RIDGING THE GAP 2017Overview and Helpful Suggestions. 2: Types of Medicare Supplement Policies. 3:...
Transcript of RIDGING THE GAP 2017Overview and Helpful Suggestions. 2: Types of Medicare Supplement Policies. 3:...
BRIDGING THE GAP 2017 MEDICARE SUPPLEMENT COMPARISON (MEDIGAP) GUIDE
from the Arkansas Insurance Department Division of Senior Health Insurance Information Program (SHIIP)
This booklet contains
Page Topic
1 Overview and Helpful Suggestions
2 Types of Medicare Supplement Policies
3 Significant Medigap Insurance Laws
4 Special Circumstances for Medigap
5 Buyer Beware and Variables
6 2017 Medicare Costs Parts A & B
7 Medigap Plan Options A-N
8 Medigap Providers for Ages Under 65
9-14 Medigap Providers 65 and Older
15-46 Medigap Plans 65 and Older
47-48 Glossary
49-50 Notes and Helpful Phone Numbers
SHIIP can help in understanding your
Medicare choices
SHIIP is funded by the Administration for
Community Living, an agency of the U.S.
Department of Health and Human Services.
SHIIP works to help people save money and
make informed decisions about Medicare.
SHIIP offers telephonic and in-person
counseling to discuss Medicare choices and
answer questions.
SHIIP does not sell insurance or offer legal
advice. SHIIP certified Medicare counselors
offer unbiased information and referral
services.
Senior Health Insurance Information Program Arkansas Insurance Department
Medicare Plans Change. People Change.
Shop & Compare Plans Oct. 15—Dec. 7
FIND US ON FACEBOOK AND TWITTER
1200 W 3rd St Little Rock, Arkansas 72201 Toll Free: 1-800-224-6330
www.insurance.arkansas.gov
This guide summarizes the benefits of Medicare Supplement Policies approved by the Arkansas
Insurance Department for sale in 2017. Inclusion of information in this guide regarding a policy
does not, in any way, constitute an endorsement of the policy or company by the Arkansas
Insurance Department.
● For quotes and exact premium cost contact company or agent to purchase.
● Be advised that some new policies may have entered the marketplace since this publication
was printed and will not be included. See the back cover of this publication, lower left corner
for revision date.
● Don't be alarmed if your Medicare Supplement Policy does not appear in this booklet. You
may choose to keep your policy as long as you pay the premium.
● Publication of this guide is for information purposes only. Please refer to the policy itself for
the complete and actual terms of coverage since the policy constitutes the contract between
the insurer and the insured and will ultimately be the basis of final determinations.
SHOP WITH CAUTION. Do not just buy the cheapest policy without weighing other factorsand determining the company’s financial stability and reputation for resolving complaints.
● AVOID HIGH PRESSURE SALES TACTICS. Take time and avoid being pushed into buying aninsurance policy. Do not buy a policy under the pressure of limited enrollment periods or of“last chance to enroll.” Be wary of agents and sales material that imply a policy is connectedwith or endorsed by the government. Medicare Supplement Insurance and Long-term Careinsurance are not connected with or endorsed by the federal government.
● DON’T BE MISLED BY ADVERTISING. Do not buy a policy because celebrities endorse it ontelevision, radio, newspaper, or other advertisements. Ask questions before buying a policy.
● BE CAREFUL HOW YOU PAY FOR POLICIES. Do not pay in cash. When purchasing MedicareSupplement Insurance, it is always best to pay by check, money order, or bank draft.Premium payments should always be made payable to the insurance company, not the agentselling the policy. If you must pay in cash, be sure to get a company-authorized receiptsigned by the agent.
KEEP YOUR POLICY IN A SAFE PLACE. Select a friend or relative in advance to handle yourmedical affairs in case of illness and let that person know where to locate your policy.
KEEP RECORDS. Write down and keep the correct name, telephone number, and permanentaddress of the agent and the insurance company. Ask for a toll-free number in case youneed to call long distance. Record important policy, company and agent information andkeep it in a safe place.
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HELPFUL SUGGESTIONS:
TYPES OF MEDICARE SUPPLEMENT INSURANCE/MEDIGAP
Most companies offer two rates: Preferred and Standard. The monthly premium amount is
based on medical underwriting. Underwriting is the method insurance companies use to
evaluate your health status to determine risk and insurability (if they’ll sell you a policy).
Preferred Premium
The Preferred insurance premium is typically
lower than the standard premium. Insurance
companies base their decision to offer a
preferred premium on a variety of factors
including but not limited to: smoking/tobacco
use, weight, cholesterol, blood pressure,
substance abuse, etc.
The Preferred Premiums are offered to those
purchasing during the Medigap Open
Enrollment Period (OEP) as well. See page 9
for more information about the Medigap OEP.
Standard Premium
The standard rates apply outside the
Medigap Open Enrollment Period and
for those with less favorable medical
histories.
Medigap Select Policy
The select policy usually offers the lowest cost premium. In Arkansas, three companies offer select
policies:
1. AARP/United Healthcare Insurance Company
2. Marquette National Life Insurance Company
3. Sterling Life Insurance Company
A select policy has a NETWORK or specific list of providers (hospitals) an insured person can use. In
general, Medicare SELECT policies are not required to pay any benefits (claims/bills) if you do not
use a preferred/network provider for non-emergency services. Medicare, however, will still pay its
share of approved charges regardless of the provider you choose. If you choose a Medicare Select
Policy, be sure your hospital is in-network (see page 44).
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SIGNIFICANT MEDIGAP INSURANCE LAWS
► A free-look period of 30 days is required, duringwhich time the applicant may return the policyto the insurance company and receive a fullrefund. The free-look period begins from theday the applicant receives the certificate orpolicy, not the day of the application.
► A pre-existing condition waiting period mayextend no longer than six months for healthconditions diagnosed or treated within the sixmonths immediately prior to the application.The medical questionnaire accompanying anapplication should have accurate informationand should be completed by the applicant, notthe agent.
► Should the applicant be replacing a Medicaresupplement policy, no new waiting period isallowed by the replacing insurer for equivalentcoverage.
► For replacement policies, the applicant isrequired to sign a replacement form indicatingthat he/she understands the hazards ofchanging.
► No agent in Arkansas may sell a new MedicareSupplement Policy to anyone who already has aMedicare Supplement unless the applicantagrees to drop his or her previous insurance.
► All Medicare supplement policies must beguaranteed renewable.
► The 101st Congress (1990) passed strong federallegislation, which made uniform requirementsfor Medicare Supplement Insurance policies ineach state. Policy holders are not required tochange from their old supplemental policies to apolicy with the new standards unless they sochoose.
► MEDIGAP OPEN ENROLLMENT: A Medicaresupplement insurer may not deny an applicant apolicy during the six months period known asthe Medigap Open Enrollment Period. The sixmonth period begins with the Medicarebeneficiary is BOTH enrolled in Part B and age65 or older. During this enrollment period aninsurance company can not deny a policy basedon the applicants health status. This is aone time enrollment period. Once the MedigapOpen Enrollment Period begins, it can not bestarted again.
In Arkansas, there is no open enrollment period for Medicare Beneficiaries who are not yet 65. However, they are entitled to a six-month Open Enrollment Period when they reach age 65.
► An insurer must suspend Medicare SupplementPremiums and benefits while the policyholder isentitled to Medicaid. The insurer mustreinstate policy benefits upon request ifMedicaid entitlement ends. This suspensionmay last up to two years. Policyholders areresponsible for informing the insurer of theirMedicaid eligibility within 90 days of eligibilitydetermination.
MEDIGAP OPEN ENROLLMENT
If Medicaid eligible, may suspend
Medigap for two years.
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CATEGORY 1:
If a Medicare beneficiary is enrolled in an employer-sponsored plan and the plan terminates or ceases to provide some or all supplemental benefits to Medicare, or the insured chooses to leave the plan.
Then guarantee issue of Medigap Plans A, B, C, F, K or L with any company selling these plans.
CATEGORY 2:
If a Medicare beneficiary is enrolled in a Medicare Advantage Plan and
the plan’s certification is terminated, or the plan ceases to provide all services, or the enrollee moves out of the service , or the plan violates the contract, misrepresents during
marketing, or there are other circumstances as determined by HHS
Secretary,
Then guarantee issue of Medigap Plans A, B, C, F, K or L with any company selling these plans.
CATEGORY 3:
If a Medicare beneficiary is enrolled in a Medicare Risk, Cost, Demonstration, Health Care Prepayment Plan, or select plan, and
the plan’s certification is terminated, or the plan ceases to provide all services, or the enrollee moves out of the service , or the plan violates the contract, misrepresents during
marketing, or there are other circumstances as determined by HHS
Secretary,
Then guarantee issue of Medigap Plans A, B, C, F, K or L with any company selling these plans.
CATEGORY 4:
If a Medicare beneficiary is enrolled in a Medigap policy and any of the following occur:
the Insurer becomes insolvent or bankrupt, or there is involuntary termination of coverage or
enrollment, or
there is material violation of the policy, or there is material misrepresentation during marketing,
Then guarantee issue of Medigap Plans A, B, C, F, K or L with any company selling these plans.
CATEGORY 5:
If a Medicare beneficiary is enrolled in a Medigap policy, terminates it and enrolls for the first time in a Medicare Advantage Plan, Risk, Cost, Demonstration, HCPP, or Select plan, and disenroll from the chosen coverage within the first 12 months as permitted under federal law,
Then guarantee issue of Medigap Plans A, B, C, F, K or L with any company selling these plans or his/her prior Medigap plan, if it is still available.
CATEGORY 6:
If an individual is first eligible for Medicare Part A at the age of 65, and
enrolls in a Medicare Advantage plan , and disenroll within the first 12 months after enrollment as
permitted by federal law,
Then guarantee issue of any Medigap plan sold by any insurer.
CATEGORY 7:
If an individual leaves a Medicare Advantage Plan or drop a Medigap policy because the company has not followed the rules or misled the individual,
Then guarantee issue of Medigap Plans A, B, C, F, K, L, M, or N sold by any insurer.
SPECIAL CIRCUMSTANCES FOR GUARANTEED ISSUE FOR MEDIGAP
If you believe you meet the criteria in one of these categories and have been denied a policy, contact
SHIIP
1-800-224-6330 or email [email protected]
Federal and state laws guarantee acceptance into Medicare Supplement insurance (Medigap), if a Medicare beneficiary
qualifies in one of seven categories listed below. This means the insurance company can not deny a policy nor impose a
pre-existing waiting period based on medical history. There is a strict time limit! The Medicare beneficiary has ONLY 63 days
from the date of loss of coverage to apply for a Medigap policy and be granted a guaranteed issue.
The Arkansas Insurance Department is committed to seeing that your rights are upheld in all circumstances pertaining to
guaranteed acceptance into Medicare Supplement Insurance.
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When describing the benefits of Medicare Supplement Plans, all insurers use the same format, language, and definitions. They are required to use a uniform chart and outline of coverage to summarize the benefits of the plans they offer. These requirements make it easier to compare policies from different insurers. As you shop for a policy, keep in mind that each company’s products are standard, products compete based on price, service, and reputation.
PRICE. While the benefits are identical for allMedicare Supplemental Plans of the sametype, the premiums vary from one company toanother and from area to area. The plan withthe lowest price is not necessarily the bestplan. The price should not be the onlyconcern. You may prefer a particular scheduleof payments. Some companies bill thepremium each month, while others bill eachquarter or once a year. In addition, prices arebased in part on the services a companyprovides and on their reputation. Some plansadd benefits but remember the basic coverageis the same from plan to plan based on federallaw.
CUSTOMER SERVICES. You should ask aboutthe insurer’s customer services. For example,some companies link their computers with thecomputers at the federal Medicare office toprocess your health insurance claims withoutadditional paperwork. This is called MedicareCrossover. This and other available customerservices may be important considerations inmaking a decision.
REPUTATION. You should consider the reputation of the insurer before buying a policy. Find out about the company by asking for referrals, asking others about their experiences, and check out the number of complaints filed at this website: https://eapps.naic.org/cis/
POLICY FEE: Some policies add a one-time policy fee.
These are not allowed in Arkansas.
UNDERWRITING: Most companies underwrite.
However, a few policies are “guaranteed issue.”
PREMIUM TYPE: The premium for your policy may
increase every year, primarily due to inflation in
medical costs and the use of more advanced
technology. The amount your premium goes up may
depend upon the manner in which the company has
reflected the aging of its policyholders in its rates. The
general approach that companies use are described
below. In Arkansas, the no age rating method is used.
1. Attained Age: In addition to medical inflation and
advancing technology, your premium will also rise
due to the increased use of medical services as
people age.
2. Issue Age: The premium you pay will initially be
somewhat higher than under the attained age
approach because a portion of the initial premium
is used to pre-fund the increased claims cost in later
years. As a result, in subsequent years your
premiums should be somewhat less than they
would be under an attained age approach.
3. No Age Rating: Under this approach, the premium
is the same for all customers who buy this policy,
regardless of age.
DIRECT RESPONSE/AGENT: Premiums are basically the
same when comparing a direct response sale to an
agent-marketed sale.
NON-SMOKER: Few companies have non-smoker
discounts.
MEDICARE CROSSOVER: This is one of the more
significant service enhancements that companies can
offer. A “crossover” company has a contract with
Medicare requiring Medicare to send the policyholder’s
balance bills directly to the Medicare Supplement
Insurance Company.
BUYER BEWARE VARIABLES
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2017 COSTS OF MEDICARE
PART A HOSPITAL INSURANCE COVERED SERVICES
SERVICES BENEFITS MEDICARE PAYS YOU PAY
Hospitalization Semi-private room, general nursing, miscellaneous services and supplies-
First 60 days
61st to 90th day
91st to 150th day
Beyond 150 days
All but $1,316
All but $329 per day
All but $658 per day
Nothing
$1,316 deductible
$329 per day
$658 per day
All charges
POST-HOSPITAL Skilled Nursing Facility Care (SNF) after a 3 night hospital stay
First 20 days
21st to 100th day
Beyond 100 days
100% of approved
All but $164.50 per day
Nothing
Nothing if approved
$164.50 per day
All costs
Home Health Care following a 3-night inpatient hospital or SNF stay
Part-time care as long as you meet guidelines
100% of approved Nothing if approved
Hospice Care Full scope of pain relief and support services for the terminally ill
As long as doctor certifies need
All but limited costs for drugs & respite care
Limited costs for drugs & respite care
Blood Blood All but first 3 pints First 3 pints
PART B MEDICAL INSURANCE COVERED SERVICES
SERVICES BENEFITS MEDICARE PAYS YOU PAY
Medical Expense Physician services and medical supplies in and out of the hospital
Medical services in and out of the hospital
80% of approved amount (after $183 deductible)
20% of approved amount (after $183 deductible)
Clinical Laboratory Diagnostic tests 100% of approved Nothing if approved
Home Health Care Medically necessary skilled care, home health aide services, medi-cal supplies, etc. after a 3-day in-patient hospital stay .Requires a prescription
Part-time care as long as you meet guidelines
100% of approved Nothing if approved
Outpatient Hospital Treatment
Unlimited if medically necessary
80% of approved 20% of approved amount (after $183 deductible)
Durable Medical Equipment Prescribed by doctor for use in home
80% of approved amount (after $183 deductible)
20% of approved amount (after $183 deductible)
Blood Blood All but first 3 pints First 3 pints
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Reading the chart: If a “x” mark appears in a column of this chart, the Medigap policy covers 100% of
the desired benefit. If a column lists a percentage, then the policy covers that percentage of the
described benefit. If a column is blank, then the policy does not cover that benefit.
Note: The Medigap policy covers coinsurance only after you have paid the deductible (unless the
Medigap policy also covers the deductible).
Note: Out-of-Pocket Limit K and L, $5,120 & $2,560
MEDIGAP PLAN OPTIONS
Medigap Plan Benefits A B C D F* G K** L** M N
Medicare Part A eligible hospital costs up to an additional 365 days after all Medicare hospital benefits are ex-hausted
X X X X X X X X X X
Medicare Part B Coinsurance or Copay-ment (20% of Medicare Assignment)
X X X X X X 50% 75% X X
Blood (First 3 Pints) X X X X X X 50% 75% X X
Part A Hospice Care Coinsurance or Copayment
X X X X X X 50% 75% X X
Skilled Nursing Facility Care Copayment (Days 21-100 = $164.50 per day in 2017)
X X X X 50% 75% X X
Medicare Part A Deductible ($1,316.00 per benefit period in 2017)
X X X X X 50% 75% 50% X
Medicare Part B Deductible ($183 per year in 2017)
X X
Medicare Part B Excess Charges (up to 15% above Medicare approved amount if provider does not accept Medicare assignment)
X X
Foreign Travel Emergency (Up to Plan Limits)
X X X X X X
Medicare Preventive Part B Coinsur-ance (as of 2011 most preventive screenings no longer require coinsur-ance payment)
X X X X X X X X X X
***Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up
to a $50 copayment for emergency room visits that don't result in inpatient admission.
Plan F offers a high-deductible plan. This means you must pay for Medicare-covered costs up to the deductible amount $2,200 in 2017 before Medigap high-deductible plan pays anything.
After you meet the 2017 out-of-pocket yearly limit and yearly Part B deductible ($183 in 2017), the Medigap plan pays 100% of covered services for the rest of the calendar year. Out-of-pocket limit is the maximum amount you would pay.
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MEDIGAP PROVIDERS FOR PEOPLE UNDER AGE 65
Medigap for Medicare recipients under age 65
Federal law does not require people under the age of 65 with Medicare Part B be granted a Medigap Open Enrollment Period. Younger Medicare beneficiaries are subject to medical underwriting and may be denied a policy based on medical history. There is no assurance that those under age 65 will be issued a Medigap Policy.
Liberty National Life Insurance Company P. O. Box 8080
McKinney, TX 75070
1-800-331-2512
www.libertynational.com
United American Insurance Co P.O. Box 8080
McKinney, TX 75070
1-800-331-2512
www.UnitedAmerican.com
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MEDIGAP PROVIDERS FOR PEOPLE AGE 65 & OLDER
AARP (United Healthcare Insurance Co.) P.O. Box 130
Montgomeryville, PA 18936
1-800-523-5800
www.aarphealthcare.com
American Continental Insurance Company (Subsidiary of Aetna) 101 Continental Place
Brentwood, TN 37027
1-800-264-4000
American Republic Insurance Company P.O. Box 2780
Omaha, NE 68103-2780
1-800-987-8988
www.americanrepublic.com
American Retirement Life Insurance Company 11200 Lakeline Blvd., Suite 100
Austin, TX 78717
1-866-459-4272
Arkansas Blue Cross & Blue Shield P.O. Box 2181
Little Rock, AR 72203
1-800-392-2583
www.arkansasbluecross.com
Assured Life Association/Woodmen of the World 6030 Greenwood Plaza Blvd., Suite 100
Greenwood Village, CO 80111
1-800-777-9777
www.denverwoodmen.org
Bankers Fidelity Life 4370 Peachtree Rd. NE
Atlanta, GA 30319
1-866-458-7500
www.BFLIC.com
Central States Indemnity Co. of Omaha Medicare Sup. Admin. Offices
P.O. Box 10817
Clearwater, FL 33757-8817
1-855-664-5517
Colonial Penn Life Insurance Company Admin. Address 600 West Chicago Ave.
Chicago, IL 60654-2800
1-312-396-6000
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MEDIGAP PROVIDERS FOR PEOPLE AGE 65 & OLDER
Combined Insurance Company of America 5050 North Broadway
Chicago, IL 606040
1-800-225-4500
www.combined.com
Companion Life Insurance Company P.O. Box 100102
Columbia, SC 29202
1-800-753-0404
www.companionlife.com
Coventry Health and Life Insurance Company (Subsidiary of Aetna) 800 Crescent Centre Dr., Suite 200
Franklin, TN 37067
1-800-264-4000
Equitable Life & Casualty Insurance Company 3 Triad Center
Salt Lake City, UT 84180
1-800-352-5170
Family Life Insurance Company P. O. Box 924408
Houston, TX 77292-4408
1-800-877-7705
First Health Life & Health Insurance Company 800 Crescent Centre Dr., Suite 200
Franklin, TN 37067
1-800-264-4000
Gerber Life Insurance Company 1311 Mammaroneck Avenue
White Plains, NY 10605
1-914-272-4000
Globe Life & Accident Insurance Company P.O. Box 2440
McKinney, TX 75070
1-800-801-6831
www.globecaremedsupp.com
Government Personnel Mutual Life Insurance Company P.O. Box 659567
San Antonio, TX 99999
1-800-929-4765
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Guarantee Trust Life Insurance Company 1275 Milwaukee Avenue
Glenview, IL 60025
1-847-460-4772
Heartland National Life Insurance Company 10689 N. Pennsylvania Street
Indianapolis, IN 46280
1-816-478-0120
Humana Insurance Company P.O. Box 14601
Lexington, KY 40512
1-800-866-0581
www.humana.com
Individual Assurance Company, Life, Health & Accident P.O. Box 3270
Salt Lake City, UT 84110-3270
1-888-524-3629
Liberty National Life Insurance Company P. O. Box 2612 (35202)
Birmingham, AL 35233
1-800-331-2512
www.libertynational.com
Loyal American Life Insurance Company (Subsidiary of Cigna) P.O. Box 559004
Austin, TX 78755
1-800-633-6752
www.loyalamerican.com
Madison National Life Insurance Company 1241 John Q. Hammons Dr.
Madison, WI 53717
1-800-356-9601
Manhattan Life Insurance Company 10777 Northwest Freeway
Houston, TX 77092
1-713-529-0045
Marquette National Life Insurance Company (Subsidiary of Aetna) 411 N. Baylen Street
Pensacola, FL 32502
1-800-934-8203
www.marquettenationallife.com
MEDIGAP PROVIDERS FOR PEOPLE AGE 65 & OLDER
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MEDIGAP PROVIDERS FOR PEOPLE AGE 65 & OLDER
Medico Corp Life Insurance Company 11808 Grant St
Omaha, NE 68103-0160
1-800-822-9993
Medico Insurance Company 1515 South 75th Street
Omaha, NE 68124
1-800-695-5976
Old Surety Life Insurance Company P.O. Box 54407
Oklahoma City, OK 73154
1-800-272-5466
Order of United Commercial Travelers of America P. O. Box 159019
631 North Park Street
Columbus, OH 43215-8619
1-800-848-0123
Philadelphia American Life Insurance Company P.O. Box 4884
Houston, TX 77210-4884
1-800-713-4680
Physicians Mutual Insurance Company 2600 Dodge
Omaha, NE 68131
1-800-228-9100
Puritan Life Insurance Company (formerly known as Admiral Life Insurance Company
of America) P.O. Box 10860
Clearwater, FL 33757-8860
1-800-513-3243
QualChoice Life and Health Insurance Company P. O. Box 25626
Little Rock, AR 72221-5626
1-855-633-4765
Reserve National Insurance Company 6100 North West Grand Blvd.
Oklahoma City, OK 73118
1-800-654-9106
www.reservenational.com
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MEDIGAP PROVIDERS FOR PEOPLE AGE 65 & OLDER
Standard Life & Accident Insurance Co. One Moody Plaza
Galveston, TX 77550
1-888-350-1488
www.AINCO.com
State Farm Mutual Automobile Ins. Co. One State Farm Plaza
Bloomington, IL 61710
www.statefarm.com
1-309-763-8104
State Mutual Insurance Company One State Mutual Drive
Rome, GA 30162
1-855-764-4000
www.statemutualinsurance.com
Thrivent Financial For Lutherans 4321 North Ballard Road
Appleton, WI 54919
1-800-847-4836
www.thrivent.com
Transamerica Life Insurance Company
Medicare Supplement Sales 300 Eagleview Blvd.
Exton, PA 19341
1-800-247-1771
www.TAMedSupp.com
United American Insurance Co P.O. Box 8080
McKinney, TX 75070
1-800-331-2512
www.UnitedAmerican.com
United National Life Insurance 1275 Milwaukee Ave.
Glenview, IL 60025
1-800-207-8050
www.unlinsurance.com
United of Omaha Life Insurance Company Mutual of Omaha Plaza
Omaha, NE 68175
1-800-775-6000
13
MEDIGAP PROVIDERS FOR PEOPLE AGE 65 & OLDER
United Teachers Associates P.O. Box 26580
Austin, TX 78755
1-800-880-8824
www.UTAIC.com
USAA Life Insurance Company 9800 Fredericksburg Road
San Antonio, TX 78288
1-800-531-8000
www.USAA.com
World Corp Insurance Company 1000 World Corp Plaza, North Park
P.O. Box 3160
Omaha, NE 68103-0160
1-402-496-8000
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Aetna Life Insurance Company800 Crescent Centre Dr. Franklin, TN 37067
F - Female
M - Male
NT - Non Tobacco User
T - Tobacco User
HD - High Deductible Plan
888-624-6290
www.aetnaseniorproducts.com
Medical Underwriting: Yes/No questions, outside of open enrollment and other guaranteed issue periods
Pre-existing condition waiting period: None Policy
Fee: None SEL - Select Plan
Medicare Crossover: Yes
Annual Premiums: Rates available as annual, semi-annual, quarterly and monthly. Plan B also available
Zip Code Areas: Rest of state Preferred Non-Tobacco User
Zip Code Areas: Rest of state Standard Tobacco User
Zip Code Areas:72002, 72053, 72065, 72076, 72078, 72099, 72103, 72113-72120, 72124,72135, 72142, 72164, 72180, 72183, 72190, 72198, 72199, and all ZIP codesbeginning with 722 Standard II Non-Tobacco User
SUPERSCRIPT MEANINGS
IN THE CHARTS
85+ 160.14 239.28 218.66 166.39
65 160.14 239.28 218.66 166.39
70 160.14 239.28 218.66 166.39
75 160.14 239.28 218.66 166.39
80 160.14 239.28 218.66 166.39
80 140.94 210.67 192.34 146.52
85+ 140.94 210.67 192.34 146.52
AGE A F G N<65 Preferred Non-Tobacco User Preferred Non-Tobacco User
<6565 140.94 210.67 192.34 146.52
70 140.94 210.67 192.34 146.52
75 140.94 210.67 192.34 146.52
85+ 128.12 128.12 191.42 191.42 174.93 174.93 133.11 133.11
AGE A F G N
75 128.12 128.12 191.42 191.42 174.93 174.93 133.11 133.1180 128.12 128.12 191.42 191.42 174.93 174.93 133.11 133.11
65 128.12 128.12 191.42 191.42 174.93 174.93 133.11 133.1170 128.12 128.12 191.42 191.42 174.93 174.93 133.11 133.11
AGE A F G NF M F M F M F M
<65
A.M. Best
Rating:
NR
DISCLAIMER: These rates were correct at the time of Provider's submission. For the most current rates, CONTACT THE INSURANCE COMPANY DIRECTLY.
15
Aetna Life Insurance Company (Continued)
Zip Code Areas:72002, 72053, 72065, 72076, 72078, 72099, 72103,
72113-72120, 72124, 72135, 72142, 72164, 72180, 72183,
72190, 72198, 72199, and all ZIP codes beginning with 722 Standard III Tobacco
4
Zip Code Areas:All other Zip Codes beginning with 720 or 721 Preferred Non-Smoker
Zip Code Areas:All other ZIP codes beginning with 720 or 721 Standard Smoker
MFMFMFMFNGFAAGE
80 149.40 149.40 223.31 223.31 203.88 203.88 155.32 155.3285+ 149.40 149.40 223.31 223.31 203.88 203.88 155.32 155.32
70 149.40 149.40 223.31 223.31 203.88 203.88 155.32 155.32
75 149.40 149.40 223.31 223.31 203.88 203.88 155.32 155.32
<6565 149.40 149.40 223.31 223.31 203.88 203.88 155.32 155.32
85+ 135.80 135.80 202.91 202.91 185.43 185.43 141.10 141.10
AGE A F G NF M F M F M F M
75 135.80 135.80 202.91 202.91 185.43 185.43 141.10 141.10
80 135.80 135.80 202.91 202.91 185.43 185.43 141.10 141.10
65 135.80 135.80 202.91 202.91 185.43 185.43 141.10 141.1070 135.80 135.80 202.91 202.91 185.43 185.43 141.10 141.10
AGE A F G NF M F M F M F M
<65
80 176.18 176.18 263.33 263.33 240.42 240.42 183.16 183.1685+ 176.18 176.18 263.33 263.33 240.42 240.42 183.16 183.16
70 176.18 176.18 263.33 263.33 240.42 240.42 183.16 183.16
75 176.18 176.18 263.33 263.33 240.42 240.42 183.16 183.16
<65 Standard Tobacco User Standard Tobacco User
65 176.18 176.18 263.33 263.33 240.42 240.42 183.16 183.16
DISCLAIMER: These rates were correct at the time of Provider's submission. For the most current rates, CONTACT THE INSURANCE COMPANY DIRECTLY.
16
American Continental Insurance Company800 Crescent Centre Dr. Franklin, TN 37067
F - Female
M - Male
888-624-6290
www.aetnaseniorproducts.com
Medical Underwriting: Yes/No questions, outside of open enrollment NT - Non Tobacco User
and other guarantee issue periods T - Tobacco User
Pre-existing waiting period: None HD - High Deductible Plan
Policy Fee: None SEL - Select Plan
Medicare Crossover: YesAnnual Premiums: Rates available as annual, semi-annual, quarterly and monthly. Plans B and High
Zip Code Areas: 722 Preferred Non-Tobacco User
Zip Code Areas: 722 Standard Tobacco User
Zip Code Areas: 72202, 72053,72065 Standard II Tobacco User
SUPERSCRIPT MEANINGS
IN THE CHARTS
70 198.55 288.37 249.89 184.46
75 198.55 288.37 249.89 184.46
80 198.55 288.37 249.89 184.46
85+ 198.55 288.37 249.89 184.46
85+ 220.76 320.56 277.53 205.11
AGE A F G N<65 Preferred Non-Tobacco
65 288.37 249.89 184.46
65 220.76 320.56 277.53 205.11
70 220.76 320.56 277.53 205.1175 220.76 320.56 277.53 205.11
80 220.76 320.56 277.53 205.11
AGE A F G N
<65 220.76 320.56 277.53 205.11
85+ 198.55 198.55 288.37 288.37 249.89 249.89 184.46 184.46
75 198.55 198.55 288.37 288.37 249.89 249.89 184.46 184.4680 198.55 198.55 288.37 288.37 249.89 249.89 184.46 184.46
65 198.55 198.55 288.37 288.37 249.89 249.89 184.46 184.4670 198.55 198.55 288.37 288.37 249.89 249.89 184.46 184.46
AGE A F G NF M F M F M F M
<65
A.M. Best
Rating:
___
DISCLAIMER: These rates were correct at the time of Provider's submission. For the most current rates, CONTACT THE INSURANCE COMPANY DIRECTLY.
17
American National Life Insurance Company of TexasOne Moody Plaza Galveston, TX 77550
888-350-1488 www.slaico.com F - Female
M - Male
NT - Non Tobacco User
T - Tobacco User
HD - High Deductible Plan
Medical Underwriting: Outside open enrollment Pre-existing condition waiting period: None Policy Fee: None
Medicare Crossover: Yes
Annual Premiums: Community Rated SEL - Select Plan
Zip Code Areas: 716-717, 725-729 Preferred Non-Tobacco User
Zip Code Areas: 716-717, 725-729 Standard Tobacco User
Zip Code Areas: 718 Standard II Tobacco User
SUPERSCRIPT MEANINGS
IN THE CHARTS
85+ 1415.18 2011.03 1554.83
65 1415.18 2011.03 1554.8370 1415.18 2011.03 1554.8375 1415.18 2011.03 1554.8380 1415.18 2011.03 1554.83
80 1397.70 1986.2185+ 1397.70 1986.21 1535.63
AGE A F G N<65 N/A N/A N/A
<65 N/A N/A N/A
65 1397.70 1986.21 1535.6370 1397.70 1986.21 1535.6375 1397.70 1986.21 1535.63
85+ 1257.94 1257.94 1787.58 1787.58 1382.07 1382.07
AGE A F G N
75 1257.94 1257.94 1787.58 1787.58 1382.07 1382.0780 1257.94 1257.94 1787.58 1787.58 1382.07 1382.07
65 1257.94 1257.94 1787.58 1787.58 1382.07 1382.0770 1257.94 1257.94 1787.58 1787.58 1382.07 1382.07
NF M F M F M F M
<65 N/A N/A N/A N/A N/A N/A
AGE A F G
A.M. Best
Rating:
A
DISCLAIMER: These rates were correct at the time of Provider's submission. For the most current rates, CONTACT THE INSURANCE COMPANY DIRECTLY.
1535.63
18
American National Life Insurance Company of Texas (Continued)
Zip Code Areas: 718 Standard III Tobacco User
Zip Code Areas: 719-724 Preferred Non-Smoker
Zip Code Areas: 719-724 Standard Smoker
85+ 1537.47 1537.47 2184.83 2184.83 1689.20 1689.20
75 1537.47 1537.47 2184.83 2184.83 1689.20 1689.20
80 1537.47 1537.47 2184.83 2184.83 1689.20 1689.20
65 1537.47 1537.47 2184.83 2184.83 1689.20 1689.20
70 1537.47 1537.47 2184.83 2184.83 1689.20 1689.20
AGE A F G NF M F M F M F M
<65 N/A N/A N/A N/A N/A N/A
80 1383.73 1383.73 1966.34 1966.34 1520.28 1520.2885+ 1383.73 1383.73 1966.34 1966.34 1520.28 1520.28
70 1383.73 1383.73 1966.34 1966.34 1520.28 1520.28
75 1383.73 1383.73 1966.34 1966.34 1520.28 1520.28
<65 N/A N/A N/A N/A N/A N/A
65 1383.73 1383.73 1966.34 1966.34 1520.28 1520.28
85+ 1572.42 1572.42 2234.48 2234.48 1727.59 1727.59
AGE A F G NF M F M F M F M
75 1572.42 1572.42 2234.48 2234.48 1727.59 1727.59
80 1572.42 1572.42 2234.48 2234.48 1727.59 1727.59
65 1572.42 1572.42 2234.48 2234.48 1727.59 1727.59
70 1572.42 1572.42 2234.48 2234.48 1727.59 1727.59
AGE A F G NF M F M F M F M
<65 N/A N/A N/A N/A N/A N/A
DISCLAIMER: These rates were correct at the time of Provider's submission. For the most current rates, CONTACT THE INSURANCE COMPANY DIRECTLY.
19
F - Female
M - Male
NT - Non Tobacco User
T - Tobacco User
American Republic Corp Insurance Co. PO Box 14510 Des Moines, IA 50306
888-755-3065
www.AmericanRepublic.com
Medical Underwriting:
Preexisting condition waiting period:
Policy Fee: No Medicare Crossover:
Annual Premiums:
HD - High Deductible Plan
SEL - Select Plan
Zip Code Areas: 71700-71799, 72600-72999 Preferred
Zip Code Areas: 71800-71899, 72300-72599 Preferred
Zip Code Areas: Rest of State Preferred
Zip Code Areas: 72200-72299 Preferred
SUPERSCRIPT MEANINGS
IN THE CHARTS
80 1984.92 1984.92 2958.28 2958.2885+ 1984.92 1984.92 2958.28 2958.28
70 1984.92 1984.92 2958.28 2958.28
75 1984.92 1984.92 2958.28 2958.28
85+
AGE A F G NF M F M F M F M
65 1984.92 1984.92 2958.28 2958.28
AGE
6570
2829.651898.62 1898.62
7580
A F G NF M F M
80 1795.06 1795.06 2675.31 2675.31
85+ 1795.06 1795.06 2675.31 2675.31
70 1795.06 1795.06 2675.31 2675.31
75 1795.06 1795.06 2675.31 2675.31
<6565 1795.06 1795.06 2675.31 2675.31
85+ 1708.76 1708.76 2546.69 2546.69
AGE A F G NF M F M F M F M
75 1708.76 1708.76 2546.69 2546.69
80 1708.76 1708.76 2546.69 2546.69
65 1708.76 1708.76 2546.69 2546.69
70 1708.76 1708.76 2546.69 2546.69
AGE A F G NF M F M F M F M
<65
1898.621898.621898.621898.62
1898.621898.621898.621898.62
F
2829.652829.652829.652829.65
M2829.652829.652829.652829.652829.65
F M
A.M. Best
Rating:
NR
DISCLAIMER: These rates were correct at the time of Provider's submission. For the most current rates, CONTACT THE INSURANCE COMPANY DIRECTLY.
20
American Republic Corp Insurance Company (Continued)
Zip Code Areas: 71700-71799, 72600-72999 Standard
Zip Code Areas: 71800-71899, 72300-72599 Standard
Zip Code Areas: Rest of State Standard
Zip Code Areas: 72200-72299 Standard
80 2335.20 2335.20 3480.32 3480.32
85+ 2335.20 2335.20 3480.32 3480.32
70 2335.20 2335.20 3480.32 3480.32
75 2335.20 2335.20 3480.32 3480.32
<6565 2335.20 2335.20 3480.32 3480.32
85+ 2233.67 2233.67 3329.01 3329.01
AGE A F G NF M F M F M F M
75 2233.67 2233.67 3329.01 3329.01
80 2233.67 2233.67 3329.01 3329.01
65 2233.67 2233.67 3329.01 3329.01
70 2233.67 2233.67 3329.01 3329.01
AGE A F G NF M F M F M F M
<65
80 2111.83 2111.83 3147.42 3147.42
85+ 2111.83 2111.83 3147.42 3147.42
70 2111.83 2111.83 3147.42 3147.42
75 2111.83 2111.83 3147.42 3147.42
<6565 2111.83 2111.83 3147.42 3147.42
85+ 2010.30 2010.30 2996.10 2996.10
AGE A F G NF M F M F M F M
75 2010.30 2010.30 2996.10 2996.10
80 2010.30 2010.30 2996.10 2996.10
65 2010.30 2010.30 2996.10 2996.10
70 2010.30 2010.30 2996.10 2996.10
AGE A F G NF M F M F M F M
<65
DISCLAIMER: These rates were correct at the time of Provider's submission. For the most current rates, CONTACT THE INSURANCE COMPANY DIRECTLY.
21
F - Female
M - Male
NT - Non Tobacco User
T - Tobacco User
HD - High Deductible Plan
SEL - Select Plan
Americo Financial Life & Annuity Insurance Co. 300 West 11th Street, Kansas City, MO 64105
800-231-0801
www.americo.com
Medical Underwriting: Yes Preexisting condition waiting period: No Policy Fee: NoMedicare Crossover: YesAnnual Premiums:
Zip Code Areas: 720-722 Preferred Non-Tobacco User
Zip Code Areas: 720-722 Standard Tobacco User
Zip Code Areas: 716-719, 723-729 Preferred Non-Tobacco User
Zip Code Areas: 716-719, 723-729 Standard Tobacco User
SUPERSCRIPT MEANINGS
IN THE CHARTS
AGE A F G NM/F M/F M/F M/F
All $1622 $2075 $1738 $1492
All $1411 $1804 $1511 $1297
AGE A F G NM/F M/F M/F M/F
All $1807 $2311 $1935 $1661
AGE A F G NM/F M/F M/F M/F
All $1571 $2010 $1683 $1444
AGE A F G NM/F M/F M/F M/F
A.M. Best
Rating:
A
DISCLAIMER: These rates were correct at the time of Provider's submission. For the most current rates, CONTACT THE INSURANCE COMPANY DIRECTLY.
22
Arkansas Blue Cross & Blue ShieldPO Box 2181, Little Rock, AR 72203
F - Female800-392-2583www.arkansasbluecross.com M - Male
Medical Underwriting: Only outside of open enrollment NT - Non Tobacco User
Pre-existing condition waiting period: None T - Tobacco User
Policy fee: None HD - High Deductible Plan
Monthly Premiums SEL - Select Plan
Zip Codes: 716, 721‐723 Monthly Standard Non- Tobacco
Zip Codes: 716, 721‐723 Monthly Standard Tobacco
Zip Codes: 717‐720, 724‐729 Monthly Standard Non-Tobacco
Zip Codes: 717‐720, 724‐729 Monthly Standard Tobacco
SUPERSCRIPT MEANINGSIN THE CHARTS
117.26 117.26 175.32 175.32 150.76 150.76 NA NA
80 117.26 117.26 175.32 175.32 150.76 150.76 NA NA
106.69 106.69 159.43 159.43 137.12 137.12 NA NA
191.26 191.26 164.47 164.47 NA NA
127.91 127.91 191.26 191.26 164.47 164.47 NA NA
<65 127.91 127.91 191.26 191.26 164.47 164.47 NA NA
65 127.91 127.91 191.26 191.26 164.47 164.47 NA
85+ 117.26 117.26 175.32 175.32 150.76 150.76 NA NA
F M F M F
70 116.39 116.39 173.94 173.94 149.59 149.59 NA
116.39 116.39
NA
173.94 173.94 149.59 149.59 NA NA
75
AGEF M F M F M F M
A F G N
6570 117.26 117.26 175.32 175.32 150.76 150.76 NA NA
<65 117.26 175.32 175.32 150.76 150.76 NA117.26
80 106.69 106.69 159.43 159.43 137.12 137.12 NA NA
85+ 106.69 106.69 159.43 159.43 137.12 137.12 NA NA
7075 106.69 106.69 159.43 159.43 137.12 137.12 NA NA
65 106.69 106.69 159.43 159.43 137.12 137.12 NA NA
AGEF M F M F M F M
A F G N
<65 NA NA106.69 106.69 159.43 159.43 137.12 137.12
85+ 116.39 116.39 173.94 173.94 149.59 149.59 NA NA
AGEF M F M F M F M
A F G N
7580 116.39 116.39 173.94 173.94 149.59 149.59 NA NA
AGE A F G NF M M
NANA149.59149.59173.94173.94116.39116.39
85+ 127.91
NANA149.59149.59173.94173.94116.39116.3965
127.91
<65
NA
117.26 117.26 175.32 175.32 150.76 150.76 NA NA
NA
70 127.91 127.91 191.26 191.26 164.47 164.47 NA NA
75 127.91 127.91 191.26 191.26 164.47 164.47 NA NA
80
A.M. Best
Rating:
NR
DISCLAIMER: These rates were correct at the time of Provider's submission. For the most current rates, CONTACT THE INSURANCE COMPANY DIRECTLY.
23
Assured Life Association
PO Box 2397
Omaha, NE 68103-2397 F - Female
877-223-3666 M - Male
NT - Non Tobacco User
T - Tobacco User
HD - High Deductible Plan
SEL - Select Plan
Medical Underwriting: Yes (Outside open enrollment & guaranteed issue periods)
Pre-existing condition waiting period: NonePolicy Fee: 0Medicare Crossover: YesAnnual Premiums: Annual premiums shown belowZip Code Areas: 716-717, 724-729 Non-Tobacco user
Zip Code Areas: 718-721 Non-Tobacco User
Zip Code Areas: 722-723 Non-Tobacco User
Zip Code Areas: 716-717, 724-729 Tobacco User
Zip Code Areas: 718-721 Tobacco User
Zip Code Areas: 722-723 Tobacco User
SUPERSCRIPT MEANINGS
IN THE CHARTS
$1,779.94
65+ $1,849.25 $2,138.45 $2,581.21 $2,115.43 $2,639.15 $2,115.43 $1,906.02
AGE A B C D F G N
65+ $1,984.98 $2,295.40 $2,770.65 $2,270.69 $2,832.85 $2,270.69 $2,045.91
AGE A B C D F G N65+ $1,696.56 $1,961.88 $2,368.08 $1,940.76 $2,421.24 $1,940.76
AGE A B C D F G N
65+ $1,608.85 $1,860.45 $2,245.65 $1,840.42 $2,296.06 $1,840.42 $1,658.24
B C D F G NAGE A65+ $1,726.93 $1,997.00 $2,410.47 $1,975.50 $2,464.58 $1,975.50
AGE A B C D F G N65+ $1,476.01 $1,706.84 $2,060.23 1,688.46 $2,106.48 $1,688.46 $1,521.32
AGE A B C D F G N
$1,748.64
A.M. Best
Rating:
NR
DISCLAIMER: These rates were correct at the time of Provider's submission. For the most current rates, CONTACT THE INSURANCE COMPANY DIRECTLY.
24
F - Female
M - Male
Bankers Fidelity Life Insurance Company 4370 Peachtree Road, N.E., Atlanta, Georgia 30319 866-458-7504 x 876
www.bflic.com
Medical Underwriting: Yes, all available plans NT - Non Tobacco User
T - Tobacco User
HD - High Deductible Plan
SEL - Select Plan
Pre-existing condition waiting period: NA
Policy Fee: No
Medicare Crossover: Yes
Annual Premium: Issue Age
Zip Codes: 720-722 Preferred Non-Tobacco User
Zip Codes: 720-722 Standard Tobacco User
Zip Codes: 720-722 Standard II Non-Tobacco User
SUPERSCRIPT MEANINGS
IN THE CHARTS
85+ 1704 2571 1940
65 1704 2571 1940
70 1704 2571 1940
75 1704 2571 1940
80 1704 2571 1940
80 1704 2571 1940
85+ 1704 2571 1940
AGE A F G N<65
<6565 1704 2571 1940
70 1704 2571 194075 1704 2571 1940
85+ 1425 1425 2137 2137 1619 1619
AGE A F G N
75 1425 1425 2137 2137 1619 1619
80 1425 1425 2137 2137 1619 1619
65 1425 1425 2137 2137 1619 161970 1425 1425 2137 2137 1619 1619
AGE A F G NF M F M F M F M
<65
A.M. Best
Rating:
NR
DISCLAIMER: These rates were correct at the time of Provider's submission. For the most current rates, CONTACT THE INSURANCE COMPANY DIRECTLY.
25
Central States Indemnity Co. of Omaha1212 North 96th Street, Omaha, NE 68114-2200
F - Female
M - Male
NT - Non Tobacco User
T - Tobacco User
HD - High Deductible Plan
866-644-3988
Medical Underwriting: Yes
Pre-existing condition waiting period: No Policy Fee: No
Medicare Crossover: Yes
Annual Premiums: SEL - Select Plan
Zip Code Areas: 720-722 Preferred Non-Tobacco User
Zip Code Areas: All except 720-722 Preferred Non-Tobacco User
Zip Code Areas: 720-722 Standard Smoker
Zip Code Areas:All except 720-722 Standard Smoker
CM/F
SUPERSCRIPT MEANINGS
IN THE CHARTS
AGE A B F
AllM/F M/F M/F
$1582 $1827 $2224 $2286
M/F M/F M/F M/FAGE A B C F
AGE A B C FM/F M/F M/F M/F
All $1425 $1662 $2001 $2058
AGE A B C FM/F M/F M/F M/F
All $1605 $1872 $2254 $2318
GM/F
$1,400
NM/F
$1,200
M/F
G NM/F
$1,576M/F
$1,352
NM/F
$1,334
M/F$1,751
GM/F
$1,555
G N
$1782 $2057 $2505 $2575 $1,502All
A.M. Best
Rating:
A+
DISCLAIMER: These rates were correct at the time of Provider's submission. For the most current rates, CONTACT THE INSURANCE COMPANY DIRECTLY.
26
Colonial Penn Life Insurance Company11825 North Pennsylvania Street, Carmel, IN 46032
800-800-2254 F - Female
https://www.bankerslife.com/products/medicare-supplement-insurance/ M - Male
NT - Non Tobacco User
T - Tobacco User
HD - High Deductible Plan
SEL - Select Plan
Medical Underwriting: YesPre-existing condition waiting period: Yes Policy Fee: NoneMedicare crossover: YesAnnual Premiums: Yes
Zip Code Areas: All Zips - Preferred Preferred Non-Tobacco User
Zip Code Areas: All Zips - Standard Standard Tobacco User
Zip Code Areas: All Zips - Substandard Standard II Non-Tobacco User
SUPERSCRIPT MEANINGS
IN THE CHARTS
85+ 2,555.54 3,129.46 2,751.58 1,831.95
65 2,555.54 3,129.46 2,751.58 1,831.95
70 2,555.54 3,129.46 2,751.58 1,831.95
75 2,555.54 3,129.46 2,751.58 1,831.95
80 2,555.54 3,129.46 2,751.58 1,831.95
80 2,299.94 2,816.59 2,476.56 1,648.79
85+ 2,299.94 2,816.59 2,476.56 1,648.79
AGE A F G N<65 - - - -
<65 - - - -
65 2,299.94 2,816.59 2,476.56 1,648.79
70 2,299.94 2,816.59 2,476.56 1,648.7975 2,299.94 2,816.59 2,476.56 1,648.79
85+ 2,069.98 2,069.98 2,535.14 2,535.14 2,228.93 2,228.93 1,483.84 1,483.84
AGE A F G N
75 2,069.98 2,069.98 2,535.14 2,535.14 2,228.93 2,228.93 1,483.84 1,483.84
80 2,069.98 2,069.98 2,535.14 2,535.14 2,228.93 2,228.93 1,483.84 1,483.84
65 2,069.98 2,069.98 2,535.14 2,535.14 2,228.93 2,228.93 1,483.84 1,483.8470 2,069.98 2,069.98 2,535.14 2,535.14 2,228.93 2,228.93 1,483.84 1,483.84
AGE A F G NF M F M F M F M
<65 - - - - - - - -
A.M. Best
Rating:
A-
DISCLAIMER: These rates were correct at the time of Provider's submission. For the most current rates, CONTACT THE INSURANCE COMPANY DIRECTLY.
27
Gerber Life Insurance Company P.O. Box 2271Omaha, NE 68103-2271 F - Female
877-778-0839 M - Male
NT - Non Tobacco User
T - Tobacco User
HD - High Deductible Plan
SEL - Select Plan
Medical Underwriting: Yes (Outside open enrollment and guaranteed issue periods)Pre-existing condition waiting period: None Policy Fee: 0Medicare Crossover: YesAnnual Premiums: Annual premiums shown below
Zip Code Areas: 716-719, 723-729 Non-Tobacco User
Zip Code Areas: 72001, 72003-007, 72010-048, 72051-052, 72055, 72057-061, 72063-064, 72066- 075,
72079-089, 72101-102, 72104-108, 72110-112, 72121-123, 72125-134, 72136-137, 72139-141, 72143, 72145,
72149-150, 72152-153, 72156-158, 72160, 72165-170, 72173, 72175-176,
72178-179, 72181-182, 72189 Non-Tobacco User
Zip Code Areas: 72002, 72053, 72065, 72076, 72078, 72099, 72103, 72113-120, 72124, 72135, 72142, 72164, 72180,
72183, 72190, 72198-199, 722 Non-Tobacco User
Zip Code Areas: 716-719, 723-729 Tobacco User
Zip Code Areas: 72001, 72003-007, 72010-048, 72051-052, 72055, 72057-061, 72063-064, 72066- 075,
72079-089, 72101-102, 72104-108, 72110-112, 72121-123, 72125-134, 72136-137, 72139-141, 72143, 72145,
72149-150, 72152-153, 72156-158, 72160, 72165-170, 72173, 72175-176,
72178-179, 72181-182, 72189 Tobacco User
Zip Code Areas: 72002, 72053, 72065, 72076, 72078, 72099, 72103, 72113-120, 72124, 72135,
72142, 72164, 72180, 72183, 72190, 72198-199, 722 Tobacco User
SUPERSCRIPT MEANINGSIN THE CHARTS
65+ $1,994.23 $2,880.86 $2,413.82
AGE A B C D F G N65+ $2,190.09 $3,163.81 $2,650.90
AGE A B C D F G N65+ $1,780.56 $2,572.20 $2,155.20
AGE A B C D F G N
65+ $1,734.98 $2,506.35 $2,100.02
AGE A B C D F G N65+ $1,905.38 $2,752.51 $2,306.28
AGE A B C D F G N65+ $1,549.09 $2,237.81 $1,875.02
AGE A B C D F G N
A.M. Best
Rating:
A+
DISCLAIMER: These rates were correct at the time of Provider's submission. For the most current rates, CONTACT THE INSURANCE COMPANY DIRECTLY.
28
F - Female
M - Male
NT - Non Tobacco User
T - Tobacco User
HD - High Deductible Plan
SEL - Select Plan
Globe Life and Accident Insurance Company 3700 S. Stonebridge Drive
PO Box 8080, McKinney, TX 75070
800-801-6831
www.globecaremedsupp.com
Medical Underwriting: Simple underwriting with yes/no questions Pre-existing condition waiting period: 2 months
Policy Fee:
Medical Crossover:
Annual Premiums: Yes
Zip Code Areas Preferred Non-Tobacco User
Zip Code Areas: All Areas Standard Tobacco User
SUPERSCRIPT MEANINGS
IN THE CHARTS
80 1123 1861
85+ 1123 1861
<6565 1123 1861
70 1123 1861
75 1123 1861
85+
AGE A F G N
7580
6570
AGE A F G NN/A N/A N/A N/A N/A N/A N/A N/A
<65
A.M. Best
Rating:
A+
DISCLAIMER: These rates were correct at the time of Provider's submission. For the most current rates, CONTACT THE INSURANCE COMPANY DIRECTLY.
1970 16971970197019701970
1697
16971697
1697
29
Government Personnel Mutual Life Insurance Company P.O. Box 2679
Omaha, NE 68103-2679F - Female866-242-7573
www.gpmlife.com M - Male
NT - Non Tobacco User
T - Tobacco User
HD - High Deductible Plan
SEL - Select Plan
Medical Underwriting: Yes (Outside open enrollment and guaranteed issue periods)Pre-existing condition waiting period: NonePolicy Fee: 0Medicare Crossover: YesAnnual Premiums: Annual premiums shown below
Zip Code Areas: 716-719, 724-729 Non-Tobacco User
Zip Code Areas: 720-721 Non-Tobacco User
Zip Code Areas: 722-723 Non-Tobacco User
Zip Code Areas: 716-719, 724-729 Tobacco User
Zip Code Areas: 720-721 Tobacco User
Zip Code Areas: 722-723 Tobacco User
SUPERSCRIPT MEANINGSIN THE CHARTS
NG
65+ 2042 $2,852.51 $2,921.59 $2,182.66 $1,936.84
AGE A B C D F G N65+ $2,243.08 $3,132.66 $3,208.53 $2,397.02 $2,127.06
AGE A B C D F G N65+ $1,823.64 $2,546.88 $2,608.56 $1,948.80 $1,729.32
AGE A B 65+ C D F G N
65+ $1,776.96 $2,481.68 $2,541.78 $1898.91 $1,685.05
AGE A B C D F G N65+ $1,951.48 $2,725.41 $2,791.42 $2,085.41 $1,850.54
65+ 1,586.57 $2,215.79 $2,269.45 $1,695.46 $1,504.51
B C D F G N
AGE A B C D F
A.M. Best
Rating:
A-
DISCLAIMER: These rates were correct at the time of Provider's submission. For the most current rates, CONTACT THE INSURANCE COMPANY DIRECTLY.
30
F - Female
M - Male
NT - Non Tobacco User
T - Tobacco User
HD - High Deductible Plan
SEL - Select Plan
Humana Insurance Company500 West Main Street
Louisville, Ky 40202
888-310-8482
www.Humana.com
Medical Underwriting: Yes
Pre-existing condition waiting period: 3 months Policy Fee: N/A
Medicare Crossover: Yes
Annual Premiums: No
Zip Code Areas: Pulaski Preferred Non-Tobacco User
Zip Code Areas: Pulaski Standard Non-Tobacco User
Zip Code Areas Arkansas, Clark, Conway, Faulkner, Garland, Grant, Hot Springs,
Jackson, Lonoke, Monroe, Montgomery, Perry, Pike, Polk, Prairie,
Saline, Van Buren, White, and Woodruff Standard II Non-Tobacco User
SUPERSCRIPT MEANINGS
IN THE CHARTS
A.M. Best
Rating:
NR
AGE B C HD K LF M F M F M F M F M
<65 65 186.36 186.36 216.94 216.94 76.01 76.01 100.42 100.42 142.74 142.7470 186.36 186.36 216.94 216.94 76.01 76.01 100.42 100.42 142.74 142.7475 186.36 186.36 216.94 216.94 76.01 76.01 100.42 100.42 142.74 142.7480 186.36 186.36 216.94 216.94 76.01 76.01 100.42 100.42 142.74 142.74
85+ 186.36 186.36 216.94 216.94 76.01 76.01 100.42 100.42 142.74 142.74
AGE B C HD K LF M F M F M F M F M
<65 65 186.36 186.36 216.94 216.94 76.01 76.01 100.42 100.42 142.74 142.7470 186.36 186.36 216.94 216.94 76.01 76.01 100.42 100.42 142.74 142.7475 186.36 186.36 216.94 216.94 76.01 76.01 100.42 100.42 142.74 142.7480 186.36 186.36 216.94 216.94 76.01 76.01 100.42 100.42 142.74 142.74
85+ 186.36 186.36 216.94 216.94 76.01 76.01 100.42 100.42 142.74 142.74
AGE B C HD K LF M F M F M F M F M
<65 65 178.68 178.68 216.94 216.94 72.88 72.88 96.28 96.28 136.85 136.85
70 178.68 178.68 216.94 216.94 72.88 72.88 96.28 96.28 136.85 136.85
75 178.68 178.68 216.94 216.94 72.88 72.88 96.28 96.28 136.85 136.85
80 178.68 178.68 216.94 216.94 72.88 72.88 96.28 96.28 136.85 136.8585+ 178.68 178.68 216.94 216.94 72.88 72.88 96.28 96.28 136.85 136.85
DISCLAIMER: These rates were correct at the time of Provider's submission. For the most current rates, CONTACT THE INSURANCE COMPANY DIRECTLY.
31
Humana Insurance Company (Continued)
Zip Code Areas: Rest of state Standard III Non-Tobacco User
Zip Code Areas: Pulaski Standard Tobacco User
Zip Code Areas Arkansas, Clark, Conway, Faulkner, Garland, Grant, Hot Springs, Jackson, Lonoke, Monroe, Montgomery, Perry, Pike, Polk, Prairie, Saline, Van Buren, White, and Woodruff Standard II Tobacco User
Zip Code Areas: Rest of State Standard III Tobacco User
AGE B C HD K L F M F M F M F M F M
<65 65 164.52 164.52 191.52 191.52 67.10 67.10 88.65 88.65 126.00 126.00 70 164.52 164.52 191.52 191.52 67.10 67.10 88.65 88.65 126.00 126.00 75 164.52 164.52 191.52 191.52 67.10 67.10 88.65 88.65 126.00 126.00 80 164.52 164.52 191.52 191.52 67.10 67.10 88.65 88.65 126.00 126.00
85+
AGE B C HD K LF M F M F M F M F M
<65 65 278.55 278.55 324.26 324.26 113.61 113.61 150.10 150.10 213.32 213.32 70 278.55 278.55 324.26 324.26 113.61 113.61 150.10 150.10 213.32 213.32 75 278.55 278.55 324.26 324.26 113.61 113.61 150.10 150.10 213.32 213.32 80 278.55 278.55 324.26 324.26 113.61 113.61 150.10 150.10 213.32 213.32
85+ 278.55 278.55 324.26 324.26 113.61 113.61 150.10 150.10 213.32 213.32
AGE B C HD K L F M F M F M F M F M
<65 65 267.07 267.07 310.90 310.90 108.93 108.93 143.91 143.91 204.53 204.53 70 267.07 267.07 310.90 310.90 108.93 108.93 143.91 143.91 204.53 204.53 75 267.07 267.07 310.90 310.90 108.93 108.93 143.91 143.91 204.53 204.53 80 267.07 267.07 310.90 310.90 108.93 108.93 143.91 143.91 204.53 204.53
85+ 267.07 267.07 310.90 310.90 108.93 108.93 143.91 143.91 204.53 204.53
AGE B C HD K LF M F M F M F M F M
<65 65 245.90 245.90 286.26 286.26 100.29 100.29 132.50 132.50 188.32 188.32 70 245.90 245.90 286.26 286.26 100.29 100.29 132.50 132.50 188.32 188.32 75 245.90 245.90 286.26 286.26 100.29 100.29 132.50 132.50 188.32 188.32 80 245.90 245.90 286.26 286.26 100.29 100.29 132.50 132.50 188.32 188.32
85+ 245.90 245.90 286.26 286.26 100.29 100.29 132.50 132.50 188.32 188.32
DISCLAIMER: These rates were correct at the time of Provider's submission. For the most current rates, CONTACT THE INSURANCE COMPANY DIRECTLY.
32
F - Female
M - Male
NT - Non Tobacco User
T - Tobacco User
HD - High Deductible Plan
SEL - Select Plan
Medico Corporation Life Insurance Co. 11808 Grant St., Omaha, NE 68103-0160
800-547-2401, option 3
www.goMedico.com
Medical Underwriting:
Preexisting condition waiting period:
Policy Fee: NoMedicare Crossover:
Annual Premiums: Yes
Zip Code Areas: 71700-71799, 72600-72999 Preferred
Zip Code Areas: 71800-71899, 723-72599 Preferred
Zip Code Areas: Rest of State Preferred
Zip Code Areas: 72200-72299 Preferred
SUPERSCRIPT MEANINGS
IN THE CHARTS
85+ 2066.15 2066.15 2788.82 2788.82
75 2066.15 2066.15 2788.82 2788.82
80 2066.15 2066.15 2788.82 2788.82
65 2066.15 2066.15 2788.82 2788.82
70 2066.15 2066.15 2788.82 2788.82
85+ 1976.32 1976.32 2667.56 2667.56
AGE A F G NF M F M F M F M
65 1976.32 1976.32 2667.56 2667.56
70 1976.32 1976.32 2667.56 2667.56
75 1976.32 1976.32 2667.56 2667.56
80 1976.32 1976.32 2667.56 2667.56
80 1868.52 1868.52 2522.06 2522.06
85+ 1868.52 1868.52 2522.06 2522.06
AGE A F G N
<6565 1868.52 1868.52 2522.06 2522.06
70 1868.52 1868.52 2522.06 2522.06
75 1868.52 1868.52 2522.06 2522.06
85+ 1778.69 1778.69 2400.81 2400.81
AGE A F G N
75 1778.69 1778.69 2400.81 2400.81
80 1778.69 1778.69 2400.81 2400.81
65 1778.69 1778.69 2400.81 2400.81
70 1778.69 1778.69 2400.81 2400.81
AGE A F G NF M F M F M F M
<65
A.M. Best
Rating:
NR
DISCLAIMER: These rates were correct at the time of Provider's submission. For the most current rates, CONTACT THE INSURANCE COMPANY DIRECTLY.
33
Medico Corporation Life Insurance Company (Continued)
Zip Code Areas: 71700-71899, 72300-72599 Standard
Zip Code Areas: 71800-71899, 73600-72599 Standard
Zip Code Areas: Rest of State Standard
Zip Code Areas: 72200-72299 Standard
85+ 2430.77 2430.77 3280.96 3280.96
75 2430.77 2430.77 3280.96 3280.96
80 2430.77 2430.77 3280.96 3280.96
65 2430.77 2430.77 3280.96 3280.96
70 2430.77 2430.77 3280.96 3280.96
AGE A F G NF M F M F M F M
<65
80 2325.08 2325.08 3138.31 3138.31
85+ 2325.08 2325.08 3138.31 3138.31
70 2325.08 2325.08 3138.31 3138.31
75 2325.08 2325.08 3138.31 3138.31
<6565 2325.08 2325.08 3138.31 3138.31
85+ 2198.26 2198.26 2967.13 2967.13
AGE A F G NF M F M F M F M
75 2198.26 2198.26 2967.13 2967.13
80 2198.26 2198.26 2967.13 2967.13
65 2198.26 2198.26 2967.13 2967.13
70 2198.26 2198.26 2967.13 2967.13
AGE A F G NF M F M F M F M
<65
80 2092.57 2092.57 2824.48 2824.4885+ 2092.57 2092.57 2824.48 2824.48
70 2092.57 2092.57 2824.48 2824.4875 2092.57 2092.57 2824.48 2824.48
<6565 2092.57 2092.57 2824.48 2824.48
AGE A F G NF M F M F M F M
DISCLAIMER: These rates were correct at the time of Provider's submission. For the most current rates, CONTACT THE INSURANCE COMPANY DIRECTLY.
34
F - Female
M - Male
NT - Non Tobacco User
T - Tobacco User
HD - High Deductible Plan
SEL - Select Plan
Medico Insurance Company PO Box 10386, Des Moines, IA 50306 800-228-6080
www.goMedico.com
Medical Underwriting:
Preexisting condition waiting period:
Policy Fee: No Medicare Crossover:
Annual Premiums: Yes
Zip Code Areas: 716, 720-723 Preferred
F
Zip Code Areas: 717-719, 724-729 Preferred
NF
Zip Code Areas: 716, 720-723 Standard
F
Zip Code Areas: 717-719, 724-729 Standard
F G
F G N
2561.842234.05 2234.05 1918.72 1918.72
2561.84 2234.05 2234.05 1918.72 1918.722561.84 2234.05 2234.05 1918.72 1918.722561.84 2234.05 2234.05 1918.72 1918.72
198.05 1724.10 1724.10 1480.75 1480.75198.05 1724.10 1724.10 1480.75 1480.75
M M F2234.05 2234.05 1918.72 1918.72
198.05 1724.10 1724.10 1480.75 1480.75198.05 1724.10 1724.10 1480.75 1480.75198.05 1724.10 1724.10 1480.75 1480.75
G N
1942.65
1942.65
1942.651942.651942.651942.65
1942.65
1942.65
1942.65
F M
1668.461668.461668.461668.461668.46
1668.461668.461668.461668.461668.46
M F M
SUPERSCRIPT MEANINGS
IN THE CHARTS
80 1522.70 1522.70 2273.63 2273.63 1982.72 1982.72 1702.87 1702.87
85+ 1522.70 1522.70 2273.63 2273.63 1982.72 1982.72 1702.87 1702.87
70 1522.70 1522.70 2273.63 2273.63 1982.72 1982.72 1702.87 1702.87
75 1522.70 1522.70 2273.63 2273.63 1982.72 1982.72 1702.87 1702.87
G NF M F M F M F M
65 1522.70 1522.70 2273.63 2273.63 1982.72 1982.72 1702.87 1702.87
70 1715.72 1715.72 2561.84
75 1715.72 1715.72 2561.84
80 1715.72 1715.72 2561.84
85+ 1715.72 1715.72 2561.84
AGE A F
2561.84
85+ 1324.83 1324.83 1978.05
AGE AF M F M
65 1715.72 1715.72 2561.84
<6565 1324.83 1324.83 1978.05
70 1324.83 1324.83 1978.05
75 1324.83 1324.83 1978.05
80 1324.83 1324.83 1978.05
80 1492.76 1492.76 2228.78
85+ 1492.76 1492.76 2228.78
2228.782228.782228.78
AGE AF M F M
<6565 1492.76 1492.76 2228.78
70 1492.76 1492.76 2228.782228.782228.78
1942.65
75 1492.76 1492.76 2228.78
AGE AF M F M M
F
A.M. Best
Rating:
NR
DISCLAIMER: These rates were correct at the time of Provider's submission. For the most current rates, CONTACT THE INSURANCE COMPANY DIRECTLY.
35
F - Female
M - Male
NT - Non Tobacco User
T - Tobacco User
HD - High Deductible Plan
SEL - Select Plan
Omaha Insurance Company Mutual of Omaha Plaza, Omaha, NE 68175 800-667-2937www.mutualofomaha.com
Medical Underwriting: Yes (Outside open enrollment and guaranteed issue periods)Pre-existing condition waiting period: None Policy Fee: 0Medicare Crossover: YesAnnual Premiums: Annual premiums shown below
Zip Code Areas: 716-719, 723-729 Non-Tobacco User
Zip Code Areas: 72001, 72003-007, 72010-048, 72051-052, 72055, 72057-061, 72063-064, 72066- 075,
72079-089, 72101-102, 72104-108, 72110-112, 72121-123, 72125-134, 72136-137, 72139-141, 72143, 72145,
72149-150, 72152-153, 72156-158, 72160, 72165-170, 72173, 72175-176,
72178-179, 72181-182, 72189 Non-Tobacco User
65+
Zip Code Areas: 72002, 72053, 72065, 72076, 72078, 72099, 72103, 72113-120, 72124, 72135, 72142, 72164, 72180,
72183, 72190, 72198-199, 722 Non-Tobacco User
65+
Zip Code Areas: 716-719, 723-729 Tobacco User
65+
Zip Code Areas: 72001, 72003-007, 72010-048, 72051-052, 72055, 72057-061, 72063-064, 72066- 075,
72079-089, 72101-102, 72104-108, 72110-112, 72121-123, 72125-134, 72136-137, 72139-141, 72143, 72145,
72149-150, 72152-153, 72156-158, 72160, 72165-170, 72173, 72175-176,
72178-179, 72181-182, 72189 Tobacco User
65+
Zip Code Areas: 72002, 72053, 72065, 72076, 72078, 72099, 72103, 72113-120, 72124, 72135,
72142, 72164, 72180, 72183, 72190, 72198-199, 722 Tobacco User
65+
SUPERSCRIPT MEANINGSIN THE CHARTS
AGE A F HDF G N N
2088.47 638.15 1732.31 1334.25
F HDF G N N
65+ 1513.39 1991.34 608.47 1651.74 1272.19
F HDF G N N
N
2152.80 657.80 1785.66 1375.34
F HDF G N N
2379.89 727.20 1974.03 1520.42
F HDF G N N
2572.85 786.16 2134.09 1643.70
AGE A
AGE A
AGE A
AGE A
AGE A
1587.22
1808.69
1636.10
1715.91
1955.34
2257.81 689.89 1872.77 1442.43
F HDF G N
A.M. Best
Rating:
A+
DISCLAIMER: These rates were correct at the time of Provider's submission. For the most current rates, CONTACT THE INSURANCE COMPANY DIRECTLY.
36
F - Female
M - Male
NT - Non Tobacco User
T - Tobacco User
HD - High Deductible Plan
SEL - Select Plan
Physicians Mutual Insurance Company 2600 Dodge Street Omaha, NE 68131
800-228-9100
www.physiciansmutual.com
Medical Underwriting:
Preexisting condition waiting period: 0 Medicare Crossover: YesPolicy Fee: NoAnnual Premiums:
Zip Code Areas: 71600-71899 & 72300-72999 (AREA E) Preferred Non-Tobacco User
Zip Code Areas: 71900-72199 (AREA F) Standard Non-Tobacco User
Zip Code Areas: 72200-72299 (AREA H) Standard II Non-Tobacco User
Zip Code Areas: 71600-71899 & 72300-72999 (AREA E) Standard Tobacco User
SUPERSCRIPT MEANINGS
IN THE CHARTS
85+ $1,888 $1,888 $1,574 $1,574 $806 $806 $2,430 $2,430 $2,293 $2,293
75 $1,888 $1,888 $1,574 $1,574 $806 $806 $2,430 $2,430 $2,293 $2,293
80 $1,888 $1,888 $1,574 $1,574 $806 $806 $2,430 $2,430 $2,293 $2,293
65 $1,888 $1,888 $1,574 $1,574 $806 $806 $2,430 $2,430 $2,293 $2,293
70 $1,888 $1,888 $1,574 $1,574 $806 $806 $2,430 $2,430 $2,293 $2,293
F M F M F M F M F M<65 N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A
85+ $1,968 $1,968 $1,641 $1,641 $840 $840 $2,532 $2,532 $2,390 $2,390
AGE A F HD G N
75 $1,968 $1,968 $1,641 $1,641 $840 $840 $2,532 $2,532 $2,390 $2,390
80 $1,968 $1,968 $1,641 $1,641 $840 $840 $2,532 $2,532 $2,390 $2,390
65 $1,968 $1,968 $1,641 $1,641 $840 $840 $2,532 $2,532 $2,390 $2,39070 $1,968 $1,968 $1,641 $1,641 $840 $840 $2,532 $2,532 $2,390 $2,390
F M F M F M F M F M<65 N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A
85+ $1,789 $1,789 $1,494 $1,494 $764 $764 $2,302 $2,302 $2,173 $2,173
AGE A F HD G N
75 $1,789 $1,789 $1,494 $1,494 $764 $764 $2,302 $2,302 $2,173 $2,17380 $1,789 $1,789 $1,494 $1,494 $764 $764 $2,302 $2,302 $2,173 $2,173
65 $1,789 $1,789 $1,494 $1,494 $764 $764 $2,302 $2,302 $2,173 $2,173
70 $1,789 $1,789 $1,494 $1,494 $764 $764 $2,302 $2,302 $2,173 $2,173
F M F M F M F M F M<65 N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A
85+ $1,699 $1,699 $1,417 $1,417 $726 $726 $2,187 $2,187 $2,064 $2,064
AGE A F HD G N
75 $1,699 $1,699 $1,417 $1,417 $726 $726 $2,187 $2,187 $2,064 $2,06480 $1,699 $1,699 $1,417 $1,417 $726 $726 $2,187 $2,187 $2,064 $2,064
65 $1,699 $1,699 $1,417 $1,417 $726 $726 $2,187 $2,187 $2,064 $2,064
70 $1,699 $1,699 $1,417 $1,417 $726 $726 $2,187 $2,187 $2,064 $2,064
HD G NF M F M F M F M F M
<65 N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A
AGE A F
A.M. Best
Rating:
A
DISCLAIMER: These rates were correct at the time of Provider's submission. For the most current rates, CONTACT THE INSURANCE COMPANY DIRECTLY.
37
Physicians Mutual Insurance Company (Continued)
Zip Code Areas: 71900-72199 (AREA F) Standard II Tobacco User
Zip Code Areas: 72200-72299 (AREA H) Standard III Tobacco User
85+ $2,186 $2,186 $1,823 $1,823 934 934 $2,814 $2,814 $2,655 $2,655
75 $2,186 $2,186 $1,823 $1,823 934 934 $2,814 $2,814 $2,655 $2,655
80 $2,186 $2,186 $1,823 $1,823 934 934 $2,814 $2,814 $2,655 $2,655
65 $2,186 $2,186 $1,823 $1,823 934 934 $2,814 $2,814 $2,655 $2,655
70 $2,186 $2,186 $1,823 $1,823 934 934 $2,814 $2,814 $2,655 $2,655
F M F M F M F M F M<65 $2,186 $2,186 $1,823 $1,823 934 934 $2,814 $2,814 $2,655 $2,655
85+ $1,988 $1,988 $1,657 $1,657 849 849 $2,558 $2,558 $2,414 $2,414
AGE A F HD G N
75 $1,988 $1,988 $1,657 $1,657 849 849 $2,558 $2,558 $2,414 $2,41480 $1,988 $1,988 $1,657 $1,657 849 849 $2,558 $2,558 $2,414 $2,414
65 $1,988 $1,988 $1,657 $1,657 849 849 $2,558 $2,558 $2,414 $2,414
70 $1,988 $1,988 $1,657 $1,657 849 849 $2,558 $2,558 $2,414 $2,414
F M F M F M F M F M<65 N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A
AGE A F HD G N
DISCLAIMER: These rates were correct at the time of Provider's submission. For the most current rates, CONTACT THE INSURANCE COMPANY DIRECTLY.
38
F - Female
M - Male
NT - Non Tobacco User
T - Tobacco User
HD - High Deductible Plan
SEL - Select Plan
S.USA Life Insurance Company100 West 33rd Street, Suite 1007, New York, NY 10001 877-725-4872
www.sbliusa.com
Medical Underwriting: Yes
Preexisting condition waiting period: No
Policy Fee: No
Medicare Crossover: YesAnnual Premiums: Shown Below
Zip Code Areas: 720-722 Preferred Non-Tobacco User
Zip Code Areas: 720-722 Standard Tobacco User
Zip Code Areas: 716-719, 723-729 Preferred Non-Tobacco User
Zip Code Areas: Standard Tobacco User
All $1823$1,413
AGE A F
M/F M/F
All $1253 $1620
AGE A F
M/F M/F
AGE A F
M/F M/FAll $1592 $2054
All $1411 $1825
AGE A FM/F M/F
SUPERSCRIPT MEANINGS
IN THE CHARTS
A.M. Best
Rating:
A-
DISCLAIMER: These rates were correct at the time of Provider's submission. For the most current rates, CONTACT THE INSURANCE COMPANY DIRECTLY.
39
F - Female
Standard Life & Accident Insurance Company One Moody Plaza Galveston, TX 77550888-350-1488www.slaico.com M - Male
NT - Non Tobacco User
Medical Underwriting: Outside Open Enrollment T - Tobacco User
Pre-existing condition waiting period: None HD - High Deductible Plan
Policy Fee: $0.00 SEL - Select Plan
Medicare Crossover: YesAnnual Premiums: Community Rated
Zip Code Areas: 716-717, 719, 724-726, 728 Preferred Non-Tobacco User
Zip Code Areas: 716-717, 719, 724-726, 728 Standard Tobacco User
Zip Code Areas: 718, 723 Standard II Non-Tobacco User
SUPERSCRIPT MEANINGSIN THE CHARTS
85+ 2468.45 2627.69 1940.11 1267.32
75 2468.45 2627.69 1940.11 1267.3280 2468.45 2627.69 1940.11 1267.32
65 2468.45 2627.69 1940.11 1267.3270 2468.45 2627.69 1940.11 1267.32
<65 N/A N/A N/A N/A
AGE A F G N
80 2455.46 2613.86 1929.90 1260.6585+ 2455.46 2613.86 1929.90 1260.65
70 2455.46 2613.86 1929.90 1260.6575 2455.46 2613.86 1929.90 1260.65
<65 N/A N/A N/A N/A65 2455.46 2613.86 1929.90 1260.65
AGE A F G N
M F F M F MN/A N/A N/A N/A N/A N/A
2221.60 2364.92 1746.10 1746.10 1140.59 1140.592221.60 2364.92 1746.10 1746.10 1140.59 1140.592221.60 2364.92 1746.10 1746.10 1140.59 1140.592221.60 2364.92 1746.10 1746.10 1140.59 1140.592221.60 2364.92 1746.10 1746.10 1140.59 1140.59
75 2221.60 2364.9280 2221.60 2364.92
85+ 2221.60 2364.92
<65 N/A N/A65 2221.60 2364.9270 2221.60 2364.92
AGE A F G N
F M
A.M. Best
Rating:
NR
DISCLAIMER: These rates were correct at the time of Provider's submission. For the most current rates, CONTACT THE INSURANCE COMPANY DIRECTLY.
40
Standard Life and Accident Insurance Company (Continued)
Zip Code Areas: 718,723 Standard III Tobacco User
Zip Code Areas: 727,729 Preferred Non-Smoker
Zip Code Areas: 727,729 Standard Smoker
M F F M F MN/A N/A N/A N/A N/A N/A
2728.29 2904.29 2144.33 2144.33 1400.72 1400.722728.29 2904.29 2144.33 2144.33 1400.72 1400.722728.29 2904.29 2144.33 2144.33 1400.72 1400.722728.29 2904.29 2144.33 2144.33 1400.72 1400.722728.29 2904.29 2144.33 2144.33 1400.72 1400.7285+ 2728.29 2904.29
70 2728.29 2904.2975 2728.29 2904.2980 2728.29 2904.29
F M<65 N/A N/A
65 2728.29 2904.29
AGE A F G N
M F F M F MN/A N/A N/A N/A N/A N/A
1987.75 2115.98 1562.30 1562.30 1020.53 1020.531987.75 2115.98 1562.30 1562.30 1020.53 1020.531987.75 2115.98 1562.30 1562.30 1020.53 1020.531987.75 2115.98 1562.30 1562.30 1020.53 1020.531987.75 2115.98 1562.30 1562.30 1020.53 1020.53
75 1987.75 2115.9880 1987.75 2115.98
85+ 1987.75 2115.98
<65 N/A N/A65 1987.75 2115.9870 1987.75 2115.98
AGE A F G N
F M
M F F M F MN/A N/A N/A N/A N/A N/A
2208.61 2351.09 1735.89 1735.89 1133.92 1133.922208.61 2351.09 1735.89 1735.89 1133.92 1133.922208.61 2351.09 1735.89 1735.89 1133.92 1133.922208.61 2351.09 1735.89 1735.89 1133.92 1133.922208.61 2351.09 1735.89 1735.89 1133.92 1133.92
80 2208.61 2351.0985+ 2208.61 2351.09
65 2208.61 2351.0970 2208.61 2351.0975 2208.61 2351.09
AGE A F G N
F M<65 N/A N/A
DISCLAIMER: These rates were correct at the time of Provider's submission. For the most current rates, CONTACT THE INSURANCE COMPANY DIRECTLY.
41
F - Female
M - Male
United American Insurance Company 3700 S. Stonebridge DrivePO Box 8080, McKinney, TX 75070800-331-2512www.unitedamerican.com NT - Non Tobacco User
T - Tobacco User
Medical Underwriting: Simple underwriting with yes/no questions HD - High Deductible Plan
Pre-existing condition waiting period: 2 months SEL - Select Plan
Policy Fee: NoMedicare Crossover: YesAnnual Premiums:
Zip Code Areas: All Preferred Non-Tobacco User
Zip Code Areas: Standard Tobacco User
Zip Code Areas: Standard II Non-Tobacco User
Zip Code Areas: Standard III Tobacco User
SUPERSCRIPT MEANINGSIN THE CHARTSA.M.
Best Rating:
A+
p
8085+
7075
<6565
AGE A F G N
85+ 1662 2609 3080 1870
75 1662 2609 3080 1870
80 1662 2609 3080 1870
65 1662 2609 3080 1870
70 1662 2609 3080 1870
<65
AGE A F G N
M F F M F M
7580
85+
<656570
AGE A F G NF M
M F F M F M
7580
85+
<656570
AGE A F G NF M
DISCLAIMER: These rates were correct at the time of Provider's submission. For the most current rates, CONTACT THE INSURANCE COMPANY DIRECTLY.
42
United American Insurance Company (Continued)
Zip Code Areas: Preferred Non-Smoker
Zip Code Areas: Standard Smoker
Zip Code Areas: Standard II Non-Smoker
Zip Code Areas: Standard II Smoker
M F F M F M
7580
85+
<656570
AGE A F G NF M
M F F M F M
7580
85+
<656570
AGE A F G NF M
M F F M F M
7580
85+
<656570
AGE A F G NF M
M F F M F M
7580
85+
<656570
AGE A F G NF M
DISCLAIMER: These rates were correct at the time of Provider's submission. For the most current rates, CONTACT THE INSURANCE COMPANY DIRECTLY.
43
The Order of United Commercial Travelers of America1801 Watermark Dr., Suite 100Columbus, OH 43215
F - Female 800-848-0123 www.uct.org M - Male
NT - Non Tobacco User
T - Tobacco User
HD - High Deductible Plan
SEL - Select Plan
Medical Underwriting: YesPre-existing condition waiting period: N/A Policy Fee: 0Medicare Crossover: YesMonthly Premiums: Shown Below
Zip Code Areas: 722 Preferred Non-Tobacco User
Zip Code Areas: 722 Standard Tobacco User
Zip Code Areas: All except 720-722 Preferred Non-Tobacco User
80 $174 $174 $211 $211 $242 $242 $214 $214 $170 $17085+ $174 $174 $211 $211 $242 $242 $214 $214 $170 $170
70 $174 $174 $211 $211 $242 $242 $214 $214 $170 $17075 $174 $174 $211 $211 $242 $242 $214 $214 $170 $170
<65 $174 $174 $211 $211 $242 $242 $214 $214 $170 $17065 $174 $174 $211 $211 $242 $242 $214 $214 $170 $170
AGE A B F G NF M F M F M F M F M
80 $257 $257 $310 $310 $356 $356 $315 $315 $249 $249
85+ $257 $257 $310 $310 $356 $356 $315 $315 $249 $249
70 $257 $257 $310 $310 $356 $356 $315 $315 $249 $24975 $257 $257 $310 $310 $356 $356 $315 $315 $249 $249
<65 $257 $257 $310 $310 $356 $356 $315 $315 $249 $24965 $257 $257 $310 $310 $356 $356 $315 $315 $249 $249
AGE A B F G NF M F M F M F M F M
80 $205 $205 $248 $248 $285 $285 $252 $252 $199 $19985+ $205 $205 $248 $248 $285 $285 $252 $252 $199 $199
70 $205 $205 $248 $248 $285 $285 $252 $252 $199 $19975 $205 $205 $248 $248 $285 $285 $252 $252 $199 $199
<65 $205 $205 $248 $248 $285 $285 $252 $252 $199 $19965 $205 $205 $248 $248 $285 $285 $252 $252 $199 $199
AGE A B F G NF M F M F M F M F M
SUPERSCRIPT MEANINGSIN THE CHARTS
A.M. Best
Rating:
B+
DISCLAIMER: These rates were correct at the time of Provider's submission. For the most current rates, CONTACT THE INSURANCE COMPANY DIRECTLY.
44
The Order of United Commercial Travelers of America (Continued)
Zip Code Areas: All except 720-722 Standard Tobacco User
Zip Code Areas: 720, 721 Preferred Non-Tobacco User
Zip Code Areas: 720, 721 Standard Tobacco User
80 $231 $231 $279 $279 $321 $321 $283 $283$283
AGE A B F G
<65
$225 $225
85+ $231 $231 $279 $279 $321 $321 $283 $283 $225 $225
70 $231 $231 $279 $279 $321 $321 $283 $283 $225 $225
75 $231 $231 $279 $279 $321 $321 $283 $225 $225
<65 $231 $231 $279 $279 $321 $321 $283 $283 $225 $225
65 $231 $231 $279 $279 $321 $321 $283 $283 $225 $225
NF M F M F M F M F M
80 $185 $185 $223 $223 $256 $256 $227 $227 $180 $180
85+ $185 $185 $223 $223 $256 $256 $227 $227 $180 $180
70 $185 $185 $223 $223 $256 $256 $227 $227 $180 $180
75 $185 $185 $223 $223 $256 $256 $227 $227 $180 $180
$223 $223 $256 $256 $227 $227 $180 $180
65 $185 $185 $223 $223 $256 $256 $227 $227 $180 $180$185 $185
AGE A B F G NF M F M F M F M F M
80 $218 $218 $264 $264 $303 $303 $268 $268 $212 $212
85+ $218 $218 $264 $264 $303 $303 $268 $268 $212 $212
70 $218 $218 $264 $264 $303 $303 $268 $268 $212 $212
75 $218 $218 $264 $264 $303 $303 $268 $268 $212 $212
<65 $218 $218 $264 $264 $303 $303 $268 $268 $212 $212
65 $218 $218 $264 $264 $303 $303 $268 $268 $212 $212
AGE A B F G NF M F M F M F M F M
DISCLAIMER: These rates were correct at the time of Provider's submission. For the most current rates, CONTACT THE INSURANCE COMPANY DIRECTLY.
45
United Healthcare Insurance Company PO Box 30607, Salt Lake City, UT 84130888-378-0254 F - Female
M - Male
Medical Underwriting: Yes NT - Non Tobacco User
Pre-existing condition waiting period: 3 months T - Tobacco User
Policy Fee: none HD - High Deductible Plan
Medicare Crossover: Yes SEL - Select Plan
Annual Premiums:
Zip Code Areas: ALL Preferred Non-Tobacco User
Zip Code Areas: ALL Standard Non‐Tobacco User
Zip Code Areas: ALL Preferred Tobacco
SUPERSCRIPT MEANINGS
IN THE CHARTS
A.M. Best
Rating:
A
AGE A F HD G N F M F M F M F M F M
<65 65 $108.50 $108.50 $193.50 $193.50 $135.75 $135.75 70 $108.50 $108.50 $193.50 $193.50 $135.75 $135.75 75 $108.50 $108.50 $193.50 $193.50 $135.75 $135.75 80 $108.50 $108.50 $193.50 $193.50 $135.75 $135.75
85+ $108.50 $108.50 $193.50 $193.50 $135.75 $135.75
AGE A F HD G N F M F M F M F M F M
<65 65 $162.75 $162.75 $290.25 $290.25 $203.62 $203.62 70 $162.75 $162.75 $290.25 $290.25 $203.62 $203.62 75 $162.75 $162.75 $290.25 $290.25 $203.62 $203.62 80 $162.75 $162.75 $290.25 $290.25 $203.62 $203.62
85+ $162.75 $162.75 $290.25 $290.25 $203.62 $203.62
AGE A F HD G N F M F M F M F M F M
<65 65 $119.35 $119.35 $212.85 $212.85 $149.32 $149.32 70 $119.35 $119.35 $212.85 $212.85 $149.32 $149.32 75 $119.35 $119.35 $212.85 $212.85 $149.32 $149.32 80 $119.35 $119.35 $212.85 $212.85 $149.32 $149.32
85+ $119.35 $119.35 $212.85 $212.85 $149.32 $149.32
DISCLAIMER: These rates were correct at the time of Provider's submission. For the most current rates, CONTACT THE INSURANCE COMPANY DIRECTLY.
46
Approved Charges, also known as allowable charges, Medicare eligible expenses, or Medicare covered charges, apply to the specific dollar amount on which Medicare will base its payment for every medical procedure under Part B. Medicare will pay 80% of this "approved" amount.
Assignment is the means by which doctors or suppliers receive payment directly from Medicare. When assignment is used, the provider of medical service agrees that his or her total charge for the covered Medicare Part B service will be the charge approved by the Medicare Carrier. Medicare then pays your doctor or supplier 80% of the approved charge, less any part of the $183 annual deductible. You are responsible for the 20% of the approved amount not paid by Medicare plus the $183 annual deductible. Accepting assignment means that the doctor or medical provider will not bill you for the difference between the actual charge and the Medicare approved amount. Find out in advance whether your doctor or medical provider will accept assignment. When assignment is not accepted, you will be responsible for any amount up to 15% above the charges approved by Medicare. Using doctors or suppliers who accept assignment will save you money. Any physician may take assignment on a claim-by-claim basis whether he is a "participating" provider or not.
Carrier is the Medicare Part B claims processor. In Arkansas, the Medicare "Carrier" is Novitas-Solutions (www.novitas-solutions.com). For questions about your Part B claims payments, telephone 1-800-633-4227.
Contestable Clause is a policy provision that gives an insurer the right to rescind your insurance policy in the event there are any material errors, omissions or misstatements on your insurance application or enrollment form. The contestable period is generally the two years following the effective date of the policy.
Coordination Of Benefits (COB) means that one of your health insurance policies may reduce its benefits if you are also covered by another insurance plan. Important! This usually applies only to employer-sponsored plans.
Private Medicare supplements ordinarily do not have COB regardless of how many policies you have.
Co-payment is the amount that you or your insurance plan must pay to supplement Medicare's payments for Part A and Part B expenses. For example, for charges incurred in 2017, you will have a $329 per dayco-payment for days 61-90 and a $658 per day co-payment for days 91-150 while in a hospital. There is also a co-payment of $164.50 for skilled nursing days 21-100 and a co-payment of 20% for all Part B services after your annual deductible of $183.
Deductible is the dollar amount that you will have to pay before either Medicare or your insurance plan will begin paying benefits. Your Medicare Part A deductible is $1316 per benefit period for 2017. Your Medicare PartB deductible is $183 of approved charges each calendar year.
Effective Date is the date your policy becomes effective. When you talk to your insurer, ask what the effective date will be. The effective date is printed on your insurance policy or certificate.
Exclusions or Exceptions is the list of specific conditions or circumstances that are not covered by the policy. The exceptions in Medicare supplements are limited by state law and cannot exclude or limit coverage for any specific health condition for more than six months. Other health insurance plans such as hospital indemnity or medical-surgical expense plans may have a 12-month exclusion for pre-existing conditions and/or permanent exclusions for certain health conditions.
Excess Charge are additional charges approved by Medicare if your doctor or provider does not accept Medicare Assignment (Medicare approved amount). The maximum excess charge is 15% of the Medicare approved amount.
Free Look is the time period after you receive the policy in which you can review its benefits. State law requires Medicare supplement insurers to give the consumer 30 days to review the policy. If you return the policy within the 30-day free look period, you will get a full refund. Other types of individually marketed health insurance plans are limited to a 10-day free look period.
GLOSSARY
47
GLOSSARY
Grace Period is the time period (usually 31 days) or the payment of an overdue premium, during which time the policy remains in force.
Hospice is a program for the terminally ill. Medicare does reimburse most Hospice expenses if the Medicare patient chooses to take Hospice benefits instead of regular Part A and Part B benefits. There may be a co-payment for outpatient drugs and inpatient respite care. Care must be provided through certified Hospice organizations.
Intermediary is the Medicare Part A claims processor. In Arkansas, the Medicare Part A "intermediary" is Pinnacle Business Solutions. For questions about Part A claims payments, contact Pinnacle Business Solutions at 1-866-799-2110.
Limiting Charge is the limit on the amount physicians who do not accept assignment can charge a Medicare beneficiary. The limiting charge is no more than 15% over Medicare's approved amount. Limiting charge information appears on the Medicare Summary Notice (MSN) form.
Material Misrepresentation is a misrepresentation that was important or essential to the decision to issue or not issue an insurance policy.
Medicaid is a federal and state program that provides health insurance benefits for certain low-income, disabled or blind individuals, and families. There are strict income eligibility guidelines. Applications must be made at the local county office of the Department of Human Services. 1-800-482-8988
Medicare Crossover is one of the more significant service enhancements that insurance companies can offer. A "crossover" company has a contract with Medicare requiring Medicare to send the insured's remainder of the bill directly to the Medicare supplement insurance company.
Medicare Advantage is a part of the Balanced Budget Act (BBA) of 1997 that authorizes the Centers for Medicare & Medicaid Services to enter into contracts with insurance companies, managed care organizationsand other entities to give Medicare beneficiaries a choice in how they receive their Medicare benefits.
Participating Physicians are doctors who have contracted with Medicare to accept assignment for all Medicare patients, file all claims for Medicare patients, and agree to all Medicare rules. Check the MedPard database http://www.pinnaclemedicare.com/bene/medpard/default.aspx
Non-Participating Physicians have not signed a contract with Medicare to accept assignment, but may do so on a case-by-case basis. Non-participating physicians must still file all claims with Medicare.
Pre-Existing Conditions are health conditions for which you have been diagnosed, treated, or had symptoms during the time before your policy's effective date of coverage.
Pre-Existing Condition Waiting Period is the amount of time after your effective date of coverage during which your insurance plan will not cover any pre-existing conditions. Medicare supplement law in Arkansas says your waiting period cannot be any longer than six months. Many Medicare supplements offer plans with shorter waiting periods. When a Medicare supplement policy replaces an existing Medicare supplement policy, the replacing issuer must waive any time period applicable to pre-existing conditions.
Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO) are groups of doctors and health care professionals who are paid by the federal government to review Medicare hospital admissions and reimbursements and to monitor inpatient quality of care. BFCC-QIO’s have the authority to deny hospital payments if care is not medically necessary. They also handle patient appeals and complaints the patient makes regarding non-payment of service or quality of care. If you have any questions, please contact them at 1-844-430-9504.
Underwriting is the method insurance companies use to evaluate risks and determine insurability.
Usual, Customary and Reasonable (UCR) typically means the fees most frequently charged in a geographic by providers with similar training and experience for the same or like service or supply.
48
Notes
My Medigap Information
Agent Name: __________________________________________________
Company Name: _____________________________________________
Company Address: _____________________________________________
Phone Number(s): _____________________________________________
Email: ______________________________________________________
Arkansas Insurance License Number: _______________________________
Medigap Plan Choice (A-L): ________
Monthly Premium: $____________ How do I pay? _________________
Is my spouse covered? ________ Spouse Premium: $___________
49
Comparing Medicare drug plans can save you money. Provide a list of current medications and SHIIP uses
the Medicare website to compare plans www.medicare.gov
Call 1-800-224-6330 for information
Helpful Phone Numbers
1-800-Medicare Helpline 1-800-633-4227
Arkansas Attorney General’s Office 1-800-482-8982
Beneficiary and Family Centered Care Quality
Improvement organization (BFCC-QIO) (KEPRO)
1-844-430-9504
Arkansas SMP (Medicare Fraud) 1-866-726-2916
Marketplace (Affordable Care Act) 1-800-318-2596
Medicaid (Department of Human Services) 1-800-482-5431
Senior Health Insurance Information Program
(SHIIP)
1-800-224-6330
Social Security Administration 1-800-772-1213
Tricare 1-866-773-0404
Veterans Administration 1-800-827-1000
www.insurance.arkansas.gov
Allen Kerr, Commissioner 1200 W 3rd St.
Little Rock, Arkansas 72201
Toll Free: 1-800-224-6330
This publication is produced by the State of Arkansas Insurance Department division of Senior Health Insurance Information Program (SHIIP) with financial assistance through a grant from the Administration for Community Living, an agency of the U.S. Department of the Health and Human Services.
Revised 06.17 50