Nebraska Department of Insurance
THE NEBRASKA HEALTH INSURANCE INFORMATION, COUNSELING, AND ASSISTANCE (NICA) PROGRAM
DECEMBER 2002 NICA NEWS
QUESTIONS AND ANSWERS
Q: I received a letter stating that I won't become eligible for full benefits from Social Security until 10 months after my 65th birthday. Will this affect my Medicare benefits?A: No, the enrollment age for Medicare has not changed. A person continues to be eligible to enroll in Medicare 3 months before their 65th birthday through 3 months after their 65th birthday without penalty, regardless of the new enrollment dates for Social Security Benefits. After enrollment for Medicare, a bill will be sent to the beneficiary for the Part B premiums every three months until Social Security benefits begin.
To see the chart with the phase-in of the new Social Security age, visit: http://www.ssa.gov/retirechartred.htm
Q: Does Medicare cover Air Ambulance?
A: Yes, if it is medically necessary (life or death situation) and the patient must be taken to the closest hospital available. If the beneficiary could have gone by land ambulance without serious danger to his/her life or health, Medicare will only pay the land ambulance rate and the beneficiary would be responsible for the difference.
Q: Will Medicare pay for the medical care I received overseas if the treatment was received in an American hospital?
A: Medicare does not cover foreign hospital stays, with the few noted exceptions involving some situations in Canada and Mexico. Standard Medicare Supplement plans C through J do include a foreign travel emergency benefit. In addition, the Medicare Complete HMO available to Douglas County residents in Nebraska does have a benefit covering emergency services received at a foreign hospital.
Q: Why do Medicare Supplement prices increase so much?
A: Do you have the Medicare supplement blues? You've got a lot of company. Many policyholders wonder why, when health care inflation has been moderate; policy prices have risen so fast.
Medicare supplement insurance companies selling to individuals must pay out at least 65% of premiums for health claims. If they meet this requirement, the Nebraska Department of Insurance must approve the insurer's request for an increase. Each company's products are evaluated separately. A Medicare supplement insurer whose policyholders have a greater number or more expensive claims will face larger price increases. Companies whose policyholders are older also may face larger increases.
In addition to the percent of premiums paid out in health benefits, insurers also look at expected future trends to set their prices. They will make assumptions about how the rate of increase over the past year will continue in the future, modified by other factors such as changes in Medicare prices and deductible amounts.
Another reason some policies may increase is that they are "attained age rated" policies. These policies automatically increase in price as a policyholder ages, because on average older consumers use more health care services than younger ones. As a result, 65-year olds get lower rates than 75- or 80-year olds.