David Crotts & AssociatesDavid Crotts & Associates “Agent Support Services”

Today’s Agenda

• The ABC’s of Medicare & Gaps In Coverage

• What Is A Medicare Supplement

• Part A: -Eligible at age 65 & most people automatically enroll-Covers most costs for inpatient Hospital Care-Initial deductible of $1,132 with $283 & $566 co-payments-Covers skilled nursing facilities for up to 100 days

• Part B: -Must sign up for it &most pay a monthly premium -Deductible of $162 in 2011 -Helps cover doctors’ visits & outpatient hospital care expenses

• Part C: -Medicare Advantage health plans options approved by Medicare -Run by private companies & usually offer additional benefits -May provide specialized care for people in need -Replaces Medicare Parts A and B.

Medicare ABC’SMedicare ABC’S

• Part D: -Prescription Drug Plans for Medicare A&B clients’ -Charge a monthly premium that varies by plan -Allows clients to get the coverage needed at the best price possible.

Gaps In Coverage Original Medicare “Parts A&B”

-Covers a portion of approved medical expenses

-Individual is reasonable for the remaining share

Hospital Stays

Skilled NursingFacility Care

Blood

– $1,132 deductible for days 1 – 60

– $283 per day for days 61 – 90

– $566 per day for days 91 – 150

– $0 for first 20 days– Up to $141.50 per day for

days 21 – 100– 100% after day 100

– 100% for first 3 pints– 20% for additional pints

Deductible

Doctor & Outpatient Services

$162 per year

20% coinsuranceCopayments for hospitaloutpatient services

Part A Part B

Covering The Gaps

• Medicare Supplement Polices

-Helps individuals reduce financial liability.

- May give discounts on vision.

-Coverage level depends on the plan you buy.

- Costs are in addition to original Medicare premiums.

Additional No Coverage Gaps

• Not covered under Medicare Supplement or Medicare

- Dental

- Vision

- Long Term Care

- Eyeglasses

- Private – Duty Nursing

Medicare Supplements Glance

• Supplement Basics

- Sometimes called Medigap

- Offered through Private Companies

- Follows Federal & State Laws

- Most states only offer “standardized”

- All plans regardless of company must offer same benefits

- Price & customer service “Only” difference

Medicare Plans

• Plan Identification Letters- A,B,C,D,E,F,G,H,I,J,K,L,M,N

• Plans No Longer Available - E,H,I,J

• New Plans In 2010- N and M

Note;Note;

Carries May Carries May Choose To Offers Choose To Offers Select PlansSelect Plans

Medicare Plans Cond’

Plan Premiums

• Factors That Effect Costs; 1. Plan

2.*Company

3.Where you live “zip code”

4.**Age

* Benefits remain the same regardless of company.

** Individuals can’t be single out for an increase based on age. The increase must be given to entire age group in that zip code.

Important Changes To Know

• Policies effective on-after June 1st 2010- Hospice Part A “Covered” - K- covers 50% and L- covers 75%

• Plans K,L,N- May require cost share in Part B Coinsurance

• Plans D and G- Sold before June 1, 2010 “Old Benefits”- Purchased after June 1, 2010 “New Benefits”

• All Medicare Supplement Carriers - Must offer plan A- Also have to carry either plan C or F as option.

Selling Medicare Supplements

Enrollment Denied

• * People On Medicare Under 65- Generally can’t purchase medigap “If offered it’s costly”- End-Stage Renal Disease

• Individuals over 65 not in GI under certain situations -That can’t pass medical underwriting.

* Some states require carries to sell * Some states require carries to sell to under 65 Medicare beneficiaries to under 65 Medicare beneficiaries such as “North Carolina”. such as “North Carolina”.

Understanding The Individuals Needs

• Are you concerned about the cost involved in recuperating from a sickness or injury?

• Do you know anyone with cancer?

- 59.4% cancer cost are non-medical

• Have you consider paying for Final Expenses?

- If so, what do you have set aside?

• Ask about other concerns or questions.

• Confused about healthcare options?- Page 5 “2010 Medigap Book”

• Can you explain the changes CMS made in 2010- New Plans - Benefit Changes

• Is their coverage guaranteed renewable?

- Page 36 “2010 Medigap Book”.

• Is a network important?- Do they travel?

• Are out-of-pocket costs a concern?- Hospital stays - Doctor visits

• What would they change about current insurance carrier?

• What do they look for in an insurance

company?- Price- Service - Financial Security

Medicare Supplement Additional Products

Who Can Buy & When

Who??

Individuals with Medicare Parts A and B - Generally only people 65 and older

Medicare members in your open enrollment period

People covered under a guaranteed issue right

When??

Individuals enrolling in Medicare Parts A and B - 65th Birthday

• During Guaranteed issue period - Up to 6 month before birthday - Up to 6 months after birthday

• If on Medicare Advantage Plan - Leaving service area.

Questions You May Get Asked • Can I get a Medicare Supplement with drugs?

- No! Page 7 “2010 Medigap Book”.

• What plans can I get during guaranteed issue?- Page 23-26 “2010 Medigap Book”.

• What documents will the company ask for during guaranteed issue period?- Page 26 “2010 Medigap Book”.

• Can I switch Medicare supplement plans? “Yes”- Although, companies do NOT have to appect you outside “GI”- *Some cases allow you to switch from Medicare Select to regular plan if relocated outside service area.

* Plan must have same benefits.

Medigap Carriers

Additional Options

• Medicare Advantage Plans

- Can be issued to individuals under 65

- Some come with Rx coverage

- Costs as little as 0 in addition to Part B

- Flexible underwriting

Why David Crotts Agent Support

• One-day turnaround on all individual and group quotes. • The most up-to-date market information

•  Product and sales training, personalized to meet your agency's needs. 

• Professional representative will work with you to close your business accounts across the state.

•  Interactive on-line agent tools. 

Our Commitment ToYou….

As your General Agency’ is to bring you the best the insurance industry has to offer, including unsurpassed personalized service and the latest in online interactive agent tools.

Agent Support Staff

David Crotts “President”

Kara Chastain

“Marketing Manager”

Chris Johnson

“Marketing Representative”

Kathy Clarke

“Support Specialist”

LaNelle Grubbs

“Senior Products Specialist”

The Extra Mile For You

At our Agency we understand the value of deep client relationship. The more you can assist a client the better the value your offering. With that in mind we developed an investment division dedicated to providing you the agent with a trusted source to refer your clients to help them with all their financial planning needs. This includes helping them understand how to organize, control and accumulate their wealth.

Products

• Health “Group & Individual”

• Life “Group & Individual”

 • Short Term Disability

 • Long Term Disability

 

• Medicare Advantage

 • Medicare Supplements

 • Prescription Drug Plans

• Long Term Care

• Critical Illness

The Next StepAs your Agent Support Liaison team, we will

partner with you to develop a marketing strategy that will enhance and grow your

current organization.  

No matter the size or stage of your business, we will enhance your product portfolio,

solidify your client relationships, and lock out the competition, maximizing your profit

potential.

Call: 1-(800)-803-7873 Ext: 237

422 Montague Avenue, Suite #7 ● Greenwood, SC 29649-1961864-223-8788 ● 1-800-803-7873 ● Fax: 864-229-7392

Email: chris.johnson@dcrotts.com ● Web Page: www.dacagentsupport.com