • 71. HMO – Get your care in Network You choose your doctor Low to No Monthly Premiums Copays more predictable PCP copays Specialist copays Outpatient Surgery Worldwide Emergency Care Additional Benefits - Dental - Vision - Health Club 1. Review maximum cost exposure Accumulation of copays 2. Review Recurring Costs Doctor Visits Lab Visits Physical Therapy RX Costs Monthly Premium 3. Trial Right Formulary – Rx List Tiers 1 -5 $104.90/mo. Use only by permission from Senior Insurance Services of NCW, LLC. VRM Part A Part B Most often included Part D ELIGIBILITY Part A & B ESRD 6 months in service area Election Periods AEP: Oct 15 – Dec 7 2 Ways To Get Medicare Inpatient Hospital Ins. Outpatient Medical Ins. Prem: $104.90/mo. Part A Part B A B Rx – Prescription Drugs [Stand Alone Plans] Part D Medi-Gaps Original Medicare Federal Gov’t Medicare ADVANTAGE Part C
  • 72. HMO – Get your care in Network You choose your doctor Low to No Monthly Premiums Copays more predictable PCP copays Specialist copays Outpatient Surgery Worldwide Emergency Care Additional Benefits - Dental - Vision - Health Club 1. Review maximum cost exposure Accumulation of copays 2. Review Recurring Costs Doctor Visits Lab Visits Physical Therapy RX Costs Monthly Premium 3. Trial Right Formulary – Rx List Tiers 1 -5 $104.90/mo. Use only by permission from Senior Insurance Services of NCW, LLC. VRM Part A Part B Most often included Part D ELIGIBILITY Part A & B ESRD 6 months in service area Election Periods AEP: Oct 15 – Dec 7 MADP: Jan 1 – Feb 14 2 Ways To Get Medicare Inpatient Hospital Ins. Outpatient Medical Ins. Prem: $104.90/mo. Part A Part B A B Rx – Prescription Drugs [Stand Alone Plans] Part D Medi-Gaps Original Medicare Federal Gov’t Medicare ADVANTAGE Part C
  • 73. HMO – Get your care in Network You choose your doctor Low to No Monthly Premiums Copays more predictable PCP copays Specialist copays Outpatient Surgery Worldwide Emergency Care Additional Benefits - Dental - Vision - Health Club 1. Review maximum cost exposure Accumulation of copays 2. Review Recurring Costs Doctor Visits Lab Visits Physical Therapy RX Costs Monthly Premium 3. Trial Right Formulary – Rx List Tiers 1 -5 $104.90/mo. Use only by permission from Senior Insurance Services of NCW, LLC. VRM Part A Part B Most often included Part D ELIGIBILITY Part A & B ESRD 6 months in service area Election Periods AEP: Oct 15 – Dec 7 MADP: Jan 1 – Feb 14 SEP: common examples Leave employer coverage Moving out of area 2 Ways To Get Medicare Inpatient Hospital Ins. Outpatient Medical Ins. Prem: $104.90/mo. Part A Part B A B Rx – Prescription Drugs [Stand Alone Plans] Part D Medi-Gaps Original Medicare Federal Gov’t Medicare ADVANTAGE Part C
  • 74. HMO – Get your care in Network You choose your doctor Low to No Monthly Premiums Copays more predictable PCP copays Specialist copays Outpatient Surgery Worldwide Emergency Care Additional Benefits - Dental - Vision - Health Club 1. Review maximum cost exposure Accumulation of copays 2. Review Recurring Costs Doctor Visits Lab Visits Physical Therapy RX Costs Monthly Premium 3. Trial Right Formulary – Rx List Tiers 1 -5 $104.90/mo. Use only by permission from Senior Insurance Services of NCW, LLC. VRM Part A Part B Most often included Part D ELIGIBILITY Part A & B ESRD 6 months in service area Election Periods AEP: Oct 15 – Dec 7 MADP: Jan 1 – Feb 14 SEP: common examples Leave employer coverage Moving out of area LIS 2 Ways To Get Medicare Inpatient Hospital Ins. Outpatient Medical Ins. Prem: $104.90/mo. Part A Part B A B Rx – Prescription Drugs [Stand Alone Plans] Part D Medi-Gaps Original Medicare Federal Gov’t Medicare ADVANTAGE Part C
  • 75. Inpatient Hospital Ins. Outpatient Medical Ins. Ded. $1260/Stay (Benefit Period Day 1-60) Prem: $104.90/mo. Ded: $147/yr. Co-Ins. You – 20% & Medicare – 80% NF 100% HMO – Get your care in Network You choose your doctor Low to No Monthly Premiums Copays more predictable PCP copays Specialist copays Outpatient Surgery Worldwide Emergency Care Additional Benefits - Dental - Vision - Health Club 1. Review maximum cost exposure Accumulation of copays 2. Review Recurring Costs Doctor Visits Lab Visits Physical Therapy RX Costs Monthly Premium 3. Trial Right Formulary – Rx List Tiers 1 -5 $188/mo. 100% K 50% $57-mo. $4940 MOOP $128/mo. Pt. B $147 Doc/$20 - ER/$50 [Doctor, Outpatient Surgery, Ambulance, etc.] Part A Part B $104.90/mo. Use only by permission from Senior Insurance Services of NCW, LLC. VRM A B [Hospital, Hospice, Homecare, Skilled Nursing, etc.] G $158/mo. Pt. B $147 Part A Part B Most often included Part DRx – Prescription Drugs [Stand Alone Plans] Part D 1% Penalty Avg. $33.13/ mo. Formulary – Rx List Tiers 1 -5 [Monthly Changeable] [Network: Any provider that accepts Medicare]Medi-Gaps Original Medicare Federal Gov’t 2 Ways To Get Medicare Medicare ADVANTAGE Part C