The Sunken Ship
(c) copyright 1999 by Browzer Books.
Medicare Supplement
Insurance
by Lin Stone
| sickness means | sickness or disease of an insured person which first manifests itself after the effective dae of insurance and while the insurance is in force. |
| Accident, Accidental Injury and Accidental means must NOT use "result" terminolgy and must NOT include words such as _____ | a: external b: visible wounds c: violent |
| Accident, Accidental Injury and Accidental means shall not be defined more restrictively than _____ | Injury or injuries, for which benefits are provided, means accidental bodily injury sustained by the insured person which is the direct result of an accident, independent of disease or bodily infirmity or any other cause, and occurs while the insurance coverage is in force. |
| Medicare Eligible Expenses are: | health care expenses of the kinds covered by Meicare, to the extent recognized as reasonable and medically necessary by Medicare. |
| An Applicant is defined as | a: the person who seeks to contract for
insurance benefits b: the proposed certificate holder of a group policy or subscriber contract. |
A Medicare Supplement Policy is a
group or individual policy of accident and health insurance,
or a subscriber contract of
hospital and medical service corporations
or a health maintenance organization
which is marketed
or designed primarily
as a supplement to rembursements under Medicare
for the hospital, medical, or surgical expenses
of persons eligible for Medicare by reason of age.
|
R E S T R I C T I O N S Certificates or supplement policies containing limitations or exclusions on coverage that are more restrictive than those of Medicare may not be advertised, solicited, or issued for delivery in Oklahoma. Certificates or supplement policies containing benefits duplicating those provided by Medicare shall be advertised, solicited, or issued for delivery in Oklahoma. Certificates or supplement policies which use waivers to exclude, limit or reduce coverage or benefits for specifically named or described preexisting diseases or physical conditions shall not be advertised, solicited, or issued for delivery in Oklahoma. |
All insurers selling Medicare supplement coverage in Oklahoma must offer a basic contract (known as Plan "A") that provides the "core benefits." Standardized Plans "B" through "J" may also be offered by the insurer.
Insurers in Oklahoma shall not provide for the payment of benefits to claims of the insured based on standards described as "Reasonable and customary" or "usual and customary" or similar wording.
Medicare supplement policies must include a RENEWAL or CONTINUATION provision. Such provisions must be appropriately captioned and appear on the first page of the policy.
Long Term Care Inflation Protection. Every insurer issuing long term care policies in Oklahoma must offer meaningful optional inflation protection at the time of purchase.
Annual benefit levels must increase 5% or more, compounded annually.
The Insured has the right to increase benefit levels without giving evidence of current insurability or health status.
The insured will be covered with a specified percentage of actual or reasonable charges and will not be subject to a maximum specified benefit amount or limit.
To the insureds:
Type A insurance is a supplement to medicare. There are many companies
that specialize in this type of coverage: Conseco, United American,
NationalCare, etc. all are available HERE.
United American claims to cover more people with medicare supplements than any other
company in the U.S.
NationalCare usually costs less and covers more per dollar invested.
And Conseco is the Cadillac of coverage.
Supplemental coverage for Medicare "gaps" are quite standardized. Types A, B, C,
D, E, F, G, H exist with minimum coverages stated in writing by law. ANY company offering
type "A" absolutely MUST give you that minimum of coverage.
Thus it would look like the lowest price you are offered for "A" would be the
best bet.
However, at this point in your life you need to pay particular attention to the stability
of the company you engage, and their history of dropping coverage. Yes, I know, they CAN'T
drop you UNLESS -- but any student of this business sees not only isolated COUNTIES being
dropped by companies, but whole regions being dropped. And when you are dropped by a
company you will be scrambling for insurance with the age factor advanced in premiums, and
any infirmities you acquire with age to no longer be covered automatically. Consequently,
it behooves you to buy your policy from the best COMPANY you can afford.
And, by the way, before you sign on the dotted line for type "A", put your
pencil to the paper and evaluate type "F".
My Protect Page will reveal all kinds of insurance quote aids.
Individual companies which offer online quotes are nearer the bottom. Pick out one, and
ask for the best prices available to fit your circumstances and your expectations.
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