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This information is designed for people who have Original Medicare and want to learn more and make educated decisions about how to cover their health care costs. Medigap (Medicare Supplemental) insurance covers some of the costs not paid by Original Medicare, like the coinsurance payments for doctors' and hospital services.
Contents
Medicare and Medigap
Medigap Basics
Medigap Extra Benefits
Medigap Coverage By Benefit
Medigap Coverage By Plan
How to Choose a Medigap Insurance Company
Enrollment
Waiting Periods and Switching
Things You Need to Know If...
Your Rights
Resources
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Medicare.gov - Medigap Compare Home
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Medigap Compare
Welcome to Medigap Compare. This is an interactive tool for Medicare
beneficiaries and people who assist them with their care. It is designed
to help you find the insurance companies in your state that sell Medigap
(Medicare supplemental insurance) plans, and it gives you information on
how to contact the insurance companies. Medigap Compare
also provides general information about Medigap insurance
to help you with your
health care choices.
Begin Medigap Plan Search
Some data included on the site was provided directly from
the insurance companies selling Medigap plans. Medigap Compare currently
contains some basic information about each reporting insurance company,
such as:
which plans they offer,
if
the plans are offered to persons at or over age 65, under
65 with disabilities and/or ESRD,
how they price their plans based on what rating
method they use, and
if you need to be a member of a certain organization to buy one
of their plans.
Select a Geographic Area (Step 1 of 2)
Please choose one of the following ways to search for a Medigap plan.
ZIP Code Search
Enter a ZIP code in the box below and click on the "Search by ZIP Code" button.
State Search
Select a state/terrirory and click on the "Search by State" button.
Select a State Alabama
Alaska
American Samoa
Arizona
Arkansas
California - Northern & Central
California - Southern
Colorado
Connecticut
Delaware
District of Columbia
Federated States of Micronesia
Florida - Northern
Florida - Southern
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Marshall Islands
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York - New York City Vicinity
New York - Upstate
North Carolina
North Dakota
Northern Mariana Islands
Ohio - Eastern
Ohio - Western & Southern
Oklahoma
Oregon
Palau
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas - Eastern & Southern
Texas - Northern & Western
U.S. Minor Outlying Islands
Utah
Vermont
Virgin Islands of the U.S.
Virginia
Washington
West Virginia
Wisconsin
Wyoming
CA, FL, NY, OH, TX have a large number of Medigap plans. To make your search easier, we split these
states in half geographically (e.g., Northern California & Southern
California). If you are not sure which area you need to search, you can
view a list of counties belonging to
each area in these states.
Important Note: If you search for plans by state or county, not all of the plans
listed may be available in your area. For the most reliable information, please
search by ZIP code.
Help with Medigap Compare search
A Medigap plan is a health insurance plan that fills the gaps
in Original Medicare plan coverage. In all states, there are
basic standardized Medigap plans .
Each plan has a different set of benefits. Any standardized
plan may also be sold as a Medicare
Select plan. Medicare Select plans usually cost less
because you must use certain doctors and hospitals, except in
an emergency.
Before you begin your search, there are some important things you should
know. Shopping for health insurance is a complicated matter.
To help you start looking for a Medigap plan, we are providing you with
steps to buying a Medigap Policy .
The rating method that insurance companies use
to price their plans can be complex. So, please read the information
and examples on rating methods
to help you realize why it is important for you to understand
the rating method the insurance company uses. Finally, as a
Medicare beneficiary, you have certain rights and protections
related to Medigap plans. Please be aware of what these rights
and protections are as you shop for Medigap plans. For
detailed information on Medigap, you may want to read the
Guide to Health Insurance for People with Medicare .
If you are in a Medicare managed care plan, or private fee-for-service
plan, or if you are covered by Medicaid, you do not need a Medigap
plan. Generally, it is not legal for anyone to sell you a Medigap
plan in these cases.
Special Note to Medigap Insurers:
We have made every effort to contact all insurers who sell Medicare
Medigap insurance and to include their information in this database.
If you sell Medicare Medigap insurance and are not included
in this database, please contact
us and we will provide you with information to enter
your data. Thank you.
Important Information on Medigap Compare
Medicare Plan Choices Publications
Subscribe to our Mailing List
Download Medigap Compare Database
Data Last Updated: April 8, 2002
Medigap Compare Home
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Compare nursing homes in your area.
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Programs that offer discounted or free medications.
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Compare dialysis facilities in your area.
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Locate Medicare participating physicians in your area.
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Results from search: http://www.hhs.state.ne.us/ags/medsupp.htm
Nebraska HHS System: Aging Services: Medicare Supplemental Insurance
Medicare Supplemental Insurance
Medicare pays a large part of health care
expenses. It doesn't pay them all. Older people should consider purchasing a private
health insurance policy to offset the cost remaining after Medicare. But, most
supplemental policies won't pay for certain kinds of medical expenses.
All Medicare supplemental plans sold in Nebraska must comply with one of ten plans
approved by federal law. The plans are labeled "A" through "J".
Plan "A" is considered a basic plan. However, it doesn't pay
deductibles. Plans "B" through "J" provide additional benefits. Before
considering any policy, it's important to understand what the Medicare benefits are,
then decide on the amount of extra coverage needed.
People who are eligible for Medicaid don't need
additional insurance. Medicaid pays almost all health care costs, including long-term care
in a nursing facility.
Some people may be able to carry over the health insurance policy they had before age
65. Anyone having group coverage should talk to his or her employer about converting it to
a Medicare supplement plan.
You should purchase only one Medicare supplement plan.
Compare these policies with those being sold by other companies to see which provides
the best coverage. Before purchasing a policy, it's wise to consult someone who
understands insurance, as well as your individual financial situation, and who can help
you explore policy options. It's important to remember that slight differences in wording
can greatly change meanings/coverage.
Local insurance agents can often be of help. You may also want to contact your local Area Agency on Aging to see if they offer insurance counseling.
If the agent says the policy covers a stay in the local nursing home, go ask the
administrator. It may be that your stay will only be covered if you receive a higher level
of care than is available at the home, so the policy would be a poor buy.
If an agent says the policy pays everything Medicare doesn't, be sure there's
no reasonable and customary limitation. The amount approved by Medicare is determined
solely by Medicare and is the fee most frequently charged in a geographic area for the
specific services that have been received.
Nebraska Medicare supplemental insurance law allows a company to exclude existing
illnesses for only six months. Other types of policies may have longer or permanent
exclusions, so read them carefully.
Look for a renewal clause. Check to see if the policy can be renewed for the lifetime of
the policyholder.
Agents selling supplemental insurance must be licensed by the state and carry proof of
such licensing. Don't be misled into thinking that the agent is representing Medicare or
any government agency.
Complete the application carefully. The insurance company can deny a claim if necessary
information is omitted.
Never pay the agent in cash. Make the check or money order payable to the insurance
company.
Aging Services Page
HHS System Home | Search the Site |
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About HHS System | What's New | Programs & Services | Research & Statistics
Job Opportunities | Office Locations | Administrative Contacts | Useful Links
Nebraska Department of Health and Human Services P.O. Box 95044 Lincoln, NE 68509-5044 (402) 471-2306
Nebraska Department of HHS Regulation and Licensure P.O. Box 95007 Lincoln, NE 68509-5007 (402) 471-2133
Nebraska Department of HHS Finance and Support P.O. Box 95026 Lincoln, NE 68509-5026 (402) 471-3121
Disclaimer | Questions about HHS System: hhsinfo@www.hhs.state.ne.us | Site Feedback: webmaster@www.hhs.state.ne.us
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Medicare Supplemental Insurance Quotes
Though Medicare covers many health care costs, there are many medical services that Medicare does not cover. Supplemental insurance policies fill the gaps in your Medicare coverage. Before Medicare will pay for any of the medical services you want or need, you must first pay the Medicare deductibles.
Acordia has partnered with eHealthInsurance, the leading destination seniors to learn about, compare and
buy health insurance. Offering the largest selection of health plans from
leading insurance companies nationwide, our web site features online instant
quotes, side-by-side plan price and benefit comparisons and online physician
directories to help our customers select the health plan that best meets their
needs. Our Customer Care Center is staffed with knowledgeable representatives
available, once online, to answer questions via email, online chat and phone.
All of these features and services combined with our online applications make
finding and buying the right plan easier than ever before. Visit us today by selecting the product that
meets your needs!
Individual
& Family Plans
Medicare
Supplemental Plans
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Senior Advocate - Medicare Supplemental Insurance Plans
General Information
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Bethany Hospital
Christ Medical Center
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Ravenswood Medical Center
South Suburban Hospital
Trinity Hospital
Medicare Supplemental Insurance Plans
Medigap Plan Choices
Printable Application Form
On-line Application Form
Caregiver's Discussion Forum
Medicare Supplemental Insurance Plans
If you are interested in a Medicare supplement policy, contact the insurance company that you are interested in and they will be happy to mail information to you.
Listed below is a partial list of some popular Medicare supplemental plans:
Insurance Company Name
Telephone
Number
American Assn. For Retired People (AARP)
1.800.523.5800
American Family Insurance
1.800.374.0008 ext.33100
Blue Cross/Blue Shield
1.800.624.1723
Banker's Life
1.312.396.6000
1.800.621.3724
Golden Rule Insurance Company
1.618.943.8000
1.800.444.8990
Mutual of Omaha
1.800.775.6000
Provident Life
1.800.228.9100
Physicians Mutual
1.800.228.9100
Insurance
Contact Local Agent
Union Fidelity Insurance
1.800.523.5758
United American Insurance Co.
1.800.331.2512
1.972.529.5085
Medicare Disability Supplemental Plans
Bankers Fidelity Life
1.800.241.1439
GE Life and Annuity
1.800.253.0856
United American Insurance
1.800.331.2512
CHIP program (limited enrollment, call for details)
1.866.851.2751
If you would like to speak with a Senior Advocate representative to discuss your insurance options, call the Senior Advocate office nearest you.
Advocate Bethany Hospital, Chicago (west)
1.773.265.3500
Advocate Christ Medical Center, Oak Lawn
1.708.346.4150
Advocate Good Samaritan Hospital, Downers Grove
1.630.275.5800
Advocate Good Shepherd Hospital, Barrington
1.847.382.7277 x 5441
Advocate Lutheran General Hospital, Park Ridge
1.847.723.7277
Advocate Ravenswood Medical Center, Chicago (north)
1.773.907.7888
Advocate South Suburban Hospital, Hazel Crest
1.708.346.4150
Advocate Trinity Hospital, Chicago (south)
1.773.967.3900
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AHIRC
MEDICARE SUPPLEMENTAL
INSURANCE CONTACT
INFORMATION
WHAT IS MEDICARE SUPPLEMENTAL INSURANCE?
MEDIGAP EXTRAS
The Medicare hospital deductible
The skilled nursing facility co-insurance
The Part B annual deductible
The Part B excess charge benefit
Coverage for emergency care outside the
U.S.
At-home recovery benefit
Preventive medical care benefit
Prescription drug benefits
ENROLLMENT
If you are 65 or older
If
you have a disability and are under 65
WHAT ARE YOUR RIGHTS?
WAITING PERIODS
MEDICAID RECIPIENTS
MEDICARE SELECT
STATE INSURANCE COUNSELING AND ASSISTANCE CENTERS
MEDICARE SUPPLEMENTAL INSURANCE
Please note the Medicare information has been provided by the
Medicare Rights Center. The Medicare Rights Center is the only national, not-for-profit
organization exclusively devoted to ensuring that seniors and people with disabilities on
Medicare have access to quality, affordable care.
CONTACT INFORMATION
You can view the Medicare Rights Center's website at: http://www.medicarerights.org .
You can also contact the center at:
Medicare Rights Center
1460 Broadway, 11th Floor
New York, New York 10036
(212) 869 - 3850
There is also a Medicare Hotline number at 1 (800) 638-6833. We advise that you call
this number to order a copy of "The Guide to Health Insurance for People with
Medicare" which provides comprehensive information regarding Medigap and other
supplemental health insurance.
Hours are between 8 a.m. and 8 p.m., from Monday through Friday.
OR
Much of the same information is available on the Health Care Financing Administration
website at http://www.hcfa.gov and http:/ /www.medicare.gov
The Health Care Financing Administration administers the Medicare and Medicaid
programs.
What is Medicare
Supplemental Insurance?
If you have traditional Medicare, you will probably want to purchase
a Medicare Supplemental ("Medigap") policy to fill gaps in your Medicare
coverage, such as Medicare deductibles and your 20% co-insurance payment for doctors'
services. If you are in a Medicare HMO, you do not need a Medigap policy.
Federal law allows Medigap insurers to offer only 10 standardized Medigap plans to
individuals on Medicare. These 10 standard Medigap plans are labeled Plan A through Plan
J, and each of them offers a different set of benefits, fills different "gaps"
in Medicare coverage, and costs different amounts.
Each Medigap plan provides the exact same benefits no matter which insurance company
offers the plan. Plan A, for example, always provides the same benefits.
In 1997, federal law was amended to authorize the sale of two additional Medigap plans
that offer the same benefit package in Plan F or Plan J, with
A $1500 deductible (in 1999).
Deciding which plan best meets your needs can be a confusing task. Each plan provides a
variety of different benefits. Some plans include coverage for the Medicare deductibles
and co-insurance for skilled nursing facilities, while other plans provide limited home
care and prescription drug coverage.
None of the Medigap plans cover long-term custodial care at home or in a nursing
facility, vision and dental care, hearing aids, private duty nursing, or unlimited
prescription drugs.
The following Basic Benefits are included in all 10 standardized plans:
Hospitalization : Part A co-insurance, plus coverage for 365 additional
days after Medicare benefits end.
Medicare pays for the first 60 days of hospitalization in full, except for the initial
deductible of $768 (1999) per benefit period. After 60 days, the coinsurance is $192
(1999) a day for days 61-90 and $384 (1999) a day for lifetime reserve days 91-150.
Medical Expenses : Part B co-insurance (generally 20% of
Medicare-approved expenses)
Medicare generally pays 80% of physician services and 50% of mental health services.
Medigap picks up the remaining 20% of the Medicare-approved amount for physician services
and 50% for mental health services.
The first three pints of blood you need each year :
Medicare will cover your blood needs in full afterwards.
Medigap Plan A covers these basic benefits ONLY . For some people, Plan A offers
enough coverage. Other people would rather receive the additional benefits offered by
Plans B through J. Plans B through J all cover the basic benefits listed above, as well as
different combinations of the extra benefits.
Medigap Extras
Medicare hospital
deductible (Plans B, C, D, E, F, G, H, I, J)
When considering this benefit, keep in mind that the additional
premium for this extra benefit is generally far less than the cost of paying the hospital
deductible even once a year. And you may need to pay the deductible more than once in a
year, if you are hospitalized more than once.
The skilled nursing
facility co-insurance (Plans C, D, E, F, G, H, I, J)
Few people use this benefit because Medicare so rarely covers
skilled nursing facility care. When Medicare does pay for skilled nursing facility care,
it covers the first 20 days of care in full.
However, if you are one of the few who receive Medicare-covered skilled nursing care
and spend more than 20 days in the skilled nursing facility, coinsurance for days 21
through 100 is covered at $96 (1999) a day. This benefit could save you as much as $7,680
in out-of-pocket costs based on 1999 estimates.
Part B annual
deductible (Plans C, F, J)
Even if you see a doctor only twice in the year, you are likely to
use this benefit. The real question is whether the extra premium cost for this benefit is
worth the extra $100 in coverage.
Part B excess
charge benefit (Plans F, I, J, and G)
Pays the difference between your doctor's charge and Medicare's
approved amount. Plans F, I, and J pay the excess charge in full, and Plan G pays 80% of
this excess charge.
Under federal law, doctors who do not agree to accept Medicare's approved amount as
payment in full (also referred to as assignment) may charge 15% more than Medicare's
approved amount.
Some states have lower limits. For example, under federal law, if Medicare only agrees
to pay $100, your doctor may charge as much as $115. Plans F, I or J would cover the $15
difference between what Medicare approves and what the doctor may charge. Plan G would pay
you $12 (80% of $15).
If your doctors accept assignment, you may not want to pay the additional cost for this
benefit.
However, you may want to consider the benefit, if your doctors do not accept
assignment. You may also want to ensure excess charge coverage in the event that
you are hospitalized and do not have control over whether the doctors who treat you accept
assignment .
Coverage
for emergency care outside the United States (Plans C, D, E, F, G, H, I, J)
After you meet the $250 deductible, it pays 80% of the cost of
your care for up to $50,000 in lifetime benefits. If you do not plan to travel outside the
United States, you will not need this benefit. But if you do travel abroad, it could save
you thousands of dollars in expenses for emergency care.
At-home recovery
benefit (Plans D, G, I, J)
It covers additional custodial care, if you qualify for the
Medicare home health benefit. It pays no more than $40 per visit and $1600 per year.
In order to receive the benefit, you must be receiving Medicare-covered home health
services already. If you are receiving Medicare-covered home health services, you may
find that Medicare provides you with ample coverage for the same services that this
benefit covers. This benefit tends to be quite expensive and may not be worth the
additional premiums you pay for it.
Preventive
medical care benefit (Plans E and J)
It is limited to $120 each year. Since Medicare does not cover
most preventive medical services, some people like having a Medigap policy that covers
these services. It may not be worthwhile, because you are likely to pay as much in
additional premiums for this benefit as the $120 you will receive in covered services.
Prescription
drug benefits (Plans H, I, J)
The benefit has a $250 deductible, pays only 50% of drug costs,
and is limited to a maximum of $1250 a year under Plans H and I and a maximum of $3000 a
year under Plan J.
This benefit may only be worthwhile if you have costly prescription drug needs. To get
$1250 in benefits under Plans H and I, you must have at least $2750 in drug costs in a
year. To get $3000 under Plan J, you must have at least $6250 in drug costs in a year.
Enrollment
If you are 65 or
older ,
you can enroll in any Medigap plan of your choice during the six months following your
enrollment in Medicare Part B. The insurance company cannot deny you Medigap coverage
during this six-month open-enrollment period. After these six months are over, under
federal law, insurance companies have the right to refuse you a new Medigap policy, in
most circumstances.
However, effective July 1998, insurance companies are required to offer Plans A, B, C
and F on an "open enrollment" basis outside of the initial six-month period for
people who want to buy one of these plans after having been terminated from an
employer-sponsored retiree plan.
Also, effective July 1998, if you drop Medigap coverage to enroll in a Medicare HMO or
other Medicare + Choice health plan for the first time and then disenroll from one of
these plans within the first 12 months, the insurer must offer you the same Medigap plan
you dropped. Or, if that plan is no longer available from the same insurer, you can
purchase Plans A,B, C or F.
In addition, if you enroll in a Medicare HMO or other Medicare + Choice plan when you
are first eligible for Medicare at age 65, and then disenroll within the first 12 months,
insurers must offer you all of the Medigap plans on an open enrollment basis.
If you live in New York, Virginia or Connecticut, you can have an unlimited open
enrollment period. In these states, insurers are required to sell you the Medigap plan of
your choice, whenever you want it.
Some other states also require insurers to offer certain Medigap plans on a continuous
open enrollment basis. Check with your state insurance department.
If you have a disability and
are under 65 ,
you are not entitled to open enrollment under federal law, and you may not be able
to buy a Medigap policy until you turn 65. However, some states require insurers to sell
Medigap policies to people with disabilities under 65. You should contact your state
insurance department for more information.
What are your rights ?
Once you have enrolled, your Medigap insurer must renew your
policy for life, as long as you pay your premiums. You have the right to review your new
Medigap policy for 30 days and to cancel it within that time for a full refund, if it does
not meet your needs.
You have the right to cancel your policy at any time. You may replace it with another
Medigap plan, but the insurance company may refuse to approve your application based on
your age or your health status (except in New York State).
You have the right to renew your Medigap policy for life. Your policy cannot be
canceled because of your health or age.
Waiting periods
Companies selling Medigap insurance can impose a waiting period
of up to six months for coverage of pre-existing health conditions. Any condition which
was diagnosed or for which you received treatment in the six months before your Medigap
coverage began can be counted as a pre-existing condition.
Your Medigap policy will not cover treatment for it during the first six months of
coverage.
Effective July 1998, however, if you purchase a Medigap plan within 63 days of the
termination of previous health insurance coverage (for example, insurance received from a
former employer), the time you spent on the first health plan must be credited toward the
Medigap plan's pre-existing condition period.
For example, if you purchase a Medigap plan when you retire and lose employer coverage
that you have had for two years, you will have no pre-existing condition period.
You can switch Medigap insurance companies, change Medigap plans at the same insurance
company, or both without having to go through a new waiting period for pre-existing
conditions as long as:
1) you have had a Medigap policy for at least six months; and
2) you are purchasing the same or lesser level of coverage.
If you are purchasing additional benefits under your new Medigap plan, you might have a
waiting period before you are covered for the additional benefits. For example, you can
switch from Plan F to Plan C (which differ only by the excess charge benefit) without a
waiting period, because you are changing to a lesser level of coverage. However, you might
have a waiting period before you can begin receiving the excess charge benefit when
switching from Plan C to Plan F.
Note: Some states (such as New York) do not allow insurers to impose a pre-existing
condition period, even when you switch to a policy with a greater level of coverage.
If you are disenrolling from a Medicare HMO or other Medicare + Choice health plan in
the situations described in the "enrollment" section above, there may be no need
to go through a new pre-existing condition period.
Medicaid Recipients
Medicaid recipients may decide to suspend their Medigap coverage
within 90 days of becoming eligible for Medicaid. Suspension may last 24 months. If you
lose Medicaid coverage during this time, Medigap coverage will be automatically
reinstated, provided that you notify the insurance company within 90 days of losing
Medicaid coverage and that you pay the Medigap premiums.
Medigap coverage applies to pre-existing conditions.
Medicare SELECT
Medicare SELECT is a Medigap policy which restricts the
providers you are allowed to see. Costs can be lower than standard Medigap policies,
because Medicare SELECT policyholders are insured for care only at specific hospitals and
may be limited to the services of specific physicians.
Medicare SELECT plans are not as widely available as Medigap plans. Ask your state
insurance department about Medicare SELECT plans available in your state.
Contact the following Insurance Counseling and Assistance Centers in your
state for Medicare information.
The Counseling and Assistance Centers have highly-skilled and trained volunteers to
provide counseling, information and assistance to Medicare consumers. Consumers may talk
with counselors by telephone or meet face to face. The specific goals of the centers are
to educate people on Medicare about health insurance coverage and benefits, consumer
rights, insurance industry performance and consumer safeguards; provide " hands
on" advice and service to consumers in understanding their health insurance coverage
and benefits; protect consumers from fraud, collection agencies and unlawful or
overzealous providers; and empower consumers to make informed choices about health
insurance options, affirm their rights and bring about system changes.
State
Insurance Counseling and Assistance Centers
STATE
PHONE NUMBER
ALABAMA
1 (800) 243-5463
ALASKA
1 (800) 478-6065/ 1 (907) 562-7249
ARIZONA
1 (800) 432-4040/ 1 (602) 542-6595
ARKANSAS
1 (800) 852-5494/ 1 (501) 686-2940
CALIFORNIA
1 (800) 434-0222/ 1 (916) 323-7315
COLORADO
1 (800) 544-9181/ 1 (303) 894-7499 EXT.
356
CONNECTICUT
1 (800) 994-9422
DELAWARE
1 (800) 336-9500
DISTRICT OF COLUMBIA
1 (202) 676-3900
FLORIDA
1 (800) 963-5337
GEORGIA
1 (800) 669-8387
HAWAII
1 (808) 586-0100
IDAHO
1 (800) 247-442 (S.W.) / 1 (800) 488-5725
ILLINOIS
1 (800) 548-9034
INDIANA
1 (800) 452-4800
IOWA
1 (800) 351-4664
KANSAS
1 (800) 432-3535
KENTUCKY
1 (800) 372-2973/1 (502) 564-7372
LOUISIANA
1 (800) 259-5301/1 (504) 341-0828
MAINE
1 (800) 750-5353
MARYLAND
1 (800) 243-3425/1 (410) 225-1074
MASSACHUSETTS
1 (800) 882-2003/ 1 (617) 727-7750
MICHIGAN
1 (800) 803-7174
MINNESOTA
1 (800) 882-6262
MISSISSIPPI
1 (800) 948-3090
MISSOURI
1 (800) 390-3330
MONTANA
1 (800) 332-2272
NEBRASKA
1 (402) 471-2201
NEVADA
1 (800) 307- 4444/ 1 (702) 367-1218
NEW HAMPSHIRE
1 (800) 852-3388/ 1 (603) 271-4642
NEW JERSEY
1 (800) 792-8820
NEW MEXICO
1 (800) 432-2080
NEW YORK
1 (800) 333-4114/ NYC 1 (212) 869-3850
NORTH CAROLINA
1 (800) 443-9354
NORTH DAKOTA
1 (800) 247-0560
OHIO
1 (800) 686-1578
OKLAHOMA
1 (800) 763-2828/1 (405) 521-6628
OREGON
1 (800) 722-4134
PENNSYLVANIA
1 (800) 783-7067
RHODE ISLAND
1 (800) 322-2880
SOUTH CAROLINA
1 (800) 822-8804/ 1 (803) 737-7500
SOUTH DAKOTA
1 (800) 822-8804/ 1 (605) 773-3656
TENNESSEE
1 (800) 525-2816
TEXAS
1 (800) 252-3439
UTAH
1 (800) 439-3805/ 1 (801) 538-3910
VERMONT
1 (802) 828-3302
VIRGINIA
1 (800) 552-3402
WASHINGTON
1 (800) 397-4422
WEST VIRGINIA
1 (800) 642-9004/1 (304) 558-3317
WISCONSIN
1 (800) 242-1060
WYOMING
1 (800) 856-4398
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Results from search: http://www.lowinsure.com/Medicare_Supplements.htm
Medicare Supplemental Insurance for Oregon
Medicare Supplements:
Although the benefits are identical for all Medicare Supplemental Insurance Plans of the same type, the premiums
may vary greatly from company to company and area to area.
In Oregon there are 25 companies that sell Medicare Supplement Plans. We represent many of them.
The U.S. Government Medicare site has a page of publications for further information
on Medicare and Insurance, and you can also check out our chart of basic types of medicare supplements.
Medicare Supplemental Insurance Options:
Medicare supplement coverage can be sold in only ten standard plans. We feel that the best care is
received when you have your choice of Doctors, and you and your Doctor make your medical decisions. Medicare
HMO plans (MCO) are also available. Medicare Supplements are available with no medical underwriting during
your open enrollment period. This is the 6 months before and 6 months after your 65th birthday. The only other
time for open enrollment is if you are disabled and put onto Medicare. Then the 6 months after going onto
Medicare is an open enrollment period. You may however, apply to a company and fill out the medical underwriting
questions after open enrollment.
Medicare Supplemental Insurance (Medigap) is specifically designed to supplement Medicare's benefits
and is regulated by federal and state law, It must be clearly identified as Medicare supplemental insurance
and it must provide specific benefits that help fill the gaps in your Medicare coverage. Other kinds of insurance
may help you with out-of-pocket health care costs but they do not qualify as Medigap plans.
Standard Medigap Plans: To make it easier for you to compare Medigap insurance policies, all states
(except Minnesota, Massachusetts and Wisconsin), U.S. territories and the District of Columbia limit the number
of different Medigap policies that can be sold in any of those jurisdictions to no more than 10 standard Medigap
plans. The plans were developed by the National Association of Insurance Commissioners and incorporated into
state and federal law. They have letter designations ranging from "A" through "J," with Plan A being the "basic"
benefit package. Each of the other 9 plans includes the basic package plus a different combination of additional
benefits. Plan J provides the most coverage of all the plans. The plans cover specific expenses either not
covered or not fully covered by Medicare. Insurance companies are not permitted to change the combination
of benefits or the letter designations of any of the plans.
What is Medicare?
Medicare is a national health insurance program for people 65 years of age and older, certain younger
disabled people and people with permanent kidney failure. Medicare is run by the Health Care Financing Administration.
The Social Security Administration helps HCFA by enrolling people in Medicare and by collecting Medicare premiums.
Medicare is divided into two parts: Hospital Insurance (Part A) and Medical Insurance (Part B). Part
A helps pay for care in a hospital, skilled nursing facility, some home health care, and hospice care. Part
B helps pay for doctor bills, outpatient hospital care and other medical services not covered by Part A. Your
Medicare card shows the Medicare coverage you have--Hospital Insurance (Part A), Medical Insurance (Part B),
or both--and the date your coverage started.
Enrollment in Medicare is handled in two ways: either you are automatically enrolled or you must apply.
If you are getting Social Security or Railroad Retirement Board benefits before you turn 65, you are automatically
enrolled and your Medicare card will be mailed to you about three months before your 65th birthday. If you
are not receiving retirement benefits, you must apply by contacting a Social Security Administration office
or, if appropriate, the Railroad Retirement Board. You should apply three months before your 65th birthday
to avoid a possible delay in the start of your coverage. If you have been a disabled beneficiary under Social
Security or Railroad Retirement for 24 months, you will automatically get a Medicare card in the mail.
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Results from search: http://www.state.sd.us/social/ASA/SHIINE/
SHIINE
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SHIINE Program
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SHIINE
(Insurance Counseling)
Senior Health Information and Insurance Education (SHIINE) has trained
volunteer counselors across South Dakota to assist senior citizens who
have problems or questions with Medicare or private Medicare
supplemental insurance. This federally-funded
program is free to the citizens of South Dakota.
SHIINE's goals are
to:
Educate older Americans
about their health insurance coverage and benefits, consumer rights,
insurance industry performance, and consumer safeguards.
Provide hands-on advice
and service to the consumer in understanding their health insurance
coverage and eligibility for programs.
Protect consumers from
fraud, misdirected collection agencies, and unlawful or overzealous
providers.
Empower consumers to make
informed decisions concerning health insurance options, exercising
appeal and grievance rights, and recommending system reforms.
Services
SHIINE
provides the following c ounseling services on a one-on-one basis,
and the information is kept strictly confidential. For more information
about SHIINE or to obtain SHIINE services
call 1-800-822-8804.
Medicare+Choice
Program: Providing answers
and information to frequently asked consumer questions about health
plans offered in the Medicare+Choice program such as Health Maintenance
Organizations (HMO's); Preferred Provider Organizations (PPO's);
Provider Sponsored Organizations (PSO's); Private Fee-For-Service (PFFS);
and a Medicare Savings Account (MSA) demonstration project.
Information on
Medicare+Choice terminology such as coordinated election periods,
enrollment, disenrollment, benefits, access, consumer protections and
premiums.
Information on the
relationship between Medicare+Choice plans and original Medicare.
Medicare Counseling,
Part A: Helping someone to understand what Medicare Part A does
and does not pay for, eligibility questions, or understanding
intermediary action.
Medicare Counseling Part B: Helping someone to
understand what Medicare Part B does and does not pay for, eligibility
questions, or understanding carrier action.
Medicare Billing and Claims: Problems of easy
correction related to Medicare Summary Notices; Helping a person sort
their bills to determine what medical providers have or have not been
paid, and to determine the liability of the Medicare beneficiary;
Teaching a Medicare beneficiary to organize and understand Medicare
billings and claims.
Medicare Supplemental Insurance Claims: Claims
submittal to an issuer of Medicare supplemental insurance of a Medicare
beneficiary, advocacy to get a Medicare supplemental insurance carrier
to meet policy obligations such as
payment of provider bills, eligibility issues, coding errors, etc.
Medicare Appeals: Review, reconsideration, or
formal appeal regarding
Medicare's Summary Notices--including referral and involvement of an
attorney
when required for appeals.
Medicare Supplemental Insurance Counseling:
Medicare supplemental
insurance policy analysis and comparison, eligibility for insurance,
Medicare
supplemental insurance rate comparison, explanation of Medicare
supplemental insurance standardized plans.
Medicaid, QMB or
SLMB referral: Outreach to Medicare beneficiaries for
recommendation to apply to the Department of Social Services for
determination of eligibility for the Medicaid, Qualified Medicare
Beneficiary or Special Low Income Medicare Beneficiary program.
SHARECARE referral: Outreach to Medicare
beneficiaries for recommendation to apply to the South Dakota State
Medical Association for a SHARECARE card. The SHARECARE program allows
for mandatory assignment of South Dakota physician claims for Medicare
beneficiaries with incomes between 100% and 150% of the federal poverty
level.
Long Term Care Insurance Counseling: Long Term Care
Insurance policy
analysis and comparison, eligibility, explanation of policy benefits,
etc.
Additional Information
How do I get help understanding my
i nsurance coverage and benefits?
What
clients had to say about the SHIINE program
SD Consumer's Guide to Long-Term Care Insurance
2001 SD Consumer's Guide to Insurance to Supplement Medicare
Medicare Fact Sheets
Order SHIINE publications
Optional SHIINE Survey
How do I become a SHIINE volunteer?
SHIINE Links and Resources
SHIINE Administrative Forms (staff only)
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Supplemental Insurance for a Disabled Person on Medicare
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Filling in Medicare Gap My husband recently opened his own business, and we lost group coverage for
medical. I am 51 and on Medicare for the last four years. Could you please
advise me what type of insurance I should get and who would be able to provide
this insurance? I need insurance to cover physician, medicine and hospital
costs not covered by Medicare.
Pat
David Lack
David Lack, a Colorado-based corporate consultant, has worked for 15 years
with the life and health insurance industry and with public policy makers on
insurance concerns.
The Medicare program covers two classes of people in the United States --
those age 65 or older and those with certain disabilities, including people on
kidney dialysis and kidney transplant patients. Your age indicates that you
fall into the second category, meaning that you also receive Social Security
disability benefits.
PAGE 1 OF 5 NEXT
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ARTICLE: Health Insurance
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ARTICLE: Pick the Health Plan for You
ARTICLE: Do you need long-term care (LTC) insurance?
ARTICLE: Qualifying for Disability
Created: 05/15/2000 Reviewed: 06/13/2001
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