UNITED INSURANCE SERVICES

United Insurance Services

– Proven Success in the Medicare World since 1986

– Our Pricing is identical, we offer personalzed services.

– We are your coaches to get you through the Medicare maze

– You pick how you want our support• Online• Phone• House Call

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What is Medicare?

Initial Idea started in 1912 with Teddy Roosevelt. It took over 50 years to really get going.

Medicare program finally began in 1965 to provide health insurance coverage for people age 65 or older.

Today Medicare is the nation’s largest health insurance program, covering more than 49 million people over the age of 65.

Medicare Eligibility Guidelines

You are eligible for Medicare if… You or your spouse paid into Medicare Tax for at least ten (10) years or (40 quarters) through employment; AND You are a US citizen or permanent resident of the US.

Pick Your Scenario

1. Turning 65, going on to medicare2. Over 65, continuing to work, no benefits3. Over 65, continuing to work, employer

benefits4. Over 65, retired, covered under spouse5. Over 65, Veterans, Thank You, great

plans

Turning 65 Medicare Enrollment Automatic vs. Manual

Automatic Enrollment• If receiving Social Security benefits before age 65. • Medicare Part A and Part B benefits start the first day of

the month you turn 65.• Medicare ID Card mailed within 3 months of 65th birthday.

Manual EnrollmentManually trigger Medicare benefits within 3 months of 65th birthday (to avoid penalties or gap in coverage) if not currently receiving Social Security benefits. • Call Social Security at 1-800-772-1213 • Apply online at www.ssa.gov/medicare/apply• Visit your local Social Security Office

Scenario 1 & 2

Turning 65 Medicare Enrollment Period

Initial Enrollment PeriodYou can sign up for Medicare Part A and/or Part B during the Initial Enrollment Period when you are first eligible (you are turning 65).

3 months before

the monthyou turn 65

2 months before

the monthyou turn 65

1 month before

the monthyou turn 65

The month

you turn65

1 month after

the monthyou turn 65

2 months after

the monthyou turn 65

3 months after

the monthyou turn 65

Sign up early to avoid a delay in coverage. To get Part A and/or Part B the month you turn 65, you must sign up during the first 3 months before the month you turn 65.

If you wait until the last 4 months of your Initial Enrollment Period to sign up for Part A and/or Part B, your coverage will be delayed.

If you enroll in this month of your initial enrollment period

Your coverage starts

The month you turn 65 1 month after enrollment

1 month after you turn 65 2 month after enrollment

2 month after you turn 65 3 month after enrollment

3 month after you turn 65 3 month after enrollment

Scenario 1 & 2

Scenario 3 & 4

Delaying Medicare – Enrollment Period

Enrollment PeriodIf you are continuing to work and delaying Medicare, you need to enroll in Medicare Part A and/or Part B as soon as you lose coverage. You have an 8-month period to enroll, but to avoid penalties, enroll as soon as you find out your coverage is ending.

63 days before

the day you lose

coverage

The day you

Lose coverage

6 months after

the day you lose

coverage• Coverage will start the first day of the month

following enrollment. • Enroll within eight month period, there are special

circumstances we can help to guide you and avoid penalties.

If you or your spouse (or family member if you're disabled) are still working and you have insurance through that employer or union, contact your employer or union benefits administrator to find out how your insurance works with Medicare. This includes federal or state employment, but not military service (unless on active duty). It may be to your advantage to delay Part B enrollment. SOURCE: Medicare.gov

Veterans

Thank you for your service• There are many great options and beneifts

provided for you. • We can help you select some additional options

and programs that can save you money, some at no cost to you.

Parts of Medicare

Medicare currently has four parts.

MEDICARE PART A = HOSPITAL INSURANCE MEDICARE PART B = MEDICAL INSURANCE MEDICARE PART D = PRESCRIPTION DRUG COVERAGE__________________________________________

MEDICARE PART C = MEDICARE ADVANTAGE PLANS (HMO/PPO)

Parts of Medicare Costs

Medicare Part A = Hospital Insurance• You have already paid into this program.• Helps pay for inpatient hospital care, skilled

nursing facility care, home health care, hospice care and blood.

• Most people do not pay a premium for Part A (if they or a spouse worked 40 quarters and paid a Medicare tax).(This program is worth $411 pre month for each member)

Source: www.cms.gov

Parts of Medicare - Costs

Medicare Part B = Medical Insurance• Helps pay for doctor’s services and many other medical

services and supplies.

• Some Medicare Part B premiums include an Income-Related Monthly Adjustment Amount (IRMAA). If your yearly income in 2014 (for what you pay in 2016) was:

Source: www.cms.gov

File Individual Tax Return

File Joint Tax Return

File Married & Separate Tax Return

IRMAA Total 2016 Part B Premium

$85,000 or less $170,000 or less $85,000 or less $0 $121.80

File Individual Tax Return

File Joint Tax Return

File Married & Separate Tax Return

IRMAA Total 2016 Part B Premium

$85,001 up to $107,000

$170,001 up to $214,000

Not applicable

$48.70 $170.50

$107,001 up to $160,000

$214,001 up to $320,000

Not applicable

$121.80 $243.60

$160,001 up to $214,000

$320,001 up to $428,000

$85,001 up to $129,000 $194.90 $316.70

$214,001 $428,001 $129,001 $268.00 $389.90

Parts of Medicare - Costs

Medicare Part D = Prescription Drug Coverage• A prescription drug option administered by

private insurance companies approved by and under contract with Medicare.

• Enrollment rules apply.• Contact our UIS Certified Part D Specialist for

more information at 866-457-2783.Source: www.cms.gov

Parts of Medicare - Costs

Medicare Part C = Medicare Advantage Plans The “All in one” approach

HMO and PPO plans, sometimes called “Part C” or “MA Plans,” are offered by

private insurance companies that are approved by Medicare. Medicare Advantage Plans are all-in-one plans. They are easy to use and budget-friendly.

Source: www.cms.gov

2016 Medicare Part A

Service What Medicare Pays What Medicare Leaves you to Pay

Part A (Hospital)

First 60 days of an admission

All covered changes but a $1,288 deductible each

benefit period

$1,288

61st to 90th Day All covered charges but $322 a day

$322 a day

91st to 150th Day All covered charges but $644 a day

$644 a day

Beyond 150 days $0 100% of expenses

Skilled Nursing Facility Care

First 20 Days 100% of approved costs $0

21st to 100th Day All covered charges but $161 a day

$161 a day

Beyond 100 days $0 100% of expenses

2016 Medicare Part B

*By law, no physician may charge more than 15% of Medicare-approved amounts.

Service What Medicare Pays What Medicare Leaves you to Pay

Part B (Medical & Doctor Charges)

$166 Annual Deductible

$0 $166

Medical Services 80% of Medicare-approved charges after the $166 calendar year

deductible is met

$166 deductible, then 20% of Medicare-approved charges

NOT paid by Medicare

Excess charges* $0 100% of expenses

How to Fill The GapsAfter Medicare Pays

with a Medicare Supplement Plan

Medicare Supplement Plans

A B C D F F** G K L M NBASIC

BENEFITS100% 100% 100

%100% 100% 100% 100% 100%/

75%100%/75%

100%/50%

Copay Applie

s

SKILLED NURSING

COINSURANCE

100%

100% 100% 100% 100% 50% 75% 100% 100%

PART A DEDUCTIBLE $1,288/benefit

period

100% 100%

100% 100% 100% 100% 50% 75% 50% 100%

PART B DEDUCTIBLE

$166/month

100%

100% 100%

PART B EXCESS

100% 100% 100%

FOREIGN TRAVEL

EMERGENCYX X X X X X X

ANNUAL OUT-OF-

POCKET LIMIT

$4940 $2470

Next Steps - REWORK Talk with one of our specialized coaches one-on-one and have they guide you through the maze if medicare.

Review your current health insurance coverage to find out what happens when you turn 65 or after you and/or your spouse retires.

Contact the Social Security Administration to confirm your eligibility for Medicare Benefits at 1-800-772-1213. remove?

Schedule an appointment with a representative from United Insurance Services to enroll. You may apply for coverage up to 12 months prior to

your 65th birthday. Stay with us to be organized and on track! Thank you for attending!