Medicare Part A
What is another name for Medicare Part A?
Hospital Insurance
What is the Medicare Part B deductible for 2021?
$203
What is the purpose of Medicare Supplements?
To fill the 20% gap that Medicare does not cover.
What are the two standard maximum annual benefit amounts for a Dental Vision & Hearing policy?
$1000 or $1500
Which 3 major areas of health insurance does Medicare NOT cover?
Dental, vision, and hearing.
What is the Medicare Part A deductible for 2021?
$1,484
What are the 2 ways you can be billed for Medicare Part B?
If you are drawing social security, it is automatically deducted on a monthly basis. If you are not drawing social security it is billed to you in the mail on a quarterly basis.
What does it mean when they say that all Medicare supplements are "standardized"?
It means that all companies are required to offer the exact same Medicare Supplement products, and to coordinate with Medicare the exact same way.
Which ancillary product(s) would be a good fit for someone on Medicare Advantage?
-Hospital Indemnity (VERY IMPORTANT)
-Cancer Heart Attack & Stroke
-DVH (if not already included in MA coverages)
Mrs. Jones is new to Medicare and doesn't understand what it covers. In as few words as possible, how would you explain this to her?
Mrs. Jones, Medicare Part A is your hospital coverages, Medicare Part B is your doctors coverages. Together they cover about 80% of your medical expenses, and you will need a Medicare supplement to cover the rest. Medicare Part D is for your prescriptions. You will need to enroll in a drug plan that suits your specific needs.
How many days in a Skilled Nursing Facility does Medicare Part A cover?
Up to 100 consecutive days. With a copay of $176 (per day) starting on day 21.
What percent coinsurance does Medicare Part B cover?
Medicare Part B covers 80%, and the insured is responsible for 20%.
Which Plan is no longer offered to anyone eligible for Medicare after January 1, 2020?
Plan F (as well as HDF)
What are the minimum and maximum benefit amounts we offer for Cancer Heart Attack & Stroke policies?
Minimum: $5,000
Maximum:$75,000
Mr. Smith has group insurance from his previous employer, and is considering deferring Medicare and keeping his insurance as is. What are the 3 things you should review to make sure that is the best option for him?
-Monthly Cost
-Coverage
-Network
How much does Medicare Part A cost? (2 part answer)
$0 if you worked 40 quarters in your lifetime (equivalent to 10 years).
If you did not work 40 quarters, the cost is $458 per month.
How much would Medicare Part B cost per month for someone who made $82,000 in 2019?
$148.50. This is the average cost of Medicare Part B. Anyone who made less than $88,000 in 2019 is charged this price.
What are 3 examples of groups of people that do not need a supplement?
-Medicaid
-Group Insurance (Or other credible coverage)
-Indian Health Service
-Tricare
-VA Benefits (In most cases do not need a supplement, but they can take one if they want to receive care outside of the VA doctors and hospitals.)
Which ancillary product(s) would an 86 year old male, with no major health issues, be eligible for?
-Cancer Heart Attack & Stroke
-DVH in most states
***The age cut off for Hospital Indemnity eligibility is 85.
Mrs. Roberts tells you that she isn't signing up for Medicare because she doesn't want to start drawing from her Social Security yet. How should you respond?
Let her know that just because she is not drawing social security, does not mean that she cannot sign up for Medicare. Also warn her of the late enrollment penalties associated with not signing up if she does not have other credible coverage in place.
What are the daily copays for an inpatient hospital stay for days 1-60, 61-90, and days 91 and beyond?
Days 1-60: $0
Days 61-90: $371
Day 91 and beyond: $742 for "lifetime reserve days". ***Only allowed 60 in a lifetime.
How long do you have to sign up for Part B before being penalized? And what percent is the penalty for each 12 month period that you could have had Part B, but did not sign up for it?
3 months before eligibility, and 3 months after. Then you will receive a 10% premium penalty for each 12 month period you do not sign up or have credible coverage. This penalty lasts a lifetime.
Which 3 states always require 2 people to apply to receive a household discount?
New Jersey, Illinois, Ohio.
In what situation is a Hospital Indemnity Plan crucial? And how do you know how much coverage to offer?
-If someone has a Medicare Advantage Plan
-Match up the coverages of the plan to the out of pocket copays on the Medicare Advantage plan. (Ex. MA plan has a $295 copay for days 1-6 for an inpatient hospital stay, so you would set up the HIP for $300 per day for 6 days.)
Mr and Mrs Jones are both 72 and both have Medicare Advantage plans. They missed the Annual Enrollment Period, and it is now February 3rd. They would both like to switch to a Medicare Supplement Plan. Are they eligible to switch at this time? And if so, what are 2 things you should go over with them when considering switching to a Medicare Supplement?
-They are eligible to change until March 31st.
-They will need to be underwritten, so you need to make sure their health meets eligibility requirements.
-Let them know about needing to enroll in a stand-alone Part D.
-Address the monthly cost. Premiums are significantly higher for supplements, but the coverage is much more comprehensive.