2. United Insurance Services
– Proven Success in the Medicare World since
1986
– Our Pricing is identical, we offer personalzed
services.
– We are your coaches to get you through the
Medicare maze
– You pick how you want our support
• Online
• Phone
• House Call
Chose pic
3. What is Medicare?
Initial Idea started in 1912 with Teddy
Roosevelt. It took over 50 years to really
get going.
Medicare program finally began in 1965 to
provide health insurance coverage for
people age 65 or older.
Today Medicare is the nation’s largest
health insurance program, covering more
than 49 million people over the age of 65.
4. Medicare Eligibility Guidelines
You are eligible for Medicare if…
You or your spouse paid into Medicare
Tax for at least ten (10) years or (40
quarters) through employment; AND
You are a US citizen or permanent
resident of the US.
5. Pick Your Scenario
1. Turning 65, going on to medicare
2. Over 65, continuing to work, no benefits
3. Over 65, continuing to work, employer
benefits
4. Over 65, retired, covered under spouse
5. Over 65, Veterans, Thank You, great
plans
6. Turning 65 Medicare Enrollment
Automatic vs. Manual
Automatic Enrollment
• If receiving Social Security benefits before age 65.
• Medicare Part A and Part B benefits start the first day of
the month you turn 65.
• Medicare ID Card mailed within 3 months of 65th birthday.
Manual Enrollment
Manually trigger Medicare benefits within 3 months of 65th birthday
(to avoid penalties or gap in coverage) if not currently receiving
Social Security benefits.
• Call Social Security at 1-800-772-1213
• Apply online at www.ssa.gov/medicare/apply
• Visit your local Social Security Office
Scenario 1 & 2
7. Turning 65
Medicare Enrollment Period
Initial Enrollment Period
You can sign up for Medicare Part A and/or Part B during the Initial
Enrollment Period when you are first eligible (you are turning 65).
3 months
before
the month
you turn 65
2 months
before
the month
you turn 65
1 month
before
the month
you turn 65
The month
you turn
65
1 month
after
the month
you turn 65
2 months
after
the month
you turn 65
3 months
after
the month
you turn 65
Sign up early to avoid a delay in coverage. To
get Part A and/or Part B the month you turn 65,
you must sign up during the first 3 months
before the month you turn 65.
If you wait until the last 4 months of your Initial Enrollment
Period to sign up for Part A and/or Part B, your coverage will be
delayed.
If you enroll in this month of
your initial enrollment period
Your coverage starts
The month you turn 65 1 month after enrollment
1 month after you turn 65 2 month after enrollment
2 month after you turn 65 3 month after enrollment
3 month after you turn 65 3 month after enrollment
Scenario 1 & 2
9. Delaying Medicare –
Enrollment Period
Enrollment Period
If you are continuing to work and delaying Medicare, you need to enroll
in Medicare Part A and/or Part B as soon as you lose coverage. You
have an 8-month period to enroll, but to avoid penalties, enroll as soon
as you find out your coverage is ending.
63 days
before
the day you
lose
coverage
The day
you
Lose
coverage
6 months
after
the day you
lose
coverage
• Coverage will start the first day of the month following
enrollment.
• Enroll within eight month period, there are special
circumstances we can help to guide you and avoid penalties.
If you or your spouse (or family member if you're disabled) are still working and you have
insurance through that employer or union, contact your employer or union benefits
administrator to find out how your insurance works with Medicare. This includes federal or
state employment, but not military service (unless on active duty). It may be to your
advantage to delay Part B enrollment. SOURCE: Medicare.gov
10. Veterans
Thank you for your service
• There are many great options and beneifts
provided for you.
• We can help you select some additional options
and programs that can save you money, some at
no cost to you.
11. Parts of Medicare
Medicare currently has four parts.
MEDICARE PART A = HOSPITAL INSURANCE
MEDICARE PART B = MEDICAL INSURANCE
MEDICARE PART D = PRESCRIPTION DRUG COVERAGE
__________________________________________
MEDICARE PART C = MEDICARE ADVANTAGE PLANS
(HMO/PPO)
12. Parts of Medicare Costs
Medicare Part A = Hospital Insurance
• You have already paid into this program.
• Helps pay for inpatient hospital care, skilled
nursing facility care, home health care, hospice
care and blood.
• Most people do not pay a premium for Part A (if
they or a spouse worked 40 quarters and paid a
Medicare tax).
(This program is worth $411 pre month for each
member)
Source: www.cms.gov
13. Parts of Medicare - Costs
Medicare Part B = Medical Insurance
• Helps pay for doctor’s services and many other medical
services and supplies.
• Some Medicare Part B premiums include an Income-
Related Monthly Adjustment Amount (IRMAA). If your
yearly income in 2014 (for what you pay in 2016) was:
File Individual
Tax Return
File Joint
Tax Return
File Married & Separate
Tax Return
IRMAA Total 2016 Part B
Premium
$85,000 or less $170,000 or less $85,000 or less $0 $121.80
File Individual
Tax Return
File Joint
Tax Return
File Married &
Separate Tax Return
IRMAA Total 2016 Part B
Premium
$85,001 up to
$107,000
$170,001 up to
$214,000
Not
applicable
$48.70 $170.50
$107,001 up to
$160,000
$214,001 up to
$320,000
Not
applicable
$121.80 $243.60
$160,001 up to
$214,000
$320,001 up to
$428,000
$85,001 up to $129,000 $194.90 $316.70
$214,001 $428,001 $129,001 $268.00 $389.90
14. Parts of Medicare - Costs
Medicare Part D = Prescription Drug Coverage
• A prescription drug option administered by
private insurance companies approved by
and under contract with Medicare.
• Enrollment rules apply.
• Contact our UIS Certified Part D Specialist for
more information at 866-457-2783.
Source: www.cms.gov
15. Parts of Medicare - Costs
Medicare Part C = Medicare Advantage Plans
The “All in one” approach
HMO and PPO plans, sometimes called
“Part C” or “MA Plans,” are offered by
private insurance companies that are
approved by Medicare. Medicare
Advantage Plans are all-in-one plans.
They are easy to use and budget-friendly.
16. 2016 Medicare Part A
Service What Medicare Pays
What Medicare
Leaves you to Pay
Part A (Hospital)
First 60 days of an
admission
All covered changes but
a $1,288 deductible each
benefit period
$1,288
61st to 90th Day All covered charges but
$322 a day
$322 a day
91st to 150th Day All covered charges but
$644 a day
$644 a day
Beyond 150 days $0 100% of expenses
Skilled Nursing Facility Care
First 20 Days 100% of approved costs $0
21st to 100th Day All covered charges but
$161 a day
$161 a day
Beyond 100 days $0 100% of expenses
17. 2016 Medicare Part B
*By law, no physician may charge more than 15% of Medicare-approved amounts.
Service What Medicare Pays
What Medicare
Leaves you to Pay
Part B (Medical & Doctor Charges)
$166 Annual
Deductible
$0 $166
Medical Services 80% of Medicare-
approved charges after
the $166 calendar year
deductible is met
$166 deductible, then
20% of Medicare-
approved charges
NOT paid by Medicare
Excess charges* $0 100% of expenses
18. How to Fill The Gaps
After Medicare Pays
with a
Medicare Supplement Plan
19. Medicare Supplement Plans
A B C D F F** G K L M N
BASIC
BENEFITS
100% 100% 100% 100% 100% 100% 100% 100%/
75%
100%/
75%
100%/
50%
Copay
Applie
s
SKILLED
NURSING
COINSURANCE
100% 100% 100% 100% 100% 50% 75% 100% 100%
PART A
DEDUCTIBLE
$1,288/benefit
period
100% 100% 100% 100% 100% 100% 50% 75% 50% 100%
PART B
DEDUCTIBLE
$166/month
100% 100% 100%
PART B
EXCESS
100% 100% 100%
FOREIGN
TRAVEL
EMERGENCY
X X X X X X X
ANNUAL
OUT-OF-
POCKET LIMIT
$4940 $2470
20. Next Steps - REWORK
Talk with one of our specialized coaches one-on-one and
have they guide you through the maze if medicare.
Review your current health insurance coverage to find out
what happens when you turn 65 or after you and/or your
spouse retires.
Contact the Social Security Administration to confirm your
eligibility for Medicare Benefits at 1-800-772-1213. remove?
Schedule an appointment with a representative from
United Insurance Services to enroll.
You may apply for coverage up to 12 months prior to
your 65th birthday.
Stay with us to be organized and on track!
Thank you for attending!
