If you are turning 65 soon review our presentation on Medicare Insurance.

1. An Educational
Presentation for
Kansas City Medicare
Eligible Folks.

2. Original Medicare
PART A
• Hospital Benefit
• Room & Jell-O
PART B
• Doctors
• Outpatient

3. PART A – Hospital Benefit
• There is no premium for Part A.
• It covers Room & Board.
• The deductible is $1132 per Benefit Period.
• The Benefit Period is 60 days.
• For days 61 – 90 the cost is $283 per day.
• For days 91 – 150 the cost is $566 per day.
• All cost for each day beyond 150 days.
Skilled Nursing Facility
• Up to $141.50 a day for the 21st -100th day each benefit period.

4. PART B – Doctors
• Monthly premium Part B is $115.40
• Annual deductible is $162
• Covers Doctor’s services, outpatient care etc.
• Medicare pays 80% of Medicare’s approved amount.
• Beneficiary pays 20% of Medicare's approved amount.
• Approval for Medically Necessary care only.
• No Foreign Travel Coverage.

5. PART D – Prescription Drug Plan
• Part D must be obtained through a private carrier.
• The National Average premium is $32.00
• Most plans have an Annual Deductible of $310.
• The RX limit is $2840, then Coverage Gap
• The Out-Of-Pocket limit is $4550
• Catastrophic Coverage $2.50 (gen.) and $6.30 (brand)

6. PART D – Prescription Drug Plan
The basic plan – all Part D plans are required by law to offer benefits equal to or
better than the following:
2011 Basic Benefits You Pay
Deductible $310 100% of first $310
25% of the next $2530
Initial Coverage Limit $2,840
($632.50)
Coverage Gap* $3,607.50 100% of next $3,607.50
Annual Out-Of-Pocket $4,450**
Catastrophic Coverage Medicare and Plan 95% 5%***
* CMS and drug companies to provide a 50% discount on covered brand name drugs while in the coverage gap or ‘Donut Hole’
** Annual Out-Of-Pocket Amount does not include monthly premiums.
*** Member pays the greater of $2.50 for generic/preferred drugs and $6.30 for all other drugs, or 5% percent coinsurance.

7. Are you eligible?
• Enrolled in Medicare Part A and Part B through age or
disability?
• Permanent resident in service area?
• Do you have End Stage Renal Disease (ESRD)?

8. PART C – Medicare Advantage
• Obtained through Private Insurance Carrier.
• “Pay As You Go”
• $0 - $60 monthly premium.
• In most cases includes Part D Prescription Coverage.
• Humana or Coventry for Kansas City Metro.
• Can change plan at AEP – Oct. 15th – Dec. 7th 2011.

9. Medicare Supplements - Medigap
• Obtained through Private Insurance Carrier
• “All You Can Eat”
• Guaranteed Issue for turning age 65
• You pay a Monthly Premium
• Typically more expensive than Advantage Plans
• Plans types from A through N.
• Must have a separate Prescription Drug Plan

10. Medicare Supplements - Medigap
• Pays the Part A Deductable, some pay Part B also.
• Pays the 20% Part B remainder.
• Only pays if Medicare Approves.
• Always go with an A rated company.
• No Networks for services.
• Can be used by anyone who accepts Medicare.
• World wide coverage for emergency and urgent care.

11. What happens now?
• Call Paul at 816-898-6969 for a consultation and the
best advice on which products to consider.
• Email Paul with any questions at
paul@prairiehealthandlife.com
• Complete an application and you will receive your ID
card in about two weeks.