Medicare Supplements(MSPs)

supplements are lettered because:

all carriers'coverage differs

Medigap policies must also include a (blank) DAY FREE LOOK PROVISION

30 - that allows insured to return the policy to the insurer within 30 days for a full refund of the premium paid

The core benefits found in plan (blank) must be offered in all the plans

A

The core benefits of Medicare supplement A cover the following: The first (blank) pints of blood(deductible for parts A and B)

3

For supps can sign up 6 mo prior to bday and (blank) months after turn 65 to be ok to sign up

6

Medigap policies CANNOT include a provision that restricts coverage for PRE-EXISTING conditions for more than (blank) months

6 (Also know that if they've had a Medigap policy For at least six months and change to another policy with the same coverage they cannot have a waiting period for pre-existing but if the new policy includes additional coverage not on the old policy then the six-month waiting. Can be applied but only to the additional coverages part

For supplements- blank mo prior bday & blank mo after bday month to be ok to sign up

6 months/6 months

Non-duplication of coverage

A Medicare supplement policy cannot contain benefits that duplicate those provided by Medicare

(Blank) costs for each day after the lifetime reserve days (core benefits section continued on Medicare supps plan A)

All

When is Medicare supplement open enrollment period?

An open enrollment period is a 6 month period that guarantees the applicants the right to buy Medigap once they first sign up for Medicare Part B

Eligibility for Medigap (supplements)

Anyone who qualify for Medicare may also purchased Medicare supplement and pay the necessary premium for those additional benefits

The core benefits of Medicare supplement A cover the following: Part (blank) coinsurance amount of (blank) percent

B 20%

Core benefits -Medicare supp plan A provides CORE BENEFITS -core benefits are Aka (blank)

Basic benefits

The core benefits of Medicare supplement A cover the following:DAYS 1-60

Coinsurance

What are some of Medicare's gaps

Deductibles copayments and benefit periods

Only call for Supps cancellations

Even if switching from 1 supp carrier to another, you must call to cancel the supp you don't want anymore

The core benefits of Medicare supplement A cover the following: after day 90:

Lifetime is there a date up to 60 days over your lifetime

What is Medigap?

Medicare Supplemental Insurance-to pay for medical services and items not covered by Medicare and Medicare's coinsurance and deductible. Medigap is a private insurance designed to help pay for those amounts that are typically the pt's responsibility under Medicare. there are several standard Medigap policies established by the federal gov w/ the ins industry (policies issued by PRIVATE insurance companies that are designed to fill in some of the gaps in Medicare)

Medicare Supplement Insurance is also referred to as:

Medigap

Initial 12 month trial period where they can switch Even from advantage to a supplement and they won't be denied for a (blank) condition unless (blank)

Pre-existing ESRD

What do Medicare supplement policy's Pay for?

Some or all of Medicare's deductibles and copayments

All Medigap(supplemental) policies are GUARANTEED RENEWABLE

The Insurance company cannot cancel or nonrenew coverage except for non-payment of the premium or because of material misrepresentation on the application

The core benefits of Medicare supplement A cover the following: Days 61-90

The insured share of hospital cost under Medicare part a

Standardized Medicare supplements plans

The standardized Medicare supplement plans are identified with the letters A through N

Under the Omnibus Budget Reconciliation Act of 1990(OBRA) congress Passed a law-standardized model for supps

This model requires Medigap plans to meet certain requirements as to participant eligibility and the benefits provided

Once eligible for Medicare supplement plan & during the open enrollment period,coverage offered on guaranteed issue basis & insurance co MUST DO THE FOLLOWING:

sell the patient a Medicare supplement policy, cover all pre-existing conditions incurred more than 6 months prior to effective date of coverage and... not charge more for a supplement policy bc of past or present health problems