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We have everything you need! EXPERIENCED, COMMITTED  & offering old fashion personal service! Health and Life Insurance Expert Serving Texas Residents Since 1999       The Centers for Medicare & Medicaid Services (CMS) administers Medicare, the nation's largest health insurance program, which covers nearly 40 million Americans.   Medicare Deductible and Coinsurance Amounts for 2010: MEDICARE PART A Medicare hospital insurance provided for those who are eligible for monthly Social Security benefits that pays for some of your inpatient hospital expenses, care in a skilled nursing facility (does not include custodial care facilities), some hospice care, and some home health care.  There are limits to the plan, deductibles and other costs that you may incur out of pocket. Part A: (pays for inpatient hospital, skilled nursing facility, and some home health care) For each benefit period Medicare pays all covered costs except the Medicare Part A deductible (2010 = $1,100) during the first 60 days and coinsurance amounts for hospital stays that last beyond 60 days and no more than 150 days. For each benefit period you pay: •A total of $1,100 for a hospital stay of 1-60 days. •$275 per day for days 61-90 of a hospital stay. •$550 per day for days 91-150 of a hospital stay (Lifetime Reserve Days). •All costs for each day beyond 150 days Skilled Nursing Facility Coinsurance •$137.50 per day for days 21 through 100 each benefit period. MEDICARE PART B Medicare medical insurance that helps pay for medically necessary doctors’ services, outpatient hospital care, and some medical services that aren’t covered by Medicare Part A.  You have to elect this benefit and pay a monthly premium. Part B: (covers Medicare eligible physician services, outpatient hospital services, certain home health services, durable medical equipment) •$155.00 per year. (Note: You pay 20% of the Medicare-approved amount for services after you meet the $155.00 deductible.) MEDICARE PART C Medicare Part C is known as Medicare Advantage Plans. This is a plan offered by a private company that contracts with Medicare to provide you with all your Medicare Part A and Part B benefits. Medicare Advantage Plans are HMOs, PPOs, or Private Fee-for-Service Plans. If you are enrolled in a Medicare Advantage Plan, Medicare services are covered through the plans, and are not paid for under Original Medicare.  You can choose a Medicare Advantage plan that includes Medicare prescription drug coverage (MA-PD) or one that does not (MA). MEDICARE PART D This optional plan provides prescription drug coverage through private companies and organizations. You may choose any of the standalone Medicare-approved drug plans (or Medicare Advantage HMO, PPO or PFFS plans) that offer drug coverage in your area. LEARN MORE Medigap / Medicare Supplemental Insurance: Many companies sell Medicare supplement policies in Texas. Privately purchased health insurance that fills in the "gaps" in Medicare coverage. They are designed to supplement the coverage of the Medicare program minimizing deductibles and copayments for covered services such as hospital and doctor bills; it does not provide help with long term care costs. A Medigap company may have a competitive price in one part of Texas, but not in another. Look for competitive Medicare supplement rates as this can make your out of pocket expenses more affordable. Purchasing a Medicare Supplement should be one of the simplest insurance purchases you ever make with affordable rates and major carriers.   texas health insurance Individual & family health insurance    texas medicare supplement insurance Senior health texas group insurance Texas Small Group 2-50 employees texas dental insurance Dental plans for  beautiful smiles texas life insurance Protecting our loved ones travel health insurance International travel health insurance texas student insurance Student health insurance plans texas short term insurance Texas Short Term health plans texas insurance product list       Are your Eligible? Eligibility Tool can help you determine whether you qualify for Medicare.  Then you decide if you need a Medicare Supplement policy or Medigap Insurance. 2010 Choosing a Texas Medigap Policy: A Guide to Health Insurance for People with Medicare. This is the official government guide with important information about: what a Medigap (Medicare Supplement Insurance) policy is, what Medigap policies cover, an individual's rights to buy a Medigap policy, steps to follow when he/she buys a Texas Medigap policy and switching Texas Medigap policies. 2010 Medicare & You: This is the official government handbook with important information about the following: what's covered, preventive services, health plans, prescription plans, and member rights and appeals.
Notice of Medicare Supplement plan changes effective June 1, 2010 Companies may offer two new Medicare supplement insurance plans and will stop selling five plans on June 1, 2010. Certain other plans will also have benefits added or deleted. The changes are as follows: Plan changes • Plans E, H, I, J, and High-Deductible J will no longer be available for purchase • New plans M and N will be available for purchase Benefit changes • At-home recovery benefit will be eliminated from plans D and G sold on or after June 1, 2010 • Part B excess charge benefit in Plan G will increase from 80 percent to 100 percent for plans sold on or after June 1, 2010 • A new hospice benefit will be added to the basic benefit for plans sold on or after June 1, 2010. You will have to pay the following: – 5 percent of Medicare-approved amount for inpatient respite care (not including room and board) – Copay of $5 or less for outpatient prescription drug plans for pain and symptom management If you currently have plans E, H, I, or J, you can keep your policy and continue to receive benefits as long as you continue to pay premiums. You don’t have to buy a new policy. All companies selling Medicare supplement insurance must offer at least Plan A, but do not have to offer the other plans.  Contact us for more information.		2010 Medicare Part A & B Premium and Deductible Information Hospital Deductible $1,100 / benefit period Hospital Coinsurance Days 0-60: $1,100 Days 61-90: $275 / day Days 91-150: $550 / day All costs for each day beyond 150 days Skilled Nursing Facility Coinsurance Days 0-20: $0 Days 21-100: $137.50 / day Part A Hospital Insurance Premium (for voluntary enrollees only) •With 40 or more quarters of Medicare-covered employment: $0 •With 30-39 quarters of Social Security coverage: $254 / month •With 29 or fewer quarters of Social Security coverage: $461 / month Part B Premium & Deductible Standard Premium: $96.40 / month Deductible: $155 / year
Texas Medicare Supplement Insurance Medicare supplement insurance fills the “gaps” between Medicare benefits and what you must pay out-of-pocket for deductibles, coinsurance, and copayments. Therefore, it is often called Medigap insurance. Medigap policies only pay for services that Medicare deems as medically necessary, and payments are generally based on the Medicare-approved charge. Some plans offer benefits that Medicare doesn’t, such as emergency care while in a foreign country. Medigap policies are sold by private insurance companies that are licensed and regulated by the Texas Department of Insurance (TDI). Medigap benefits, however, are set by the federal government. The benefits provided by these plans are described in the appendix. Medigap policies are automatically renewed each year. Texas Medicare Select Medicare Select is a type of Medigap policy that generally requires you to use doctors and other providers in the plan’s network for your routine care. If you use out-of-network providers, you’ll have to pay more of the cost. Alternatives to Texas Medicare Supplement Insurance Before you buy a Medigap policy, consider these other options: Medicare Advantage Plans Depending on where you live, you may have the option to choose between Medicare or a Medicare Advantage plan. If you are in a Medicare Advantage plan, you don’t need a Medigap policy. Medicare Advantage plans provide at least the same benefits as Medicare. There are several types of Medicare Advantage plans: -Managed care plans, which include HMOs, PPOs, provider-sponsored organizations, and religious fraternal benefit society plans -private fee-for-service plans -special needs plans -Medicare medical savings accounts Medicare pays a monthly premium to the Medicare Advantage plan to provide your health care. The plan may require you to pay an additional premium and may charge you a copayment each time you go to the doctor or get a prescription. To join a Medicare Advantage plan, you must have both Medicare parts A and B and live in an area that has a plan. Some plans have other eligibility criteria. Not all plans are available in all areas of the state. Call Medicare or visit the Medicare web page and select the Compare Health Plans and Medigap Policies in Your Area interactive page. You may also call TDI’s Consumer Help Line to learn which plans are available in your area. Texas Medicare HMOs typically require you to use only physicians and hospitals in the HMO’s network. A Medicare HMO with a point-of-service option allows you to choose your own doctors, but you will have to pay extra. With a private fee-for-service plan, you can generally go to any doctor or provider and receive care anywhere in the United States. The doctor and provider, however, must agree to treat you and to accept the plan’s payment terms. If your Texas Medicare Advantage plan terminates its contract in your service area, you have the right to purchase Medigap plans A, B, C, F, K, or L offered in Texas without regard to your medical history or condition. If your Medicare Advantage plan ends services in your area, it must explain to you in writing your options and timeframes to buy a Medigap policy. Everyone deserves the peace of mind of knowing that when you need medical care it will be covered or need help with prescription cost you'll have it.  Although the vast majority of senior citizens will obtain their main health benefits through Medicare, Medicare supplement insurance helps to pay large medical costs not covered by them.  And to offset ever rising cost for prescriptions, it is highly recommended that seniors purchase a Prescription Drug Plan (PDP). Are you looking for affordable health coverage? We can help you review your options so you can make a decisions with confidence and find plans that meet your needs and a premium you can afford.  We assist seniors to make the best affordable health insurance choice from many Texas Medicare Supplement health insurance plans that we offer.  We take the guess work out to offer you a solid quality insurance plan you can count on. You can get a free, no-obligation quote for personal health insurance in about 5 minutes. We would love to help you! Full name: Email address: Telephone number: Can we use your name? Yes No Your friend's information: Full name: Email address: Telephone number: Comments:         Resources TrailBlazer is the Medicare carrier for Texas. TrailBlazer maintains the Medicare Participating Physician/Supplier Directory. The directory lists physicians and other providers who accept assignment on Medicare claims. For a list of providers who accept assignment in your area, call Medicare or visit the TrailBlazer website. 1-800-Medicare (1-800-633-4227) www.trailblazerhealth.com Information on Medicare Centers for Medicare & Medicaid Services Social Security Administration Guide to Understanding Social Security Benefits Caregivers resource Alzheimer's Association CareFinder site Locate Nursing Home Facilities and Home Healthcare Agencies Find Nursing Homes and Assisted living facilities Find local community assistance for seniors Administration on Aging National Institute on Aging Mayo Clinic on Senior Health Partnership for Prescription Assistance Texas Medicaid Program Texas Department of Aging and Disability Services (DADS)

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