What is Medicare?
When are you eligible for Medicare?
Signing Up – Already Receiving Social Security Benefits
Signing Up – Not Receiving Social Security Benefits
|When you sign up for Medicare||When your Medicare will begin|
|Automatically enrolled/signed up before your 65th birthday month||First day of your birth month.|
|Automatically enrolled/signed up before 65th birthday month BUT your birthday falls on the 1st||Your coverage will start on the 1st day of month prior to your birthday|
|During the 1st month you turn 65||Medicare will start 1 month after you sign up|
|One month after you turn 65||Medicare will start 2 months after you sign up|
|2 months after you turn 65||Medicare will start 3 months after you sign up|
|3 months after you turn 65||Medicare will start 3 months after you sign up|
|After that time, you can usually only apply during the General Election Period (1/1-3/31)||Medicare will start July 1st|
|How to Sign Up|
Sign Up Online
Sign Up Over The Phone
Sign Up at Your Local
Medicare Parts A and B
Medicare Part A Hospital Insurance Premiums
- No Cost! (If you have worked for at least 10 years for which you paid Medicare taxes)
- If you have worked less than 10 years, you will share in the cost of your Medicare Part A premium.
A non-working spouse can qualify for no cost Part A at age 65 if their spouse has worked 10 years and is at least age 62.
Medicare Part B Medical Insurance Premiums
- Monthly premium based on taxable income
|Yearly Income and Filing Status for 2016||Part B Premium for 2018|
|File individual tax return||File joint tax return||File married & separate tax return|
|$85,000 or less||$170,000 or less||$85,000 or less||
|$85,000 to $107,000||$170,000 to $214,000||Not applicable||
|$107,000 to $133,000||$214,000 to $267,000||Not applicable||
|$133,000 to $160,000||$267000 to $320,000||Not applicable||
|$160,000 and above||$320,000 and above||Greater than $85,000||
|Medicare Part A Hospital Insurance Benefits
Part A Benefits do not cover all costs. You will pay:
Beyond the lifetime limit: you are responsible for all costs
|Medicare Part B Medical Insurance Benefits
Part B Benefits do not cover all costs. You will pay:
There is no Out of Pocket limit on your responsibility for Medicare Part A and Medicare Part B Benefits
What about prescriptions?
Medicare Plans: Plugging the Holes in Medicare Part A and Medicare Part B
|Path 1||Path 2|
|Medicare Supplement and a Part D Prescription Drug Plan||Medicare Advantage Plan|
|Medicare Supplement Plans
Medicare Part D Prescription Drug Plans
Annual Open Enrollment
|Medicare Advantage Plans
How do I enroll? A local insurance agent can:
Annual Open Enrollment
Medicare Special Enrollment
|If you…||You Should…|
I am 65 and Will Keep Working
I am on my employer’s group plan
How do I decide what to do?
Analyze Cost and Benefits
What benefit package can deliver the most benefits at the lowest cost?
|Employer Plan||Medicare / Medicare Supplement / Part D|
|Employer Plan||Medicare Advantage|
Medicare and You This is the official U.S. government Medicare handbook.
Choosing a Medigap Policy A Guide to Health Insurance for People with Medicare. Published by the Centers for Medicaid and Medicare services and the National Association of Insurance Commissioners.
Blue Medicare SupplementSM
For North Carolina beneficiaries enrolled in Medicare Part B
Choose the Plan That’s Right for You
- See the Doctor You Want
- Value-Added Discounts
- Control of Your Care
Savings and peace of mind
Medicare only covers some of your medical costs. That’s why Blue Cross® and Blue Shield® of North Carolina (BCBSNC) offers dependable Medicare supplement plans for Medicare beneficiaries, to help lessen the worries over costs that Medicare doesn’t cover. Choose from our 111 Blue Medicare SupplementSM plans to find the plan that best fits your needs and your budget.
- Wide Selection of Plans
- Protection Against Unexpected Events
A local company you can trust2
BCBSNC serves more than 273,0003 North Carolina Medicare beneficiaries with over 80 years of experience in the health care industry.
- Named one of the world’s most ethical companies for five years in a row2
See the doctor you want
No matter which Blue Medicare Supplement plan you choose, you’re free to select your own Medicare-participating doctor or visit any Medicare-participating hospital. In most cases, your Part A and Part B Medicare claims and supplement claims are handled automatically by BCBSNC.
- Choice of Medicare-participating doctors
- Easy to use, virtually no claims to file
Blue365® Discount Program
Enroll in a Blue Medicare Supplement plan and get savings on a variety of products and services that can help you live a more healthy and active lifestyle – all at a discounted cost4. Save on services such as:
- Laser Eye Surgery
- Medical Bracelets
- Healthy Eating
- Hearing Aids
- Gym Discounts
Silver&Fit® Fitness Program
Blue Medicare Supplement is now offering an exercise and healthy aging program5. Questions about the program can be answered by calling 1-877-764-2746 (TTY/TDD 1-877-710-2746), Monday through Friday 8 a.m. to 9 p.m. Eastern Time
No waiting periods
If you enroll early, you may be eligible for this plan without waiting periods for pre-existing conditions. Pre-existing conditions are conditions for which medical advice was given or treatment was recommended by or received from a physician within six months before the effective date of coverage. If you wait until after the deadline to enroll, you may have a waiting period for pre-existing conditions.
- No waiting periods for pre-existing conditions if you enroll early
Guaranteed acceptance by enrolling early
You cannot be turned down for Blue Medicare Supplement and may not have to complete a medical questionnaire if you meet the following:
- You are age 65 or older, or under age 65 and are eligible for Medicare by reason of disability (Plans A and C 6)
- You enroll within 6 months of enrolling in Medicare Part B
- You are not covered by certain Medicaid programs
- You are a resident of North Carolina
For more information about Blue Medicare Supplement plans, including a free rate quote, call Marcie Dicus at 828-348-2583, or e-mail email@example.com
For costs and further details of the coverage, including exclusions, any reductions or limitations and terms under which the policy may be continued in force, contact your agent or the company.
1 Plan A: BMS A, 11/13, Plan B: BMS B, 11/13, Plan C: BMS C, 11/13, Plan D: BMS D, 11/13, Plan F: BMS F, 11/13, HI DED Plan F: BMS HDF, 11/13, Plan G: BMS G, 11/13, Plan K: BMS K, 11/13, Plan L: BMS L, 11/13, Plan M: BMS M, 11/13, Plan N: BMS N, 11/13
2 Awarded by the Ethisphere Institute, http://ethisphere.com/worlds-most-ethical/wme-honorees (accessed December 2016).
3 Based on BCBSNC enrollment data, July 2016.
4 Blue365 offers access to savings on items that Members may purchase directly from independent vendors, which are different from items that are covered under the policies with BCBSNC. Blue Cross and Blue Shield Association (BCBSA) may receive payments from Blue365 vendors. Neither BCBSNC nor BCBSA recommends, endorses, warrants or guarantees any specific Blue365 vendor or item. This program may be modified or discontinued at any time without prior notice.
5 The Silver&Fit® program is a value-added service on most plans that is provided by American Specialty Health Fitness, Inc. (ASH Fitness), a subsidiary of American Specialty Health Incorporated (ASH) and an independent company, to members of BCBSNC’s Blue Medicare Supplement plans. The program is not available on our F-HD plan and is not a part of a member’s policy or benefits. The program may be changed or discontinued at any time. Additional fees may apply and results are not guaranteed. You should consult with your doctor before taking part in a fitness program. All programs and services are not available in all areas. Silver&Fit and the Silver&Fit logo are trademarks of ASH and are used with permission herein.
CAUTION: POLICY BENEFITS ARE LIMITED TO THOSE APPROVED BY MEDICARE FOR PAYMENT.
WNC Health Insurance / The Asheville Blue Cross and Blue Shield of North Carolina® Store is an independent authorized Agency licensed to sell and promote products from Blue Cross and Blue Shield of North Carolina (BCBSNC). The content contained in this site is maintained by WNC Health Insurance / The Asheville Blue Cross and Blue Shield of North Carolina® Store . Neither BCBSNC nor its agents are connected with or endorsed by the United States government or the federal Medicare program.
BLUE CROSS®, BLUE SHIELD® and the Cross and Shield Symbols are registered service marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans. All other marks are property of their respective owners. BCBSNC is an independent licensee of the Blue Cross and Blue Shield Association. U4093, 1/17
Home Health Care
Most people would prefer not to enter a nursing home…
Kempers Home Health Care insurance plan is an affordable solution that gives you the flexibility to utilize the type of care that is right for you in the comfort of your own home.
Kemper will pay, subject to the policy provisions and limitations, a benefit each day you receive the following services from an approved Home Health Care Practitioner.
- Skilled Nursing Care $75
- General Nursing Care (LPN or LVN) $60
- Physical Therapy $75
- Speech Pathology $75
- Occupational Therapy $75
- Chemotherapy Specialist Services $60
- Enterostomal Therapy $50
- Respiration Therapy $50
- Medical Social Services $50
The maximum benefit for these services is $150 / day for 360 days. The benefit will reset after 180 days of no care.
Prescription Drug Benefit
If you incur expenses in excess of the deductible of $50 per policy year for Prescription Drugs, Kemper will pay 80% of those expenses up to $250 per policy year.
Home Health Care Aide Benefit
Kemper will pay, subject to the policy provisions and limitations, a daily benefit of $40 for each day you require the services of a Home Health Care Aide for up to 60 days
Optional EXTRA Benefits
- Annual Physical Exam $150
- Vision $40 per exam
- Frame and Lenses $75
- Hearing Benefit $50 per exam
- Ambulance $100 per trip
- In Hospital Private Duty Nurse $80 per day
Affordable Rates for North Carolina Residents
|Kemper Home Health Care Benefits|
|Attained Age||Monthly Bank Draft||Annual|
|40 – 45||$11.65||$140.20|
|46 – 50||$11.65||$140.20|
|51 – 55||$11.65||$140.20|
|56 – 60||$12.05||$144.65|
|61 – 64||$13.95||$167.80|
|65 – 70||$14.20||$169.45|
|71 – 75||$18.35||$220.25|
|76 – 80||$21.05||$252.85|
|Kemper Home Health Care with EXTRA BENEFITS|
|Attained Age||Monthly Bank Draft||Annual|
|40 – 45||$17.45||$209.75|
|46 – 50||$17.45||$209.75|
|51 – 55||$17.50||$230.30|
|56 – 60||$17.90||$234.75|
|61 – 64||$19.85||$238.45|
|65 – 70||$20.05||$240.65|
|71 – 75||$24.40||$293.10|
|76 – 80||$27.15||$326.25|
Short Term Care
Bankers Fidelity Life
If you know the need for Long Term Care insurance but cannot afford the premiums, a Short-Term Care policy (B 9305) may be your answer for covering a Nursing Home Confinement expense. By providing up to 360 days of nursing home benefits per confinement, Short-Term Care will cover most all nursing home stays at a price that is much more affordable than traditional long-term care insurance.
In addition, Short-Term Care coverage helps provide a degree of protection from the depletion of your assets should you require a brief stay in a nursing facility. And a Short-Term Care policy allows you time to make critical financial arrangements if long term nursing home care becomes necessary.
- Guaranteed Renewable for Life. As long as you pay your premium, your coverage cannot be cancelled.
- No Prior Hospitalization Required. You may enter a nursing home directly from home.
- Flexible Benefits. Choose from $ 20 a day to $ 300 a day with benefit periods from 180 days to 360 days.
- Full Restoration of Benefits. Following confinement in a nursing home and after you have been confinement free for six consecutive months, 100% of any benefits paid are restored. Your lifetime maximum benefit is two times the benefit period selected.
- Full Benefits Paid for Alzheimer’s Disease. Cognitive impairment, including senile dementia, Parkinson’s Disease and Alzheimer’s Disease are covered with the same benefits.
- Broad Definition of Coverage. Benefits are paid when you are unable to perform two of five activities of daily living (ADL’s) and your nursing home stay is medically necessary as determined by your physician. ADL’s include:
Long Term Care
It’s a fact: 70% of Americans over the age of 65 will need Long Term Care. Who says so? The Centers for Medicare and Medicaid Services.
For some people, the words “long term care” may bring to mind the image of a nursing home. In reality, long term care is a wide range of services and other support you may need to get though the basic and personal tasks of everyday life as you get older.
Putting a plan in place NOW, as you would for any other future financial need, can help prevent potential long-term care expenses from impacting your family and finances later on.
The cost of long-term care can be staggering. It’s estimated that one year of home health care, which costs about $ 45,000 today, will cost over $ 72,000 by the year 2034, assuming an annual inflation rate of 2.4%. Putting a plan in place NOW to address these expenses can give you the freedom to select the services and providers you want later on. Planning now may even extend the length of time you’re able to remain in your home.
Know Your Options
- Health Insurance and Social Security
DO NOT cover long term care expenses
May cover a portion of long term care costs, but only up to 100 days. Requires a three – consecutive – day stay in the hospital under treatment as well as other qualifiers.
Covers long-term care expenses for individuals with assets of $ 2000 or less (varies by state); care may be limited to a nursing home.
- Adult children
Many people assume their adult children will care for them later in life, but this presents a huge financial, physical and emotional burden that some people aren’t willing or able to take on.
- Out of Pocket
Using income and savings or selling assets may be an option, however, considering the median annual cost for a private room in a nursing home is $ 87,600, it may not be a very efficient option.
- Long-term care coverage
Long-term care coverage is simply a way to protect yourself and your assets from the potentially devastating impact of a long-term care expense.
Together, We Can Select the Product that Fits Your Needs
If we decide that long-term care insurance is the right choice for you, here are three common types of products to choose from.
- Life insurance policies with a LTC rider.
Consider this option if you’re most concerned with leaving a legacy or caring for loved ones when you pass, but would still like to have access to the death benefit yourself if long-term care needs should arise;
- Linked Benefit Policies
If you are primarily concerned with LTC coverage and have less need for life insurance coverage, then a linked benefit LTC policy may be a good option for you; they offer an extension of LTC benefits beyond the life insurance coverage; premiums are guaranteed never to increase and are typically funded with a single premium or limited pay.
- Stand Alone Policies
If you don’t need additional life insurance coverage and desire LTC coverage with lower premiums compared to other polices, then a stand-alone LTC policy may be right for you. Please note that premiums may increase NUMEROUS times in the future, and there are no policy benefits other than LTC coverage.
How Benefits are Paid
With a reimbursement-style policy, which is the most common, the policy owner (or care provider) submits bills or receipts to the insurance carrier for approval. If approved, the insurance carrier then reimburses the exact amount of the bill monthly, up to the amount the insured qualifies for, but never more.
In contrast, cash indemnity-style policies pay the policy owner directly each month, without requiring monthly bills or receipts. Because the monthly benefit amount is sent to the policy owner, it offers flexability to use the funds for individualized care needs including:
- Home Saftey Improvements
- Prescription Medications
- Massage Therapy
- Home Maintenance or Yard Work
Don’t Leave Your Future Up To Chance
Taking control of your future long-term care expenses can be as simple as having a plan. Ask us for more information about long-term care coverage today!