2005 Choosing A Medigap Policy - Gateway Insurance

1 This official government guide can help you Learn what a Medigap (Medicare Supplement Insurance ) Policy is. Decide if you want to buy a Medigap Policy . Understand when you can buy a Medigap Policy . Choose the Medigap Policy that best meets your needs. Understand how Medigap policies willchange when Medicare prescription drugplans start in 2006. Know where to go if you have jointly by the Centers for Medicare & Medicaid Services(CMS) and the National Association of Insurance CommissionersChoosing AMedigap Policy :A Guide to Health Insurancefor People With Medicare2005 How to use this GuideThere are two ways to find the information you need:1. The Table of Contents on pages 1 2 can help youfind the sections you need to The List of Topics on pages 94 97 lists every topic in this Guide and the page number tofind it should read this GuideThis guide was written to help people with the OriginalMedicare Plan understand Medigap (MedicareSupplement Insurance ) Medigap Policy is private Insurance that helps you payfor some of the costs that Medicare doesn t pay for.

2 This guide explains in detail how Medigap policies also includes information about new Medicareprescription drug plans (starting in 2006) and how theseplans will change Medigap you have a Medigap Policy with prescription drugcoverage, you should read pages 39 2005 Choosing A Medigap Policy : A Guide to Health Insurancefor People With Medicare isn t a legal document. The officialMedicare Program provisions are contained in the relevant laws,regulations, and of Contents1 Section 1: How Medicare and MedigapPolicies are Changing3 6 What s NEW in Medicare .. 4 What s NEW in Medigap policies .. 5 Section 2: Medicare Overview7 10 What is Medicare? .. 8 What is Medicare Part A? .. 8 What is Medicare Part B? .. 8 What are Medicare Health Plans? .. 9 Original Medicare Plan and Medigap policies at a glance.

3 9 10 Medicare Advantage Plans at a glance .. 10 Section 3:What You Need to Know About Medigap Policies11 36 What it is and isn 12 14 Why you might need a Medigap Policy .. 14 15 Who can buy a Medigap Policy .. 16 What is Medicare SELECT .. 16 What s not covered by Medigap policies .. 16 How Medigap Plans A through J differ from Medigap Plans K and L .. 17 What Medigap policies cover .. 18 Basic Benefits for Medigap Plans A through J .. 18 Basic Benefits for Medigap Plans K and L .. 19 Overview of Medigap Plans A through 20 Overview of Medigap Plans K and L .. 21 Information on Medigap 22 25 How much policies cost, ways of pricing policies, and what can affect the costBuying a Medigap Policy .. 26 28 Best time to buy and information on Medigap Open Enrollment PeriodPre-existing 29 Creditable coverage (past health care coverage).

4 30 31 Switching Medigap 32 Losing Medigap coverage .. 33 How your bills get 34 Illegal Insurance practices .. 35 Reliable Insurance companies .. 36 Continuedon nextpage Table of Contents2 Section 4: Prescription Drug Coverage Overview37 40 Medicare prescription drug plans .. 38 Medigap policies and Medicare prescription drug plans .. 39 40 Section 5:Steps to Buying a Medigap Policy 41 52 Steps to buying a Medigap Policy .. 42 52 Section 6: Medigap Rights and Protections53 64 Medigap rights and protections (guaranteed issue rights) .. 54 63 Section 7: Medigap Policies and Disability or ESRD65 68 Information on disability and End-Stage Renal Disease .. 66 68 Section 8:Other Ways to Pay Health Care Costs 69 78 Other kinds of Insurance and ways to pay health care costs.

5 70 77 Section 9:Massachusetts, Minnesota, and Wisconsin Medigap Plans79 82 Information for 80 Information for 81 Information for Wisconsin .. 82 For information about Medigap policies sold in other states, see pages 19 and 10:For More Information83 86 Where to get 84 Where to call with Medicare questions .. 84 Important telephone numbers for each state .. 85 86 Section 11:Words to Know87 92 Where words in greenare defined .. 88 91 Section 12:List of Topics93 97An alphabetical list of what is in this Guide .. 94 97 HowMedicareand MedigapPoliciesare ChangingUse this section to find out aboutthe changes in 1: How Medicare and Medigap Policies are ChangingIf you already have a Medigap Policy or you are thinking aboutbuying a Medigap Policy , there are a few things you should knowabout what s new in Medicare and how Medigap policies arechanging.

6 Below is a quick look at these changes. What s NEW in MedicareA new Federal law has brought many new changes to theMedicare Program. The following changes give you even morechoices in how you get your health care benefits, includingcoverage for prescription drugs. Medicare prescription drug coverage Starting in 2006 Enrollment in Medicare prescription drug plans starts in2005. Medicare prescription drug plans will begin coverageon January 1, 2006. New Medicare-covered preventive services Starts in 2005 Cardiovascular screening blood tests Diabetes screening tests Welcome to Medicare physical examTo learn more about Medicare choices or changes, you can get afree copy of the Medicare & You handbook (CMS Pub. ) by visiting on the web. Select SearchTools at the top of the page.

7 This website also includes informationon what Medicare health plans and Medigap policies are availablein your area. Or, call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1: How Medicare and Medigap Policies are ChangingWhat s NEW in Medigap (Medicare SupplementInsurance) policiesNew Medigap policies The new Federal law gives you more choices in Medigap policies. In addition to Medigap Plans A through J, two new Medigap policieswill be offered in 2005 ( Medigap Plans K and L). Below is a quicklook at the two new Medigap Plans K and L will offer different benefits than Medigap Plans A through J. lower premiums than Medigap Plans A through you use the benefits in Medigap Plans K and L, you will have topay higher out-of-pocket costs than Medigap Plans A through , Medigap Plans A through J may be learn about the types of benefits that Medigap Plans K and Loffer, see pages 19 and more information about how Medigap Plans A through J aredifferent from Medigap Plans K and L, see page 17.

8 Note:If you bought your Medigap Policy before 1992 orlive inMassachusetts, Minnesota, or Wisconsin, your Medigap Policy maybe called something to Medigap policies with prescription drug coverage Medicare will start to offer prescription drug coverage starting January 1, 2006. Some Medigap policies offer prescription drugcoverage, and the new Medicare prescription drug coverage willaffect those policies. Beginning January 1, 2006, when Medicare prescription drugplans start, you won t be able to buy a new Medigap policycovering prescription drugs. These same policies may still be sold,but without prescription drug coverage. If the Medigap Policy that you have now covers prescription drugs,you will get detailed information in the mail from your Medigapinsurance company about your drug options (see page 39 andSituation #8on page 62).

9 You will need to decide which drugoption best meets your needs. Help will be :MedigapPlans H, I, and Jare differentfromMedicareprescription drug you live inMassachusetts,Minnesota, orWisconsin, seepages 80 1: How Medicare and Medigap Policies are ChangingWhere can I get more information aboutwhat s new in Medicare and Medigap policies?If you have questions about Medicare, Medicare prescriptiondrug plans, Medigap policies, or other Medicare-relatedquestions, you can visit on the web. Or, call 1-800-MEDICARE (1-800-633-4227). TTY usersshould call 1-877-486-2048. You can also call yourStateHealth Insurance Assistance Program(see pages 85 86).Words in greenare defined onpages 88 Use this section tolearn the basics 2: Medicare OverviewBefore you decide whether or not to buy a Medigap Policy , there are afew things you should know about Medicare and Medicare health next few pages give you a quick look at Medicare and howMedicare health plans work with Medigap you already know the basics about Medicare and Medicare healthplans, turn to Section 3 What You Need to Know About MedigapPolicies, which starts on page you want to learn more about the new Medicare prescription drugplans and how they affect Medigap policies, read Section 4 PrescriptionDrug Coverage Overview, which starts on page is Medicare?

10 Medicare is a health Insurance program for people age 65 or older, people under age 65 with certain disabilities, and people of all ages with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a kidney transplant).Medicare has Medicare Part A (Hospital Insurance ), Medicare Part B (Medical Insurance ), and Medicare prescription drug November 15, 2005, you can enroll in a Medicareprescription drug plan. Medicare prescription drug plans will begin coverage on January 1, 2006. For information about Medicare prescription drug plans, see page is Medicare Part A?Medicare Part A helps cover your inpatient care in hospitals, includingcritical access hospitals, and skilled nursing facilities (not custodial orlong-term care) when they are medically is Medicare Part B?