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Medicare Supplement Insurance Medicare Options and Part

VIEWS: 41 PAGES: 44

									                             Ohio Consumer Guide Series

                               Ohio Department of Insurance
                          1-800-686-1578   •   www.insurance.ohio.gov




Guide to
 Medicare Supplement Insurance,
  Medicare Options and Part D
       •	Describes when and how to apply for Medicare
       •	Describes	the	prescription	drug	benefit
       •	Explains options for health plans used with Medicare
       •	Includes sample premiums
       •	Lists Medicare Advantage plans
       •	Lists company names and phone numbers


                                                        John R. Kasich
                                                             Governor
                                                           Mary Taylor
                                                 Lt. Governor / Director
          Governor John R. Kasich
  Lt. Governor / Department of Insurance
            Director Mary Taylor
The Ohio Department of Insurance produces this consumer
guide to help you learn more about Medicare and health
insurance options in Ohio for people with Medicare.

Inside, you will find an overview of Medicare as well as
detailed information on the various choices available to
Ohioans under this federal health insurance program
for seniors and people with disabilities. Topics include
Medicare’s original plan, Medicare supplement insurance,
Medicare Advantage plans and Medicare prescription drug
coverage known as Part D.

Choosing the right insurance plan is an important decision.
If you have questions after reading this guide, the Ohio
Department of Insurance is ready to help. Please call our
the Department’s Ohio Senior Health Insurance Information
Program (OSHIIP) at 1-800-686-1578 or email us at
oshiipmail@insurance.ohio.gov.

John R. Kasich                  Mary Taylor
Governor                        Lt. Governor / Director
                                Ohio Department of Insurance
                                                                                                    1
Contents
 Medicare basics ....................................................................2-3
 Basics of Medicare supplement insurance ...........................4
 Basics of Medicare Advantage .............................................4
 Basics of Medicare prescription drug plans ..........................4-5
 Shopping tips ........................................................................5
 When and how to enroll in Medicare ....................................6-7
 Medicare open enrollment examples ....................................7
 Almost age 65 and new to Medicare ....................................8-9
 At least 65 and in a retirement plan ......................................10-11
 At least 65 and in an employer health plan...........................12-13
 At least 65 with MedSup or an Advantage plan
  and want to switch..............................................................14-15
 Under age 65 and covered by Medicare...............................16
 Any age with ESRD (kidney failure)......................................17
 At least 65 with limited finances............................................18-19
 MedSup policy comparison worksheet .................................20
 Choosing a MedSup plan .....................................................21
 Benefits chart of standard MedSup plans .............................22
 How to use the premium charts ............................................23
 Medicare supplement plan premiums ...................................24-31
 Medicare Select plan premiums ...........................................32-33
 Stand-alone prescription drug plans for 2012 .......................34-35
 Medicare Advantage plan comparison worksheet ................36
 Medicare Advantage plans in 2012.......................................37
 Glossary of terms..................................................................38-39
 Helpful phone numbers and web sites..................................40
 Ohio Senior Health Insurance Information Program ............. Cover



Alerts
We use the umbrella as a symbol for Medicare coverage and an                                !

                                                                                                !
to highlight areas where coverage gaps can occur. While Medicare
provides many benefits, most people probably need a separate
health plan to fill the gaps in Medicare coverage.
This guide is about your options for a health care plan to work with
Medicare in your effort to stay healthy both physically and financially.



              Disclaimer notice:
              The information included in this publication is meant to serve as a
              guide and is not a substitute for legal or professional advice. Please
              be certain to check with a professional if you have questions.
                                     Updated November 2011. May change without notice.
2
                               Medicare basics
    Medicare is federal health insurance for people age 65 and older, under
    age 65 with certain disabilities, and any age with End-Stage Renal Disease
    (permanent kidney failure requiring dialysis or a kidney transplant).

    Most people get their Medicare health coverage in one of two ways. Your
    costs vary depending on your plan, coverage and the services you use.


          Original Medicare              OR      Medicare Advantage Plans
        Part A              Part B                 like HMOs and PPOs
       (Hospital)          (Medical)
                                                    Called “Part C,” this option
       Medicare provides this


                                   !
                                                          combines your
       coverage. Part B is optional.                   Part A (Hospital) and
       You have your choice of                           Part B (Medical)
       doctors. See page 3 for
                                                   Private insurance companies
       costs you could pay with
                                                   approved by Medicare provide
       Original Medicare only.
                                                   these options. Generally, you

                     +                             must see doctors in the plan.
                                                   You may get extra benefits.
                                                   See page 4.
         Medicare Supplement
      Insurance (Medigap) Policy
       You can choose to buy this
       private coverage — or an                                  +
       employer / union may offer
       similar coverage — to fill gaps                        Part D
       in part A and Part B coverage.                      (Prescription


                                                                               !
       Costs vary by policy and                           Drug Coverage)
       company. See page 4.
                                                    Most Part C plans cover

                     +                              prescription drugs. If they
                                                    don’t, you may be able to
                                                    choose this coverage. Plans
                 Part D                             have different costs and cover
     (Prescription Drug Coverage)                   different drugs. See page 4.
       You can choose this



                                   !
       coverage. Private companies
       approved by Medicare run
                                              Annual Open Enrollment Period
       these plans. Plans have
       different costs and cover              People on Medicare can change plans
       different drugs. See page 4.           during the Annual Open Enrollment
                                              Period. Starting in 2011, this period
                                              begins Oct. 15 and ends Dec. 7.
                                                                                   3
                Medicare basics (continued)
  For many years, Medicare had two major parts: A for hospital
  insurance and B for medical insurance. These parts are known as
  the Original Medicare Plan. In recent years, two additional parts
  were added to Medicare. Here are the four parts of the program.
   Part A (Hospital Insurance) - Covers inpatient care in hospitals,
   skilled nursing facilities, some home health and hospice care. Part A
   does not cover long-term care.

   Part B (Medical Insurance) - Covers doctors’ services and
   outpatient care, other medical services that Part A doesn’t cover (like
   physical and occupational therapists), and some home health.

   Part C (Medicare Advantage Plans) - Private companies such as
   Health Maintenance Organizations, Preferred Provider Organizations
   and Private Fee-for-Service Plans provide both Part A and Part B
   benefits to eligible people who enroll. Many plans cover prescription
   drugs as well. See page 37 for a list of companies by plan type.

   Part D (Medicare Prescription Drug Coverage) - Private
   companies contract with Medicare to provide this coverage. See
   pages 34-35 for a list of stand-alone plans.



What you pay in 2012 with Original Medicare only

                                                                               !
            Service                  Amount
Part A     Hospital stay ............. $1,156 deductible per benefit period
                $ 289 daily copay for days 61-90
                $ 578 daily copay for days 91-150 (lifetime reserve days)
                All charges beyond 150 days
            Skilled nursing .......... $ 144.50 daily copay for days 21-100
Part B     Doctor visit ................ $ 140 annual deductible
            Generally, 20 percent for all medical services
            ALSO: Part B monthly premium of $99.90*.
                                   * Premium may be higher based on income

       Questions? Call OSHIIP for answers: 1-800-686-1578.
4
     Basics of Medicare supplement insurance
Medicare supplement insurance (also            The plans available for new sales changed
called MedSup or Medigap) is private           as of June 1, 2010. See page 22 for a
health insurance. You must have both           chart describing the benefits of each of
Medicare Part A and Part B before you          these standardized plans. Pages 24-33
apply for this insurance.                      show sample premiums from companies.
MedSup helps pay amounts not covered by A MedSup policy covers one person. If
the Original Medicare Plan. Only you can   you and your spouse both want MedSup
decide which policy best meets your needs. coverage, you must buy two policies.
MedSup policies are “standardized” —           No MedSup policy covers: long-term
the plans are identified by letters. Two       care (such as care in a nursing home),
plans with the same letter are identical, no   vision or dental care, eyeglasses,
matter which companies sell them. The          prescription drugs, private-duty nursing or
only difference is the cost.                   hearing aids.

        Basics of Medicare Advantage (Part C)
Medicare Advantage plans provide an            Companies that serve your county may
option to Original Medicare with MedSup        offer several different Advantage plans in
insurance. Private companies offer these       the county. Choose a plan based on your
plans to work with Medicare. You must          needs.
have both Part A and Part B to enroll.         Many plans include Part D drug coverage.
In general, Advantage plans require you to     Plans that offer Part D benefits may have
live in a service area to qualify. See page    a gap in coverage when costs reach a
37 for a list of companies serving Ohio.       certain point.
Normally, the plan pays its full share only if If you choose an Advantage plan you
you use doctors, health care facilities and    remain in the Medicare program. You do
other providers that contract with the plan. not need a Medicare supplement policy.


    Basics of prescription drug coverage (Part D)
If you have either Part A or Part B, you can a Medicare supplement policy, you may
buy coverage that helps pay prescription         need to consider a “stand-alone” drug plan
costs. Medicare-approved drug plans are          in addition.
offered by private insurance companies.
                                                 If you choose a Medicare Advantage plan,
In general, there is a penalty if you delay      coverage for prescription drugs may be
enrolling in Part D when you are first eligible. included. Ask the plan for details.
But if you have equal or better coverage
                                                 Coverage gap: You may owe the full cost
from another source – such as a retirement
                                                 for prescriptions in the “donut hole.”


                                                                                     !
plan – you won’t have a penalty.
                                                 Read more about this possible gap in
MedSup insurance sold today does not             coverage at the top of the next page.
include prescription coverage. If you buy
                                                                                               5
                      Basics of Part D — continued
What is the “donut hole” in Part D?               Other ways to avoid, delay or lessen
 You can enter a coverage gap called              the effect of the donut hole:


                                                                                           !
 the donut hole. In 2011, copays are
                                                   • Ask your doctor if a generic drug
 reduced for people while in the
                                                     is available. Generics cost less
 gap. For brand names, you’ll pay 50
                                                     than brand-name drugs. When
 percent; for generic drugs, you’ll
                                                     you use generics, you lower your
 receive a 7 percent discount. The
                                                     total prescription costs and delay
 2011 gap starts when your prescriptions’
                                                     entering the donut hole.
 total cost reaches $2,830 and ends
 when the total cost reaches $6,440.               • If the drug is new, ask your doctor
 Then catastrophic coverage starts and               if a less expensive, older drug is
 you pay five percent of your drug costs             appropriate for your situation.
 until year end. People who qualify for the
 low income subsidy (includes those on             • Ask your doctor for free samples.
 Medicaid) will not have a donut hole. See         • Buy your prescriptions in bulk or
 pages 18- 19.                                       through mail order.
How do I avoid the donut hole?                     • Call OSHIIP at 1-800-686-1578 for
  Some Part D and Advantage plans cover              help finding discount prescription
  this gap. Such plans usually have higher           cards.
  premiums than plans that do not cover
  the gap. See pages 34-35.

                                 Shopping tips
  To help identify plans that will best cover you and fill the gaps in Medicare.


            MedSup / Medigap                             Medicare Advantage
  • Plan benefits are shown on page 22.          • Many plans require you to use network
    Other than price, each plan is identical       providers. Ask your health care
    from company to company.                       providers about plans in which they
                                                   participate.
  • Pick the plan that best meets your
    medical needs and budget. Then shop          • Plans are available by service area only.
    companies for price and service.               See page 37 for a company list.

  • You have a 30-day “free look” period
                                                       Prescription drug plans
    after the policy arrives during which you    • Plans vary. Visit www.medicare.gov or
    can decide to cancel the policy for a full     call OSHIIP (1-800-686-1578) for your
    refund.                                        report. See pages 34-35.

           •	 On Medicaid or eligible? You likely don’t need a Medicare
              supplement policy or an Advantage plan. See pages 18-19.
6
                   When and how to enroll
                    in Original Medicare
For most people, the time to enroll is
when their 65th birthday is approaching.         To apply for Medicare:
Letting this milestone pass without action
on your part can have consequences. At
any rate, you cannot enroll in a MedSup
                                                 Contact your local Social
                                                 Security Administration (SSA)
                                                                                 
plan or a Medicare Advantage plan until          office or call SSA’s national number:
you have first enrolled in Medicare Part A            1-800-772-1213.
and Part B — Original Medicare.

            Remember these things about enrolling in Medicare:
            • It’s not automatic (for most people).
            • If you don’t apply, you won’t get it.
            • If you apply late, you’ll pay a penalty.
            • You apply at your local Social Security office.

Seven-month enrollment period                 If you miss your enrollment
You have a total of seven months to enroll    If you don’t enroll in Medicare during your
in Medicare without a financial penalty.      initial seven-month enrollment period...

When Medicare enrollment starts                 • You must wait to apply until the next
Your Medicare enrollment period starts            General Enrollment Period (January
three months before the month of your             through March each year)
65th birthday.                                  • Once enrolled you won’t be covered
                                                  until the following July
When Medicare enrollment ends
                                                • For each year you delay, you’ll pay
Your enrollment period ends three
                                                  an extra 10 percent for the Part B
months after the month of your 65th
                                                  premium
birthday.
When Medicare coverage starts
If you apply before your birth month, your
Medicare coverage should start on the first      Medicare may work differently...
day of your birth month.                        • If you have retirement benefits from
                                                  an employer (see pages 10-11) or,
Sooner beats later!
                                                • If you still work and have employer
If you apply during your birth month or
                                                  health coverage (see pages 12-13).
the next three months, coverage may be
delayed for as long as six months.
                                                                                                        7
Medicare enrollment examples:
• If your 65th birthday is April 10 and you apply for Medicare in...
   January		•		February		•		March                      April		•		May		•		June		•		July
                                                       Medicare	starts	the	first	day	of



                     




                                                          




                                                                                        
                                                                    


                                                                              
          Medicare starts April 1                       May		•		July		•		Sept.		•		Oct.

• However, if you miss your enrollment period and apply...

                           after July                  • You can’t enroll until next January
                                                        • Your coverage starts the following July
                                                        • You’ll pay a 10 percent penalty each year
                                                          you wait


Now you try
My Medicare enrollment dates:
The month I turn age 65 is ________________________________.

My Medicare enrollment starts three months BEFORE my birth month.
That means I can enroll starting in _________________________________.

My Medicare enrollment ends three months AFTER my birth month.
That means I must enroll by _________________________________.



                       What’s your situation?
               Find your Medicare situation below then turn to the
                pages shown to read helpful general information.
I am...
 • Almost age 65 and new to Medicare............................................. pages 8-9
 • At least 65 and in a retirement health plan ................................... pages 10-11
 • At least 65 and in an employer health plan ................................... pages 12-13
 • At least 65 with MedSup or an Advantage plan & want to switch . pages 14-15
 • Under age 65 and covered by Medicare....................................... page 16
 • Any age with ESRD (permanent kidney failure)............................ page 17
 • At least 65 with limited finances .................................................... pages 18-19
8
      Almost age 65 and new to Medicare
    Before your 65th birthday, you must decide whether to enroll in Medicare
    Part B. Your Medicare enrollment period begins three months before the
    month you turn 65 and ends three months after your birthday month.

How do I get started?                          If you and your spouse are ready to
                                               retire and will no longer have health
 Read pages 6-7 of this guide.                 coverage through a current employer,
 Call your local Social Security               you must enroll in Part B during your
 Administration (SSA) office to apply for      seven-month enrollment period to avoid
 Medicare. If you miss your seven-month        penalty.
 enrollment window, you may have to
 wait more than a year before you are         How	will	my	retirement	benefits	work	
 covered. To find an office near you:         with Medicare?
  •	 Visit www.ssa.gov                         If you have retirement benefits through
  •	 Or call 1-800-772-1213.                   an employer or union, see pages 10-11.

My 65th birthday is at the end of             I’m 65, still work and have coverage
the month. When am I eligible for             through my employer. What should I
Medicare?                                     do?
 Medicare says you turn 65 on the first        If you still work (or your spouse does)
 day of the month of your 65th birthday,       and have group health coverage through
 no matter what day your birthday really       a current employer, you can delay Part B
 is. So, if you apply the month before you     without penalty. See pages 12-13.
 turn 65, you are covered as of the first
 day of your birthday month.                   When you enroll in Part B, you
                                               automatically begin your open
 However, if your birthday is the first day    enrollment period for coverage that
 of the month, you “turn 65” a month           supplements Medicare. These plans
 early. (Example: your birthday is July 1,     are sold by private companies and pay
 and if you apply in May, you’re covered       most of your Medicare deductibles and
 as of June 1.)                                coinsurance.

What happens if I miss my Medicare            When should I buy a Medicare
enrollment period?                            supplement insurance policy?
 You would have to wait to apply until the     Your Medicare supplement open
 next General Enrollment Period (January       enrollment period is the best time to
 - March each year). Your coverage will        apply for and buy a MedSup policy
 start the following July. Plus, you may       (Medigap). This period lasts six months,
 pay a penalty for your Part B premium.        starting the first day of the month in
 See pages 6-7 for details.                    which you are age 65 and enrolled in
                                               Medicare Part B.
                                                                                           9
      Almost age 65 and new to Medicare (continued)
Why is this the best time?                       People with retiree benefits (see
 During your initial enrollment period, an       pages 10-11) or an employer health
 insurance company cannot deny you               plan (see pages 12-13) should ask
 coverage because of your health, make you       about “creditable coverage” relating to
 wait for coverage to start or charge you more   Medicare Part D.
 for a policy because of health problems.
                                                 Part D is available in stand-alone plans
 If you (or your spouse) still work at           (used with Original Medicare) or as part
 age 65, you may want to wait to enroll          of a Medicare Advantage plan. Many
 in Medicare Part B. MedSup open                 plans are available. The Department’s
 enrollment will begin when you enroll in        Ohio Senior Health Insurance
 Part B. See pages 12-13.                        Information Program (OSHIIP) can give
What if I cannot afford to buy                   you the information on available plans.
Medicare supplement insurance?
                                              What should I know about the donut
  First, enroll in Medicare Part A and        hole?
  B through your local Social Security
                                                If your prescriptions are expensive or
  office. People on Medicare with limited


                                                                                     !
                                                many, you may enter a coverage gap
  incomes can apply for help to pay health
                                                known as the donut hole.
  care costs. Apply through your county’s
                                                See page 5 for more information.
  Department of Job and Family Services.
  See pages 18-19 of this guide for more        Consider cost, convenience and
  information.                                  coverage before choosing a prescription
                                                plan. Once you select a plan, you
What should I know about Part D
                                                typically must stay with that plan for
prescription drug coverage?
                                                the calendar year. Penalties for late
  All people with Medicare are eligible         enrollment may apply.
  to enroll in Part D, which helps pay
  prescription costs. Your initial enrollment   People with limited incomes may
  period lasts seven months and matches         get help paying for Part D coverage
  your Part B enrollment period (starts         through the low income subsidy (LIS)
  three months before and ends three            program provided by the Social Security
  months after your birthday month).            Administration.
  As with Part B, you can decide to opt out     To get an LIS application, call OSHIIP at
  of Part D during your initial enrollment      1-800-686-1578.
  period. If you enroll at a later date you
  may owe a penalty on the premium.

   Annual Open Enrollment Period
                                                 Helpful contacts             
                                                 Medicare............. 1-800-633-4227
   People on Medicare can change plans
   during the Annual Open Enrollment             Social Security.... 1-800-772-1213
   Period. Starting in 2011, this period
                                                 OSHIIP ............... 1-800-686-1578
   begins Oct. 15 and ends Dec. 7.
10
  At least 65 and in a retirement health plan
      If you have benefits from a retirement plan offered by your employer
      (or your spouse’s employer) the best way to decide what you should
      do about Medicare is to discuss your situation with the employer’s
      Human Resources experts or the union office. How the retirement
      plan works and whether it’s continued is the employer’s decision.

How and when should I sign up for         Will my former employer continue to
Medicare?                                 cover my health care?
 Talk with your retirement plan to         Retiree health benefits vary with
 decide what you should do. If you         every employer. Some plans offer
 retire before age 65, the retirement      no health benefits while others add
 plan will likely cover health services    to Medicare’s coverage. To find out
 at some set level and you will be         if your former employer (or your
 responsible for the rest. Ask the         spouse’s former employer) will
 people who run your plan how the          continue to cover health care, contact
 coverage works.                           the company’s Human Resources
                                           department or the union office.
 At age 65 you will be entitled to
 Medicare. You must enroll during your     Here are some sample questions you
 enrollment period. This begins three      might ask:
 months before the month you turn          • Will health insurance be offered
 65 and ends three months after your         to me when I am eligible for
 birthday month. See pages 6-7 for           Medicare?
 more information.                         • Should I enroll in Medicare? (Many
                                             plans require you to enroll in
Must I enroll in Medicare even               Medicare and the plan acts as a
though I already get Social Security         secondary payer.)
payments?
                                           • How will the insurance coordinate
 If you are already receiving Social         with Medicare?
 Security income prior to age 65, you      • What will be my out-of-pocket
 should receive your Medicare card           costs? Premium? Deductible?
 from Social Security automatically.         Copayment? Coverage limits?
                                             Maximum out-of-pocket?
                                           • Are additional benefits available?
                                             What about vision, dental,
                                             prescription and preventive?
                                                                                    11
     At least 65 and in a retirement plan (continued)
What if my former employer does             What about prescription drug
not continue to cover my health             coverage?
care?
                                              If your former employer’s retirement
 If you are not eligible for group            plan includes prescription coverage
 health coverage from a former                that is at least as good as Medicare’s
 employer, consider the options shown         Part D plans, you can keep the
 below.                                       employer’s coverage. This is known
                                              as “creditable” coverage.
 • Option One: Enroll in Medicare with
   no additional insurance. See pages         Each year the employer must notify
   2-3 to learn about your out-of-            you in writing to tell you if your drug
   pocket expenses.                           coverage is creditable. Having
                                              creditable coverage allows you to
 • Option Two: Enroll in Medicare and
                                              enroll in Part D without penalty at
   shop for a Medicare supplement
                                              some later date, if necessary.
   policy (Medigap).
                                              If your retirement plan offers health
 • Option Three: Enroll in a Medicare


                                                                                   !
                                              care without prescription drug
   Advantage Plan. See page 37 for
                                              coverage — or drug coverage
   companies serving Ohio.
                                              that is not as good as Medicare
                                              Part D — you can choose a stand-
                                              alone drug plan. Consider all of your
                                              out-of-pocket costs, including the
                                              monthly premium, deductible,
                                              copays and the coverage gap known
                                              as the donut hole (see page 5 for
                                              details). See pages 34-35 for a list of
                                              stand-alone Part D plans.




        Helpful contacts               
        Medicare ................ 1-800-633-4227
        U.S. Dept. of Labor 1-866-487-2365
        OSHIIP ................... 1-800-686-1578
12
     At least 65 and in an employer health plan
If you still work or your spouse still works you might be covered by an employer
health plan. Talk to the employer’s Human Resources office and ask about the
coverage. Find out how the plan works with Medicare to pay health costs.
Am I entitled to Medicare even              If you are covered by the employer’s
though I’m still working?                   health plan, you have a choice. You
                                            can either enroll in Part B now or
 Yes. At age 65, you qualify for
                                            delay enrollment with no penalty.
 Medicare benefits. The Medicare Part
 A premium is free for most people          Delaying Part B will save you money
 who have worked and contributed to         because you won’t owe the monthly
 Social Security; others may purchase       Part B premium. You can’t buy a
 Part A coverage. If you have current       MedSup policy until you’re enrolled in
 employer group coverage, you can           Part B.
 delay enrolling in Part B.
                                            When you decide to retire, you will
                                            have a special Part B enrollment
Should I enroll in Medicare even if
                                            period of eight months. Consider a
I’m still employed at 65?
                                            MedSup policy once you’re enrolled in
 Talk to a health benefits specialist in    Part B.
 the employer’s Human Resources
 office to decide.                         Who	pays	first?



                                                                           !
 In general:                                If you have health insurance
 If you’re not covered by an employer’s     through a current employer,
 group health plan, it’s a good idea        your group health plan will
 to enroll. You will owe a monthly          usually pay first. In this case
 premium for Part B. Once you have          Medicare will pay second, and if you
 Part B, consider buying a MedSup           have a MedSup policy, it will pay last.
 policy (Medigap) to help with the          Always check with your employer’s
 gaps in Medicare coverage. MedSup          Human Resources office to find out
 enrollment starts as soon as you have      how the health plan works with
 Part B; this enrollment period cannot      Medicare.
 be changed or restarted.
                                                                                    13
    At least 65 and in an employer health plan (continued)
What if I lose my group health plan?
                                             OSHIIP can run a computer report to
 If your employer decides to end group       compare all the available prescription
 health insurance, you would want to         drug plans and their costs. Call us at
 enroll in Part B, if you haven’t done so    1-800-686-1578 to have a report done
 already. You have eight months after        for you. Or run your own report at
 your coverage ends to enroll in Part B      www.medicare.gov.
 without a penalty.
                                             Prescription drug coverage may be
 Once you’re enrolled in Part B, you         included in your employer health plan.
 would have 63 days to buy a MedSup          If so, your employer must let you
 Plan A, Plan B, Plan C, Plan F, Plan K      know in writing by Oct. 15 each year
 or Plan L with no regard to your health     if the plan’s drug coverage is at least
 status. If you wait longer than 63          as good as the Medicare plans. If it is,
 days, companies can ask you health          you have “creditable” coverage and
 questions and may decide not to offer       can delay enrolling in a Part D plan
 you coverage.


                                                                                    !
                                             without penalty.
 If you are in good health, you can          If your employer informs you the
 likely get any MedSup plan from any         plan’s prescription coverage is not
 company.                                    as good as Medicare’s Part D plans,
                                             consider buying a Part D plan.
Do I need Part D for prescriptions?
                                             Consider all of your out-of-pocket
 If the employer plan doesn’t have a         costs, including the monthly premium,
 prescription benefit, consider buying       deductible, copays and the coverage
 a Part D prescription drug plan. Many       gap known as the donut hole. See
 plans are available. The Department’s       page 5 for details on the donut hole;
 Ohio Senior Health Insurance                see pages 34-35 for a list of plans.
 Information Program (OSHIIP) can
 help you find a plan to pay some of
 your costs.


                                      Helpful contacts                
                                      Medicare .................. 1-800-633-4227
                                      U.S. Dept. of Labor .. 1-866-487-2365
                                      OSHIIP ..................... 1-800-686-1578
14
            At least 65 with MedSup or
       an Advantage plan and want to switch
     If Medicare has covered you for some time and you want to switch health
     plans, it’s a good idea to follow Medicare’s rules for switching. Consider
     all the factors that may affect your health care when you switch.

                                            Can I switch from one Medicare
  Annual Open Enrollment Period             Advantage plan to another?
  People on Medicare can change plans
  during the Annual Open Enrollment          Yes. However, changing plans is
  Period. Starting in 2011, this period      limited to certain time frames, as
  begins Oct. 15 and ends Dec. 7.            follows.
                                             • Annual Open Enrollment Period,
Can I switch from one MedSup plan              Oct. 15 - Dec. 7. All people on
to another?                                    Medicare can change plans during
                                               this time. Coverage under the new
 If you stay with the same company,
                                               plan starts Jan. 1.
 you may be able to switch to a
 different plan. If you decide to switch     • Special Enrollment Periods. You
 to a new company, you may be asked            may be allowed to change plans
 health questions on the application.          at different times during the year,
 It is important to be honest and              depending on your situation. Call
 complete in your answers. The new             OSHIIP (1-800-686-1578) for
 company will decide whether to offer          details.
 you coverage.
                                            How can I be sure I won’t have a gap
 If you allowed your old MedSup policy
                                            in coverage when I switch plans?
 to lapse, you may find it more difficult
 to find coverage. The company could         Keep your old plan in place until the
 make you wait before it covers a pre-       new coverage starts. You might pay
 existing condition.                         two premiums for a short time but you
                                             won’t have a break in coverage and
 Shop carefully to be sure the new
                                             won’t risk large out-of-pocket health
 plan meets your needs.
                                             care expenses.
                                                                                         15
        At least 65 with MedSup or an Advantage plan
                and want to switch (continued)
How do I switch from a MedSup                   How do I switch from a Medicare
policy to a Medicare Advantage                  Advantage plan to a MedSup policy?
plan?
                                                 You can leave Medicare Advantage
 You generally must wait until the               and return to Original Medicare during
 annual enrollment period (Oct. 15 -             the annual open enrollment period
 Dec. 7). Contact the Advantage plan             (Oct. 15 - Dec. 7). Your coverage
 directly to enroll. Coverage will start         under Original Medicare will start
 Jan. 1.                                         Jan. 1.
 Find out from the Advantage plan                Contact Medicare directly to disenroll
 whether prescription drug coverage              from the Advantage plan and return to
 (Part D) is included. If it is, this benefit    Original Medicare.
 will take the place of any Medicare
                                                 You have an additional 45-day
 stand-alone drug plan you have.
                                                 window (starts at the beginning of the
 Keep the MedSup policy and the                  year) to leave Medicare Advantage
 old drug plan in place until your new           and return to Original Medicare and
 coverage begins.                                qualified prescription drug coverage.
 Cancel the old plans once your                  Shop for a MedSup policy (and
 new coverage is in effect. Send the             a prescription drug plan if your
 insurance company a written request             Advantage plan included drug
 to cancel your old coverage on a                coverage). Request appropriate start
 specific date. If you don’t cancel, you         dates to avoid coverage gaps.
 could continue getting premium bills.




                                          Helpful contacts                 
                                          Medicare ....................1-800-633-4227
                                          Social Security ...........1-800-772-1213
                                          Ohio Medicaid ............1-800-324-8680
                                          Ohio Dept. of Aging ....1-800-282-1206
                                          OSHIIP .......................1-800-686-1578
16
       Under age 65 and covered by Medicare
         If you are under age 65 and covered by Medicare due to a disability,
         your choices may be limited. Once you’re 65, you’ll have full options.
Do any companies sell Medicare                           When I reach age 65, will I have
supplement insurance to people                           more MedSup policy choices?
who are under age 65?                                        You’ll have a six-month open
  Yes. Some companies make policies                          enrollment to choose any regular
  available to Ohioans who are covered                       MedSup plan. Companies cannot
  by Medicare due to a disability. See                       reject your application or medically
  the premium chart at the bottom of                         underwrite the policy at that time.
  this page.
                                                         Beside MedSup, what other options
  A limited number of plans may be                       do I have before I turn 65?
  offered. Ask if the company will
  medically underwrite the policy. If it                     Unless you have kidney failure
  will be underwritten, you’ll need to                       (ESRD), you can enroll in any
  answer questions about your health                         Medicare Advantage plan serving
  and the company may decide not to                          your county. You must be accepted.
  offer you coverage.                                        See the list of Advantage plans on
                                                             page 37.
Why don’t more companies sell to
those under age 65?                                      What can I do if I can’t afford any
                                                         plan available to me?
  Ohio allows Medicare supplement
  (MedSup) companies to decide                               One option may be Medicaid. If you
  whether to include this group for                          qualify, Medicaid pays costs not
  coverage.                                                  covered by Medicare. See pages 18-
                                                             19 for general details. Contact your
  Premiums for these plans can be
                                                             county Department of Job and Family
  more expensive than MedSup policies
                                                             Services to find out if you’re eligible.
  for people age 65 and older.


Company                       Phone         Internet Address     M Zip Age X? Pre-Ex        A      B     F	*

Liberty National Life     1-800-331-2512        libnat.com       A    Z    AI    Y     6          $453

United American           1-800-331-2512    unitedamerican.com   A    Z    AI    Y     6   $378   $477   $213


Companies shown quoted premiums Plan A, A, Plan B, and high-deductible only.
Companies shown quoted premiums for for PlanPlan B and high-deductible Plan F Plan F only.
If your health insurance hasn't lapsed, the companies shown will issue you a policy.

                       See page 23 for details on using the premium charts.
    Monthly premiums were reported in April 2011 and can change at any time.
                                                                                    17
         Any age with ESRD (kidney failure)
  People with End-Stage Renal Disease (kidney failure, also known as ESRD)
  have very limited options for health coverage to fill Medicare’s gaps.

Can I get a Medicare supplement             What are my other options?
policy or a Medicare Advantage plan
                                             One option could be Medicaid. If
to cover my health costs not paid by
                                             you qualify, Medicaid pays costs not
Medicare?
                                             covered by Medicare. See pages 18
  Unless your situation qualifies you for    and 19 for general details. Contact
  a Guaranteed Issue Opportunity, you        your county Department of Job and
  cannot get coverage.                       Family Services to find out if you’re
  Without some other type of                 eligible.
  assistance, you will be responsible        The National Kidney Foundation
  for paying Medicare deductibles,           (1-800-622-9010) may also provide
  coinsurance and other medical              assistance.
  costs not paid by Medicare. These
  amounts can be quite large.               Are there any other alternatives?

How can I qualify for a Guaranteed           The Ohio Benefit Bank connects
Issue Opportunity?                           people with limited and moderate
                                             incomes to public programs for
 You have a Guaranteed Issue
                                             people in need. Check your eligibility
 Opportunity when:
                                             from multiple sources of assistance
  • You have both Medicare Part A and        by contacting Ohio Benefits Bank.
    Part B along with insurance that is
    secondary to Medicare — such as          Visit	www.ohiobenefits.org	or call
    employer coverage through your           1-800-648-1176 for more information.
    spouse
  • You are at least age 65 and your
    Medicare Initial Enrollment Period
    has ended and                             Helpful contacts               
  • You lose the secondary insurance.         Medicare ............... 1-800-633-4227
 Within 63 days after losing the              Ohio Medicaid ....... 1-800-324-8680
 secondary coverage, you can apply
                                              Dept. of Aging ....... 1-800-282-1206
 for MedSup Plan A, Plan B, Plan C,
 Plan F, Plan K or Plan L. Companies          Kidney Foundation. 1-800-622-9010
 cannot reject your application or            OSHIIP .................. 1-800-686-1578
 underwrite the policy if you apply
 within the time limit.
18
           At least 65 with limited finances
 People with Medicare who have limited finances may get help paying
 medical costs through Medicaid. Check the eligibility chart shown below. Your
 county Department of Job and Family Services can determine if you qualify.

What is the difference between             To qualify, you must meet the specific
Medicare and Medicaid?                     income and resource limits shown
                                           below. These figures may change
 Medicare is federal health insurance
                                           each year.
 for people age 65 or older, under 65
 with certain disabilities and any age
 with End Stage Renal Disease              As of Jan. 1, 2011
 (permanent kidney failure) requiring
 dialysis or kidney transplants.           Medicaid      Monthly    Total
                                           eligibility   income     resources
 Medicaid is a program that helps pay       Single       $ 609      $1,500
 medical costs for people with limited
                                            Married      $1,031     $2,250
 incomes and resources. Medicaid
 programs vary from state to state, but
 most health care costs are covered
 if you qualify for both Medicare and     What is Medicaid spend down? Can
 Medicaid.                                it help me?

If I qualify for Medicaid, do I need       Spend down helps if you have out-
Medicare supplement insurance?             of-pocket medical costs you can use
                                           to reduce your income to or below
 No. Medicaid pays costs that the
                                           current Medicaid income limits.
 Medicare supplement (MedSup)
 policy would pay. With full Medicaid
                                           • Example: Jane is single with a
 coverage, you will not have to pay
                                             monthly income of $800. She pays
 Medicare’s deductibles or copays.
                                             $150 / month for health insurance.
 Medicaid covers these expenses
                                             Her net income is still $41 above
 and the cost of health services not
                                             the Medicaid limit, but Jane can
 covered by Medicare.
                                             qualify for spend down. She
                                             becomes eligible each month by
                                             spending $41 for medical expenses
                                             like doctor visits or dental work.
                                                                                  19
        At least 65 with limited finances (continued)
What if I don’t meet the Medicaid         Do I need Part D prescription
requirements for eligibility even         coverage?
though	my	finances	are	limited?
                                           Having a Part D plan will help you
 You may be able to get help with          save money on prescriptions. If you’re
 your out-of-pocket medical costs if       covered by Medicaid, you qualify
 you qualify as a Qualified Medicare       for the low income subsidy (LIS).
 Beneficiary (QMB), Specified Low          The LIS gives you extra help paying
 Income Medicare Beneficiary (SLMB)        the monthly premium and out-of-
 or Qualified Individual (QI).             pocket costs. Your monthly Part D
 Qualified Medicare Beneficiary:           plan premium will be reduced or fully
 You do not need a MedSup if you’re        covered; you may have a copay at the
 eligible for QMB because the program      drug store.
 is like having a free MedSup policy.      Even with a slightly higher income
 QMB pays:                                 (not Medicaid-eligible) you may
                                           qualify for the LIS and get extra help
  • Your deductibles and coinsurance
                                           with your drug costs. People who
    that are not paid by Medicare
                                           qualify will not have the coverage gap
  • Your Medicare Part B premium           which is built into many plans.
 Specified Low Income Medicare             OSHIIP can help you complete the
 Beneficiary and Qualified Individual:     application. Call us: 1-800-686-1578.
 SLMB and QI offer fewer benefits
 than QMB because the income limits        LIS eligibility is determined by the
 are higher.                               Social Security Administration (SSA).
                                           You can go to www.ssa.gov to
 Both programs pay:                        complete an application online.
  • Your Medicare Part B premium
  • Retroactive Part B premiums for
    each of the past three months
 Call your county Department of Job         Helpful contacts               
 and Family Services for eligibility        Medicare ............... 1-800-633-4227
 information. Or call the Ohio Medicaid
 hotline: 1-800-324-8680.                   Ohio Medicaid ....... 1-800-324-8680
                                            Social Security ...... 1-800-772-1213
                                            OSHIIP .................. 1-800-686-1578
20
       MedSup Policy comparison worksheet
Ask each insurance company                Insurance Insurance   Insurance
the questions below and write             Company 1 Company 2   Company 3
the answers in the space provided.

Which MedSup policies do you sell?
(Make sure the company sells the plan
you want.)

What will the MedSup policy I am
interested in cost this year?
What has been the cost of this
MedSup policy for the past few years?

How is the price decided?
 • What type of pricing does this
   insurance company use?
 • Does it make a difference if I am
   male or female?
 • Does it make a difference if I
   smoke or don’t smoke?
 • Does it make a difference if I am
   married or single?

Are there any additional benefits or
discounts included in this policy?

If you aren’t in your MedSup open
enrollment period or in another
situation where you have a
guaranteed issue right, ask:
 • Will you accept my application?
 • Do you review my health records or
   application to decide how much to
   charge me for a MedSup policy?
 • Will I have to wait for my pre-
   existing conditions to be covered if
   I already have a health problem?
                                                                                                   21
                       Choosing a MedSup plan
          Use this page to help understand the benefits chart on page 22.
          Every company that sells MedSup must offer Plan A. All of the
          other standard plans must include Plan A’s basic benefits.
Plan A: bargain basic                                  Standard MedSup plans combine these
Plan A is very basic. It has the fewest benefits       extra	benefits	in	different	ways
and the lowest prices. While it won’t patch
                                                        • Part A deductible ($1,156 per benefit
all the holes, Plan A fills some of the biggest
                                                          period in 2012)
gaps in coverage by Medicare. Its benefits are
described below.                                        • Part B deductible ($140 per calendar year
                                                          in 2012)
Hospitalization (Medicare Part A)
You pay the deductible ($1,156 in 2012), then           • Skilled Nursing Care: starts paying after
Plan A combines with Medicare to cover all                Medicare has paid for your first 20 days
Medicare-approved hospital charges for at                 in a skilled nursing facility. MedSup pays
least 515 continuous days in a hospital. And              your coinsurance for the next 80 days
if you were in and out of the hospital you’d be           ($144.50 per day in 2012). It pays for
covered for more than 515 days, because 90                those 80 days only.
of the Medicare days are “renewable.”                   • Excess charges under Part B: pays
                                                          either 80 percent or 100 percent of the
Medical bills (Medicare Part B)                           amount a doctor can legally add to a
You pay the annual deductible ($140 in 2012),             Medicare approved charge.
then you’re covered for 100% of Medicare-                    Note: Most Ohio residents do not need
approved medical expenses (Medicare pays                     excess charges coverage because of
80%, Plan A pays 20%). Because of Ohio’s                     the state’s balance bill ban. Call OSHIIP
law on balance billing, that’s your full bill if you         for details: 1-800-686-1578.
are treated by an Ohio practitioner.
                                                        • Foreign	travel	emergency:	emergency
Blood (Medicare Part B)                                   care when traveling outside the U.S. You
You pay the annual Part B deductible ($140                pay a $250 deductible; coverage pays 80
in 2012), then Plan A combines with Medicare              percent up to $50,000 lifetime limit.
to cover all blood expenses for the first three
pints each year.                                       Use the chart on page 22
                                                       The company’s sales material must include
Other	plans	add	benefits                               a similar chart. Pick the plan that best meets
The basic benefits are identical in each of            your needs, then shop for price and service.
the standard MedSup policies. So when
shopping, you can focus on the extra benefits
that help fill the rest of the gaps in Medicare
coverage, such as deductibles, copayments
and medical expenses that Medicare does not
cover.
                                                                                                                                                                                   22
Benefits chart of standard MedSup plans
    Plan A          Plan B         Plan C            Plan D           Plan F #           Plan G            Plan K ^          Plan L ^^          Plan M *         Plan N * ~

      Basic           Basic          Basic             Basic             Basic             Basic         Hospitalization    Hospitalization        Basic             Basic
    including       including      including         including         including         including       and preventive     and preventive       including         including
  100% Part B     100% Part B     100% Part B       100% Part B       100% Part B       100% Part B        care 100%;      care 100%;           100% Part B       100% Part B
  coinsurance     coinsurance     coinsurance       coinsurance       coinsurance       coinsurance      other basic 50% other basic 75%        coinsurance       coinsurance

Basic = Part A       Part A          Part A            Part A            Part A            Part A          50% Part A        75% Part A         50% Part A           Part A
coinsurance +      deductible      deductible        deductible        deductible        deductible        deductible        deductible         deductible         deductible
365 days;                        Skilled nursing   Skilled nursing   Skilled nursing   Skilled nursing    50% Skilled        75% Skilled       Skilled nursing   Skilled nursing
                                      facility          facility          facility          facility     nursing facility   nursing facility        facility          facility
Part B copays                     coinsurance       coinsurance       coinsurance       coinsurance       coinsurance        coinsurance        coinsurance       coinsurance

   coinsurance
or coinsurance                       P tB
                                     Part                                P tB
                                                                         Part                              50% P t B
                                                                                                               Part          75% P t B
                                                                                                                                 Part
for outpatient;                    deductible                          deductible                          deductible        deductible

                                                                         100%              100%
blood, first 3                                                          Part B            Part B
pints per year;                                                         excess            excess

                                   Foreign           Foreign           Foreign           Foreign                                                 Foreign           Foreign
hospice, Part A                     travel            travel            travel            travel                                                  travel            travel
coinsurance.                      emergency         emergency         emergency         emergency                                               emergency         emergency

# A separate version of Plan F is sold with a $2,070 deductible (2012).                                                     • Only the plans shown here can be sold
 # A separate version of Plan F is available with a $2,000 deductible (2011).
^ Plan K has an out-of -pocket limit of $4,660 (2012) for covered services. Medicare then pays 100%.                        • Every company must have a chart like this in
 ^ Plan K has an out-of-pocket limit of $4,640 (2011) for covered services. Medicare then pays 100%.                          its sales material
^^ Plan L has an out-of -pocket limit of $2,330 (2012) for covered services. Medicare then pays 100%.
 ^^ Plan L has an out-of-pocket limit of $2,320 (2011) for covered services. Medicare then pays 100%.
* Plan M and Plan N became available in June 2010.                                                                          • Every company must offer Plan A
 * Plan M and Plan N have been available since June 2010.
~ Plan N has a copay of up to $20 / office visit; up to $50 / emergency room visit.
 ~ Plan N has a copay of up to $20 / office visit; up to $50 / emergency room visit.
                                                                                  23
Using the premium charts on pp. 24-33
This page helps you understand the insurance company and policy information
contained in our premium charts. Each company reported the premiums for its policies
to the Department of Insurance in April 2011. Please note: premiums can change at
any time. Use these premium charts as a shopping tool, not as current information.


       Using the premium charts
       Read the premium charts from left to right to find these details about
       the company and the policies it offers. Companies may offer various
       discounts, so be sure to ask if you qualify.
       • Company — Due to space limitations words like Insurance,
         Company and Corporation are not used.

       • Phone — The number to call for new sales.

       • Internet Address — How to reach the company online.

       • M (Marketing) — How the company markets its policies.
          o M = Policies sold by mail
          o A = Policies sold by agents
          o I = Policies sold on the Internet


       • Zip — Costs for policies marked with a “Z” may vary by zip code.

       • Age — How the company prices its policies based on age.
          o AI = Age at issue (how old you were when you bought the
           policy)
          o AA = Attained age (how old you are now)


       • X? — Will the policy “crossover?” After processing your claim, will
         Medicare send any unpaid charges directly to the company?
          o Y = Yes          o N = No


       • Pre-ex — The number of months before the policy will pay for your
         pre-existing conditions, if pre-ex applies to you.

       • Plans A, B, C, etc. — The monthly premium amount a new
         customer would pay for a policy. A separate version of Plan F with
         a $2,070 deductible (2012) is noted with an *.
          o GI = The policy is Guaranteed Issue; you cannot be turned
            down for coverage because of poor health.
                                                                                                                                                                                             24
MedSup plan monthly premiums for age 65
Company                              Phone             Internet Address         M     Zip   Age     X? Pre-Ex      A      B      C      D      F     F*     G     K      L      M      N

AARP / United Healthcare *G*     1-800-523-5800       aarphealthcare.com      A/M/I   A      AI     Y    3        $68    $97    $120          $121                $48   $71           $80

Admiral Life                     1-800-987-1593                                 M     Z      AA     Y    0        $83    $97    $116   $101   $120   $47   $102                $91    $84

American Continental             1-800-264-4000          cont-life.com          A     Z      AA     Y    0        $95    $119                 $138   $54   $121                       $96

American Republic Corp           1-888-755-3065     americanenterprise.com      A     Z      AA     Y    0        $99                         $135   $58          $70   $96

Anthem BC / BS                   1-888-641-5224          anthem.com             A     A      AA     Y    6        $93                         $133   $46   $122                       $92

Assured Life Association         1-877 223-3666      denverwoodmen.com          A     Z      AA     Y    0        $81    $89    $110   $91    $111         $92                        $79

Bankers Fidelity Life            1-866-458-7500            bflic.com            A     Z     AI/AA   Y    0        $99                         $137   $48   $96    $56

Central States Indemnity         1-866-644-3988         medsup-csi.com          A     Z      AA     Y    0        $86    $100   $120   $99    $121                                    $87

Colonial Penn Life               1-800-800-2254        colonialpenn.com         A     A      AA     N    0        $120   $148                 $165   $40   $150   $64   $104   $130   $94

Combined                         1-800-544-5531     combinedinsurance.com     A/M/I   Z      AA     Y    0        $111                        $158                                    $111

Equitable Life & Casualty        1-800-352-5170           equilife.com          A     Z      AA     Y    0        $97                         $137                                    $96

Everence Association #           1-800-348-7468          everence.com           A     Z     AI/AA   Y    0        $99           $133          $165                      $96           $84

Gerber Life                      1-877-778-0839          gerberlife.com         A     Z      AA     Y    0        $79           $108   $93    $111         $94

Globe Life & Accident            1-800-801-6831     globecaremedsupp.com        M     A      AA     Y    2        $76    $114   $131          $132

Government Personnel Mutual      1-866-865-7631           gpmlife.com           A     Z      AA     Y    0        $79           $107   $89    $109         $89                        $78

Humana                           1-888-310-8482     humana-medicare.com        A/I    Z      AA     Y    3        $109   $114   $131          $134   $51          $62   $88

KSKJ Life                        1-800-321-0102           kskjlife.com          A     Z      AA     Y    0        $74    $90    $102   $87    $107         $87                 $78    $71

Liberty National Life            1-800-331-2512           libnat.com            A     Z      AA     Y    2        $119   $167                 $188   $43                              $150

Loyal American Life              1-800-633-6752       gasbinsurance.com         A     Z      AA     Y    6        $96    $112   $134   $117   $139         $120                       $97


*G* -- Group policy; may not be available for individual purchase.

                                                                           See page 23 for details on using the premium charts
# -- Company is a fraternal benefit organization; policies are available only to those eligible for membership.

^^ -- Company offers extra / innovative benefits on this plan.
                                                               Premiums were reported in April 2011 and can change at any time.
MedSup plan monthly premiums for age 65
Company                                Phone             Internet Address         M      Zip   Age   X? Pre-Ex     A      B      C      D       F       F*     G     K      L      M      N

Marquette National Life           1-800-934-8203     marquettenationallife.com     A     Z     AA    Y     6      $83                  $93     $109           $99                        $74

Medical Mutual                    1-800-722-7331          medmutual.com            A     A     AA    Y     0      $88           $125           $126     $44                              $87

Medico                            1-800-228-6080          gomedico.com             A     Z     AA    Y     0      $95           $134                          $111                $112   $106

Paramount                         1-888-891-0707     paramounthealthcare.com      A/M    A     AA    Y     0      $93           $134           $140                                      $104

Philadelphia American Life        1-800-552-7879          neweralife.com           A     Z     AA    Y     0      $78           $116                          $89                        $82

Physicians Mutual                 1-800-228-9100       physiciansmutual.com        A     Z     AA    Y     0      $124                        $116 ^^   $51   $155

Reserve National                  1-800-654-9106        reservenational.com        A     A     AA    Y     6      $110          $164           $143     $45                              $113

Royal Neighbors of America #      1-800-568-2382        royalneighbors.org         A     Z     AA    Y     0      $95    $120   $139   $112    $140           $112

Standard Life & Accident          1-888-350-1488            slaico.com             A     Z     AA    Y     0      $166   $189   $215   $130    $177     $26   $131                       $85

State Farm Mutual Auto            1-866-855-1212          statefarm.com            A     Z     AA    Y     0      $94           $142           $144

State Mutual                      1-888-764-1936     statemutualinsurance.com     A/I    Z     AA    Y     0      $76    $89    $107   $93     $111     $44   $94                 $84    $78

Sterling Investors                1-877-896-6434       sterlinginvestors.com       A     Z     AA    Y     0      $107   $125   $150   $131    $156     $61   $132                $118   $109

Sterling Life                     1-800-688-0010         sterlinghealth.com        A     Z     AA    Y     0      $152   $178   $185          $182 ^^         $162   $79                 $137

Summa                             1-888-464-8440         summacare.com           A/M/I   Z     AA    Y     0      $93           $129   $124    $136

Thrivent Fin. for Lutherans #     1-800-847-4836           thrivent.com            A     Z     AA    Y     0      $101   $119   $154   $133    $155     $51   $137         $95    $121

United American                   1-800-331-2512        unitedamerican.com         A     Z     AA    Y     2      $103   $150   $170   $159    $177     $39   $154   $86   $121          $135

United Commercial Travelers #     1-800-848-0123              utc.org              A     Z     AA    Y     0      $89    $104   $125   $109    $129           $110                       $91

United of Omaha                   1-800-354-3289        mutualofomaha.com         A/M    Z     AA    Y     0      $94           $134   $112    $136           $113                $108

USAA Life                         1-800-531-8722             usaa.com             M      A     AA    Y     0      $112                         $127


*G* -- Group policy; may not be available for individual purchase.
            Please note:
# -- Company is a fraternal benefit organization; policies are available only to those eligible for membership.

              offers Group policy; may this be
^^ -- Company*G*.. extra / innovative benefits onnot plan. available           for individual purchase.
                  # .... Company is a fraternal benefit organization; policies are available only to those eligible for membership.
                 ^^ .... Company offers extra / innovative benefits on this plan.




                                                                                                                                                                                                25
                                                                                                                                                                                             26
MedSup plan monthly premiums for age 70
Company                              Phone             Internet Address         M     Zip   Age     X? Pre-Ex      A      B      C      D      F     F*     G     K      L      M      N

AARP / United Healthcare *G*     1-800-523-5800       aarphealthcare.com      A/M/I   A      AI     Y    3        $84    $120   $148          $149                $59   $87           $99

Admiral Life                     1-800-987-1593                                 M     Z      AA     Y    0        $99    $115   $138   $121   $142   $56   $121                $109   $99

American Continental             1-800-264-4000          cont-life.com          A     Z      AA     Y    0        $107   $135                 $155   $61   $137                       $109

American Republic Corp           1-888-755-3065     americanenterprise.com      A     Z      AA     Y    0        $110                        $150   $64          $78   $107

Anthem BC / BS                   1-888-641-5224          anthem.com             A     A      AA     Y    6        $121                        $173   $60   $159                       $119

Assured Life Association         1-877 223-3666      denverwoodmen.com          A     Z      AA     Y    0        $95    $104   $130   $107   $130         $108                       $93

Bankers Fidelity Life            1-866-458-7500            bflic.com            A     Z     AI/AA   Y    0        $110                        $153   $54   $113   $66

Central States Indemnity         1-866-644-3988         medsup-csi.com          A     Z      AA     Y    0        $102   $119   $142   $118   $143                                    $102

Colonial Penn Life               1-800-800-2254        colonialpenn.com         A     A      AA     N    0        $146   $180                 $200   $49   $184   $78   $124   $161   $122

Combined                         1-800-544-5531     combinedinsurance.com     A/M/I   Z      AA     Y    0        $145                        $207                                    $145

Equitable Life & Casualty        1-800-352-5170           equilife.com          A     Z      AA     Y    0        $104                        $148                                    $104

Everence Association #           1-800-348-7468          everence.com           A     Z     AI/AA   Y    0        $107          $157          $179                      $105          $101

Gerber Life                      1-877-778-0839          gerberlife.com         A     Z      AA     Y    0        $93           $128   $111   $131         $111

Globe Life & Accident            1-800-801-6831     globecaremedsupp.com        M     A      AA     Y    2        $100   $143   $160          $161

Government Personnel Mutual      1-866-865-7631           gpmlife.com           A     Z      AA     Y    0        $86           $117   $98    $120         $98                        $86

Humana                           1-888-310-8482     humana-medicare.com        A/I    Z      AA     Y    3        $128   $135   $155          $158   $60          $73   $104

KSKJ Life                        1-800-321-0102           kskjlife.com          A     Z      AA     Y    0        $88    $107   $122   $103   $125         $104                $93    $84

Liberty National Life            1-800-331-2512           libnat.com            A     Z      AA     Y    2        $132   $192                 $220   $53                              $179

Loyal American Life              1-800-633-6752       gasbinsurance.com         A     Z      AA     Y    6        $109   $127   $152   $133   $156         $136                       $109


*G* -- Group policy; may not be available for individual purchase.
                                                                           See page 23 for details on using the premium charts
# -- Company is a fraternal benefit organization; policies are available only to those eligible for membership.

^^ -- Company offers extra / innovative benefits on this plan. Premiums were reported in April 2011 and can change at any time.
MedSup plan monthly premiums for age 70
Company                                Phone             Internet Address          M     Zip   Age   X? Pre-Ex     A      B      C      D       F       F*     G      K      L      M      N

Marquette National Life           1-800-934-8203     marquettenationallife.com     A     Z     AA    Y     6      $104                 $119    $137           $126                        $97

Medical Mutual                    1-800-722-7331          medmutual.com            A     A     AA    Y     0      $123          $174           $176     $62                               $122

Medico                            1-800-228-6080          gomedico.com             A     Z     AA    Y     0      $104          $147                          $122                 $123   $117

Paramount                         1-888-891-0707     paramounthealthcare.com      A/M    A     AA    Y     0      $116          $168           $175                                       $130

Philadelphia American Life        1-800-552-7879          neweralife.com           A     Z     AA    Y     0      $80           $131                          $100                        $93

Physicians Mutual                 1-800-228-9100       physiciansmutual.com        A     Z     AA    Y     0      $144                        $137 ^^   $67   $183

Reserve National                  1-800-654-9106        reservenational.com        A     A     AA    Y     6      $131          $195           $170     $53                               $134

Royal Neighbors of America #      1-800-568-2382        royalneighbors.org         A     Z     AA    Y     0      $109   $137   $159   $128    $160           $128

Standard Life & Accident          1-888-350-1488            slaico.com             A     Z     AA    Y     0      $170   $194   $221   $133    $181     $26   $134                        $87

State Farm Mutual Auto            1-866-855-1212          statefarm.com            A     Z     AA    Y     0      $119          $179           $181

State Mutual                      1-888-764-1936     statemutualinsurance.com     A/I    Z     AA    Y     0      $91    $106   $127   $111    $130     $51   $112                 $100   $91

Sterling Investors                1-877-896-6434       sterlinginvestors.com       A     Z     AA    Y     0      $128   $149   $178   $156    $183     $72   $157                 $141   $128

Sterling Life                     1-800-688-0010         sterlinghealth.com        A     Z     AA    Y     0      $173   $208   $215          $211 ^^         $189   $93                  $160

Summa                             1-888-464-8440         summacare.com           A/M/I   Z     AA    Y     0      $114          $167   $160    $176

Thrivent Fin. for Lutherans #     1-800-847-4836           thrivent.com            A     Z     AA    Y     0      $115   $136   $177   $152    $177     $58   $156          $109   $138

United American                   1-800-331-2512        unitedamerican.com         A     Z     AA    Y     2      $114   $172   $199   $188    $207     $48   $182   $115   $161          $162

United Commercial Travelers #     1-800-848-0123              utc.org              A     Z     AA    Y     0      $99    $116   $139   $121    $142           $122                        $100

United of Omaha                   1-800-354-3289        mutualofomaha.com         A/M    Z     AA    Y     0      $109          $156   $130    $158           $131                 $126

USAA Life                         1-800-531-8722             usaa.com             M      A     AA    Y     0      $130                         $148


*G* -- Group policy; may not be available for individual purchase.
            Please note:
# -- Company is a fraternal benefit organization; policies are available only to those eligible for membership.

              offers Group policy; may not be
^^ -- Company*G*..extra / innovative benefits on this plan. available          for individual purchase.
                  # .... Company is a fraternal benefit organization; policies are available only to those eligible for membership.
                 ^^ .... Company offers extra / innovative benefits on this plan.




                                                                                                                                                                                                 27
                                                                                                                                                                                             28
MedSup plan monthly premiums for age 75
Company                              Phone             Internet Address         M     Zip   Age     X? Pre-Ex      A      B      C      D      F     F*     G     K      L      M      N

AARP / United Healthcare *G*     1-800-523-5800       aarphealthcare.com      A/M/I   A      AI     Y    3        $111   $157   $194          $195                $78   $114          $129

Admiral Life                     1-800-987-1593                                 M     Z      AA     Y    0        $117   $137   $166   $143   $169   $67   $144                $129   $119

American Continental             1-800-264-4000          cont-life.com          A     Z      AA     Y    0        $125   $158                 $178   $70   $160                       $127

American Republic Corp           1-888-755-3065     americanenterprise.com      A     Z      AA     Y    0        $129                        $176   $75          $91   $125

Anthem BC / BS                   1-888-641-5224          anthem.com             A     A      AA     Y    6        $149                        $213   $74   $196                       $147

Assured Life Association         1-877 223-3666      denverwoodmen.com          A     Z      AA     Y    0        $105   $116   $145   $120   $145         $121                       $104

Bankers Fidelity Life            1-866-458-7500            bflic.com            A     Z     AI/AA   Y    0        $124                        $173   $60   $135   $79

Central States Indemnity         1-866-644-3988         medsup-csi.com          A     Z      AA     Y    0        $121   $141   $171   $140   $172                                    $123

Colonial Penn Life               1-800-800-2254        colonialpenn.com         A     A      AA     N    0        $178   $217                 $243   $59   $227   $98   $152   $199   $156

Combined                         1-800-544-5531     combinedinsurance.com     A/M/I   Z      AA     Y    0        $176                        $252                                    $176

Equitable Life & Casualty        1-800-352-5170           equilife.com          A     Z      AA     Y    0        $113                        $162                                    $114

Everence Association #           1-800-348-7468          everence.com           A     Z     AI/AA   Y    0        $112          $177          $190                      $112          $114

Gerber Life                      1-877-778-0839          gerberlife.com         A     Z      AA     Y    0        $103          $145   $125   $148         $126

Globe Life & Accident            1-800-801-6831     globecaremedsupp.com        M     A      AA     Y    2        $107   $164   $189          $190

Government Personnel Mutual      1-866-865-7631           gpmlife.com           A     Z      AA     Y    0        $97           $134   $112   $137         $112                       $98

Humana                           1-888-310-8482     humana-medicare.com        A/I    Z      AA     Y    3        $148   $156   $179          $183   $70          $85   $120

KSKJ Life                        1-800-321-0102           kskjlife.com          A     Z      AA     Y    0        $105   $127   $147   $123   $150         $123                $110   $100

Liberty National Life            1-800-331-2512           libnat.com            A     Z      AA     Y    2        $140   $209                 $249   $70                              $205

Loyal American Life              1-800-633-6752       gasbinsurance.com         A     Z      AA     Y    6        $129   $151   $183   $158   $187         $162                       $131


*G* -- Group policy; may not be available for individual purchase.
                                                                           See page 23 for details on using the premium charts
# -- Company is a fraternal benefit organization; policies are available only to those eligible for membership.

^^ -- Company offers extra / innovative benefits on this plan. Premiums were reported in April 2011 and can change at any time.
MedSup plan monthly premiums for age 75
Company                                Phone             Internet Address         M      Zip   Age   X? Pre-Ex     A      B      C      D       F       F*     G      K      L      M      N

Marquette National Life           1-800-934-8203     marquettenationallife.com    A      Z     AA    Y     6      $115                 $140    $159           $148                        $116

Medical Mutual                    1-800-722-7331          medmutual.com           A      A     AA    Y     0      $159          $225           $228     $80                               $157

Medico                            1-800-228-6080          gomedico.com            A      Z     AA    Y     0      $118          $168                          $142                 $143   $136

Paramount                         1-888-891-0707     paramounthealthcare.com     A/M     A     AA    Y     0      $135          $196           $204                                       $151

Philadelphia American Life        1-800-552-7879          neweralife.com          A      Z     AA    Y     0      $96           $158                          $121                        $112

Physicians Mutual                 1-800-228-9100       physiciansmutual.com       A      Z     AA    Y     0      $156                        $165 ^^   $86   $220

Reserve National                  1-800-654-9106        reservenational.com       A      A     AA    Y     6      $154          $229           $200     $63                               $158

Royal Neighbors of America #      1-800-568-2382        royalneighbors.org        A      Z     AA    Y     0      $124   $156   $182   $146    $183           $146

Standard Life & Accident          1-888-350-1488            slaico.com            A      Z     AA    Y     0      $183   $208   $236   $142    $194     $28   $143                        $94

State Farm Mutual Auto            1-866-855-1212          statefarm.com           A      Z     AA    Y     0      $138          $208           $210

State Mutual                      1-888-764-1936     statemutualinsurance.com     A/I    Z     AA    Y     0      $108   $126   $153   $132    $156     $61   $133                 $119   $109

Sterling Investors                1-877-896-6434       sterlinginvestors.com      A      Z     AA    Y     0      $151   $177   $215   $185    $219     $86   $186                 $167   $153

Sterling Life                     1-800-688-0010         sterlinghealth.com       A      Z     AA    Y     0      $189   $233   $241          $237 ^^         $212   $105                 $180

Summa                             1-888-464-8440         summacare.com           A/M/I   Z     AA    Y     0      $131          $207   $198    $218

Thrivent Fin. for Lutherans #     1-800-847-4836           thrivent.com           A      Z     AA    Y     0      $131   $155   $201   $173    $202     $66   $178          $124   $157

United American                   1-800-331-2512        unitedamerican.com        A      Z     AA    Y     2      $120   $187   $225   $214    $233     $60   $207   $128   $180          $185

United Commercial Travelers #     1-800-848-0123               utc.org            A      Z     AA    Y     0      $117   $137   $166   $143    $169           $144                        $118

United of Omaha                   1-800-354-3289        mutualofomaha.com        A/M     Z     AA    Y     0      $128          $184   $153    $186           $154                 $148

USAA Life                         1-800-531-8722             usaa.com             M      A     AA    Y     0      $156                         $177


*G* -- Group policy; may not be available for individual purchase.
                Please note:
# -- Company is a fraternal benefit organization; policies are available only to those eligible for membership.

              *G*.. Group policy; may this be
^^ -- Company offers extra / innovative benefits on notplan.   available for individual purchase.
                     # .... Company is a fraternal benefit organization; policies are available only to those eligible for membership.




                                                                                                                                                                                                 29
                  ^^ .... Company offers extra / innovative benefits on this plan.
                                                                                                                                                                                              30
MedSup plan monthly premiums for age 80
Company                              Phone             Internet Address         M     Zip   Age     X? Pre-Ex      A      B      C      D      F     F*     G      K      L      M      N

AARP / United Healthcare *G*     1-800-523-5800       aarphealthcare.com      A/M/I   A      AI     Y    3        $111   $157   $194          $195                $78    $114          $129

Admiral Life                     1-800-987-1593                                 M     Z      AA     Y    0        $133   $155   $189   $163   $191   $75   $164                 $147   $134

American Continental             1-800-264-4000          cont-life.com          A     Z      AA     Y    0        $138   $173                 $193   $76   $176                        $140

American Republic Corp           1-888-755-3065     americanenterprise.com      A     Z      AA     Y    0        $146                        $199   $85          $103   $141

Anthem BC / BS                   1-888-641-5224           anthem.com            A     A      AA     Y    6        $177                        $253   $88   $233                        $174

Assured Life Association         1-877 223-3666      denverwoodmen.com          A     Z      AA     Y    0        $111   $125   $156   $131   $157         $132                        $113

Bankers Fidelity Life            1-866-458-7500            bflic.com            A     Z     AI/AA   Y    0        $134                        $186   $65   $152   $90

Central States Indemnity         1-866-644-3988         medsup-csi.com          A     Z      AA     Y    0        $137   $161   $195   $159   $196                                     $138

Colonial Penn Life               1-800-800-2254        colonialpenn.com         A     A      AA     N    0        $208   $254                 $289   $70   $274   $120   $182   $237   $193

Combined                         1-800-544-5531     combinedinsurance.com     A/M/I   Z      AA     Y    0        $199                        $285                                     $199

Equitable Life & Casualty        1-800-352-5170           equilife.com          A     Z      AA     Y    0        $120                        $173                                     $122

Everence Association #           1-800-348-7468          everence.com           A     Z     AI/AA   Y    0        $119          $191          $206                       $121          $125

Gerber Life                      1-877-778-0839          gerberlife.com         A     Z      AA     Y    0        $110          $157   $136   $160         $136

Globe Life & Accident            1-800-801-6831     globecaremedsupp.com        M     A      AA     Y    2        $107   $165   $202          $204

Government Personnel Mutual      1-866-865-7631           gpmlife.com           A     Z      AA     Y    0        $106          $150   $125   $153         $125                        $110

Humana                           1-888-310-8482      humana-medicare.com       A/I    Z      AA     Y    3        $168   $177   $229          $207   $79          $96    $136

KSKJ Life                        1-800-321-0102           kskjlife.com          A     Z      AA     Y    0        $105   $127   $147   $123   $150         $123                 $110   $100

Liberty National Life            1-800-331-2512            libnat.com           A     Z      AA     Y    2        $141   $215                 $280   $92                               $236

Loyal American Life              1-800-633-6752       gasbinsurance.com         A     Z      AA     Y    6        $147   $171   $208   $180   $211         $184                        $148


*G* -- Group policy; may not be available for individual purchase.
                                                                             See page 23 for details on using the premium charts
# -- Company is a fraternal benefit organization; policies are available only to those eligible for membership.

^^ -- Company offers extra / innovative benefits on this plan.   Premiums were reported in April 2011 and can change at any time.
MedSup plan monthly premiums for age 80
Company                                Phone             Internet Address         M      Zip   Age   X? Pre-Ex     A      B      C      D       F       F*      G      K      L      M      N

Marquette National Life           1-800-934-8203     marquettenationallife.com     A     Z     AA    Y     6      $116                 $158    $176            $167                        $134

Medical Mutual                    1-800-722-7331          medmutual.com            A     A     AA    Y     0      $184          $260           $263     $92                                $181

Medico                            1-800-228-6080          gomedico.com             A     Z     AA    Y     0      $119          $190                           $161                 $162   $154

Paramount                         1-888-891-0707     paramounthealthcare.com      A/M    A     AA    Y     0      $156          $227           $236                                        $175

Philadelphia American Life        1-800-552-7879          neweralife.com           A     Z     AA    Y     0      $117          $192                           $147                        $136

Physicians Mutual                 1-800-228-9100       physiciansmutual.com        A     Z     AA    Y     0      $167                        $192 ^^   $109   $256

Reserve National                  1-800-654-9106        reservenational.com        A     A     AA    Y     6      $179          $265           $232     $73                                $183

Royal Neighbors of America #      1-800-568-2382        royalneighbors.org         A     Z     AA    Y     0      $142   $179   $208   $167    $209            $167

Standard Life & Accident          1-888-350-1488            slaico.com             A     Z     AA    Y     0      $217   $247   $280   $169    $231     $34    $170                        $111

State Farm Mutual Auto            1-866-855-1212          statefarm.com            A     Z     AA    Y     0      $155          $233           $236

State Mutual                      1-888-764-1936     statemutualinsurance.com     A/I    Z     AA    Y     0      $122   $143   $173   $150    $176     $69    $151                 $135   $123

Sterling Investors                1-877-896-6434       sterlinginvestors.com       A     Z     AA    Y     0      $172   $201   $244   $211    $247     $97    $212                 $190   $173

Sterling Life                     1-800-688-0010         sterlinghealth.com        A     Z     AA    Y     0      $200   $259   $269          $263 ^^          $238   $118                 $203

Summa                             1-888-464-8440         summacare.com           A/M/I   Z     AA    Y     0      $140          $245   $235    $258

Thrivent Fin. for Lutherans #     1-800-847-4836           thrivent.com            A     Z     AA    Y     0      $146   $172   $223   $192    $224     $73    $197          $138   $175

United American                   1-800-331-2512        unitedamerican.com         A     Z     AA    Y     2      $121   $192   $251   $240    $261     $72    $233   $137   $193          $211

United Commercial Travelers #     1-800-848-0123              utc.org              A     Z     AA    Y     0      $134   $156   $189   $164    $192            $165                        $135

United of Omaha                   1-800-354-3289        mutualofomaha.com         A/M    Z     AA    Y     0      $141          $202   $168    $204            $169                 $162

USAA Life                         1-800-531-8722             usaa.com             M      A     AA    Y     0      $181                         $205


*G* -- Group policy; may not be available for individual purchase.
            Please note:
# -- Company is a fraternal benefit organization; policies are available only to those eligible for membership.

              offers Group policy; may this be
^^ -- Company*G*..extra / innovative benefits onnot plan. available            for individual purchase.
                  # .... Company is a fraternal benefit organization; policies are available only to those eligible for membership.
                 ^^ .... Company offers extra / innovative benefits on this plan.




                                                                                                                                                                                                  31
Medicare Select plan monthly premiums




                                                                                                                                                                                           32
Medicare Select is a special type of MedSup policy which may require you to use network doctors and facilities.
Call the company for details. Standard plan benefits apply. See pages 21-22.
MedSelect / Age 65
Company                                  Phone               Internet Address           M     Zip   Age     X? Pre-ex     A        B       C         D         F        G     K      N

AARP / United Healthcare *G*        1-800-523-5800          aarphealthcare.com        A/M/I    A     AI     Y     3                       $99                 $100

Assured Life Association            1-877-223-3666         denverwoodmen.com            A      Z     AA     Y     0               $74     $91       $76       $92      $76

Gerber Life                         1-877-778-0839             gerberlife.com           A      Z     AA     Y     0                       $90       $78       $92      $78

Marquette National Life             1-800-934-8203       marquettenationallife.com      A      Z     AA     Y     6                                 $101      $90      $68          $68

Paramount                           1-888-891-0707       paramounthealthcare.com       A/M     A     AA     Y     0                       $115                                      $89

Royal Neighbors of America #        1-800-568-2382           royalneighbors.org         A      Z     AA     Y     0               $111    $129      $104      $130     $104

Sterling Life                       1-800-688-0010           sterlinghealth.com         A      Z     AA     Y     0      $138     $144    $154               $149 ^^   $122   $57   $101

Summa                                         8440
                                    1-888-464-8440            summacare.com
                                                              summacare com           A/M/I    Z     AA     Y     0                       $115      $109      $121

THP                                 1-877-236-2290             healthplan.org           A      A     AA     Y     0     $149 GI          $194 GI   $182 GI   $193 GI

United of Omaha                     1-800-354-3289          mutualofomaha.com          A/M     Z     AA     Y     0                       $114      $95       $115     $96


MedSelect / Age 70
Company                                  Phone               Internet Address           M     Zip   Age     X? Pre-ex     A        B       C         D         F        G     K      N

AARP / United Healthcare *G*        1-800-523-5800          aarphealthcare.com        A/M/I    A     AI     Y     3                       $122                $123

Assured Life Association            1-877-223-3666         denverwoodmen.com            A      Z     AA     Y     0               $86     $108      $89       $108     $90

Gerber Life                         1-877-778-0839             gerberlife.com           A      Z     AA     Y     0                       $107      $92       $109     $92

Marquette National Life             1-800-934-8203       marquettenationallife.com      A      Z     AA     Y     6                                 $125      $115     $89          $89

Paramount
Paramount                                     0707
                                    1-888-891-0707       paramounthealthcare com
                                                         paramounthealthcare.com       A/M     A     AA     Y     0                       $144                                      $111

Royal Neighbors of America #        1-800-568-2382           royalneighbors.org         A      Z     AA     Y     0               $127    $148      $119      $149     $119

Sterling Life                       1-800-688-0010           sterlinghealth.com         A      Z     AA     Y     0      $157     $164    $176               $170 ^^   $140   $65   $115

Summa                               1-888-464-8440            summacare.com           A/M/I    Z     AA     Y     0                       $148      $140      $156

THP                                 1-877-236-2290             healthplan.org           A      A     AA     Y     0     $177 GI          $252 GI   $237 GI   $251 GI

United of Omaha                     1-800-354-3289          mutualofomaha.com          A/M     Z     AA     Y     0                       $133      $110      $134     $112

*G* -- Group policy; may not be available for individual purchase.
# -- Company is a fraternal benefit organization; policies are available only to those eligible for membership.
Please note: No company reported MedSelect premiums for Plans L, M or high-deductible Plan F.
Medicare Select plan monthly premiums
MedSelect / Age 75
Company                                  Phone               Internet Address           M     Zip   Age     X? Pre-ex     A        B       C         D         F        G     K      N

AARP / United Healthcare *G*        1-800-523-5800          aarphealthcare.com        A/M/I    A     AI     Y     3                       $146                $147

Assured Life Association            1-877-223-3666         denverwoodmen.com            A      Z     AA     Y     0               $96     $120      $100      $121     $101

Gerber Life                         1-877-778-0839             gerberlife.com           A      Z     AA     Y     0                       $120      $104      $123     $104

Marquette National Life             1-800-934-8203       marquettenationallife.com      A      Z     AA     Y     6                                 $144      $134     $106         $106

Paramount                           1-888-891-0707       paramounthealthcare.com       A/M     A     AA     Y     0                       $168                                      $130

Royal Neighbors of America #        1-800-568-2382           royalneighbors.org         A      Z     AA     Y     0               $145    $169      $136      $170     $136

Sterling Life                       1-800-688-0010           sterlinghealth.com         A      Z     AA     Y     0      $170     $178    $192               $185 ^^   $153   $72   $127

Summa                                         8440
                                    1-888-464-8440            summacare com
                                                              summacare.com           A/M/I    Z     AA     Y     0                       $184      $174      $194

THP                                 1-877-236-2290             healthplan.org           A      A     AA     Y     0     $188 GI          $283 GI   $268 GI   $282 GI

United of Omaha                     1-800-354-3289          mutualofomaha.com          A/M     Z     AA     Y     0                       $156      $130      $158     $131


MedSelect / Age 80
Company                                  Phone               Internet Address           M     Zip   Age     X? Pre-ex     A        B       C         D         F        G     K      N

AARP / United Healthcare *G*        1-800-523-5800          aarphealthcare.com        A/M/I    A     AI     Y     3                       $146                $147

Assured Life Association            1-877-223-3666         denverwoodmen.com            A      Z     AA     Y     0               $104    $130      $108      $130     $109

Gerber Life                         1-877-778-0839             gerberlife.com           A      Z     AA     Y     0                       $130      $113      $133     $113

Marquette National Life             1-800-934-8203       marquettenationallife.com      A      Z     AA     Y     6                                 $159      $149     $122         $122

Paramount                           1-888-891-0707
                                    1-888-891-0707       paramounthealthcare.com
                                                         paramounthealthcare com       A/M     A     AA     Y     0                       $195                                      $150

Royal Neighbors of America #        1-800-568-2382           royalneighbors.org         A      Z     AA     Y     0               $166    $194      $155      $194     $156

Sterling Life                       1-800-688-0010           sterlinghealth.com         A      Z     AA     Y     0      $176     $186    $205               $197 ^^   $164   $77   $136

Summa                               1-888-464-8440            summacare.com           A/M/I    Z     AA     Y     0                       $218      $206      $230

THP                                 1-877-236-2290             healthplan.org           A      A     AA     Y     0     $193 GI          $314 GI   $299 GI   $313 GI

United of Omaha                     1-800-354-3289          mutualofomaha.com          A/M     Z     AA     Y     0                       $172      $143      $173     $144

*G* -- Group policy; may not be available for individual purchase.
# -- Company is a fraternal benefit organization; policies are available only to those eligible for membership.
Please note: No company reported MedSelect premiums for Plans L, M or high-deductible Plan F.

                                                                                       See page 23 for details on using the premium charts
                                                                           Premiums were reported in April 2011 and can change at any time.




                                                                                                                                                                                           33
34
Medicare Part D stand-alone prescription drug plans for 2012
 People who get their health benefits from a Medicare supplement policy or a Medicare
 Advantage plan with no drug coverage may enroll in a stand-alone prescription drug plan.
 New customers can call the phone numbers shown; if you need to contact a plan you’re
 already in, check your membership card for a customer service phone number.

Company Name          Part D Plan Names           $0 Prem. Monthly Annual Type of Coverage
Company Phone         Offered by the Company      w/LIS?   Premium Deduct. in the Gap


Aetna Medicare        Aetna/CVS PDP Basic            •     $26.00   $320   No gap coverage
1-800-529-5586        Aetna Medicare Rx Premier            $68.70   $0     Many generics



Anthem BC / BS        Blue MedicareRx Standard             $36.60   $320   No gap coverage
                      Blue MedicareRx Plus                 $66.70   $0     Some generics
1-800-243-3363        Blue MedicareRx Premier              $107.60 $0      Many generics, some brands



Bravo Health          BravoRx                              $42.20   $320   No gap coverage
1-800-821-7513



CIGNA                 Medicare Rx Plan One                 $32.00   $320   No gap coverage
Medicare Rx           Medicare Rx Plan Two                 $62.40   $0     Few generics
1-800-222-6700



Community CCRx        Community CCRx Basic           •     $26.90   $320   No gap coverage
1-866-684-5353        Community CCRx Choice                $76.00   $0     No gap coverage



EnvisionRx Plus       EnvisionRxPlus Silver          •     $26.70   $320   No gap coverage
1-866-250-2005        Rite Aid Envision RxPlus             $66.30   $0     Some generics



First Health Part D   Part D-Value Plus                    $25.10   $0     No gap coverage
1-800-588-3322        Part D-Premier Basic                 $38.20   $250   No gap coverage
                      Part D-Premier Plus                  $92.10   $0     Some generics, some brands



                                                                                   Continued 
                                                                                                35

Company Name        Part D Plan Names            $0 Prem. Monthly Annual   Type of Coverage
Company Phone       Offered by the Company       w/LIS? Premium Deduct.    in the Gap


Health Net           Orange Option 1                      $39.10   $320    No gap coverage
1-800-949-0166       Orange Option 2                      $71.20   $0      No gap coverage


HealthSpring PDP     HealthSpring PDP               •     $29.70   $320    No gap coverage
1-888-299-3582


Humana               Walmart Preferred Rx           •     $15.10   $320    No gap coverage
1-800-833-0632       Humana Enhanced                      $46.10   $0      No gap coverage
                     Humana Complete                      $111.50 $0       Many generics, some brands


Medco                Medicare Rx Plan Value               $44.60   $320    No gap coverage
1-800-758-4531       Medicare Rx Plan Choice              $63.40   $150    Many generics


PrimeTime            PrimeTime Rx Basic                   $43.50   $320    No gap coverage
1-800-577-5084       PrimeTime Rx Enhanced                $66.60   $0      All generics


SilverScript         CVS Caremark Value             •     $27.70   $320    No gap coverage
1-866-552-6106       CVS Caremark Plus                    $78.50   $0      No gap coverage


United American      United American Select         •     $29.10   $320    No gap coverage
1-866-524-4169       United American Preferred            $49.80   $100    No gap coverage


UnitedHealthcare     AARP MedicareRx Preferred            $34.80   $0      No gap coverage
1-888-867-5564       AARP MedicareRx Enhanced             $83.80   $0      Some generics


WellCare             WellCare Classic               •     $30.40   $320    No gap coverage
1-866-765-4390       WellCare Signature                   $57.00   $0      No gap coverage


                   Please note: www.medicare.gov is the source for this information.
36
 Medicare Advantage plan comparison worksheet
 Use this worksheet to help compare available Medicare Advantage plans. Page 37 lists
 contact information for Ohio-authorized plans. 1) Go to www.medicare.gov or call OSHIIP
 (1-800-686-1578) to identify the plans serving your county. 2) Call the plans for benefit
 information. Find out if your preferred doctors and hospitals are in the plan’s network and
 circle yes or no on the worksheet. Ask the plan about your financial responsibilities. Write
 these out-of-pocket costs on the worksheet. 3) Choose which plan (if any) is right for you.


                                  Plan 1                 Plan 2                  Plan 3
 Plan name                     ______________        ______________         ______________
 Phone                         ______________        ______________         ______________

 My doctors
 and hospitals are               Yes / No              Yes / No                Yes / No
 in the plan’s network

 Monthly Premium               ______________        ______________         ______________

 Copays
  Hospital                     ______________        ______________         ______________
  Emergency                    ______________        ______________         ______________
  Urgent care                  ______________        ______________         ______________
  Office visit
    Primary care               ______________        ______________         ______________
    Specialist                 ______________        ______________         ______________
  Physical exam                ______________        ______________         ______________
  Preventive care              ______________        ______________         ______________
  Therapy                      ______________        ______________         ______________
  Ambulance                    ______________        ______________         ______________

 Additional	benefits
  Drugs                        ______________        ______________         ______________
  Vision                       ______________        ______________         ______________
  Hearing                      ______________        ______________         ______________
  Dental                       ______________        ______________         ______________

 Additional plan
 information
   Do I need referrals?        ______________        ______________         ______________
   Wellness programs?          ______________        ______________         ______________
   Disease management?         ______________        ______________         ______________
   Other benefits?             ______________        ______________         ______________
                                                                                    37
        Medicare Advantage plans in 2012
     Medicare Advantage plans serve geographic areas, offering
     comprehensive health benefits that can include prescription drug coverage.
     Plans are listed here by type; companies may have multiple plans of each
     type. Go to www.medicare.gov for the plans serving your county, or call
     OSHIIP at 1-800-686-1578. Call the company for plan information.
Health Maintenance Organization             Private	Fee-for-Service	(PFFS)	
(HMO)                                       Any, Any, Any Gold (Universal Health Care):
AARP MedicareComplete (SecureHorizons       1-800-965-7034
by UnitedHealthcare): 1-800-547-5514        Humana Gold Choice: 1-800-833-2364
Aetna Medicare: 1-800-832-2640              Today’s Options Premier (Universal
Anthem Senior Advantage: 1-800-797-5957     American): 1-866-418-1923
Humana Gold Plus: 1-800-833-2364
                                            Special Needs Plan (SNP)
Kaiser Permanente Medicare Plus:
1-877-408-3495                              Special Needs Plans are generally
                                            available only to people who are covered
MediGold: 1-800-964-4525                    by both Medicare and Medicaid (dual
Molina Medicare Options: 1-866-403-8293     eligibles).
Paramount Elite : (419) 887-2525            Advantage by Buckeye Community Health
                                            Plan (HMO): 1-866-389-7690
PrimeTime Health Plan: (330) 363-7407
                                            CareSource Advantage (HMO):
SummaCare Secure: 1-800-328-7305            1-800-488-0134
SecureCare (The Health Plan):               Humana Gold Plus (HMO): 1-800-457-4708
1-877-236-2290
                                            Molina Medicare Options Plus (HMO):
Wellcare Value: 1-877-232-7119              1-866-403-8293

Preferred Provider Organization             UnitedHealthcare Dual Complete (HMO):
                                            1-888-834-3721
(PPO)
                                            United HealthCare Nursing Home Plan
Aetna Medicare: 1-800-832-2640
                                            (HMO): 1-888-834-3721
Anthem Medicare Preferred and Blue
                                            Wellcare Access (HMO): 1-877-270-0612
Medicare Access: 1-800-797-5957
HumanaChoice: 1-800-833-2364
                                            Programs for All-Inclusive Care for
MediGold Choice: 1-800-964-4525
                                            the Elderly (PACE) Plan
PrimeTime Health Plan: 1-800-577-5084        PACE plans help eligible people age
SecureChoice (The Health Plan):              55 or older who need chronic care stay
1-877-847-7915                               independent as long as possible.
UMPC for Life: 1-877-381-3765               McGregor PACE:
Universal Hassle-Free: 1-800-965-7034       (216) 791-3580 or (216) 957-3518
WindsorSterling Gold Plus: 1-888-900-4305   TriHealth Senior Link: (513) 531-5110


Please note: www.medicare.gov is the source for this information.
38
                               Glossary of terms
Assignment: A doctor agrees to accept               End-Stage Renal Disease (ESRD):
the Medicare-approved amount as full                Permanent kidney failure. Treatment may be
payment for a patient’s treatment under             lifetime dialysis or a kidney transplant.
Original Medicare. Ohio law prohibits medical       Excess charges: Any amount the doctor
practitioners and their employers from              or supplier charges you that is more than
charging more than Medicare approves. Most          Medicare approves. Ohio law prohibits this,
Ohio doctors accept Medicare assignment.            but other states may allow these charges.
Benefit	period:	Medicare measures your use          Guaranteed issue rights: In certain
of hospital and skilled nursing facility services   situations, rights you have that require an
by benefit periods. A benefit period begins the     insurance company to sell or offer you a
day you are admitted and ends when you’ve           MedSup policy. The company cannot deny
received no skilled services at a hospital or       you coverage or place conditions on a policy,
skilled nursing facility for 60 days in a row.      it must cover your pre-existing conditions and
A new benefit period begins with a new              it cannot charge more for a policy because of
admission. You pay the Part A deductible for        your past or present health problems.
each benefit period. There’s no limit to benefit
periods.                                            Guaranteed renewable: Your MedSup
                                                    policy must be automatically renewed or
Copayment (coinsurance): A cost you pay for         continued unless you commit fraud or don’t
services or treatments you receive. Usually,        pay premiums.
coinsurance is a percentage; copayments
are set dollar amounts. For ease of reading,        Home health care: Skilled nursing care and
this guide uses copayment (or copay) when           certain other health care you get in your home
referring to costs of this type — no matter         when ordered by your doctor.
what Medicare or other insurance calls such         Hospice care: A special way of caring
payments.                                           for people who are terminally ill and their
Crossover: A provision in many MedSup               families. Hospice includes physical care and
policies that allows Medicare to send claims        counseling and is covered by Medicare under
directly to the MedSup insurance company.           Part A.
Without crossover, Medicare mails you the           Lifetime reserve days: The 60 days
claims and you must send them to the insurer.       Medicare pays for when you already have
Deductible: An amount you pay for Medicare-         been in a hospital for more than 90 days.
covered services before Medicare begins to          These 60 days can be used only once during
pay. The Part A deductible is paid per benefit      your lifetime. For each lifetime reserve day,
period; the Part B deductible is paid annually.     Medicare pays all covered costs except for
Deductible amounts can change every year.           your daily copay.

Donut hole: A coverage gap allowed in Part          Long-term care: A variety of services that
D (prescription drug) plans. See page 5 for         help people who have chronic conditions.
more information.                                   The care can be received at home, in the
                                                    community, in a nursing home or an assisted
Durable Medical Equipment (DME): Medical            living facility. Most long-term care is custodial;
equipment ordered by a doctor for home use.         Medicare does not cover custodial care.
These items must be reusable (examples:
walkers, wheelchairs, hospital beds).               Low-income subsidy (extra help): Financial
                                                    assistance that helps people who qualify pay
                                                    costs associated with Part D coverage.
                                                                                                39
                      Glossary of terms (continued)
Medicaid: A program funded by federal and           MedSup open enrollment period: A one-
state money that helps pay medical costs for        time-only six month period when you can buy
some people with low incomes and limited            any MedSup policy offered in Ohio. It starts
resources. Medicaid programs vary from              when you sign up for Medicare Part B at age
state to state, but most health care costs are      65 or older. You cannot be denied coverage
covered if you qualify for both Medicare and        or charged more due to past or present health
Medicaid.                                           problems when you apply during this period.
Medical underwriting: An insurance                  MedSup policy: Medicare supplement
company process that looks at your health           insurance. MedSup is sold by private
history to decide whether to accept your            insurance companies to fill coverage gaps in
application for insurance and how much to           Original Medicare. The 10 standardized plans,
charge you for that insurance.                      named with letters of the alphabet, work only
Medically necessary: Services or supplies           with the Original Medicare Plan.
that meet the conditions below.                     Original Medicare: A fee-for-service health
 • Proper and needed for the diagnosis or           plan that lets you go to any doctor, hospital
   treatment of your medical condition              or other provider accepting Medicare. You
                                                    may first owe a deductible for services
 • Provided for the diagnosis, direct care and      under Part A (hospital insurance) or Part B
   treatment of your medical condition              (medical insurance). Medicare pays most of
 • Meet the standards of good medical               its approved amount for your services; you
   practice in the local area and are not           are responsible for your portion (usually 20
   mainly for the convenience of you or your        percent).
   doctor.                                          Pre-existing condition: A health problem
Medicare Advantage: Medicare health                 for which you were diagnosed or received
plans that must include all benefits Medicare       treatment within six months before the date a
offers and may carry extra benefits as well.        new insurance policy starts.
Medicare contracts annually with private            Premium: A periodic payment you make to
companies to offer these plans. They are            Medicare, an insurance company or a health
available based on the county where you live.       care plan for coverage.
Medicare-approved amount: In Original               Skilled nursing care: A level of care given by
Medicare, an amount Medicare sets as                Registered Nurses. Examples include giving
reasonable for a covered medical service.           intravenous injections, tube feeding, supplying
This is the amount paid by you and your             oxygen to help you breathe and changing
additional health insurance to a doctor or          sterile dressings on a wound. Any service that
other provider for a service or supply. Ohio        could be done safely by an average non-
law prohibits medical practitioners and their       medical person — or one’s self — and without
employees from charging more than Medicare          the supervision of a Registered Nurse is not
approves.                                           considered skilled care.
Medicare carrier: A private company that            Skilled	Nursing	Facility:	A facility with the
contracts with Medicare.                            staff and equipment to give skilled nursing
Medicare Select: A type of MedSup policy            care and / or skilled rehabilitation services and
that may require you to use hospitals and           other related health services.
doctors in a network for the plan to pay its full
share.
40
      Helpful phone numbers and web sites
     As you make your way through Medicare you may find it useful to keep
     handy this contact information for the various government agencies and
     other organizations that can assist people covered by Medicare.


                                                    
Organization                     Phone             Web site
Ohio Senior Health Insurance     1-800-686-1578    www.insurance.ohio.gov
 Information Program (OSHIIP)
Ohio Department of Insurance     1-800-686-1526    www.insurance.ohio.gov
 Consumer Services
Medicare                         1-800-MEDICARE www.medicare.gov
                                 (1-800-633-4227)
Medicare Fraud Reporting
 Pro-Seniors (also legal services) 1-800-488-6070   www.proseniors.org
 Office of Inspector General       1-800-HHS-TIPS www.stopmedicarefraud.gov
                                   (1-800-447-8477)
Social Security Administration   1-800-772-1213    www.ssa.gov
Ohio Department of Aging         1-800-282-1206    www.aging.ohio.gov
Ohio Medicaid                    1-800-324-8680    www.jfs.ohio.gov/ohp
Ohio Department of Health        1-800-342-0553    www.odh.ohio.gov
 (Skilled nursing complaints)
Ohio Attorney General            1-800-282-0515    www.ohioattorneygeneral.gov
Ohio KePRO                       1-800-589-7337    www.ohiokepro.com
U.S. Dept. of Labor              1-866-487-2365    www.dol.gov
Ohio’s Best Rx                   1-866-923-7879    www.ohiobestrx.org
Veterans Administration          1-877-222-8387    www.va.gov
TRICARE                          1-877-874-2273    www.tricare.mil
National Council on Aging        1-202-479-1200    www.ncoa.org
Ohio Benefit Bank                1-800-648-1176    www.ohiobenefits.org
National Kidney Foundation       1-800-622-9010    www.kidney.org
              Ohio Senior Health
        Insurance Information Program
                                OSHIIP
Since 1992, the Ohio Senior Health           OSHIIP staff — along with approximately
Insurance Information Program (OSHIIP)       800 trained volunteers who live in all parts
has provided people on Medicare with free    of our state — educate consumers about
and objective health insurance information   Medicare, Medicare supplement insurance
and one-on-one insurance counseling.         policies, Medicare Advantage plans,
A program of the Ohio Department of          Medicare prescription drug plans, certain
Insurance, OSHIIP is funded by the state     Medicaid issues, long-term care insurance
and a grant from the federal Centers for     and other health insurance matters.
Medicare and Medicaid Services (CMS).


     OSHIIP Counselors can help you:
      • Understand how various Medicare plans work
      • Make sense of doctor and hospital bills
      • Translate confusing statements from Medicare
        and insurance companies
      • Determine if you are getting the benefits you
        are entitled to, and what to do if you are not
      • Better understand how to deal with Medicare
        and insurance in the future




                      Want to be an OSHIIP Counselor?
                       • New volunteers are always needed and welcome
                       • OSHIIP has sites in most Ohio counties — call us about
                         training classes
                       • Contact us if you want OSHIIP in your area... you may
                         know of an organization that could serve as a sponsor



       Toll-free 1-800-686-1578 (7:30 a.m. - 5:00 p.m. Monday - Friday)
                              Fax (614) 752-0740
                      Internet: www.insurance.ohio.gov
                    Email: oshiipmail@insurance.ohio.gov
               To request consumer publications
       or ask questions about insurance, please call the
        Ohio Department of Insurance consumer lines:
              Medicare issues... 1-800-686-1578
         Other types of insurance...1- 800-686-1526
                         Fax (614) 644-3744
TDD/TTY phone users, please call Ohio Relay Service 9+711
            For many Department services and
      publication updates, please visit our web site...
                    www.insurance.ohio.gov
   The Ohio Department of Insurance is an Equal Opportunity Employer.
                               October 2011




                     This publication has been created or produced by Ohio with financial
                     assistance, in whole or in part, through a grant from the Centers for
                     Medicare & Medicaid Services, the Federal Medicare agency.

								
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