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2017 MEDICARE SUPPLEMENT COMPARISON GUIDE

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Temporary Suspension of

Temporary Suspension of Premiums/ Reinstitution of Coverage A Medicare beneficiary may request temporary suspension of premium if any of the following occur: CATEGORY 1: • Suspension of Premiums (not to exceed 24 months) can occur if a Medicare beneficiary has applied for and is determined to be entitled for medical assistance (Medicaid) under Title XIX of the Social Security Act and notifies the company within 90 days after the date the individual becomes entitled to assistance. Reinstitution of coverage shall (1) not provide for any waiting period with respect to treatment of preexisting conditions; and (2) provide for resumption of coverage that is substantially equivalent to coverage in effect before the date of suspension; and (3) provide for classification of premiums on terms at least as favorable to the policyholder as the premium classification terms that would have applied to the policyholder had the coverage not been suspended. • Reinstitution of coverage can occur if a Medicare beneficiary loses entitlement to medical assistance, the Medicare beneficiary shall be automatically reinstituted (effective as of the date of termination of such entitlement) as of the termination of entitlement if the policyholder or certificate holder provides notice of loss of entitlement within 90 days after the date of loss and pays the premium attributable to the period, effective as of the date of termination of entitlement. CATEGORY 2: • Suspension of Premium (for any period that may be provided by federal regulation) can occur if a Medicare beneficiary is entitled to benefits under Section 226 (b) of the Social Security Act and is covered under a group health plan [as defined in Section 1862 (b) (1)(A)(v) of the Social Security Act]. • Reinstitution of coverage can occur if a Medicare beneficiary loses coverage under the group health plan. The policy shall be automatically reinstituted (effective as of the date of loss of coverage) if the policyholder provides notice of loss of coverage within 90 days after the date of the loss and pays the premium attributable to the period, effective as of the date of termination of enrollment in the group health plan. 20

Factors to Consider When Comparing Medicare Supplement Policies For more information on “Choosing a Medigap Policy” go to www.medicare.gov. When describing the benefits of their Medicare supplemental plans, all insurers are required to use the same format, language and definitions. They are also required to use a uniform chart and outline of coverage to summarize the benefits of the plans they offer. These requirements make it easier for you to compare policies from different insurers. As you shop for a policy, you should keep in mind that each company’s products are alike, so they are competing based on their price, service and reputation. PRICE While the benefits are identical for all Medicare supplemental plans of the same type, the premiums vary from one company to another and from area to area. The plan with the lowest price is not necessarily the best plan. The price should not be the only concern. You may prefer a particular schedule of payments. Some companies bill the premium each month, while others bill each quarter or once a year. In addition, prices are based in part on the services a company provides and on their reputation. These are important factors in the decision to purchase a Medicare supplemental policy. REPUTATION You should consider the reputation of the insurer before buying a policy. Find out about the company by asking for referrals and by talking to others about their experiences. Take your time in making a choice. Choosing a plan and insurer is a major decision. Make sure you understand the choices, the responsibilities and the consequences of the decision. CUSTOMER SERVICES You should ask about the insurer’s customer services. For example, some companies link their computers to the computers at the federal Medicare office to process your health insurance claims without additional paperwork. This is called Medicare Crossover (see pages 11 and 16). This and other available customer services may be important considerations in making a decision. 21