Form MSP-02 FL – 2012 UAI0061 Medicare Supplement Protection United American Insurance Company is...

Form MSP-02 FL – 2012UAI0061

Medicare Supplement Protection

Medicare Supplement Protection

United American Insurance Company is not associated with or endorsed by Medicare, Social Security or any other governmental agency. Unless specified, these Medicare Supplement policies will not duplicate Medicare payments or pay expenses not Medicare eligible. These policies have some limitations and exclusions. This is a solicitation for insurance, and an Agent representing United American Insurance Company may call you to provide costs and complete details.


Medicare Part B CoversMedicare Part A Covers

MEDICARE is a governmental health insurance program for Seniors age 65 and older and people with disabilities. Medicare is divided into two parts.

Medical Insurance

— Doctor and surgeon fees

— Most lab tests and X-rays performed outside the hospital

— Outpatient treatment

Hospital Insurance— Room and Board— Other costs associated

with confinement— Skilled nursing facility

care and some home health and hospice care

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• Enrollment is automatic through Social Security

• Premium Free

• Enrollee responsible for certain deductibles and out-of-pocket expenses

• Enrollment is optional

• Monthly premium of $99.90, which is deducted from Social Security check

• Enrollee responsible for certain deductibles and out-of-pocket expenses

Medicare Part A

Medicare Enrollment:Medicare Enrollment:

Medicare Part B

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SkilledNursing: Medicare Pays: You Pay:Days 1-20: All eligible expenses Nothing Days 21-100: All eligible remaining $144.50 daily

expenses

Days 101 on: Nothing All costs

Medicare Part A deductibles must be paid by the beneficiary each benefit period.

Medicare Deductibles:

Hospital: Medicare Pays: You Pay:Days 1-60: Most confinement $1,156 deductible

costs after deductible

Days 61-90: All eligible remaining costs $289 daily

Days 91-150: All eligible remaining costs $578 daily

Days 151 on: Nothing All hospital costs

Medicare Deductibles:

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Medicare generally pays 80% of the “approved” amount; you pay 20% plus excess costs.

Medicare Pays:—

Generally pays 80% of “approved” charges

—

Medicare Part B has an annual deductible of $140.

For each eligible Part B medical expense, Medicare determines a reasonable fee called the “approved” charge.

Medicare Deductibles:Medicare Deductibles:

You Pay:$140 annual deductible

20% of “approved” charges

100% of charges above Medicare “approved” charges

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• All Medicare Supplement plans were standardized by the federal government to make benefit comparisons easier. (Except MA, MN & WI)

• There are 11 standardized plans offering basic to more comprehensive coverage.

• Insurers can offer any or all standardized plans, but they must offer the core Plan A.(In PA, Plan B must also be offered.)

Medicare Supplement plans are designed to cover some of the deductibles and out-of-pocket expenses Seniors face.

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• Hospitalization: Part A coinsurance plus coverage for 365 additional days after Medicare benefits end

• Medical Expenses: Part B coinsurance(generally 20% of the Medicare-approved expenses)

• Blood: First 3 pints of blood each year

All standardized plans include these core benefits:

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Comparison of Benefits:United American’s ProCare portfolio consists of 10 of the 11 standardized plans.

Plan F also has an option called a high deductible Plan F. This high deductible plan pays the same benefits as Plan F after one has paid a calendar‑year deductible. Benefits from high deductible Plan F begin after out‑of‑pocket expenses exceed the calendar‑year deductible ($2,070 in 2012). Out‑of‑pocket expenses for this deductible are expenses that are ordinarily paid by the policy. These expenses include the Medicare deductibles for Part A and Part B, but do not include the separate foreign travel emergency deductible. Out-of-pocket expenses do not include premium.

Plans K and L provide for different out-of-pocket cost-sharing (50% for Plan K, 25% for Plan L). Once you reach the annual limit ($4,660 for Plan K, $2,330 for Plan L), the plan pays 100% of the Medicare copayments, coinsurance, and deductibles for the rest of the calendar year. The out‑of‑pocket annual limit does NOT include the charges from your provider that exceed Medicare-approved amounts, called ‘excess charges’. You will be responsible for paying excess charges. The out‑of‑pocket annual limit may be increased each year for inflation. This limit does not include premium.

Plan N pays 100% of Medical Expenses (Part B Coinsurance) except for a copayment of up to $20 for an office visit and up to $50 for an emergency room visit. The emergency room copayment is waived if the insured is admitted to any hospital, and the emergency visit is covered as a Medicare Part A expense.

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Your Needs:

Your Budget:

The Company:

There are a number of factors to consider before deciding on a Medicare Supplement plan.

How much coverage will you need now and in the future? Compare the benefits of each plan carefully.

Consider whether you will be able to afford the premiums on the plan you’ve selected.

Only policies are standardized, companies are not. Research the company’s track record — number of years in the industry, ratings and claims paying history. The best company is not necessarily the one with the lowest premiums.

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Medicare Supplement NeedAfter Medicare, substantial liability can remain… let’s review a hypothetical example.

PART A: (Hospital Insurance)Part A Deductible30 Days at $28960 Days at $578Additional Hospitalization3 units of blood (at $60/unit)

Skilled Nursing Facility80 Days at $144.50/day

At-Home Recovery:14 visits at $40/visit

PART A SUB TOTAL

YOU PAY

Patient Liability$1,156$8,670

$34,680$20,000

$180

$11,560

$560

$76,806

WITHOUTMedicare Supplement

$12,656

$89,462

$89,462

Plan CPays

$1,156$8,670

$34,680$20,000

$180

$11,560

_____

$76,246

Plan DPays

$1,156$8,670

$34,680$20,000

$180

$11,560

_____

$76,246

Plan FPays

$1,156$8,670

$34,680$20,000

$180

$11,560

_____

$76,246

Plan GPays

$1,156$8,670

$34,680$20,000

$180

$11,560

_____

$76,246

$8,411

$89,462

$8,271

$89,462

$12,656

$89,462

$12,516

$89,462

$4,805 $4,945 $560 $700

(Applicable premium rates apply)10


• Community RatingThe premium is the same for all customers who buy this policy regardless of age.

• Issue AgeIf you first buy the policy at age 65, you will pay the premium that the company charges 65-year-old customers, no matter what your current age.

• Attained AgeWith this type of policy, your premium will increase as you get older. If you buy at age 65, then at age 66 you will pay whatever the company is charging 66-year-olds.

Premium TypeCompanies have three different methods of pricing policies based on age. The three methods of pricing are:

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• Special commitment to serving Seniors for more than three decades

• Personal one-on-one Agent Service for the life of the policy

• One of the largest nationwide underwriter of individual Medicare Supplement insurance.*

• Pioneered nationwide “Automatic” Claims Filing® Service**

Since 1947, United American Insurance Company has brought protection and security to hundreds of thousands of Americans across the nation.

* NAIC Medicare Supplement Loss Ratios, 2010 Medicare Supplement Insurance Experience Report, June 2011.** Available with the purchase of UA’s optional non-insurance discount health services program UA Partners®.

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• Fast policy issue and claims processing — averaging less than a week

• Automatic Payment Plan (Bank Draft) — eliminates unintentional lapse and provides non-stop protection

• Easy to understand product brochures — clearly defined benefit descriptions and simple “yes/no” applications.

United American strives to deliver quality, innovative service to our policyholders through extensive Home Office support and one-on-one Agent attention. UA delivers:

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• For more than 30 consecutive years, UA has earned the A+ (Superior)* Financial Strength Rating from A.M. Best Company

• AA- “Very Strong”** Financial Strength Rating from Standard & Poor’s

United American is proud of its strong tradition of financial stability. We continually receive top industry ratings, proof we will be here for the long term.

These ratings refer only to the overall financial strength of the company and are not a recommendation of the specific policy provisions, notes or practices of the insurance company. *Rating as of 6/11, **Rating as of 5/11.

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• No Pre-Existing Conditions/No Waiting Periods (If Replacing Another Medicare Supplement or Open-Enrollment)

• Your Choice of Doctors/Hospitals• Guaranteed Renewable*• Ratings• Local Agent• Commitment to Senior Life/Health Market• Optional UA Partners® discount health

services program including optional “Automatic” Claims Filing®

Outstanding Features /Added Value of United American:

* Premium rates or benefits may change at a certain age or class.

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With our UA Partners® program, members can receive discount health services from thousands of participating providers nationwide. Savings range from:

UA Partners is not insurance, so there are no claims to file. The Partners Discount Program is available without the purchase of an insurance policy. A small fee may be charged for a selected program, i.e. the UA Partners Program where offered. UA Partners is not available in KS.

Chiropractic . . . . . . . . . . . . . up to 40%Dental . . . . . . . . . . . . . . . . . . up to 50%Eye Care . . . . . . . . . . . . . . . . up to 50%Hearing . . . . . . . . . . . . . . . . . up to 20%Prescriptions . . . . . . . . . . . . up to 30%Mail Order Pharmacy . . . . . save more $$

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• Helps ensure no missed claims

• Speeds claims processing

• Direct provider payment

• Consolidated monthly claim statement

• Pays provider claims on out-of-state services

“Automatic” Claims Filing® virtually eliminates the need to file as a majority of all Medicare Supplement claims are Part B and come to UA directly.

Note: Federal law requires Medicare to file a small number of claims directly with insurers.

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Form MSP-02 FL – 2012 UAI0061 Medicare Supplement Protection United American Insurance Company is...

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