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Kansas Insurance Department

Medicare supplement

insurance shopper’s guideeffective March 1, 2015

Commissioner of InsuranceKen Selzer, CPA

March 2015

Dear Kansas consumer,

If you have picked up this guide, chances are you are somewhat familiar with Medicare — a federally-funded health insurance program for people with disabilities and people age 65 and older. Although Medicare may pay a large part of your health care expenses, it doesn’t cover every service or medical supply. Medicare recipients are responsible for paying coinsurance and deductibles.

This guide will help you evaluate your health care insurance needs. It will also help you gather accurate information concerning Medicare, Medicare supplement and other health insurance options so you can make decisions that will prevent serious, costly problems.

Toward the middle of this book, you’ll find rate comparisons of companies selling various Medicare supplement insurance plans. These rates were accurate as of March 2015. For the most up-to-date rate comparisons, visit our website, www.ksinsurance.org.

If you have questions or need assistance understanding insurance issues, don’t hesitate to contact the Kansas Insurance Department’s Consumer Assistance Hotline toll-free at 800-432-2484. Our trained staff is dedicated to helping answer your insurance questions and finding solutions to your problems.

Sincerely,

Ken Selzer, CPA Commissioner of Insurance

Medicare supplementinsurance shopper’s guide

Section I: About Medicare Supplement and Medicare SELECT Insurance 2

Overview of Medicare Parts A & B 6 Your Medicare coverage choices at a glance 7 Details of Plans A - N 8 Medicare supplement insurance at a glance 28

Section II: Medicare Supplement andMedicare SELECT Rates 29

Appendix I: About Medicare and Medicare Advantage Plans 41

How is Medicare divided? 42

Appendix II: Consumer Protections and Other Resources 49 Protections when you lose coverage 49 Tips & Warnings 52 Glossary of Terms 54 What you need to know in 2015 56 Customer service phone numbers inside back cover

Table of Contents

Section I: About Medicare Supplement and Medicare SELECT Insurance

What is Medicare supplement insurance?

Medicare supplement insurance can help cover the expenses that come with the gaps in Original Medicare (described in further detail in Appendix 1). This supplemental insurance is also often called “Medigap” because it helps pay for these gaps. Medicare supplement policies can only be pur-chased with Original Medicare - you may not have a Medicare supplement policy if you have a Medicare Advantage plan. The Kansas Insurance Department is responsible for regulating Medicare supplement insurance in the state of Kansas.

Costs that you must pay, like coinsurance, copay-ments and deductibles, are examples of some of the gaps in Original Medicare coverage. You might want to consider buying a Medicare supplement policy to cover these expenses. Some Medicare supple-ment policies also cover benefits that the Original Medicare plan doesn’t cover, like emergency health care while traveling outside the United States. A Medicare supplement policy may help you save on out-of-pocket costs.

How does Medicare supplement insurance work?

Medicare supplement insurance is broken down into plans identified by letters - A, B, C, D, F, G, K, L, M & N. These plans are standardized and must fol-low federal and state laws, which have been created to protect you, the consumer. (Details about each of these plans is available later in this booklet.) These plans are sold by private insurance companies, but all plans identified by the same letter have the same benefits. That is, plans identified as “Plan A” in the state of Kansas are identical, regardless of the company that is selling it. However, the cost of the plan will vary depending on the company that provides it.

All companies in the state of Kansas that wish to sell Medicare supplement insurance must make Plan A available to their customers. If they want to offer additional Medicare supplement plans, they must also offer either Plan C or Plan F. Plan A features the core benefits of a Medicare supplement policy. All other plans build upon this.

How are premium rates determined?

Premium rates for Medicare supplement insurance policies are determined in one of two ways:

Issue age - The company will not raise your premi-um just because you are getting older. Your premi-um will always be based on your age when you pur-chased the policy, but it will be adjusted for other factors, like inflation. If you buy a plan at age 65, you will always pay the current premiums charged to 65-year old customers, regardless of your current age. Issue age policies can be more costly up front but also can save money in the long run.

2015 Medicare Supplement Shopper’s Guide02

Attained age - For rates determined by attained age, the premium will increase as you get older. If you buy a plan at age 65, you may have a premium increase each year.

Enrollment Periods

Medicare supplement enrollment periods differ from other Medicare enrollment periods. Insurers must offer a six-month open enrollment period to all Medicare beneficiaries. This six-month period begins with the first month in which the beneficiary first enrolled for benefits under Medicare Part B (for many people, this is age 65; for others, it be-gins when you lose employer- or group-sponsored health care). During this six-month period, insur-ers are required to offer any Medicare supplement policy to all enrollees, regardless of their health sta-tus. During this time, the same amount is charged to both healthy individuals and those with medical conditions. After this six-month period ends, in-surers are allowed to use medical underwriting to determine whether or not you are accepted into the plan and, if so, how much you will be charged, so it is important to evaluate your options carefully during your first enrollment period. Should you decide to switch to a different Medicare supplement policy after this open enrollment period, you may be subject to medical underwriting.

The six-month open enrollment period for Medicare supplement insurance starts on the same day your Part B Medicare starts. This date is shown on your Medicare card.

Medicare SELECT insurance

Medicare SELECT is another option available to some Kansas Medicare beneficiaries. Medicare SELECT policies are just like standardized Medi-care supplement policies. However, each Medicare SELECT policy has specific hospitals and, in some cases, doctors that you must use in order to be eli-gible for full benefits (except in the case of medical emergencies).

Because the insurers negotiate directly with specific providers (sometimes called “preferred providers”), premium costs for Medicare SELECT plans are gen-erally lower than a standard Medicare supplement policy. When you choose to use a preferred provid-er, Medicare pays its share of the approved charges and the Medicare SELECT policy pays for the full supplemental benefits provided for in the policy.

Beneficiaries with disabilitiesDisabled Medicare beneficiaries under age 65 have equal access to all Medicare supplement policies sold in Kansas.

• Upon enrolling in Medicare Part B, a disabled ben-eficiary has a 6-month open-enrollment period to buy supplement coverage. That period begins the day Part B coverage becomes effective.

• Supplement policies must be sold at the same rate as for seniors who turn 65 and are eligible for Medicare.

• Disabled Medicare beneficiaries cannot be turned down for any Medicare supplement plan being sold in Kansas during the initial 6-month open-enrollment period.

• Coverage will be guaranteed issue, but the same pre-existing condition limitation as applies to age 65 beneficiaries may apply. A second open-enrollment period will apply when the disabled Medicare benefi-ciary turns 65.

2015 Medicare Supplement Shopper’s Guide 03

If you do not want to use the preferred provider, Medicare will still pay its share of approved charges. However, the Medicare SELECT policy would not be required to pay any benefits.

A comparison shopper’s guide for both Medicare supplement policies and Medicare SELECT policies for premium rates is available in Section II of this book.

Services provided under Medicare supplement policies

The following services are provided under Medi-care. Medicare supplement plans help pay for portions of these services not covered by Medicare. The following details, from www.Medicare.gov, will help you determine whether or not you will need a supplement policy.

Hospitalization - Medicare covers a semiprivate room, meals, general nursing, and other hospital services and supplies. This includes care in criti-cal access hospitals and inpatient mental health care. This does not include private duty nursing or a television or telephone in your room. It does not include a private room, unless medically necessary. Medicare does not cover Part A deductible, coin-surance, or coverage after your allotted number of days have been used each benefit period.

Skilled Nursing Facility Care - Medicare covers a semiprivate room, meals, skilled nursing and reha-bilitative services, and other services and supplies (after a related 3-day hospital stay). You must have been admitted to the Medicare-approved nursing

facility within 30 days of leaving the hospital. Medi-care does not cover coinsurance or coverage after 100 days per benefit period.

Blood - Medicare covers pints of blood you get at a hospital or skilled nursing facility during a covered stay after the first three pints. You are responsible for the cost of the first three pints and the Part B deductible.

Hospice Care - Medicare covers medical and sup-port services from a Medicare-approved hospice for people with a terminal illness, drugs for symptom control and pain relief. Hospice care is given in your home. However, short-term hospital and inpatient respite care (care given to a hospice patient by an-other caregiver so that the usual caregiver can rest) are covered when needed. You must have a doctor’s certification of a terminal illness. Medicare does not cover the copayment or coinsurance.

Medical Expenses - Medicare covers doctor ser-vices, outpatient medical and surgical services and supplies, diagnostic tests, ambulatory surgery center facility fees for approved procedures, and durable medical equipment (such as wheelchairs, hospital beds, oxygen, and walkers). It also covers second surgical opinions, outpatient mental health care, outpatient physical and occupational therapy, including speech-language therapy. Medicare does not cover the Part B deductible or coinsurance.

Clinical Laboratory Services - Medicare covers blood tests, urinalysis and other tests for diagnostic services.



Home Health Care - Medicare covers part-time skilled nursing care, physical therapy, occupational therapy, speech-language therapy, home health aide services, medical social services, durable medi-cal equipment (such as wheelchairs, hospital beds, oxygen, and walkers) and medical supplies, and other services. Medicare does not cover the Part B deductible.

The following services are not covered under Medicare, but may be covered by some Medicare supplement plans:

Part B Excess charges - “Excess charges” are not covered under Medicare. If doctors decide not to accept the reimbursement rate they receive from Medicare for providing certain services, they are al-lowed to charge up to 15% more for those covered services. If the doctor you visit is one of these, you will be responsible for paying that 15% above what Medicare covers. The Medicare supplement policy may cover some or all of your expenses above the Medicare approved amounts.

Foreign Travel - Some Medicare supplement poli-cies will cover some of your expenses related to emergency care while traveling outside the United States.

Benefit time frames

Part A of Medicare is based on a “per-benefit pe-riod” timeline. According to Medicare, a “benefit period” begins the day you go into a hospital or skilled nursing facility (SNF). The benefit period ends when you haven’t received any hospital care (or skilled care in a SNF) for 60 days in a row. If you return to the hospital or SNF before the end of that 60 day period, it will be considered part of the same benefit period. If you go into a hospital or a SNF after one benefit period has ended, a new benefit period begins. You must pay the inpatient hospital deductible for each benefit period. There is no limit to the number of benefit periods an enrollee may have.

Part B benefits are based on the calendar year, which begins January 1 of each year and ends De-cember 31.

Overview of Medicare Parts A & B

A B

$157.50 per day coinsurance

$630 per day coinsurance

$315 per day coinsurance

$1,260

Home health hospice100% Services

*Benefit period ends when patient is out of the hospital or skilled nursing

facility for 60 consecutive days.

$147 deductible(the amount you must pay before any

coverage from the insurer)

20% coinsurance

80% of costs(after deductible is met)

Physician’s charges(in or out of hospital)

Durable medical equipment

Ambulance

Outpatient hospital charges

Excess charges

If doctors do not accept Medicare’s reimbursement rate, they are allowed to charge up to 15% more for covered services. If the doctor you visit is one of these, you will be responsible for

paying that 15% above what Medicare covers.

Amount you pay

Amount Medicare pays


In-patient hospital

First 60 days

Days 61-90

Lifetime ReserveDays 91-150

Skilled nursing facility

First 20 days 100% (no copay)

Days 21-100

Your Medicare Coverage Choices at a GlanceThere are two main ways to get your Medicare coverage: Original Medicare (Parts A and B) or a Medicare Advantage Plan (Part C). Use these steps to help you decide which way to get your coverage.

StartStep 1: Decide how you want to get your coverage

orMEDICARE ADVANTAGE

PLAN(like an HMO or PPO)

Part CCombines Part A, Part B and

usually Part D

Step 2: Decide if you need to add drug coverage

Part DPrescription drug coverage

Part DPrescription drug coverage

(if not already included)

END

MedigapMedicare supplement insurance

NOTE: If you join a Medicare Advan-tage Plan, you don’t need a Medicare supplement policy. If you already have a Medicare supplement policy, you can’t use it to pay for out-of-pocket costs you have under a Medicare Advantage Plan. If you already have a Medicare Advan-tage Plan, you can’t be sold a Medicare supplement policy.

ORIGINAL MEDICARE

Part A Hospital insurance

Part B

Medical insurance

Step 3: Decide if you need to add supplemental coverage

Step 2: Decide if you need to add drug coverage

END


For more information on Original Medicare and Medicare Advantage plans, see

Appendix I.

PLAN A

SERVICES MEDICARE PAYS MED SUPP PAYS YOU PAY

Hospitalization

First 60 days All but $1,260 $0$1,260 (Part A

deductible)

Day 61 - Day 90 All but $315 per day $315 per day $0

Day 91 - 150 (while using 60 lifetime reserve days) All but $630 per day $630 per day $0

Additional 365 days $0100% of Medicare eligible

expenses $0

After additional 365 days $0 $0 All costs

Skilled Nursing Facility Care

First 20 days All approved amounts $0 $0

Day 21 - Day 100 All but $157.50 per day $0 Up to $157.50 per day

Day 101 and after $0 $0 All costs

Blood (inpatient)

First 3 pints $0 100% $0

Additional amounts 100% $0 $0

Hospice Care

100%

All but $5

95%

Medicare copayment/coinsurance

$0

$0

$0

Medicare Supplement Plans


Hospice care

Prescription drugs

Inpatient respite care

$5

5%

Benefits if you have Medicare Part A

PLAN ABenefits if you have Medicare Part B


Remainder of Medicare approved amounts Generally 80% Generally 20% $0

Part B Excess Charges $0 All costs$0

Blood (outpatient)


Any unmet Part B deductible ($147) $0 $0 $147 (Part B deductible)

Remainder of Medicare approved amounts 80% 20% $0

Clinical Laboratory Services 100% $0 $0

Home Health CareMedically necessary skilled care services and medical supplies 100% $0 $0

Any unmet Part Bdeductible ($147)

Durable medical equipment:

$0 $0 $147 (Part B deductible)


Benefits not covered under Medicare


Medical Expenses

First $147 of Medicare approved amounts $0 $0 $147 (Part B deductible)

Benefits if you have Medicare Part A and Part B

PLAN B


Hospitalization

First 60 days All but $1,260 $1,260 (Part A deductible) $0




Day 101 and after $0

Blood (inpatient)

First 3 pints


$0 100% $0

Day 91 - 150 (while using 60 lifetime reserve days)

Additional 365 days


$0100% of Medicare eligible

expenses $0

All but $630 per day $630 per day $0

Hospice Care

100%

All but $5

95%

Medicare copayment/coinsurance $0

$0

$0

$0 All costs

Day 21 - Day 100 All but $157.50 per day $0 Up to $157.50 per day


Hospice care

Prescription drugs


$5

5%


PLAN B



Blood (outpatient)


Any unmet Part Bdeductible ($147) $0 $0 $147 (Part B deductible)



Home Health Care

Medically necessary skilled care services and medical supplies 100% $0 $0







Medical Expenses


Benefits if you have Medicare Part B



PLAN C


Hospitalization

First 60 days

Day 61 - Day 90

Day 91 - 150 (while using 60 lifetime reserve days)

Additional 365 days

After additional 365 days $0


First 20 days

Day 21 - Day 100

Day 101 and after $0

Blood (inpatient)

First 3 pints


$0 100% $0

Hospice Care

Medical Expenses

First $147 of Medicare approved amounts $0 $147 (Part B deductible) $0

100%

All but $5

95%


$0

$0

$0 All costs

All but $157.50 per day Up to $157.50 per day $0

All approved amounts $0 $0

$0 All costs

$0100% of Medicare eligible

expenses $0



All but $1,260 $1,260 (Part A deductible) $0


Hospice care

Prescription drugs


$5

5%



PLAN CBenefits if you have Medicare Part B




Blood (outpatient)First 3 pints $0 100% $0

Any unmet Part Bdeductible ($147) $0 $147 (Part B deductible) $0Remainder of Medicare approved amounts 80% 20% $0





$0 $147 (Part B deductible) $0


Foreign TravelFirst $250 per calendar year $0 $0 $250

Remainder of charges $0 80% to a lifetime maximum benefit of $50,000

20% and amounts over the $50,000 lifetime

maximum



Medical ExpensesRemainder of Medicare approved amounts Generally 80% Generally 20% $0

PLAN DBenefits if you have Medicare Part A


Hospitalization





expenses $0




Day 21 - Day 100 All but $157.50 per day Up to $157.50 per day $0


Blood (inpatient)



Hospice Care

100%

All but $5

95%


$0

$0

Benefits if you have Medicare Part BMedical Expenses



Hospice care

Prescription drugs


$5

5%

PLAN DBenefits if you have Medicare Part B
















maximum




PLAN F and HIGH DEDUCTIBLE PLAN F

Benefits if you have Medicare Part ASERVICES MEDICARE PAYS MED SUPP PAYS YOU PAY

Hospitalization





expenses $0







Hospice Care

100%

All but $5

95%


$0

$0

The high deductible Plan F pays the same benefits as Plan F after one has paid a calendar year $2,140 deduct-ible. Benefits from the high deductible Plan F will not begin until out-of-pocket expenses are $2,140. Out-of-pocket expenses for this deductible are expenses that would ordinarily be paid by the policy. This includes the Medicare deductibles for Part A and Part B, but does not include the plan’s separate foreign travel emergency deductible.

First 3 pints $0 100% $0Blood (inpatient)


Hospice care

Prescription drugs


$5

5%

PLAN F and HIGH DEDUCTIBLE PLAN F



Part B Excess Charges $0 $0100%


Any unmet Part Bdeductible ($147) $0 $147 (Part B deductible) $0Remainder of Medicare approved amounts 80% 20% $0










maximum





First $147 of Medicare approved amounts


Medical Expenses

PLAN GBenefits if you have Medicare Part A


Hospitalization





expenses $0






Blood (inpatient)



Hospice Care

100%

All but $5

95%


$0

$0


First $147 of Medicareapproved amounts $0 $0 $147 (Part B deductible)


Hospice care

Prescription drugs


$5

5%

PLAN GBenefits if you have Medicare Part B



Part B Excess Charges $0 $0100%





Home Health Care






Foreign Travel

First $250 per calendar year $0 $0 $250



maximum



Medical Expenses Remainder of Medicare approved amounts Generally 80% Generally 20% $0

PLAN K

Benefits if you have Medicare Part ASERVICES MEDICARE PAYS MED SUPP PAYS YOU PAY

Day 61 - Day 90 All but $315 per day $315 per day $0Day 91 - 150 (while using 60 lifetime reserve days) All but $630 per day $630 per day $0


expenses $0




Day 21 - Day 100 All but $157.50 per dayUp to $78.75 per day (50%

of Part A coinsurance)Up to $78.75 per day (50%

of Part A coinsurance)•


First 3 pints $0 50% 50%•


You will pay half the cost-sharing of some covered services until you reach the annual out-of-pocket limit of $4,940 each calendar year. The amounts that count toward your annual limit are noted with circles (•) in the chart. Once you reach the annual limit, the plan pays 100% of your Medicare copayment and coinsurance for the rest of the calen-dar year. However, this limit does NOT include charges from your provider that exceed Medicare-approved amounts (these are called “Excess Charges”) and you will be responsible for paying this difference in the amount charged by your provider and the amount paid by Medicare for the item or service. Once you have been billed $147 of Medicare-approved amounts for covered services, your Part B deductible will have been met for the calendar year.

Hospitalization

First 60 days All but $1,260$630 (50% of Part A

deductible)$630 (50% of Part A

deductible)•

Blood (inpatient)


Hospice Care

100%

All but $5

95%

50% of copayment/coinsurance

50% of Medicare copayment/coinsurance•

Hospice care

Prescription drugs


PLAN KBenefits if you have Medicare Part B


Remainder of Medicare approved amounts Generally 80% Generally 10% Generally 10%•

Remainder of Medicare approved amounts Generally 80% Generally 10% Generally 10%•

Any unmet Part Bdeductible ($147) $0 $0 $147 (Part B deductible)•


Home Health Care





$0 $0 $147 (Part B deductible)•

Remainder of Medicare approved amounts 80% 10% 10%•

Medical Expenses

Part B Excess Charges $0 All costs (and they do not count toward annual out-of-pocket limit of $4,940)

$0


First 3 pints $0 50% 50%•

Blood (outpatient)


First $147 of Medicare approved amounts

$0 $0 $147 (Part B deductible)•

PLAN L





expenses $0



Day 21 - Day 100 All but $157.50 per dayUp to $118.13 per day (75%

of Part A coinsurance)Up to $39.37 per day (25% of Part A coinsurance) n



Hospice Care

100%

All but $5

95%

75% of copayment/coinsurance

25% of Medicare copyament/

coinsurance n

You will pay one-fourth of the cost-sharing of some covered services until you reach the annual out-of-pocket limit of $2,470 each calendar year. The amounts that count toward your annual limit are noted with a square (n) in the chart. Once you reach the annual limit, the plan pays 100% of your Medicare copayment and coinsurance for the rest of the calendar year. However, this limit does NOT include charges from your provider that exceed Medicare-approved amounts (these are called “Excess Charges”) and you will be responsible for paying this difference in the amount charged by your provider and the amount paid by Medicare for the item or service. Once you have been billed $147 of Medicare-approved amounts for covered services, your Part B deductible will have been met for the calendar year.



deductible) n

Hospitalization

All approved amounts $0 $0First 20 days

First 3 pints $0 75% 25% n

Blood (inpatient)


Hospice care

Prescription drugs



PLAN LBenefits if you have Medicare Part B


Remainder of Medicare approved amounts Generally 80% Generally 15% Generally 5% n

Remainder of Medicare Approved Amounts Generally 80% Generally 15% Generally 5% n

Any unmet Part Bdeductible ($147) $0 $0

$147 (Part B deductible) n


Medical Expenses

First 3 pints $0 75% 25% nBlood (outpatient)

Benefits if you have Medicare Part A and Part BHome Health Care




$0 $0 $147 (Part B deductible) n

Remainder of Medicare approved amounts 80% 15% 5% n

Part B Excess Charges $0 All costs (and they do not count toward annual out-of-pocket limit of $2,470)

$0



First $147 of Medicare approved amounts $0 $0

$147 (Part B deductible) n

PLAN MBenefits if you have Medicare Part A


Hospitalization



deductible)




expenses $0






Blood (inpatient)



Hospice Care

100%

All but $5

95%


$0

$0




Hospice care

Prescription drugs


$5

5%

PLAN MBenefits if you have Medicare Part B



Blood (outpatient)First 3 pints $0 100% $0Any unmet Part Bdeductible ($147) $0 $0 $147 (Part B deductible)Remainder of Medicare approved amounts 80% 20% $0


Home Health Care









maximum





PLAN NBenefits if you have Medicare Part A





expenses $0





Hospice Care

100%

All but $5

95%


$0

$0



Hospitalization



Blood (inpatient)$0 100% $0First 3 pints


Hospice care

Prescription drugs


$5

5%



Blood (outpatient)$0 100% $0First 3 pints

PLAN NBenefits if you have Medicare Part B


Benefits if you have Medicare Part A and Part BHome Health Care







Foreign Travel

First $250 per calendar year $0 $0 $250

Remainder of charges $080% to a lifetime maximum

benefit of $50,00020% and amounts over the $50,000 lifetime maximum

Other benefits not covered under Medicare


Remainder of Medicare approved amounts

Generally 80% Generally 20% of the balance, other than up to $20 per office visit and up to $50 per emer-gency room visit. The copay-ment of up to $50 is waived if the insured is admitted to any hospital and the emergency visit is covered as a Medicare Part A expense.

Up to $20 per office visit and up to $50 per emergency room visit. The copayment of up to $50 is waived if the insured is admitted to any hospital and the emergency visit is covered as a Medicare Part A expense.

Medical Expenses

$0 $0 $147 (Part B deductible)First $147 of Medicare approved amounts


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Plan AIssue age policies - annual premium

Section II: Medicare Supplement and Medicare SELECT Insurance Rates

A note about these ratesPremium quotes listed here are for a nonsmoking man living in the 66612 ZIP code and are broken into four age categories. Premiums may vary according to your age or the area in which you live. Additionally, these rates may have changed since March 2015, when these rates were compiled. An-nual costs may be higher if premiums are paid in installments. Contact the insurance company to find out exact premiums.

DisclaimerThis shopper’s guide does not recommend or endorse any insurance company or policy. It is de-signed to help you comparison shop for coverage to supplement your Medicare benefits. Contact the Kansas Insurance Department’s Consumer Assistance Hotline if you have any questions about how to use this guide: 800-432-2484.


Company Age 65 Age 70 Age 75 Age 80Bankers Fidelity Life Insurance Company $1,344 $1,500 $1,680 $1,812 Everence Association Inc. $1,575 $1,703 $1,786 $1,894

Old Surety Life Insurance Company $1,114 $1,376 $1,620 $1,822 Transamerica Life Insurance Company $1,169 $1,495 $1,862 $2,207

Attained age policies - annual premiumCompany Age 65 Age 70 Age 75 Age 80

Aetna Health and Life Insurance Company $1,312 $1,414 $1,563 $1,669Aetna Life Insurance Company $1,521 $1,816 $2,093 $2,262 American Continental Insurance Company $1,544 $1,750 $2,045 $2,252

American Family Life Assurance Co. of Columbus $1,738 $2,058 $2,276 $2,389 American Republic Corp Insurance Company $1,896 $2,124 $2,531 $2,844 American Republic Insurance Company $1,424 $1,485 $1,800 $2,109American Retirement Life Insurance Company $1,403 $1,650 $1,898 $2,133Blue Cross & Blue Shield of Kansas City $1,356 $1,860 $2,256 $2,688 Blue Cross and Blue Shield of Kansas, Inc. $1,286 $1,501 $1,752 $2,047 Central States Indemnity Company of Omaha $1,277 $1,449 $1,721 $1,956 Christian Fidelity Life Insurance Company $1,392 $1,648 $1,959 $2,135 Colonial Penn Life Insurance Company $1,892 $2,311 $2,813 $3,288 Combined Insurance Company of America $1,470 $1,736 $1,922 $2,037

Attained age policies - annual premiumPlan A (cont’d)


Company Age 65 Age 70 Age 75 Age 80Coventry Health and Life Insurance Co $1,259 $1,470 $1,716 $1,997Equitable Life & Casualty Insurance Company $1,426 $1,527 $1,671 $1,771Family Life Insurance Company $1,533 $1,823 $2,168 $2,462 First Health Life and Health Insurance Company $1,335 $1,527 $1,698 $1,799Forethought Life Insurance Company $1,563 $1,712 $1,917 $2,097Gerber Life Insurance Company $1,603 $1,897 $2,103 $2,234Globe Life & Accident Insurance Company $946 $1,264 $1,344 $1,349Government Personnel Mutual Life Insurance Co. $1,301 $1,424 $1,596 $1,745Guarantee Trust Life Insurance Company $1,174 $1,367 $1,562 $1,683Heartland National Life Insurance Company $1,357 $1,658 $1,890 $2,038Humana Insurance Company $1,733 $2,109 $2,565 $3,032Individual Assurance Co Life, Health, Accident $1,483 $1,669 $1,920 $2,140KSKJ Life, American Slovenian Catholic Union $1,515 $1,803 $2,139 $2,431Liberty National Life Insurance Company $1,949 $2,478 $2,693 $2,702

Loyal American Life Insurance Company $1,623 $1,639 $1,806 $1,910Manhattan Life Insurance Company (The) $1,229 $1,388 $1,641 $1,903Marquette National Life Insurance Company $1,575 $1,979 $2,181 $2,212Medico Corp Life Insurance Company $1,326 $1,398 $1,673 $1,965

Medico Insurance Company $1,373 $1,507 $1,704 $1,794

Order of United Commercial Travelers of America $1,658 $1,840 $2,168 $2,479

Oxford Life Insurance Company $1,392 $1,649 $1,960 $2,135Pekin Life Insurance Company $1,243 $1,359 $1,513 $1,673Philadelphia American Life Insurance Company $1,273 $1,307 $1,529 $1,685Physicians Mutual Insurance Company $1,889 $2,173 $2,353 $2,503Reserve National Insurance Company $1,304 $1,549 $1,822 $2,112Sentinel Security Life Insurance Company $1,653 $1,890 $2,117 $2,315Shenandoah Life Insurance Company $1,376 $1,520 $1,819 $2,054Standard Life & Accident Insurance Company $2,502 $2,565 $2,747 $3,260State Farm Mutual Automobile Insurance Co. $1,308 $1,648 $1,919 $2,144State Mutual Insurance Company $1,596 $1,899 $2,254 $2,562Sterling Life Insurance Company $1,920 $2,192 $2,432 $2,565Stonebridge Life Insurance Company $973 $1,100 $1,333 $1,541Thrivent Financial for Lutherans $1,150 $1,366 $1,571 $1,675United American Insurance Company $1,554 $1,973 $2,139 $2,145United National Life Insurance Co. of America $1,638 $1,827 $2,104 $2,257United World Life Insurance Company $1,181 $1,342 $1,561 $1,703UnitedHealthcare Insurance Company $1,029 $1,249 $1,470 $1,470UnitedHealthcare Insurance Company $1,314 $1,536 $1,717 $1,738USAA Life Insurance Company $1,138 $1,330 $1,585 $1,840


Plan BIssue age policies - annual premium

Company Age 65 Age 70 Age 75 Age 80Transamerica Life Insurance Company $1,544 $1,974 $2,458 $2,914


Aetna Health and Life Insurance Company $1,485 $1,617 $1,827 $2,024Aetna Life Insurance Company $1,684 $2,065 $2,455 $2,790American Continental Insurance Company $1,948 $2,206 $2,575 $2,835Central States Indemnity Company of Omaha $1,491 $1,692 $2,009 $2,284Colonial Penn Life Insurance Company $1,994 $2,427 $2,937 $3,435Family Life Insurance Company $1,865 $2,220 $2,634 $2,993First Health Life and Health Insurance Company $1,522 $1,775 $2,022 $2,226Globe Life & Accident Insurance Company $1,445 $1,794 $2,075 $2,098Humana Insurance Company $1,886 $2,295 $2,792 $3,300KSKJ Life, American Slovenian Catholic Union $1,843 $2,192 $2,602 $2,957

Liberty National Life Insurance Company $2,709 $3,498 $3,907 $3,972Order of United Commercial Travelers of America $1,934 $2,147 $2,531 $2,893Sentinel Security Life Insurance Company $1,829 $2,093 $2,372 $2,636

Standard Life & Accident Insurance Company $2,849 $2,920 $3,128 $3,711

State Mutual Insurance Company $1,863 $2,214 $3,953 $2,989Sterling Life Insurance Company $2,241 $2,617 $2,980 $3,240Thrivent Financial for Lutherans $1,289 $1,548 $1,826 $2,026

United American Insurance Company $2,500 $3,225 $3,590 $3,643

United World Life Insurance Company $1,858 $2,112 $2,457 $2,680

UnitedHealthcare Insurance Company $1,483 $1,800 $2,118 $2,118

Plan CIssue age policies - annual premium


Attained age policies - annual premium Company Age 65 Age 70 Age 75 Age 80

American Family Life Assurance Co of Columbus $2,097 $2,528 $2,909 $3,271Blue Cross & Blue Shield of Kansas City $2,016 $2,772 $3,372 $4,008Blue Cross and Blue Shield of Kansas, Inc. $1,667 $1,963 $2,371 $2,911Central States Indemnity Company of Omaha $1,784 $2,027 $2,438 $2,771Coventry Health and Life Insurance Co. $2,032 $2,391 $2,889 $3,616


Plan C (cont’d)

Company Age 65 Age 70 Age 75 Age 80Everence Association, Inc. $2,315 $2,739 $3,079 $3,325Family Life Insurance Company $2,139 $2,552 $3,071 $3,492Forethought Life Insurance Company $2,060 $2,265 $2,579 $2,879

Government Personnel Mutual Life Ins. Co. $1,763 $1,939 $2,210 $2,469Guarantee Trust Life Insurance Company $1,689 $1,962 $2,264 $2,515Humana Insurance Company $2,216 $2,696 $3,281 $3,877KSKJ Life, American Slovenian Catholic Union $2,093 $2,497 $3,005 $3,415

Manhattan Life Insurance Company (The) $1,648 $1,861 $2,201 $2,552

Order of United Commercial Travelers of America $2,314 $2,572 $3,072 $3,511

Reserve National Insurance Company $1,937 $2,301 $2,706 $3,136

Sentinel Security Life Insurance Company $2,242 $2,573 $2,933 $3,280Standard Life & Accident Insurance Company $3,239 $3,320 $3,556 $4,220

State Farm Mutual Automobile Insurance Co. $1,972 $2,485 $2,879 $3,234

State Mutual Insurance Company $2,230 $2,653 $3,191 $3,629

Sterling Life Insurance Company $2,571 $2,979 $3,379 $3,671

Thrivent Financial for Lutherans $1,523 $1,805 $2,143 $2,512



UnitedHealthcare Insurance Company $1,793 $2,178 $2,562 $2,562

Plan DIssue age policies - annual premium


Attained age policies - annual premium


American Family Life Assurance Co of Columbus $1,889 $2,278 $2,635 $2,982Family Life Insurance Company $1,958 $2,328 $2,763 $3,141Heartland National Life Insurance Company $1,707 $2,121 $2,486 $2,793KSKJ Life, American Slovenian Catholic Union $1,711 $2,034 $2,416 $2,747Marquette National Life Insurance Company $1,771 $2,268 $2,671 $2,996Order of United Commercial Travelers of America $2,027 $2,251 $2,653 $3,034Sentinel Security Life Insurance Company $1,693 $1,944 $2,221 $2,491Standard Life & Accident Insurance Company $1,952 $2,001 $2,143 $2,543State Mutual Insurance Company $1,953 $2,322 $2,756 $3,133


Plan D (cont’d)Attained age policies - annual premium

Company Age 65 Age 70 Age 75 Age 80Thrivent Financial for Lutherans $1,311 $1,586 $1,917 $2,275


United National Life Insurance Co. of America $1,939 $2,191 $2,589 $2,882


Plan FIssue age policies - annual premium

Company Age 65 Age 70 Age 75 Age 80Bankers Fidelity Life Insurance Company $1,872 $2,076 $2,316 $2,520Everence Association Inc. $2,671 $2,897 $3,071 $3,324Old Surety Life Insurance Company $1,611 $1,887 $2,100 $2,300Transamerica Life Insurance Company $1,837 $2,350 $2,992 $3,467


Aetna Health and Life Insurance Company $1,732 $1,892 $2,154 $2,412Aetna Life Insurance Company $1,950 $2,404 $2,880 $3,307American Continental Insurance Company $2,261 $2,537 $2,916 $3,153American Family Life Assurance Co. of Columbus $2,142 $2,589 $2,980 $3,355American Republic Corp Insurance Company $2,606 $2,919 $3,478 $3,909American Republic Insurance Company $2,034 $2,121 $2,571 $3,012American Retirement Life Insurance Company $1,730 $2,019 $2,352 $2,726Blue Cross & Blue Shield of Kansas City $2,028 $2,772 $3,384 $4,020

Blue Cross and Blue Shield of Kansas, Inc. $1,733 $2,040 $2,463 $3,025

Central States Indemnity Company of Omaha $1,850 $2,080 $2,490 $2,811

Christian Fidelity Life Insurance Company $1,567 $1,865 $2,175 $2,513Colonial Penn Life Insurance Company $2,329 $2,822 $3,425 $4,086Combined Insurance Company of America $1,712 $2,021 $2,447 $2,776Coventry Health and Life Insurance Company $2,057 $2,421 $2,923 $3,646Equitable Life & Casualty Insurance Company $1,902 $2,050 $2,253 $2,401Family Life Insurance Company $2,045 $2,402 $2,877 $3,248

Colonial Penn Life Insurance Company $2,469 $2,992 $3,631 $4,442Combined Insurance Company of America $1,764 $2,081 $2,521 $2,859Coventry Health and Life Insurance Company $2,201 $2,590 $3,128 $3,616Equitable Life & Casualty Insurance Company $2,131 $2,297 $2,524 $2,690Family Life Insurance Company $2,229 $2,619 $3,135 $3,541First Health Life and Health Insurance Company $1,775 $2,082 $2,389 $2,658


Plan F (cont’d)Attained age policies - annual premium

Company Age 65 Age 70 Age 75 Age 80Forethought Life Insurance Company $2,110 $2,321 $2,642 $2,949Gerber Life Insurance Company $2,263 $2,682 $3,027 $3,286

Globe Life & Accident Insurance Company $1,697 $2,061 $2,422 $2,595

Government Personnel Mutual Life Ins. Co. $1,805 $1,986 $2,262 $2,529

Heartland National Life Insurance Company $1,994 $2,415 $2,792 $3,100Humana Insurance Company $2,261 $2,751 $3,348 $3,956Individual Assurance Co Life, Health, Accident $1,749 $1,956 $2,278 $2,621KSKJ Life, American Slovenian Catholic Union $2,181 $2,562 $3,068 $3,463Liberty National Life Insurance Company $2,820 $3,666 $4,201 $4,587Loyal American Life Insurance Company $1,996 $2,096 $2,368 $2,655Manhattan Life Insurance Company (The) $1,640 $1,854 $2,190 $2,540Marquette National Life Insurance Company $2,078 $2,597 $3,015 $3,355Medico Corp Life Insurance Company $1,700 $1,793 $2,145 $2,519Medico Insurance Company $1,860 $2,068 $2,432 $2,777Order of United Commercial Travelers of America $2,398 $2,640 $3,138 $3,564Oxford Life Insurance Company $1,568 $1,865 $2,176 $2,514Pekin Life Insurance Company $1,557 $1,740 $2,027 $2,349Philadelphia American Life Insurance Company $1,827 $1,944 $2,225 $2,435Physicians Mutual Insurance Company $2,858 $3,346 $4,011 $4,650Reserve National Insurance Company $1,691 $2,009 $2,362 $2,738Sentinel Security Life Insurance Company $2,097 $2,407 $2,743 $3,067Shenandoah Life Insurance Company $1,759 $1,943 $2,326 $2,626Standard Life & Accident Insurance Company $2,664 $2,730 $2,925 $3,470State Farm Mutual Automobile Insurance Co. $1,992 $2,510 $2,908 $3,267State Mutual Insurance Company $2,318 $2,724 $3,259 $3,681Sterling Life Insurance Company $2,453 $2,843 $3,224 $3,502Stonebridge Life Insurance Company $1,644 $1,858 $2,253 $2,604Thrivent Financial for Lutherans $1,531 $1,813 $2,154 $2,524United American Insurance Company $2,758 $3,578 $4,091 $4,449United National Life Insurance Co. of America $2,362 $2,642 $3,087 $3,410United World Life Insurance Company $2,268 $2,578 $2,999 $3,271UnitedHealthcare Insurance Company $1,804 $2,190 $2,577 $2,577UnitedHealthcare Insurance Company $1,767 $2,128 $2,561 $2,932USAA Life Insurance Company $1,734 $2,032 $2,424 $2,807

Plan F (high deductible)Issue age policies - annual premium

Company Age 65 Age 70 Age 75 Age 80Bankers Fidelity Life Insurance Company $552 $624 $696 $756



Aetna Health and Life Insurance Company $692 $757 $861 $965American Continental Insurance Company $889 $998 $1,146 $1,241American Republic Corp Insurance Company $839 $940 $1,120 $1,259American Republic Insurance Company $813 $848 $1,028 $1,205Colonial Penn Life Insurance Company $466 $565 $686 $818Globe Life & Accident Insurance Company $358 $489 $617 $763

Humana Insurance Company $712 $866 $1,054 $1,246Liberty National Life Insurance Company $519 $710 $979 $1,205Medico Corp Life Insurance Company $510 $538 $643 $756Pekin Life Insurance Company $638 $715 $832 $965Philadelphia American Life Insurance Company $538 $608 $731 $891Physicians Mutual Insurance Company $533 $680 $864 $1,080Reserve National Insurance Company $532 $631 $742 $861Standard Life & Accident Insurance Company $387 $397 $425 $505State Mutual Insurance Company $911 $1,071 $1,281 $1,448Thrivent Financial for Lutherans $456 $561 $694 $843United American Insurance Company $434 $592 $746 $923UnitedHealthcare Insurance Company $569 $724 $921 $1,111

Plan GIssue age policies - annual premium


Plan F (high deductible) (cont’d)


Aetna Health and Life Insurance Company $1,594 $1,743 $1,994 $2,245Aetna Life Insurance Company $1,767 $2,191 $2,638 $3,054American Continental Insurance Company $1,924 $2,177 $2,544 $2,802American Family Life Assurance Co of Columbus $1,919 $2,324 $2,693 $3,052American Retirement Life Insurance Company $1,488 $1,766 $2,086 $2,436Bankers Fidelity Life Insurance Company $1,296 $1,524 $1,824 $2,064Colonial Penn Life Insurance Company $1,854 $2,283 $2,810 $3,389Family Life Insurance Company $1,965 $2,340 $2,778 $3,157First Health Life and Health Insurance Company $1,625 $1,913 $2,204 $2,466Forethought Life Insurance Company $1,634 $1,798 $2,050 $2,294Gerber Life Insurance Company $1,739 $2,061 $2,331 $2,539

Government Personnel Mutual Life Ins. Co. $1,418 $1,561 $1,793 $1,997Heartland National Life Insurance Company $1,767 $2,196 $2,575 $2,888


Plan G (cont’d)

Company Age 65 Age 70 Age 75 Age 80Individual Assurance Co Life, Health, Accident $1,429 $1,618 $1,911 $2,216KSKJ Life, American Slovenian Catholic Union $1,462 $1,739 $2,066 $2,347Loyal American Life Insurance Company $1,742 $1,855 $2,116 $2,393Manhattan Life Insurance Company (The) $1,358 $1,537 $1,817 $2,114Marquette National Life Insurance Co. $1,874 $2,399 $2,823 $3,169Medico Corp Life Insurance Company $1,582 $1,675 $2,029 $2,399Order of United Commercial Travelers of America $2,038 $2,263 $2,668 $3,050Pekin Life Insurance Company $1,357 $1,519 $1,776 $2,070Philadelphia American Life Insurance Co. $1,533 $1,692 $1,977 $2,194Physicians Mutual Insurance Company $1,906 $2,231 $2,676 $3,102Reserve National Insurance Company $1,476 $1,753 $2,062 $2,390Shenandoah Life Insurance Company $1,421 $1,567 $1,876 $2,119Standard Life & Accident Insurance Company $1,967 $2,016 $2,159 $2,562State Mutual Insurance Company $1,961 $2,336 $2,773 $3,150Sterling Life Insurance Company $2,236 $2,599 $2,957 $3,225

Stonebridge Life Insurance Company $1,516 $1,714 $2,077 $2,401Thrivent Financial for Lutherans $1,319 $1,595 $1,927 $2,290United American Insurance Company $2,515 $3,456 $3,979 $4,347United National Life Insurance Co. of America $1,819 $2,053 $2,427 $2,698United World Life Insurance Company $1,952 $2,219 $2,582 $2,816UnitedHealthcare Insurance Company $1,592 $1,945 $2,362 $2,722

Attained age policies - annual premium

Plan KIssue age policies - annual premium

Company Age 65 Age 70 Age 75 Age 80Transamerica Life Insurance Company $841 $1,076 $1,340 $1,588


American Republic Corp Insurance Company $1,133 $1,269 $1,512 $1,700Bankers Fidelity Life Insurance Company $768 $900 $1,080 $1,200Blue Cross and Blue Shield of Kansas, Inc. $886 $1,043 $1,260 $1,548Colonial Penn Life Insurance Company $753 $918 $1,154 $1,425Humana Insurance Company $1,016 $1,237 $1,504 $1,778Sterling Life Insurance Company $962 $1,121 $1,280 $1,401UnitedHealthcare Insurance Company $580 $704 $828 $828UnitedHealthcare Insurance Company $837 $988 $1,147 $1,199


Plan LIssue age policies - annual premium

Company Age 65 Age 70 Age 75 Age 80Everence Association Inc. $1,437 $1,573 $1,678 $1,823Transamerica Life Insurance Company $1,249 $1,597 $1,988 $2,357


American Republic Corp Insurance Company $1,561 $1,748 $2,083 $2,341Colonial Penn Life Insurance Company $1,453 $1,742 $2,128 $2,559Humana Insurance Company $1,445 $1,757 $2,138 $2,527Thrivent Financial for Lutherans $939 $1,137 $1,375 $1,635UnitedHealthcare Insurance Company $1,077 $1,308 $1,539 $1,539UnitedHealthcare Insurance Company $1,151 $1,388 $1,678 $1,932

Plan MIssue age policies - annual premium



Colonial Penn Life Insurance Company $1,823 $2,260 $2,795 $3,344Coventry Health and Life Insurance Company $1,621 $1,909 $2,306 $2,886

Family Life Insurance Company $1,761 $2,095 $2,487 $2,827Heartland National Life Insurance Company $1,597 $1,983 $2,321 $2,592KSKJ Life, American Slovenian Catholic Union $1,539 $1,831 $2,174 $2,471State Mutual Insurance Company $1,756 $2,092 $2,481 $2,821Thrivent Financial for Lutherans $1,239 $1,493 $1,793 $2,106United World Life Insurance Company $1,595 $1,812 $2,109 $2,300

Plan NIssue age policies - annual premium




Aetna Health and Life Insurance Company $1,250 $1,371 $1,573 $1,784Aetna Life Insurance Company $1,405 $1,748 $2,117 $2,471American Continental Insurance Company $1,528 $1,729 $2,023 $2,227

American Family Life Assurance Co of Columbus $1,472 $1,784 $2,080 $2,372American Retirement Life Insurance Company $1,185 $1,399 $1,656 $1,949Blue Cross & Blue Shield of Kansas City $1,680 $2,268 $2,796 $3,300Blue Cross and Blue Shield of Kansas, Inc. $1,288 $1,516 $1,830 $2,248Central States Indemnity Company of Omaha $1,295 $1,456 $1,743 $1,967Christian Fidelity Life Insurance Company $1,135 $1,338 $1,594 $1,838Colonial Penn Life Insurance Company $1,254 $1,597 $2,045 $2,536Combined Insurance Company of America $1,507 $1,786 $2,028 $2,218Coventry Health and Life Insurance Company $1,587 $1,868 $2,257 $2,825Equitable Life & Casualty Insurance Company $1,340 $1,447 $1,587 $1,693Everence Association Inc. $1,323 $1,587 $1,799 $1,965Family Life Insurance Company $1,431 $1,682 $2,012 $2,273First Health Life and Health Insurance Company $1,253 $1,481 $1,715 $1,934Forethought Life Insurance Company $1,374 $1,514 $1,731 $1,944Government Personnel Mutual Life Ins. Co. $1,239 $1,365 $1,563 $1,758Guarantee Trust Life Insurance Company $1,166 $1,375 $1,620 $1,832Heartland National Life Insurance Company $1,376 $1,698 $2,000 $2,260Humana Insurance Company $1,334 $1,623 $1,975 $2,334Individual Assurance Co Life, Health, Accident $1,208 $1,363 $1,614 $1,885KSKJ Life, American Slovenian Catholic Union $1,193 $1,402 $1,678 $1,894Liberty National Life Insurance Company $2,326 $3,092 $3,598 $3,993Loyal American Life Insurance Company $1,616 $1,692 $1,926 $2,191Manhattan Life Insurance Company (The) $1,101 $1,270 $1,536 $1,812Marquette National Life Insurance Company $1,408 $1,836 $2,213 $2,555Medico Corp Life Insurance Company $1,204 $1,275 $1,544 $1,826

Medico Insurance Company $1,315 $1,476 $1,756 $2,040Order of United Commercial Travelers of America $1,679 $1,848 $2,196 $2,495Oxford Life Insurance Company $1,135 $1,338 $1,595 $1,838Pekin Life Insurance Company $1,100 $1,241 $1,469 $1,725Philadelphia American Life Insurance Co. $1,279 $1,361 $1,558 $1,704Physicians Mutual Insurance Company $1,649 $2,010 $2,470 $2,927Reserve National Insurance Company $1,336 $1,587 $1,866 $2,164Sentinel Security Life Insurance Company $1,219 $1,399 $1,602 $1,802Shenandoah Life Insurance Company $1,164 $1,284 $1,537 $1,736Standard Life & Accident Insurance Company $1,285 $1,317 $1,411 $1,674State Mutual Insurance Company $1,621 $1,906 $2,281 $2,578Sterling Life Insurance Company $1,272 $1,482 $1,690 $1,848

Plan N (cont’d)


Attained age policies - annual premium (cont’d)

SELECT Plan AAttained age policies - annual premium

Company Age 65 Age 70 Age 75 Age 80Sterling Life Insurance Company $1,636 $1,860 $2,055 $2,155

Company Age 65 Age 70 Age 75 Age 80Stonebridge Life Insurance Company $1,267 $1,432 $1,736 $2,006United American Insurance Company $2,108 $2,805 $3,254 $3,601United National Life Insurance Co of America $1,252 $1,411 $1,659 $1,878United World Life Insurance Company $1,785 $2,029 $2,361 $2,575UnitedHealthcare Insurance Company $1,233 $1,497 $1,761 $1,761UnitedHealthcare Insurance Company $1,184 $1,491 $1,851 $2,164USAA Life Insurance Company $1,248 $1,463 $1,744 $2,020

SELECT Plan BAttained age policies - annual premium

Company Age 65 Age 70 Age 75 Age 80Blue Cross & Blue Shield of Kansas City $1,368 $1,872 $2,280 $2,712Sterling Life Insurance Company $1,778 $2,040 $2,278 $2,420

SELECT Plan CAttained age policies - annual premium

Company Age 65 Age 70 Age 75 Age 80Blue Cross & Blue Shield of Kansas City $1,716 $2,352 $2,868 $3,396Blue Cross and Blue Shield of Kansas, Inc. $1,186 $1,396 $1,677 $2,053Sentinel Security Life Insurance Company $1,794 $2,059 $2,346 $2,624Sterling Life Insurance Company $2,074 $2,369 $2,643 $2,818UnitedHealthcare Insurance Company $1,487 $1,805 $2,124 $2,124

SELECT Plan DAttained age policies - annual premium

Company Age 65 Age 70 Age 75 Age 80Sentinel Security Life Insurance Company $1,355 $1,555 $1,776 $1,993


SELECT Plan FAttained age policies - annual premium

Company Age 65 Age 70 Age 75 Age 80Blue Cross & Blue Shield of Kansas City $1,728 $2,364 $2,880 $3,408Blue Cross and Blue Shield of Kansas, Inc. $1,260 $1,483 $1,783 $2,182Sentinel Security Life Insurance Company $1,837 $2,108 $2,403 $2,686Sterling Life Insurance Company $1,825 $2,084 $2,325 $2,480UnitedHealthcare Insurance Company $1,495 $1,816 $2,136 $2,136

SELECT Plan GAttained age policies - annual premium

Company Age 65 Age 70 Age 75 Age 80Sterling Life Insurance Company $1,645 $1,883 $2,105 $2,251

SELECT Plan KAttained age policies - annual premium

Company Age 65 Age 70 Age 75 Age 80Blue Cross and Blue Shield of Kansas, Inc. $701 $825 $996 $1,224Sterling Life Insurance Company $745 $854 $956 $1,024

SELECT Plan NAttained age policies - annual premium

Company Age 65 Age 70 Age 75 Age 80Blue Cross & Blue Shield of Kansas City $1,368 $1,872 $2,280 $2,712Sentinel Security Life Insurance Company $1,164 $1,120 $1,282 $1,442Sterling Life Insurance Company $1,219 $1,397 $1,564 $1,676


Appendix I: About Medicare and Medicare Advantage Plans

What is Medicare?Medicare is a federally-run health insurance pro-gram administered by the Centers for Medicare and Medicaid Services (CMS). In order to be eligible to receive Medicare, you must meet at least one of the following criteria: • be age 65 or older • have permanent kidney failure • have a Medicare-qualified disability

The Kansas Insurance Department has no direct regulatory authority over Medicare.

How does Medicare work?

There are four separate parts to Medicare: Part A (Hospital Insurance), Part B (Medical Insurance), Part C (Medicare Advantage plans) and Part D (Prescrip-tion Drug Coverage). Each of these parts covers specific services (see graph on next page).

When you near your 65th birthday, you should contact Medicare to see about enrolling in Part A coverage. You will also have the option to enroll in Part B and Part D at this time. For most people, en-rollment in Part A is automatic and comes without cost - the Medicare taxes you’ve paid while you’ve worked take care of this premium. However, most people will need to pay a monthly premium for Part B, Part C and Part D.

Medicare enrollment

Some people qualify for automatic enrollment in Medicare, while others must apply for enrollment.

Applied enrollment - If you are not receiving Social Security or Railroad Retirement Board (RRB) benefits (for example, if you are still working), you will need to apply to receive Part A and Part B. You can contact the Social Security office 3 months

before your 65th birthday to receive this coverage. Individuals with End-Stage Renal Disease (ESRD) should also contact their local Social Security office to sign up for Parts A and B. If you want Part C and/or Part D, you must apply for it - there is no auto-matic enrollment.

Automatic enrollment - Automatic enrollment in Part A and Part B occurs if you are already receiving benefits from Social Security or the RRB. This cover-age begins the first day of the month that you turn 65 years old. If your birthday falls on the first day of the month, your coverage will begin the first day of the month before you turn 65. Individuals under age 65 and disabled will automatically be enrolled in Part A and Part B after receiving disability benefits from Social Security (or some other limited sources) for 24 months. NOTE: Three months before your 65th birthday you will receive your red, white and blue Medicare card. Keeping this card automatically enrolls you in Parts A and B. If you do not want to receive Part B, follow the instructions that are included with the card.

Enrollment periods for Parts A, B, C and D vary. The following are guidelines to help you figure out when your enrollment period is. There are several different enrollment periods that you should be aware of when signing up for Medicare.

Initial enrollment period: Your initial enrollment period lasts 7 months, beginning three months before your 65th birthday (or, if you are still covered under a group health plan, when you first become eligible for Part B coverage). During this time, you will enroll in Part A (and, if you choose, Part B) or a Medicare Advantage Plan (Part C). You will also de-cide if you want Part D prescription drug coverage. Your initial enrollment period is the only time that you can enroll in all Parts of Medicare penalty-free. Make sure to weigh your options carefully during this time so that you don’t have to pay late enroll-ment fees for Part B or Part D later on.


**Some information taken from CMS’s “Medicare Basics.”

How is Medicare divided?

Medicare has four parts:

• Helps cover doctor services and outpatient care.

• Helps cover some preventive services to help maintain a person’s health and to keep certain illnesses from getting worse.

• Helps cover durable medical equipment.

Medicare Part B (Medical Insurance)

• A way to get Medicare benefits through private insurance companies approved by and under contract with Medicare.

• Includes Part A, Part B, and usually other benefits Medicare doesn’t cover. Some plans also provide prescription drug coverage for an additional cost.

• Part C takes the place of Parts A and B.

Medicare Part C (Medicare Advantage Plans)

• Run by private companies approved by Medicare.

• Helps cover the cost of prescription drugs.

• Each plan can vary in cost and drugs covered.

Medicare Part D (Prescription Coverage)

• Helps cover inpatient care in hospitals (includes critical access hospitals, inpatient rehabilitation facilities, and long-term care hospitals).

• Helps cover skilled nursing facility (not custodial or long-term care), hospice, and home health care services.

Medicare Part A (Hospital Insurance)

General enrollment - Those who did not enroll in Part A or Part B during their initial enrollment period may do so between January 1 and March 31 each year. Those who enroll during this time will begin receiving this coverage on July 1 of the same year. You may have to pay a late enrollment fee if you sign up during this time.

Special enrollment - Special enrollment periods occur for those who chose not to enroll in Part A and/or B because they were still covered under employer or other group plan coverage when they turned 65. Generally this special enrollment period occurs during the 8-month period following the end of employment or the end of group health plan coverage, whichever comes first (for example, retirement). If you have been continuously covered under employer or group-sponsored health cover-

age since your 65th birthday, and enroll in Part A and/or Part B during this special enrollment period, you will not have to pay a late enrollment penalty.

Late enrollment penalties - Should you choose not to enroll in Part B or Part D during your initial enrollment period, then change your mind later, you may be charged a late enrollment penalty. To avoid this extra cost, make sure you weigh your options carefully during the 7-month initial enrollment period around your 65th birthday.

Gaps in MedicareMedicare was never intended to pay 100% of medi-cal bills. It forms the foundation for beneficiaries’ protection against heavy medical expenses. There


are gaps in Medicare coverage where the benefi-ciary must pay a portion of expenses. Medicare supplement insurance, also called Medigap, can help cover some of these expenses. The Kansas Insurance Department is charged with regulating Medicare supplement insurance (see Section I).

Items and services not covered under Medicare include: • Acupuncture • Deductibles, coinsurance or copayments when you obtain certain health care services • Dental care and dentures • Cosmetic surgery • Long-term care, like custodial care (help with bathing, dressing, using the bathroom and eating) at home or in a nursing home • Eye care (routine exam), eye refractions • Hearing aids and hearing exams • Orthopedic shoes (with a few exceptions) • Outpatient prescription drugs (with a few exceptions) • Routine foot care, such as cutting of corns or calluses (with a few exceptions) • Diabetic supplies (like syringes or insulin, unless the insulin is used with a pump or it may be covered by Medicare Part D) • Chiropractic services except to correct a subluxation (when bones in your spine move out of position) using manipulation of the spine. You are responsible for coinsurance, and the Part B deductible applies

To find out if Medicare will cover a service, visit www.medicare.gov/coverage or call 800-Medicare (800-633-4227).

Medicare supplement insurance was created to help cover some of these gaps in coverage. See Section I for more information on what Medicare supplement insurance covers to help you decide whether it is right for you.

What is Part A?Part A of Medicare was created to cover inpatient care in hospitals, skilled nursing facilities, hospice

and some home health care. Many people do not have to pay for this portion of Medicare because they have paid Medicare taxes while working (re-ferred to as “premium-free Part A”). You will not have to pay a monthly premium for Part A if: • You already receive retirement benefits from Social Security or Railroad Retirement Board benefits. • You are eligible for Social Security or Rail- road Retirement Board benefits but haven’t filed for them yet. • You or your spouse worked in Medicare- covered employment for at least 10 years.

If you do not qualify for premium-free Part A, you may still be able to purchase Part A coverage, as long as you meet one of the following require-ments: • Are 65 or older, are eligible to purchase Part B coverage, and meet residency or citizenship requirements. • Are under 65, disabled, and your premium- free Part A ended because you returned to work.

What is included in Part A?Generally, the following services are covered under Part A:

• Inpatient care in hospitals (such as critical access hospitals, inpatient rehabilitation facilities, and long-term care hospitals). • Inpatient care in a skilled nursing facility (not custodial or long-term care).• Hospice care services.• Home health care services.• Inpatient care in a Religious Nonmedical Health Care Institution.

For questions about common services covered un-der Part A, contact Medicare directly. Beneficiaries enrolled in Part A are subject to coinsurance and a yearly deductible. In 2015, this deductible is $1,260.NOTE: Not all overnight hospital stays are consid-ered “inpatient.” It is important to check with your doctor to find out whether your patient status is in-patient or outpatient. Overnight outpatient hospital visits are not covered under Part A of Medicare.


What is Part B?Part B of Medicare covers most doctor services and some outpatient hospital and home health care services, including some physical and occupational therapy.

What is included in Part B?Generally, Part B covers medically-necessary ser-vices and supplies that are needed to diagnose or treat your medical condition and that meet accept-ed standards of medical practice.

Enrollment in Part BMost people will first become eligible to enroll in Part B around their 65th birthday. If you receive Social Security benefits, enrollment in Part B is auto-matic: you must specifically tell Medicare if you do not want to receive Part B. Information on how to do this will be sent to your home along with your Part A Medicare card.

Consider your coverage options carefully during your intial enrollment period. If you choose not to enroll in Part B coverage during the initial sev-en-month enrollment period, then change your mind later on, you can be charged an extra 10% for every 12 months that you were eligible for Part B but did not enroll, and this fee applies for the rest of your life (See “Medicare Enrollment”, page 41).

What will I pay for Part B?If you choose to enroll in Part B you will be charged a monthly premium. Oftentimes this premium is taken directly out of your Social Security, Railroad Retirement or Civil Service Retirement payments each month. If you do not receive any of these pay-ments, you will be billed directly for the coverage.

Most new enrollees can expect to pay a monthly premium of $104.90 for Part B coverage in 2015. Enrollees who have incomes above $85,000 (single)

and $170,000 (married couple) may be charged a higher monthly premium.

Enrollees covered under Part B are subject to a de-ductible. In 2015, this deductible is $147.

What is Part C (Medicare Advantage Plans)?

Medicare Advantage Plans are an alternative way of receiving Part A and Part B coverage (see graph on page 7). Choosing a Medicare Advantage Plan takes the place of Original Medicare - you cannot have both. The Kansas Insurance Department has no direct regulatory authority over Medicare Ad-vantage Plans. Private insurance companies man-age Medicare coverage for their members, and may also provide extra benefits not included in Original Medicare, such as dental, vision or hearing cover-age. These plans include all benefits from Part A and Part B, and some plans also include Part D prescription drug coverage.

Medicare Advantage plans differ from Original Medicare because they use provider networks. Us-ing the services of doctors and hospitals outside of the network may cost you an additional fee. The types of provider networks included in the Medicare Advantage plans are Health Maintenance Organiza-tions (HMOs); Preferred Provider Networks (PPOs); Private Fee-For-Service (PFFS); Special Needs Plans (SNPs); and Medical Savings Accounts (MSA).

Health Maintenance Organizations (HMOs) - Generally, in Kansas, you can only go to doctors, specialists or hospitals on the plan’s list, except in emergency situations. This is called the plan’s “net-work.” You may also have to choose a primary care doctor and get referrals to see a specialist. You may pay lower copayments and get extra benefits, such as coverage for extra days in the hospital.

Preferred Provider Organization Plans (PPOs) - In most of these plans, you use doctors, special-ists and hospitals in the plan’s network. You can go to doctors, specialists or hospitals not in the plan’s network, but it may cost extra. You don’t need referrals to see doctors, specialists, or hospitals who

aren’t part of the plan’s network. You may pay lower copayments and get extra benefits, such as cover-age for extra days in the hospital.

Private Fee-for-Service Plans (PFFS) - These plans allow you to go to any primary care doctor, special-ist or hospital that accepts the terms of the plan’s payment. The private company, rather than Medi-care, decides how much it will pay and how much you pay for the services you get.

Special Needs Plan (SNPs) - Medicare Special Needs Plans are specially designed for people with certain chronic diseases and other special-ized health needs. These plans must provide all of the same benefits provided by Part A and Part B. They also must provide Medicare prescription drug coverage (Part D). Generally, they offer extra ben-efits and have lower copayments than the Original Medicare plan. Special Needs Plans are designed to meet the needs of people who live in certain institutions (like a nursing home), are eligible for both Medicare and Medicaid, or have one or more specific chronic or disabling conditions.

A Special Needs Plan may help manage and co-ordinate the many services and providers their members use to help them stay healthy. They also help members follow their doctor’s orders related to diet and prescription drugs, and help coordinate between Medicare and Medicaid. They may also identify care provider efforts to meet the patient’s needs. For example, a Special Needs Plan for people with diabetes might use a care coordinator to help members monitor blood sugar, follow their diet, get proper exercise, get needed preventive services such as eye and foot exams, and get the right medi-cines to prevent complications.

Medical Savings Account Plans (MSAs) - Medical Savings Account Plans (MSAs) are similar to Health Savings Account plans available outside of Medi-care. They have two parts. The first part is a Medi-care Advantage health plan with a high deductible. This health plan won’t begin to pay covered costs until you have met the annual deductible, which varies by plan. The second part is a Medical Savings Account into which Medicare deposits money that you may use to pay health care costs.

What will I pay for a Medicare Advantage Plan?

Because Medicare Advantage Plans are run by private insurance companies, costs will vary. Some factors that contribute to the costs of Medicare Advantage plans include the following: • Whether the plan charges a monthly premium, and how much that premium is. • Whether the plan pays any of your monthly Part B premium. • Whether the plan charges a yearly deductible. • Whether the plan has any copayments or coinsurance costs, and how much they are. • The type of health care services you need and how often they are needed. • Whether you follow the rules of the plan (including extra charges for using out-of- network providers). • Whether you need extra benefits, and how much the plan charges for those benefits. • The plan’s yearly limit for out-of-pocket costs.

Medicare supplement insurance cannot be used if you have a Medicare Advantage Plan (see Section I). If you switch to an Advantage Plan, but already have a Medicare supplement plan, you cannot use that coverage to pay for out-of-pocket expenses. Likewise, if you are enrolled in a Medicare Advan-


If you join a Medicare Advantage Plan...

• You are still considered part of Medicare.• You still have Medicare rights and protections.• You get the same covered services included in Original Medicare.• You may be able to get extra benefits, such as coverage for extra days in the hospital.• You are not eligible to purchase Medicare supplement insurance.

tage Plan, you cannot be sold a Medicare supple-ment plan.

What is Part D?Medicare provides prescription drug coverage to help enrollees pay for the drugs they need to stay healthy. Everyone with Original Medicare or a Medi-care Advantage Plan can choose to enroll in this voluntary drug coverage regardless of their income, health, or how they currently pay for their prescrip-tions.

Like Medicare Advantage Plans, Part D prescription drug coverage is run by private companies ap-proved by Medicare. Part D can be added to either

Original Medicare or a Medicare Advantage Plan (check to make sure your Advantage Plan doesn’t already include Part D). You must have Part A or Part B to receive Part D coverage - it cannot stand alone.

Enrollment in Part DYou have the option to enroll in Part D during your initial enrollment period. You must pay a monthly premium for this coverage. The cost for each Part D plan varies based on the company selling the policy, and those individuals with a higher modified adjusted gross income may pay a higher premium each month.

Like Part B, if you choose not to enroll in Part D dur-ing your initial enrollment period, then change your mind, you may be charged a late enrollment fee, so it is important to evaluate your coverage needs during your initial enrollment period. You will be charged more for Part D coverage if you enroll after your initial enrollment period.

How does Part D work?Medicare prescription drug plans vary. In general, when you join, you will pay a monthly premium in addition to any premiums for Medicare Part A and Part B. You may also pay a deductible for your pre-scriptions. After you pay the yearly deductible, you will pay varying coinsurance amounts.

Medicare prescription drug plans can offer more generous coverage for higher premiums. Joining is your choice. However, if you don’t join when you first become eligible, you may have to pay a higher premium should you decide to join later. You will have to pay this higher premium for as long as you have a Medicare prescription drug plan.

Things to remember:

• If you want coverage, you must enroll. Enrollment is not automatic.• Once you’re enrolled, you will pay a monthly premium.


Things to consider when looking at a Medicare

Advantage Plan:

1. Is your doctor included in the provider network? If not, you may want to either consider a different plan or find a new doctor who is included in the plan’s network.

2. Are the hospitals in the network convenient for you? Make sure you have easy access to hospitals in case of an emergency.

3. Are your prescriptions covered un-der the plan? This is especially important if you have a chronic condition that re-quires medication.

4. What will your out-of-pocket costs be?

5. Do you trust the insurance company selling the policy? You should always buy from experienced companies who come well recommended.

• If you have a low income and limited assets, you may qualify for the “Extra Help” program to help with the costs.

Part D Extra HelpSome people qualify for government assistance in paying for Part D through a program called “Extra Help.” This program can assist with the costs of monthly premiums, annual deductibles, and pre-scription copayments. In order to qualify for this program, you must meet the following criteria:

• Reside in one of the 50 states or the District of Columbia; • Have limited resources of $13,640 (single) or $27,250 (married couple living together). In this case, resources include bank accounts, stocks and bonds, but do not include things like your home or car; • Have an annual income of less than $17,655 (single) or $23,895 (married couple living together). Even if you make more each year, you may qualify for some assis-

tance. Check with your local Social Security office for more information.

To find out more about the “Extra Help” program, contact your local Social Security office or call 800-772-1213. You can also get more information, and even enroll in the program, by visiting Social Secu-rity online at www.ssa.gov/prescriptionhelp/.

How does other insurancework with Part D?

Employer or union health coverage

This is health coverage based on your, your spouse’s, or other family member’s current or former employment. If you have prescription drug coverage based on employment, the employer or union will notify you each year to let you know if your drug coverage is creditable (see Glossary of Terms for more information). Keep the information you get. If you join a Medicare drug plan, you, your spouse, or your dependents may lose your em-ployer or union health coverage. Call your benefits administrator for more information before making any changes to your coverage.

COBRAThis is a federal law that may allow you to tempo-rarily keep employer or union health coverage after the employment ends or after you lose coverage as a dependent of the covered employee. There may be reasons why you should take Part B instead of COBRA. However, if you take COBRA and it includes creditable prescription drug coverage, you will have a special enrollment period to join a Medicare drug plan without paying a penalty when the COBRA coverage ends.


4 ways to lower your costs during the Part D coverage gap

1. Consider switching to generics or other lower-cost drugs. You also might be able to save money by using mail-order pharmacies.

2. Find a pharmaceutical assistance pro-gram. Check www.medicare.gov to find out whether there’s an assistance program for the drugs you take.

3. Appy for Extra Help. If you have limited income and resources, check with your Social Security office.

4. Explore national and community-based charitable programs. Groups like the Na-tional Patient Advocate Foundation and the National Organization for Rare Disorders may be able to help you.


Medicare supplement policy with prescription drug coverage

Medicare supplement policies are no longer sold with prescription drug coverage, but if you have drug coverage under a current Medicare supple-ment policy, you can keep it. You may want to join a Medicare drug plan instead, because supplement drug coverage isn’t creditable. If you join a Medi-care drug plan, your supplement insurance compa-ny must remove the prescription drug coverage and adjust your premiums. Call your Medicare supple-ment insurance company for more information.

Federal Employee Health Benefits Program (FEHBP)

If you join a Medicare drug plan, you can keep your FEHBP plan, and your plan will let you know who pays first. For more information, contact the Office of Personnel Management at 800-332-9798. You can also call your plan if you have questions.

Veterans benefitsYou may be able to get prescription drug coverage through the U.S. Department of Veterans Affairs (VA) program. You may join a Medicare drug plan, but if you do, you can’t use both types of coverage for the same prescription. For more information, call the VA at 800-827-1000 (TTY call 800-829-4833).

TRICARE (Military Health Benefits)

People with TRICARE who are entitled to Part A must have Part B to keep TRICARE prescription drug benefits. If you have TRICARE, you aren’t required to join a Medicare drug plan. If you do, your Medicare drug plan pays first, and TRICARE pays second. If you join a Medicare Advantage plan with prescrip-tion drug coverage, TRICARE won’t pay for your prescription drugs. For more information, call the TRICARE pharmacy contractor at 877-363-8779 (TTY call 877-540-6261).


Appendix II: Consumer Protections and Other Resources

Protections when you lose coverageOpen enrollment rules protect Medicare beneficiaries who may lose their health coverage. Under certain circumstances, you have 63 days to purchase Medicare supplement insurance without having to report your health information. Details for each situation are described below. If you have questions about your particular situation, please contact our Consumer Assistance Division at 800-432-2484.

You’re in a Medicare Advantage Plan, and your plan is leaving Medicare or stops giving care in your area, or you move out of the plan’s service area.

Any Medicare supplement plan A, B, C, F, K or L that is sold in Kansas.

You only have this right if you switch to Original Medicare - not if you switch to another Advan-tage plan.

As early as 60 calendar days before the date your health care coverage will end, but no later than 63 calendar days after your health care coverage ends. Medicare supplement coverage can’t start until your Medicare Advantage Plan coverage ends.

Your situation:

You have the right to buy:

You must apply for a policy:

You joined a Medicare Ad-vantage Plan or Programs of All-inclusive Care for the El-derly (PACE) when you were first eligible for Medicare Part A at 65, and within the first year of joining you decide you want to switch to Original Medicare.

Any Medicare supplement policy that is sold in Kansas by any insurance company.

As early as 60 calendar days before the date your health care coverage will end, but no later than 63 calendar days after your health care coverage ends.

Your Medicare supplement in-surance company goes bankrupt and you lose your coverage, or your supplement policy cover-age otherwise ends through no fault of your own.


No later than 63 days after from the date your coverage ends.

You want to switch from an Advantage plan to Original Medicare

You lose Medicare supplement coverage

You lose your Medicare Advantage coverage


You have Original Medicare and an employer group health plan (including retiree or COBRA cov-erage) or union coverage, but leave that employer plan.


If you have COBRA coverage, you can either buy a Medicare supplement policy right away or wait until the COBRA coverage ends.

No later than 63 days after the latest of these 3 dates:

1. Date the coverage ends.

2. Date on the notice you get telling you that coverage is end-ing (if you get one).

3. Date on a claim denial, if this is the only way you know that your coverage ended.

You dropped a Medicare supple-ment policy to join a Medicare Advantage Plan (or to switch to a Medicare SELECT policy) for the first time, you have been in the plan less than a year, and you want to switch back.

The Medicare supplement policy you had before you joined the Advantage or SELECT policy, if the same insurance company you had before still sells it. If it included drug coverage, you can still get that same policy, but without the drug coverage.

If your former policy isn’t avail-able, you can buy any Plan A, B, C, F, K or L that is sold in Kansas.

As early as 60 calendar days before the date your health care coverage will end, but no later than 63 calendar days after your health care coverage ends.

Your situation: You have the right to buy:


You move to a Medicare Advantage plan and want to switch back

You have Original Medicare and a Medicare SELECT policy. You move out of the Medicare SE-LECT policy’s service area.

You can keep your Medicare supplement policy, or you may want to switch to another sup-plement policy.

Any Medicare supplement plan A, B, C, F, K or L that is sold by any insurance company in Kan-sas.

As early as 60 calendar days before the date your Medicare SELECT coverage will end, but no later than 63 calendar days after your Medicare SELECT cov-erage ends.

You move out of a Medicare SELECT policy’s service area

You lose employer group health plan benefits


Your situation: You have the right to buy:


You lose your eligibility for health benefits under Title XIX of the Social Security Act (Med-icaid).

Any Medicare supplement plan

Any Medicare supplement policy or Medicare Select policy offered by an company in Kansas.

No later than 63 calendar days from the date your coverage ends.

Consumer RightsFree look period

You are entitled to a 30-day “free look” at your Medicare supplement insurance policy, beginning the day you receive the policy. Be sure to keep track of the date the policy arrived; the postmark date on the envelope you receive it on can be a good indi-cator of when this 30-day period began.

If you are dissatisfied for any reason, you can return the policy within the 30 days and get your money back, no questions asked.

Use this “free look” period to do the following: • Make sure it provides the benefits you expect and desire. • Check for limitations, exclusions or waiting periods. • Read the application carefully to make sure that it has not been changed in any way and that all medical information is accurate.

Required disclosuresYour Medicare supplement policy must clearly dis-close the existence of any of the following: • Limitations or exclusion of payments for

pre-existing conditions. • Rights of the insurance company to change premiums. • Automatic premium increases based on age at renewal time.

Outline of coverageAn agent seeking your business must provide an outline of coverage when giving you an applica-tion form. This outline of coverage must do the following: • Summarize the major benefit gaps in Medicare and tell you how much each benefit package offered by the insurance company will pay toward filling each gap. • Disclose the premium for each benefit package that is offered. • State the total price of the policy and the likelihood of future premium increases as your age increases. • Declare your right to a premium refund if you return the policy during the 30-day “free look” period.

Guaranteed renewableAll Medicare supplement insurance policies sold today are guaranteed renewable. The insurance company cannot refuse to renew your policy un-less you do not pay the premiums or you submitted

You leave a Medicare Advantage Plan or drop a Medicare supple-ment policy because the com-pany hasn’t followed the rules or it misled you.

Any Medicare supplement plan that is sold in Kansas.

No later than 63 calendar days from the date your coverage ends.

Your insurance company commits fraud

You lose Medicaid eligibility

false information on the application. Older policies (prior to 1992) may allow the company to refuse to renew on an individual basis.

Tips and Warnings• Shop carefully before you buy. Policies differ as to coverage and cost. Companies differ as to ser-vice.

• Don’t buy more policies than you need. Insur-ance agents are prohibited from selling a second Medicare supplement policy to someone who has a Medicare supplement policy already in force, un-less you intend to cancel the first policy after the replacement policy goes into effect. You should use caution in purchasing other types of insurance which duplicate benefits provided by Medicare and your supplemental coverage.

• Check for pre-existing condition exclusions and waiting periods. Medicare supplement policies are required to cover pre-existing conditions after the policy has been in effect for six months. Some poli-cies may cover you sooner.

• Beware of replacing existing coverage. Make sure you have a good reason for switching from one policy to another. You should only switch for dif-ferent benefits, better service, or a more affordable price. If you decide to replace your policy, you must be given credit for the time spent under the old policy. In other words, insurance companies must take into account the amount of time you were un-der your old policy when applying any pre-existing condition exclusions or restrictions.

Companies can decline you for coverage if you have a pre-existing condition and your 6-month initial open enrollment period is over.

You must sign a statement that indicates your inten-tion to terminate the policy to be replaced. Do not cancel the first policy until you have been accepted into the new plan and you are sure that it is what you want.

• Despite misleading claims made by some insur-ers and agents, NO Medicare supplement policy covers every medical expense not covered by

Medicare.

• Be aware that Medicare supplement policies are not sold or run by any state or federal gov-ernment agencies.

• Know about the agent and company you are working with. Call our Consumer Assistance Hotline at 800-432-2484 to make sure any agent or company you are considering is licensed in Kansas.

• Take your time. Do not be pressured into buying a policy. Principled sales people will not rush you.

• If you decide to buy, complete the applica-tion carefully. It is against the law for an agent to suggest you falsify an application. Do not withhold medical information on the application for insur-ance. Coverage could be refused for a period of time, a claim could be denied or your policy can-celed if you leave out any of the medical informa-tion requested. NEVER sign a blank application. Don’t let the agent fill it out for you.

• DO NOT pay cash. Pay by check, money order or bank draft made payable to the insurance company. Get a receipt for your records.

Protect yourself fromidentity theft

Identity theft occurs when someone uses your personal information (like your name, Social Secu-rity, Medicare or credit card number) without your consent to commit fraud or other crimes. Keep this information safe. Don’t give your information to anyone who comes to your home (or calls you) un-invited selling Medicare-related products. Only give personal information to doctors or other providers that are approved by Medicare. Call 800-MEDICARE if you aren’t sure a provider is approved by Medi-care.

If you lose your Medicare card or it is stolen, or if you need a new Social Security number, go towww.socialsecurity.gov on the web, or call the Social Security Administration at 800-772-1213. If you think someone is using your personal information, call one of the following:



• 800-MEDICARE (1-800-633-4227). TTY users should call 877-486-2048. • The Fraud Hotline of the HHS Office of the Inspector General at 800-447-8477. TTY users should call 800-377-4950. • The Federal Trade Commission’s ID Theft Hotline at 877-438-4338 to make a report (TTY users should call 866-653-4261). For more information about identity theft, visit: www.consumer.gov/idtheft on the web.

NOTE: Medicare can’t ask for your Social Security Number over the telephone. Report any plans that ask for your Social Security Number over the tele-phone by calling 800-MEDICARE.

Insurance fraudFraud is not limited to Medicare. People can be victims of fraud when they are buying supplement insurance or other specialty insurance products. Consumers should be wary of agents who fill out medical history and say it’s okay not to tell the company certain health information. Also, while it’s important to shop around for the best price, if it seems too good to be true, it probably is.

To report suspected insurance fraud, call the Kansas Insurance Department at 800-432-2484.

Helpful resourcesMedicare claims service

All calls regarding Medicare claim payments should be directed to 800-MEDICARE (800-633-4227). This is an automated system that will direct your call based upon your responses to a few automated voice prompts.

Senior Health InsuranceCounseling for Kansas (SHICK)

SHICK provides Medicare, Medicare supplement, long-term care and other health insurance counsel-ing through a network of volunteers statewide. All services are free. For more information, call 800-860-5260 or visit their website, www.kdads.ks.gov/SHICK/shick_index.html.

Kansas Foundation for Medicare Care (KFMC)

KFMC provides independent medical review and the monitoring of quality of care. You have a right to proper diagnosis and treatment under Medi-care. KFMC will act on your behalf to protect your rights, especially relating to hospital confinements and treatment. These services are free to Medicare beneficiaries. For more information, call the Topeka office at (785) 273-2552 or 800-432-0407, or visit their website, www.kfmc.org.

Kansas Department for Aging & Disability Services (KDADS)

The Kansas Department for Aging & Disability Services (KDADS) provides many programs and services for Kansas seniors. These services include, but are not limited to, nutrition and meal programs; home health care; homemaker services; housing; transportation; respite care; support groups; case management; and information on long-term care. Services are available through 11 area agencies.

KDADS also administers the Senior Health Insurance Counseling for Kansas (SHICK) program.

For more information, call the Topeka office at (785) 296-4987 or 800-432-3535 or visit their website, www.kdads.ks.gov.

Centers for Medicare and Medicaid Services (CMS)

CMS is the federal agency responsible for protect-ing the rights of Medicare beneficiaries. CMS works to make Medicare more effective, responsive and user-friendly. For more information, contact one of the following:

Toll Free Hotline: 800-633-4227 (24 hours a day)Provides services in both English and Spanish TTY users: 877-486-2048Online at www.medicare.gov


Assignment - An agreement by your doctor or other supplier to be paid directly by Medicare, to accept the payment amount Medicare approves for the ser-vice, and not to bill you for any more than the Medi-care deductible and coinsurance.

Benefit period - The way that Original Medicare measures your use of hospital and skilled nursing fa-cility (SNF) services. A benefit period begins the day you go to a hospital or SNF. The benefit period ends when you haven’t received any inpatient hospital (or skilled care in a SNF) for 60 days in a row. If you go into a hospital or a SNF after one benefit period has ended, a new benefit period begins. You must pay the inpatient hospital deductible for each benefit period. There is no limit to the number of benefit periods a beneficiary can have.

Coinsurance - An amount you may be required to pay as your share of the cost for services after you pay any deductibles. Coinsurance is usually a per-centage. In a Medicare prescription drug plan (Part D) or Medicare health plan, the coinsurance will vary depending on how much you have spent.

Copayment - An amount you may be required to pay as your share of the cost for a medical service or supply, like a doctor’s visit or prescription. A copay-ment is usually a set amount, rather than a percent-age.

Cost sharing - The amount you pay for health care and/or prescriptions. The amount can include copay-ments, coinsurance, and/or deductibles.

Creditable - Creditable coverage is any coverage that is offered through an employer or group spon-sored health plan, or some other health plan, that is equal or better than coverage you would receive un-der Medicare. Providing proof to Medicare that you have creditable coverage at the time you enroll will keep you from having to pay a late penalty fee if you enroll in prescription drug coverage after your initial open enrollment period.

Deductible - The amount you must pay for health care or prescriptions, before Original Medicare, your Medicare drug plan, your Medicare health plan, or

your other insurance begins to pay. These amounts can change every year.

Extra Help - A Medicare program to help people with limited income and resources pay Medicare Part D prescription drug program costs, such as premi-ums, deductibles, and coinsurance.

Guaranteed Issue Rights - Rights you have in certain situations when insurance companies are required by law to sell or offer you a Medicare supplement policy. In these situations, an insurance company can’t deny you a Medigap policy, or place conditions on a Medicare supplement policy, such as exclusions for pre-existing conditions, and can’t charge you more for a policy because of past or present health problems.

Health Maintenance Organization (HMO) - A type of Medicare health plan that is available in most ar-eas of the country. Plans must cover all Medicare Part A and Part B services. Some HMOs cover extra ben-efits, like extra days in the hospital. In most HMOs, you can only go to doctors, specialists, or hospitals on the plan’s list, except in an emergency.

High deductible Medicare supplement policy - A type of Medicare supplement policy that has a high deductible but a lower monthly premium. You must pay the deductible before the Medicare supplement policy pays anything. The deductible amount can change each year.

Medical underwriting - Medical underwriting is the process an insurance company uses to determine whether or not to accept you as a beneficiary under a policy. The company also uses medical underwrit-ing to determine how much of a monthly premium to charge you. Medical underwriting is based on in-formation you give to the company about your past and present medical conditions.

Medically necessary - Services or supplies that are needed for the diagnosis or treatment of your medi-cal condition and accepted standards of medical practice.

Medicare Advantage Plans - Medicare Advantage

Glossary of Terms


Plans (like an HMO or PPO), also called “Part C,” are health plans run by Medicare-approved private insur-ance companies. Medicare Advantage Plans include Part A, Part B, and sometimes other coverage like Medicare prescription drug coverage (Part D), some-times for an extra cost.

Medicare Medical Savings Account (MSA) plan - A type of Medicare Advantage Plan. MSA plans combine a high deductible Medicare Advantage Plan and a bank account. The plan deposits money from Medicare into the account. You can use the money in this account to pay for your health care costs, but only Medicare-covered expenses count toward your deductible. The amount deposited is usually less than your deductible amount so you generally will have to pay out-of-pocket before your coverage begins.

Medicare Special Needs Plan (SNP) - A special type of Medicare Advantage Plan that provides more focused and specialized health care for spe-cific groups of people, such as those who have both Medicare and Medicaid, who reside in a nursing home, or have certain chronic medical conditions.

Medicare-approved amount - In Original Medicare, this is the amount a doctor or supplier that accepts assignment can be paid. It includes what Medicare pays and any deductible, coinsurance, or copayment that you pay. It may be less than the actual amount a doctor or supplier charges.

Medigap - A Medicare supplement insurance policy.

Open enrollment period (Medicare supplement insurance) - A one-time only 6-month period when federal law allows you to buy any Medicare supple-ment policy you want that is sold in your state. It starts in the first month that you are covered under Medicare Part B. During this period, you can’t be denied a Medicare supplement policy or be charged more due to a past or present health problem. Kan-sas regulations allow individuals under age 65 the same open enrollment period whether they receive Medicare because of age or disability.

Out-of-network - Generally, an out-of-network ben-efit provides you with the option to get plan services out of the plan’s contracted network of providers. In some cases, your out-of-pocket costs may be higher for an out-of-network benefit.

Out-of-pocket costs - Health or prescription drug costs that you must pay on your own because they are not covered by Medicare or other insurance.

Pre-existing condition - A health problem you had before the date that a new insurance policy starts.

Preferred Provider Organization (PPO) - A type of Medicare Advantage Plan available in a local or re-gional area in which you pay less if you use doctors, hospitals, and providers that belong to the network. You can use doctors, hospitals, and providers outside of the network for an additional cost.

Premium - The periodic payment to Medicare, an insurance company, a health care plan or a drug plan for health care or prescription drug coverage.

Private Fee-for-Service plan - A type of Medicare Advantage Plan in which you may go to any Medi-care-approved doctor or hospital that agrees to treat you under the plan and that accepts the plan’s pay-ment terms. The plan decides how much you must pay for services.

Referral - A written order from your primary care doctor for you to see a specialist or get certain services. In many HMOs, you need to get a referral before you can get care from anyone except your primary care doctor. If you don’t get a referral first, the plan may not pay for your care.

Service area - The area where a health plan accepts members. For plans that limit which doctors and hospitals you may use, it’s generally the area where you can get routine (non-emergency) services. The plan may disenroll you if you move out of the plan’s service area.

Skilled Nursing Facility (SNF) - A nursing facility with the staff and equipment to give skilled nursing care and, in most cases, skilled rehabilitation services and other related health services.


What you need to know in 2015The following are things you should know about Medicare in 2015. See CMS’s “Medi-care & You” book for more information.

Stay healthy with Medicare-covered preventive servicesMedicare pays for many preventive services that can detect health problems early when they’re easier to treat. Ask your health care provider what services you need.

Keep track of your personal health information

Medicare’s has expanded its Blue Button to provide better access to your Medicare claims and personal health information. This feature lets you download 12 - 36 months of claims information for Part A and Part B and 12 months of claims information for Part D. This information can help you make more informed decisions about your care and can give your health care providers a more complete view of your health history. Visit MyMedicare.gov to use the Blue Button.

Continued help in the prescription drug coverage gap

If you reach the coverage gap in your Medicare prescription drug coverage, you’ll qual-ify for savings on brand-name and generic drugs.

Mark your calendars for open enrollmentIn most cases, this may be your only chance to make changes to your health and prescription drug coverage:

October 1, 2015

October 15 - December 7, 2015

January 1, 2016

Start comparing your coverage with other options. You may be able to save money by comparing all of your op-tions.

Change your Medicare health or prescription drug cov-erage for 2016, if you decide to.

New coverage begins if you make a change during Open Enrollment. New costs and benefit changes also begin if you keep your existing health or prescription drug coverage and your plan makes changes.

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Kansas Insurance Department420 SW 9th StreetTopeka, KS 66612-16781-800-432-2484(785) [email protected](785) 296-7805 (fax)1-877-235-3151 (TTY/TDD)

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