Medicare supplements are great for adding extra coverage when you need it most, call Colorado Insurance Store today to answer your questions.

What you really need to know about Medicare and how to pick a good brokerage agency to work with.


Run a Free Medicare Supplement QuoteHere at Colorado Insurance Store, we take great pride in working with an extensive list of only the top Major Carriers for all your insurance needs. We represent dozens of carriers for not only Medicare Supplement plans, but also for Medicare Advantage plans as well as Part D Prescription Drug coverage. Our primary focus is making sure that Medicare makes sense to you. We realize Medicare is confusing so we take the time to educate, counsel and then give you plan recommendation(s). We love being great listeners and you’ll never feel like we don’t have time to hear everything you have to say.

One of the most important things we’ve learned in our many years of experience helping people buy insurance is that everyone’s budget, lifestyle and medical circumstances are different so a cookie cutter approach doesn’t work. We know there are lots of agents out there pushing Medicare Supplements and mostly that’s because they don’t want to spend the time it takes to become certified to truly understand and be able to sell Medicare Advantage and Part D Rx plans. In fact, that’s probably the most valuable piece of advice we can give you is to make sure you are talking with someone who is trained properly and comprehensively and can legally show you “All” of your plan options.

CMS, the Centers for Medicare and Medicaid requires all agents who want to legally represent Medicare Advantage and Part D Rx plans to complete extensive training not only with Medicare, but also with the individual carriers. This training takes many hours of reading and testing. To us, that’s the best part! We love to learn and be challenged by our industry and we take it all in stride because we aren’t satisfied unless we’re the best at what we do.

Basically what we’re saying is that we love what we do and it shows!!

Disclaimer: Below is a brief description of the many parts of Medicare and its related insurance plans. It is not a comprehensive list nor is it recommended to be used to solely make your plan purchasing decision on. We strongly recommend you contact us to make an appointment to talk more about Medicare and any other specific plan questions you have.

Medicare Part A

Part A is hospital insurance that helps cover inpatient care in hospitals, skilled nursing facility, hospice, and home health care.

In general, Part A covers:

Medicare Part B

Part B helps cover medically-necessary services like doctors' services, outpatient care, home health services, and other medical services. Part B also covers some preventive services.

Part B covers two types of services:

How Much Does Part B Cost and can I wait to sign up?

Medicare Part C (Medicare Advantage Plan)

What is a Medicare Advantage Plan?

A Medicare Advantage Plan (like an HMO or PPO or PFFS) is another Medicare health plan choice you may have as part of Medicare. Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by private companies approved by Medicare.

If you join a Medicare Advantage Plan, the plan will provide all of your Part A (Hospital Insurance) and Part B (Medical Insurance) coverage. Medicare Advantage Plans may offer extra coverage, such as vision, hearing, dental, and/or health and wellness programs. Most plans include Medicare prescription drug coverage (Part D).

Medicare pays a fixed amount for your care every month to the companies offering Medicare Advantage Plans. These companies must follow rules set by Medicare. However, each Medicare Advantage Plan can charge different out-of-pocket costs and have different rules for how you get services (like whether you need a referral to see a specialist or if you have to go to only doctors, facilities, or suppliers that belong to the plan for nonemergency or non-urgent care). These rules can change each year.

Different Types of Medicare Advantage Plans:

Medicare Part D

Medicare prescription drug coverage is insurance run by an insurance company or other private company approved by Medicare. There are two ways to get Medicare prescription drug coverage:

1. Medicare Prescription Drug Plans. These plans (sometimes called "PDPs") add drug coverage to Original Medicare, some Medicare Cost Plans, some Medicare Private Fee-for-Service (PFFS) Plans, and Medicare Medical Savings Account (MSA) Plans.

2. Medicare Advantage Plans (like an HMO or PPO) are other Medicare health plans that offer Medicare prescription drug coverage. You get all of your Part A and Part B coverage, and prescription drug coverage (Part D), through these plans. Medicare Advantage Plans with prescription drug coverage are sometimes called "MA-PDs".

If you decide not to join a Medicare drug plan when you’re first eligible, and you don’t have other credible prescription drug coverage, you will likely pay a late enrollment penalty.

Medigap\Medicare Supplement Plans

2011 Guide to Choosing a Medigap plan

Other Helpful Medicare Related Links:

http://www.medicare.gov
http://www.dora.state.co.us/insurance/
http://www.hhs.gov/
http://www.socialsecurity.gov/

Standard Medicare Supplement Benefits

Medicare Supplement insurance can be sold in only ten standard plans. The chart below shows the benefits included in each plan.  (For more details read Federal Brochure for Choosing a Medigap Policy or click here.)

Basic Benefits are included in all plans. They include:

  • Hospitalization, Part A coinsurance plus coverage for 365 additional days during your lifetime after Medicare benefits end.
  • Medical Expenses, Part B coinsurance generally (20% of Medicare approved expenses).
  • Blood, first three pints of blood each year.
  • Hospice Care, Covers Part A Coinsurance year.
A B C D F* G K L M N
Basic Benefits Basic Benefits Basic Benefits Basic Benefits Basic Benefits Basic Benefits Basic Benefits Basic Benefits Basic Benefits Basic Benefits***
    Skilled Nursing Coinsurance (100%) Skilled Nursing Coinsurance (100%) Skilled Nursing Coinsurance (100%) Skilled Nursing Coinsurance (100%) Skilled Nursing Coinsurance (50%) Skilled Nursing Coinsurance (75%) Skilled Nursing Coinsurance (100%) Skilled Nursing Coinsurance (100%)
  Part A Deductible (100%) Part A Deductible (100%) Part A Deductible (100%) Part A Deductible (100%) Part A Deductible (100%) Part A Deductible (50%) Part A Deductible (75%) Part A Deductible (50%) Part A Deductible (100%)
    Part B Deductible   Part B Deductible          
        Part B Excess Part B Excess        
    Foreign Travel Emergency Foreign Travel Emergency Foreign Travel Emergency Foreign Travel Emergency     Foreign Travel Emergency Foreign Travel Emergency
            $4,640 Out-of-Pocket Limit** $2,320 Out-of-Pocket Limit**    

            * Plan F also has a high deductible options, some companies may offer this option.

            ** Plans K & L pay 100% of covered services for the rest of the calendar year after you meet your out-of-pocket yearly limit.

            *** Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to a $50
copayment for emergency room visits that don't result in an inpatient admission.

Select Plans: Some companies may also offer plans A through N on a selective provider network with lower monthly premium but the same benefits.

The basic benefits (also known as the "core benefits" or Plan A) are the minimum coverage you may buy. These are the only benefits in Plan A. Every other plan contains these three benefits as the "core" and then adds one or more additional benefits.

  1. Hospitalization: Medicare Part A pays for hospitalizations for the first 60 days, but only pays a portion of the daily costs from the 61st day through the 150th day. You must pay the coinsurance amounts for those days. This Medicare Supplement benefit pays the coinsurance amount and an additional 365 lifetime days.
  2. Blood: Medicare pays for all blood that is medically necessary except for the first three pints in each calendar year. This Medicare Supplement benefit pays for the first three pints of blood not paid for by Medicare.
  3. Medical Expenses: Generally Medicare Part B pays for 80% of a predetermined amount (called the "Medicare approved" amount) for each procedure, supply, or service billed by your doctor or other provider that is not a hospital. This Medicare Supplement benefit pays the coinsurance generally (20% of the "Medicare approved" amount) under Medicare Part B.
Note: Plan A contains only these 3 core benefits.  Although Plan A is the least expensive policy, it may not be a good choice for low-income individuals who may not be able to afford the Medicare Part A hospital deductible when they are hospitalized.

There are five additional benefits that are combined with the basic benefits in various ways to make up the nine remaining plans called Plan B through Plan N.

  1. The Part A Deductible: The Medicare Part A deductible is the expense for which you are obligated to pay when you are admitted to a hospital as an inpatient. Medicare pays eligible benefits above that amount. (The Medicare Part A deductible amount may change yearly, so check the current handbook1). This Medicare Supplement benefit reimburses you the deductible amount, no matter what the amount may be. This benefit is included in Plans B through N.
  2. Skilled Nursing Coinsurance: Medicare Part A pays for the first 20 days of care in a skilled nursing facility following hospitalization, but requires you to pay a coinsurance beginning on the 21st day through the 100th day. This Medicare Supplement benefit pays the coinsurance amount beginning on the 21st day. This benefit is included in Plans C through N.
  3. Part B Deductible: The Medicare Part B deductible is the amount you must pay each year for medical expenses (such as doctor fees) before Medicare begins paying. (The Part B deductible amount may change per year). This Medicare Supplement benefit reimburses you the deductible amount. This benefit is included in Plan C and Plan F.
  4. Part B Excess Charges: Medicare Part B pays 80% of a predetermined amount (called the "Medicare approved" amount) for each procedure performed by your doctor or other medical care provider. If your doctor accepts Medicare "assignment", the provider may only bill you for the difference between the amount paid by Medicare and the amount approved by Medicare.

If your doctors do not accept Medicare assignment, they may bill you for the difference between the amount paid by Medicare and the amount they can legally charge you (called the "limiting charge"). If you have a Medicare Supplement Policy with the following:

  • Part B Excess Charges (100%) benefit, the policy will pay the full amount billed by your doctors or other providers who do not take Medicare assignment subject to the limiting charge. This benefit is included in Plan F and Plan G.

(Remember that this coinsurance amount is paid by the Medical Expenses part of the Basic Benefits that are part of every Medicare Supplement insurance policy).

  1. Foreign Travel Emergency: The original Medicare plan does not pay for medical care outside of the United States, but some Medicare managed care plans, private Fee-for-Service plans, and some Medicare Supplement plans do. This Medicare Supplement benefit will pay 80% of your expenses for most emergency medical care in a foreign country during the first 60 days of a trip abroad after you pay a $250 deductible. There is a lifetime maximum benefit, so check your current handbook1 for the dollar amount. This benefit is in Plan C, Plan D, Plan F, Plan G, Plan M, and Plan N. Check your insurance coverage before you travel.

1 Current handbook on Medicare is available from your local Social Security office or by calling the Social Security Administration toll-free at 800-633-4227 or via the website at www.medicare.gov.

Know Your Rights About Purchasing Medigap Coverage

Agents owe you a duty of honesty, good faith, and fair dealing. Agents are specifically prohibited from doing the following:

  • Using high pressure tactics (selling insurance through threat or undue pressure)
  • Twisting (inducing you to give up or replace an existing policy for a new one)
  • Overloading (selling you more insurance than you need or want)

Agents are required to give you an outline of coverage during the first presentation of an insurance product. The outline must inform you that HICAP is available for insurance counseling free-of-charge and tell you how to reach your local HICAP office.

If you decide to fill out an application, the agent is prohibited from taking more than one month's premium with the application unless the policy is "field-issued". Field-issued means that the agent has the authority to issue the policy to you at the same time you fill out the application. That is the only time the agent may collect more than one month's premium with the application.

After the policy is mailed or delivered, you have a 30-day free look to examine the policy and to decide if you want to keep it. If you return the policy within 30 days, all of your money must be refunded.

Note: If you buy a field-issued policy, your 30-day free look period begins when you receive written notice from the insurance company in the mail.

Always document the date you received the policy and the date you return the policy to the insurance company or the agent.

Buy a comprehensive Medicare Supplement policy that has the most benefits for the amount you can afford. Make sure to consider the following before purchasing insurance:

  • Comparison shop!
  • Call your local Department of Insurance to verify if the agent is properly licensed.
  • Decide what you need and want before you sit down with the agent.
  • Do not be rushed into buying insurance.
  • Set the place, the beginning, and the ending time of your meeting.
  • Get a second opinion before you buy or replace insurance.
  • Do not buy anything you did not intend to purchase or do not want.
  • Do not replace an existing policy unless you can not afford it or the benefits no longer meet your needs.
  • Do not pay more than one month's premium when you apply unless the policy is field-issued.
  • Do not pay cash. (Do not write a check payable to the agent. Write the check payable to the insurance company).
  • Do not be intimidated.
  • If you feel unsure or uncomfortable DON'T DO IT!

NOTICE! Final rates and benefits are based on actual plan selection (including plan riders you may request) and the assignment of any rate adjustment factors due to the medigap plan's underwriting guidelines.

IMPORTANT NOTICE: Coinsurance amounts represented with a "%" are payable after the plan deductibles are reached; Co-pay amounts represented with a "$" are not subject to plan deductibles (except where noted). Refer to contract for a detailed explanation of plan benefits, features, exclusions and limitations. Benefits subject to change without notice. Out of pocket maximum shown includes the plan deductible unless otherwise noted. Co-pays, Deductibles, and Coinsurance amounts listed above are your share of the costs for covered benefits.

Do Not Cancel your current coverage until a new policy is approved and you have received written confirmation of the policy's rates and benefits from the insurance company. Rate and Benefit Disclaimer Notification! The rate and benefit information provided herein was generated by the Quotit Corporation's individual medigap insurance quoting system. The Quotit Corporation or its licensees do not guarantee or warrant the correctness or completeness of the rate and benefit information contained herein and shall not be liable for any loss or damage arising out of use of the quoted rate and benefit information.

Additionally, information contained in this website is limited in scope, subject to change without notice, and does not contain all the terms, conditions, limitations, or exclusions of the referenced benefit plans. Only the insurance company Plan Documents and Policy's contain the exact terms and conditions of coverage. Your grant of access to the rate and benefit summaries contained herein may not be relied upon as a guarantee of your eligibility or coverage under these benefit plans.

 

 

We specialize in providing Medicare related insurance coverage to seniors