Medicare Supplements:

Although the benefits are identical for all Medicare Supplemental Insurance Plans of the same type, the premiums may vary greatly from company to company and area to area.

In Oregon there are 25 companies that sell Medicare Supplement Plans. We represent many of them. Please visit our Oregon Health Insurance site for more detailed information.

Oregon Consumer Guide to Medigap & Medicare Advantage Plans Publications Page This site has a pamphlet comparing HMO, PPO and Traditional Plans. We carry the majority of these companies and their Products. The HMO and PPO plans are available in limited areas, while the Traditional plans are available statewide.

The U.S. Government Medicare site and Oregon SHIBA site have a page of publications for further information on Medicare and Insurance, and you can also check out our chart of basic types of medicare supplements.

Medicare Supplemental Insurance Options:

Medicare Advantage Plans are now available in many parts of Oregon!  These are the Medicare HMO, PPO & PFFS Plans which have co-payments for Doctors office visits and Hospitals. For information on this type of plan please call 800.884.2343 or send us an email for infomation or complete this contact form.

2010 Medicare Supplement Changes

Background

The changes to Medicare Supplement come as a result of HR 6331, the Medicare Improvements for Patients and Providers Act (MIPPA, passed on July 9, 2008), which authorized implementation of the NAIC's proposed Medigap modernization changes, which were approved by the NAIC Plenary in March 2007.

Major Changes

The 2010 Medicare Supplement changes are an effort to modernize the Medigap Market by dropping some coverage options and adding others. See Below.

Summary of changes for 2010 Medigap plans purchased effective June 1, 2010:

• “At-Home Recovery” benefit will be dropped from all 2010 Medicare Supplement plans
• Preventative Care will be dropped from all 2010 Medicare Supplement plans
• Medigap Plans E, H, I and J will no longer be available for new sales
• Plan G will be modified to increase excess charges from 80% to 100%
• New Hospice Benefit will be added to all plans
• Two new Medigap Plans M & N will be available in June, 2010
• Insurance carriers will be allowed to offer plans that include “New” or Innovative Benefits, such as eyewear or hearing aid benefits. They may not include outpatient prescription drug benefits.

New 2010 Medigap Benefits and Plans

Hospice Benefit
Today, Medicare offers a hospice benefit that pays eligible expenses with a drug copay and inpatient respite care coinsurance, but these are not covered by Medicare supplement plans. The modernized plans will cover these expenses as a core benefit:

• $5 copay for outpatient prescription drugs for pain and symptom management
• 5% of the Medicare‐approved amount for inpatient respite care (short‐term care given by another caregiver so the usual caregiver
  can rest). Does not include room and board

New Plans 
The new regulation also makes the following two new plan options available to beneficiaries, which have higher cost–sharing responsibilities and lower estimated premiums:

• New Plan M includes 50 percent coverage of the Medicare Part A deductible and does not cover the Medicare Part B Deductible. Plan M has all the core benefits plus the foreign Travel Emergency Benefit.
• New Plan N does not cover the Medicare Part B deductible and adds a new co–payment structure of $10 for each physician visit and $50 for each emergency room visit (waived upon admission to the hospital). Plan N has all the core benefits plus the foreign Travel Emergency Benefit.

Benefit Chart of Medicare Supplement Plans Sold for Effective Dates on or After June 1, 2010

*Plan F also has an option called a high deductible plan F. This high deductible plan pays the same benefits as Plan F after one has paid a calendar year [$2,000] deductible. Benefits from high deductible plan F will not begin until out-of-pocket expenses exceed [$2,000]. Out-of-pocket expenses for this deductible are expenses that would ordinarily be paid by the policy. These expenses include the Medicare deductibles for Part A and Part B, but do not include the plan's separate foreign travel emergency deductible.

2010 Medigap Changes Frequently Asked Questions

When are these changes effective? 
The 2010 Medicare Supplement changes will be effective on any policy sold effective June 1, 2010.

How competitive will the new plans M & N be? 
We expect them to be very competitive. Co-Pays and Co-Insurance will always drop the premium.

Why were plans E, H, I and J eliminated? 
Plan E was eliminated because the new Plan D would contain exactly the same benefits. Plans H, I and J were eliminated because with the other dropped benefits these plans would also duplicate other plans available.

What will happen if the plan that you have is dropped? 
Any plan that was purchased prior to June 2010 will remain inforce. Keep in mind these new plans are for new issues with effective dates of June 2010 and beyond. Your clients’ current Medigap plan is guaranteed renewable for life. Even if their health changes, they cannot be terminated or forced to change to one of the new plans.

What is the new hospice benefit? 
All plans will now include the Hospice Benefit as part of the “Core Benefits.” Medicare provides coverage for inpatient respite care up to 5 days less a co-payment amount of 5% of the daily benefit. The new Hospice benefit will pick up this 5% co-pay.

Why was the At-Home Recovery benefit dropped? 
It was determined that the benefit was confusing and difficult to understand and administer.

Why was Preventive Care dropped from all plans? 
Because Medicare Part B has changed to cover many more preventive benefits, effectively rendering this benefit redundant.

Medicare Benefits For Part A

Medicare Benefits Part B