Medicare Supplement Plans Features

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Questions and Answers

What is the possible concern of Mr. Burkley after losing his Medicare Advantage plan?

He will have high deductibles.

He will have high copays. (correct)

He will not have a primary care physician.

He will not be able to see his specialist.

What is the benefit of catastrophic coverage?

It has high out-of-pocket limits.

It does not cover pre-existing conditions.

It has high monthly premiums.

It provides freedom and flexibility. (correct)

Why might an employer plan not be the best choice for Mrs. Parker?

It has a low monthly premium.

It has a high out-of-pocket limit.

It does not cover dental and vision care. (correct)

It has a high deductible.

What is guaranteed for those enrolled in a particular plan?

Guaranteed renewal. Signup and view all the answers

Why might a Medicare Advantage plan have a lower overall cost?

The premium plus out-of-pocket limit may be less than MAPD MOOP. Signup and view all the answers

What is a potential advantage of a catastrophic plan for Mr. Burkley?

It provides freedom and flexibility. Signup and view all the answers

What is a concern for people who don't have many health issues?

Budgeting for healthcare. Signup and view all the answers

Why might Mrs. Parker prefer a plan with a network of doctors?

She wants to keep her current doctors. Signup and view all the answers

What might be a consideration for Mrs. Parker when choosing a plan?

All of the above. Signup and view all the answers

What is the number of circumstances under federal law that give a beneficiary the right to buy a policy?

7 Signup and view all the answers

In addition to federal law, who can offer additional Open Enrollment Periods and Guaranteed Issue rights?

States Signup and view all the answers

Where can more information about guaranteed acceptance determination be found?

Both A and B Signup and view all the answers

What type of discussions may a Humana contracted agent engage in prior to submitting the application?

Preliminary underwriting discussions Signup and view all the answers

Who is required to answer the medical questions on the application?

The applicant Signup and view all the answers

What is the purpose of the preliminary underwriting discussions?

To assess applicant eligibility Signup and view all the answers

What is the benefit of using the Underwriting Pre-screen Tool?

To identify potential issues with the application Signup and view all the answers

When must the medical questions on the application be answered?

Before submitting the application Signup and view all the answers

What is the purpose of the Medicare Supplement Master Reference Guide?

To provide information on guaranteed acceptance determination Signup and view all the answers

Who can offer additional Guaranteed Issue rights?

States Signup and view all the answers

Study Notes

Humana Medicare Supplement Plans

No provider or hospital networks for Humana Medicare Supplement plans.
Policyholders enrolled in Plan C, D, F, High Deductible F, G, High Deductible G, or N receive foreign travel emergency coverage.
Electronic claims coordination with Original Medicare.

Key Features

Guaranteed renewable (if criteria is met).
30-day free look period (also referred to as the Right to Return).

Plan Offerings

Plans offered vary by state.
High Deductible Plan F and High Deductible Plan G are available.
Plan options C, F, and High Deductible Plan F are only available for purchase by applicants who were first eligible for Medicare prior to 2020, effective January 1, 2020.

Target Market

Someone who values freedom and flexibility.
Wants original Medicare to be their primary insurance.
Travel frequently and seeks routine care.
May have lots of health issues and are not eligible for Medicaid.
Employer and/or group coverage is costly or may be retiring.

High-Deductible Plans

Someone who wants a lower premium.
Willing to pay some coinsurance, including A and B deductibles.
Wants peace of mind knowing that once they meet the $2,800 deductible, the plan pays 100% of covered services for the rest of the calendar year.
People who are not concerned about hospital costs.
People who don’t have many health issues and can budget.

Sales Strategies

Focus on the value and benefits of the plan.
Highlight the peace of mind and flexibility.
Use the NEADS analysis to present the plan.
Don’t worry about pricing; present the plan based on the client’s needs.
Use open-ended questions to understand the client’s needs and concerns.

Underwriting

Preliminary underwriting discussions may be necessary.
Medical questions are required to be answered by the applicant before submitting the application.
Some states do not allow medical questions (CT, MA, NY, and VT).
Underwriting pre-screen tool is available.

Guaranteed Issue Rights

Federal law gives beneficiaries the right to buy a policy under 7 circumstances.
State-specific open enrollment periods and GI rights may apply.

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Description

Learn about the key features of Humana Medicare Supplement plans, including foreign travel emergency coverage, electronic claims coordination, and guaranteed renewability. Understand how Original Medicare and Medicare Supplement plans work together.