bridging the 9 - arkansas insurance department · 2019-10-24 · from the date of loss of coverage...

52

85 Glossary and Helpful Number

57 Medigap Plans Under 65

BRIDGING THE GAP 2019 MEDICARE SUPPLEMENT(MEDIGAP) Comparison GUIDE

from the Arkansas Insurance Department division of Senior Health Insurance Informa on Program (SHIIP)

This booklet contains

Page Topic

2 Helpful Resources

3 Types of Medicare Supplement Policies

4 Significant Medicare Insurance Law

5 Special Circumstances for Medigap

6 Buyer Beware and Variables

7 Medicare Cost Part A & B

8 Medigap Plan Op ons A‐N

9 Medigap Plans 65 and Older

Medigap Select Plans

SHIIP can help in understanding your Medicare choices

SHIIP is funded by the Administra on for Community Living, an agency of the U.S. Department of Health and Human Services.

SHIIP works to help people save money and make informed decisions about Medicare.

SHIIP offers phone and in‐person appointments to discuss Medicare choices and answer ques ons.

SHIIP does not sell insurance or offer legal advice. SHIIP cer fied Medicare counselors offer unbiased informa on and referral services.

www.insurance.arkansas.gov FIND US ON FACEBOOK AND TWITTER

Medicare Plans Change. People Change. Shop & Compare Plans

1200 W 3rd St Li le Rock, Arkansas 72201 Toll Free: 1‐800‐224‐6330

Rev 2.03.2019 1

This guide summarizes the benefits of Medicare Supplement Policies currently approved by the Arkansas Insurance Department for sale. Inclusion of informa on in this guide regarding a policy does not, in any way, cons tute an endorsement of the policy or company by the Arkansas Insurance Department.

For quotes and exact premium cost contact company or agent to purchase.

Be advised that some new policies may have entered the marketplace since this publica on was printed and will not be included. See the back cover of this publica on, lower le corner for revision date.

Don't be alarmed if your Medicare Supplement Policy does not appear in this booklet. You may choose to keep your policy as long as you pay the premium.

Publica on of this guide is for informa on purposes only. Please refer to the policy itself for the complete and actual terms of coverage since the policy cons tutes the contract between the insurer and the insured and will ul mately be the basis of final determina ons.

SHOP WITH CAUTION. Do not just buy the cheapest policy without weighing other factors and determining the company’s financial stability and reputa on for resolving complaints.

AVOID HIGH PRESSURE SALES TACTICS. Take me and avoid being pushed into buying an insurance policy. Do not buy a policy under the pressure of limited enrollment periods or of “last chance to enroll.” Be wary of agents and sales material that imply a policy is connected with or endorsed by the government. Medicare Supplement Insurance and Long‐term Care insurance are not connected with or endorsed by the federal government.

DON’T BE MISLED BY ADVERTISING. Do not buy a policy because celebri es endorse it on television, radio, newspaper, or other adver sements. Ask ques ons before buying a policy.

BE CAREFUL HOW YOU PAY FOR POLICIES. Do not pay in cash. When purchasing Medicare Supplement Insurance, it is always best to pay by check, money order, or bank dra . Premium payments should always be made payable to the insurance company, not the agent selling the policy. If you must pay in cash, be sure to get a company‐authorized receipt signed by the agent.

KEEP YOUR POLICY IN A SAFE PLACE. Select a friend or rela ve in advance to handle your medical affairs in case of illness and let that person know where to locate your policy.

KEEP RECORDS. Write down and keep the correct name, telephone number, and permanent address of the agent and the insurance company. Ask for a toll‐free number in case you need to call long distance. Record important policy, company and agent informa on below and keep it in a safe place.

Rev 2.03.2019 2

TYPES OF MEDICARE SUPPLEMENT INSURANCE/MEDIGAP

Most companies offer two rates: Preferred and Standard. The monthly premium amount is based on medical underwri ng. Underwri ng is the method insurance companies use to evaluate your health status to determine risk and insurability (if they’ll sell you a policy).

Preferred Premium

The Preferred insurance premium is typically lower than the standard premium. Insurance companies base their decision to offer a preferred premium on a variety of factors including but not limited to: smoking/tobacco use, weight, cholesterol, blood pressure, substance abuse, etc.

The Preferred Premiums are offered to those purchasing during the Medigap Open Enrollment Period (OEP) as well. See page 4 for more informa on about the Medigap OEP.

Standard Premium

The standard rates apply outside the Medigap Open Enrollment Period and for those with less favorable medical histories.

Rev 2.03.2019 3

SIGNIFICANT MEDIGAP INSURANCE LAWS

► A free‐look period of 30 days is required, during which me the applicant may return the policy to the insurance company and receive a full refund. The free‐look period begins from the day the applicant receives the cer ficate or policy, not the day of the applica on.

► A pre‐exis ng condi on wai ng period may

extend no longer than six months for health condi ons diagnosed or treated within the six months immediately prior to the applica on. The medical ques onnaire accompanying an applica on should have accurate informa on and should be completed by the applicant, not the agent.

► Should the applicant be replacing a Medicare

supplement policy, no new wai ng period is allowed by the replacing insurer for equivalent coverage.

► For replacement policies, the applicant is

required to sign a replacement form indica ng that he/she understands the hazards of changing.

► No agent in Arkansas may sell a new Medicare

Supplement Policy to anyone who already has a Medicare Supplement unless the applicant agrees to drop his or her previous insurance.

► All Medicare supplement policies must be

guaranteed renewable.

► The 101st Congress (1990) passed strong federal legisla on, which made uniform requirements for Medicare Supplement Insurance policies in each state. Policy holders are not required to change from their old supplemental policies to a policy with the new standards unless they so choose.

► MEDIGAP OPEN ENROLLMENT= A Medicare

supplement insurer may not deny an applicant a policy during the six months period known as the Medigap Open Enrollment Period. The six month period begins with the Medicare beneficiary is BOTH enrolled in Part B and age 65 or older. During this enrollment period an insurance company can not deny a policy based on the applicants health status. This is a one me enrollment period. Once the Medigap Open Enrollment Period begins, it can not be started again.

In Arkansas, there is no open enrollment period for Medicare Beneficiaries who are not yet 65. However, they are en tled to a six‐month Open Enrollment Period when they reach age 65. ► An insurer must suspend Medicare Supplement

Premiums and benefits while the policyholder is en tled to Medicaid. The insurer must reinstate policy benefits upon request if Medicaid en tlement ends. This suspension may last up to two years. Policyholders are responsible for informing the insurer of their Medicaid eligibility within 90 days of eligibility determina on.

MEDIGAP OPEN ENROLLMENT

If Medicaid eligible, may suspend Medigap for two years.

Rev 2.03.2019 4

CATEGORY 1:

If a Medicare beneficiary is enrolled in an employer‐sponsored plan and the plan terminates or ceases to provide some or all supplemental benefits to Medicare, or the insured chooses to leave the plan.

Then guarantee issue of Medigap Plans A, B, C, F, K or L with any company selling these plans.

CATEGORY 2:

If a Medicare beneficiary is enrolled in a Medicare Advantage Plan and

the plan’s cer fica on is terminated, or the plan ceases to provide all services, or the enrollee moves out of the service , or the plan violates the contract, misrepresents during

marke ng, or there are other circumstances as determined by HHS

Secretary,


CATEGORY 3:

If a Medicare beneficiary is enrolled in a Medicare Risk, Cost, Demonstra on, HCPP, or select plan, and

the plan’s cer fica on is terminated, or the plan ceases to provide all services, or the enrollee moves out of the service , or the plan violates the contract, misrepresents during

marke ng, or there are other circumstances as determined by HHS

Secretary,


CATEGORY 4:

If a Medicare beneficiary is enrolled in a Medigap policy and any of the following occur:

the Insurer becomes insolvent or bankrupt, or there is involuntary termina on of coverage or

enrollment, or there is material viola on of the policy, or

there is material misrepresenta on during marke ng,


CATEGORY 5:

If a Medicare beneficiary is enrolled in a Medigap policy, terminates it and enrolls for the first me in a Medicare Advantage Plan, Risk, Cost, Demonstra on, HCPP, or Select plan, and disenroll from the chosen coverage within the first 12 months as permi ed under federal law,

Then guarantee issue of Medigap Plans A, B, C, F, K or L with any company selling these plans or his/her prior Medigap plan, if it is s ll available.

CATEGORY 6:

If an individual is first eligible for Medicare Part A at the age of 65, and

enrolls in a Medicare Advantage plan , and disenroll within the first 12 months a er enrollment as

permi ed by federal law,

Then guarantee issue of any Medigap plan sold by any insurer.

CATEGORY 7:

If an individual leaves a Medicare Advantage Plan or drop a Medigap policy because the company has not followed the rules or misled the individual,

Then guarantee issue of Medigap Plans A, B, C, F, K, L, M, or N sold by any insurer.

SPECIAL CIRCUMSTANCES FOR GUARANTEED ISSUE FOR MEDIGAP

If you believe you meet the criteria in one of these categories and have been denied a policy, contact

SHIIP

1‐800‐224‐6330 or email [email protected]

Federal and state laws guarantee acceptance into Medicare Supplement insurance (Medigap), if a Medicare beneficiary qualifies in one of seven categories listed below. This means the insurance company can not deny a policy nor impose a pre‐exis ng wai ng period based on medical history. There is a strict me limit! The Medicare beneficiary has ONLY 63 days from the date of loss of coverage to apply for a Medigap policy and be granted a guaranteed issue.

The Arkansas Insurance Department is commi ed to seeing that your rights are upheld in all circumstances pertaining to guaranteed acceptance into Medicare Supplement Insurance.

Rev 2.03.2019 5

When describing the benefits of Medicare Supplement Plans, all insurers use the same format, language, and defini ons. They are required to use a uniform chart and outline of coverage to summarize the benefits of the plans they offer. These requirements make it easier to compare policies from different insurers. As you shop for a policy, keep in mind that each company’s products are standard, products compete based on price, service, and reputa on. PRICE. While the benefits are iden cal 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 par cular schedule of payments. Some companies bill the premium each month, while others bill each quarter or once a year. In addi on, prices are based in part on the services a company provides and on their reputa on. Some plans add benefits but remember the basic coverage is the same from plan to plan based on federal law.

CUSTOMER SERVICES. You should ask about

the insurer’s customer services. For example, some companies link their computers with the computers at the federal Medicare office to process your health insurance claims without addi onal paperwork. This is called Medicare Crossover. This and other available customer services may be important considera ons in making a decision.

REPUTATION. You should consider the

reputa on of the insurer before buying a policy. Find out about the company by asking for referrals, asking others about their experiences, and check out the number of complaints filed at this website

h ps://eapps.naic.org/cis/

POLICY FEE: Some policies add a one‐ me policy fee. These are not allowed in Arkansas. UNDERWRITING: Most companies underwrite. However, a few policies are “guaranteed issue.” PREMIUM TYPE: The premium for your policy may increase every year, primarily due to infla on in medical costs and the use of more advanced technology. The amount your premium goes up may depend upon the manner in which the company has reflected the aging of its policyholders in its rates. The general approach that companies use are described below. In Arkansas, the no age ra ng method is used. 1. A ained Age: In addi on to medical infla on and

advancing technology, your premium will also rise due to the increased use of medical services as people age.

2. Issue Age: The premium you pay will ini ally be somewhat higher than under the a ained age approach because a por on of the ini al premium is used to pre‐fund the increased claims cost in later years. As a result, in subsequent years your premiums should be somewhat less than they would be under an a ained age approach.

3. No Age Ra ng: Under this approach, the premium is the same for all customers who buy this policy, regardless of age.

DIRECT RESPONSE/AGENT: Premiums are basically the same when comparing a direct response sale to an agent‐marketed sale. NON‐SMOKER: Few companies have non‐smoker discounts. MEDICARE CROSSOVER: This is one of the more significant service enhancements that companies can offer. A “crossover” company has a contract with Medicare requiring Medicare to send the policyholder’s balance bills directly to the Medicare Supplement Insurance Company.

BUYER BEWARE VARIABLES

Rev 2.03.2019 6

CURRENT COSTS OF MEDICARE

SERVICES BENEFITS MEDICARE PAYS

All but $1,364 $1,364 deductible

$341 per day $682 per day All but $682 per day

$170.50 per day All but $170.50 per day

YOU PAY

Hospitaliza on Semiprivate room, general nursing, misc. services

First 60 days 61st to 90th day 91st to 150th day Beyond 150 days Nothing All charges

Skilled Nursing Facility Care (SNF) a er a 3 night hospital stay

First 20 days 21st to 100th day Beyond 100 days

100% of approved

Nothing

Nothing if approved

All costs

Home Health Care Medically necessary skilled

Part‐ me care as long as you meet guidelines

100% of approved Nothing if approved

Hospice Care For the terminally ill

As long as doctor cer fies need

All but limited costs for drugs & respite care

Limited costs for drugs & respite care

Blood Blood All but first 3 pints First 3 pints

PART A HOSPITAL INSURANCE COVERED SERVICES

SERVICES BENEFITS MEDICARE PAYS

80% of approved amount (a er $185 deduc ble)

20% of approved amount (a er $185 deduc ble)

80% of approved amount (a er $185 deductible)



YOU PAY

Medical Expense Physician services & medical supplies

Medical services in and out of the hospital

Clinical Laboratory Diagnos c tests 100% of approved Nothing if approved

Home Health Care Medically necessary skilled

Part‐ me care as long as you meet guidelines

100% of approved Nothing if approved

Outpa ent Hospital Treatment

Unlimited if medically necessary

80% of approved

Durable Medical Equipment Prescribed by doctor for use in home

PART B MEDICAL INSURANCE COVERED SERVICES

Blood Blood All but first 3 pints First 3 pints

Rev 2.03.2019 7

All but $341 per day

Reading the chart: If a “x” mark appears in a column of this chart, the Medigap policy covers 100% of the desired benefit. If a column lists a percentage, then the policy covers that percentage of the described benefit. If a column is blank, then the policy does not cover that benefit.

Note: The Medigap policy covers coinsurance only a er you have paid the deduc ble (unless the Medigap policy also covers the deduc ble).

MEDIGAP PLAN OPTIONS

Medigap Plan Benefits A B C D F G K L M N

Medicare Part A eligible hospital costs up to an addi onal 365 days a er all Medicare hospital benefits are ex‐ hausted

X X X X X X X X X X

Medicare Part B Coinsurance or Copay‐ment (20% of Medicare Assignment) X X X X X X 50% 75% X X

Blood (First 3 Pints) X X X X X X 50% 75% X X

Part A Hospice Care Coinsurance or Copayment X X X X X X 50% 75% X X

Skilled Nursing Facility Care Copayment (Days 21‐100 = $170.50 per day in 2019)

X X X X 50% 75% X

Medicare Part A Deduc ble ($1364 per benefit period in 2019)

X

X X X 50% 75% 50% X

Medicare Part B Deduc ble ($185 per year in 2019)

X X

Medicare Part B Excess Charges (up to 15% above Medicare approved amount if provider does not accept Medicare assignment)

X X

Foreign Travel Emergency (Up to Plan Limits) X X X X X X

Medicare Preven ve Part B Coinsur‐ance (as of 2011 most preven ve screenings no longer require coinsur‐ance payment)

X X X X X X X X X X

Rev 2.03.2019 8

X

X X

MEDIGAP PLANS FOR AGE 65 AND OLDER

MEDIGAP prices are estimations only & subject to change Call company for cost

Rev 2.03.2019 9

Medicare Supplement Summary

Company

Address

Customer Service Phone

Customer Service Email

Medical Underwriting

Pre‐existing ConditionWaiting Period A

BMedicare Crossover C

DAreas FArea 1 HD‐FArea 2 GArea 3 KArea 4 L

MMonthly Premium by Area and Plan NPreferred Non‐smoking

Area A B C D F HD‐F G K L M NArea 1 117.43 137.23 165.47 143.74 169.40 66.74 144.48 x x 129.44 118.53Area 2 112.09 130.99 157.95 137.21 161.70 63.71 137.91 x x 123.56 113.14Area 3 99.28 116.02 139.89 121.53 143.22 56.43 122.15 x x 109.44 100.21Area 4

StandardArea A B C D F HD‐F G K L M NArea 1 130.54 152.35 183.89 159.69 188.20 74.08 160.52 x x 143.74 131.83Area 2 124.61 145.43 175.53 152.43 179.65 70.71 153.22 x x 137.21 125.84Area 3 110.37 128.81 155.47 135.01 159.12 62.63 135.71 x x 121.53 111.46Area 4

Tobacco User (if different from "Standard")Area A B C D F HD‐F G K L M NArea 1Area 2Area 3Area 4

* Zip codes beginning with 722 and zip codes 72002, 72053, 72065, 72076, 72078, 72099, 72103, 72113‐72120, 72124, 72135, 72142, 72164, 72180, 72183, 72190, 72198, 72199

Admiral Life Insurance Company of America

Other

Yes or No

Yes or No (when applicable)

1720 W. Rio Salado Pkwy, Tempe, AZ 85281

888‐474‐9519

www.puritanlifeinsurance.com/Contact


KEYMedicare A PlanMedicare B PlanMedicare C PlanMedicare D PlanMedicare F Plan

Medicare N Plan

Medicare G PlanMedicare K PlanMedicare L Plan

Medicare High Deductible F PlanZip Codes Covered

*All other 720 and 721 zip codes

Rest of State

Medicare M Plan

Rev 2.03.2019 10


Company

Address



Medical Underwriting Yes


BMedicare Crossover Yes C



Area A B C D F HD‐F G K L M NArea 1 118.71 136.62 x x 161.94 64.73 139.86 x x x 106.71Area 2 131.77 151.65 x x 179.76 71.85 155.25 x x x 118.45Area 3Area 4

StandardArea A B C D F HD‐F G K L M NArea 1 131.87 151.86 x x 179.93 71.89 155.44 x x x 118.62Area 2 146.38 168.57 x x 199.73 79.80 172.54 x x x 131.67Area 3Area 4


Other

Yes or No


Aetna Health and Life Insurance Company

800 Crescent Centre Dr., Franklin,TN 37067

(800) 3624‐6290

www.aetnaseniorproducts.com


Medicare M PlanMedicare N Plan

Medicare A PlanMedicare B PlanMedicare C PlanMedicare D PlanMedicare F Plan

KEYNo

Medicare High Deductible F PlanMedicare G PlanMedicare K PlanMedicare L Plan

Zip Codes CoveredAll areas not listed for Area 2

720‐722

Rev 2.03.2019 11


Company

Address




Pre-existing Condition

Waiting Period A

B

Medicare Crossover C

D

Areas F

Area 1 HD-F

Area 2 G

Area 3 K

Area 4 L

M

Monthly Premiums by Area and Plan N

Preferred Non-smoking

Area A B C D F HD-F G K L M N

Area 1 119.84 x x x 170.30 49.68 131.68 x x x 116.69

Area 2 134.82 x x x 191.59 55.89 148.14 x x x 131.28

Area 3 131.83 x x x 187.33 54.65 144.84 x x x 128.36

Area 4

Standard


Area 1 133.16 x x x 189.22 55.20 146.30 x x x 129.65

Area 2 149.80 x x x 212.87 62.10 164.59 x x x 145.86

Area 3 146.47 x x x 208.14 60.72 160.93 x x x 142.62

Area 4

Tobacco User (if different from "Standard")


Area 1

Area 2

Area 3

Area 4

Zip Codes Covered

716-717, 725-729

718

719-724

Medicare M Plan

Medicare N Plan

Medicare G Plan

Medicare K Plan

Medicare L Plan

Medicare A Plan

Medicare B Plan

Medicare C Plan

Medicare D Plan

Medicare F Plan

Medicare High Deductible F Plan

American National Life Insurance Company of Texas

Other

Yes or No


800-899-6806


KEY

One Moody Plaza, Galveston, TX 77550

Rev 2.03.2019 12


Company

Address





Waiting Period A

B


D

Areas F

Area 1 HD-F

Area 2 G

Area 3 K

Area 4 L

M




Area 1 187.45 x x x 229.31 x 143.68 x x x 137.98

Area 2 217.27 x x x 265.80 x 166.54 x x x 159.93

Area 3

Area 4

Standard


Area 1 206.21 x x x 252.25 x 158.05 x x x 151.79

Area 2 239.01 x x x 292.38 x 183.00 x x x 175.92

Area 3

Area 4



Area 1 313.89 x x x 388.12 x 358.26 x x x 276.68

Area 2 363.83 x x x 449.86 x 415.26 x x x 320.70

Area 3

Area 4

American Retirement Life Insurance Company

Yes or No


866-459-4279


KEY

PO Box 26580, Austin, TX 78755-0580

Medicare A Plan

Medicare B Plan

Medicare C Plan

Medicare D Plan

Medicare F Plan


Zip Codes Covered

716-719, 723-729

720-722

Medicare M Plan

Medicare N Plan

Medicare G Plan

Medicare K Plan

Medicare L Plan

Rev 2.03.2019 13


Company

Address








Area A B C D F HD‐F G K L M NArea 1 599.55 x x x x x x x x x xArea 2 538.37 x x x x x x x x x xArea 3Area 4

StandardArea A B C D F HD‐F G K L M NArea 1 689.48 x x x x x x x x x xArea 2 619.13 x x x x x x x x x xArea 3Area 4

Tobacco User (if different from "Standard")Area A B C D F HD‐F G K L M NArea 1 x x x x x x x x x x xArea 2 x x x x x x x x x x xArea 3Area 4

Other

Yes or No


Americo Financial Life and Annuity Ins. Company

300 West 11th Street, Kansas City, MO 64105

(800) 231‐0801

[email protected]




KEYNo


Zip Codes Covered720‐722

716‐719, 723‐729

Rev 2.03.2019 14


Company

Address





Waiting Period A

B


D

Areas F

Area 1 HD-F

Area 2 G

Area 3 K

Area 4 L

M




Area 1 105.00 x 155.70 x 174.70 45.50 127.50 x x x 102.40

Area 2 120.50 x 175.40 x 196.70 51.20 143.30 x x x 114.50

Area 3 147.00 x 213.80 x 239.80 62.50 174.70 x x x 139.60

Area 4

Standard


Area 1

Area 2

Area 3

Area 4



Area 1

Area 2

Area 3

Area 4

Arkansas Blue Cross Blue Shield

Other

Yes or No


P.O. Box 2181, Little Rock, AR 72203-2181

800-392-2583

www.arkansasbluecross.com


KEYNo

Medicare A Plan

Medicare B Plan

Medicare C Plan

Medicare D Plan

Medicare F Plan


*Area 2 - Clark, Cleburne, Conway, Cross, Dallas, Faulkner, Garland, Hempstead, Hot Spring, Howard, Independence, Izard, Jackson, Lawrence,

Little River, Lonoke, Nevada, Ouachita, Perry, Pike, Pulaski, Saline, Sevier, Sharp and Van Buren

Zip Codes Covered

All counties not listed in Area 2

*

Out of state

Medicare M Plan

Medicare N Plan

Medicare G Plan

Medicare K Plan

Medicare L Plan

Rev 2.03.2019 15

Company

Address





Waiting Period A

B

Medicare Crossover Yes C

D

Areas F

Area 1 HD-F

Area 2 G

Area 3 K

Area 4 L

M




Area 1 165.17 191.00 230.55 188.95 235.72 x 188.95 x x x 109.32

Area 2 180.04 208.19 251.30 205.96 256.94 x 205.96 x x x 119.16

Area 3 193.25 223.47 269.75 221.08 275.80 x 221.08 x x x 127.91

Area 4

Standard


Area 1 189.85 219.54 265.00 217.19 270.95 x 217.19 x x x 125.66

Area 2 206.94 239.30 288.85 236.74 295.34 x 236.74 x x x 136.97

Area 3 222.13 256.87 310.05 254.12 317.02 x 254.12 x x x 147.03

Area 4



Area 1

Area 2

Area 3

Area 4

Assured Life Association

Yes or No


877-223-3666

[email protected]


KEYNo

PO Box 2397, Omaha, NE 68103-2397

Medicare A Plan

Medicare B Plan

Medicare C Plan

Medicare D Plan

Medicare F Plan


Zip Codes Covered

716-717, 724-729

718-721

722-723

Medicare M Plan

Medicare N Plan

Medicare G Plan

Medicare K Plan

Medicare L Plan

Rev 2.03.2019 16


Company

Address





Waiting Period A

B


D

Areas F

Area 1 HD-F

Area 2 G

Area 3 K

Area 4 L

M




Area 1 125.42 x 179.44 x x x 128.08 x x x 108.95

Area 2 142.98 x 204.57 x x x 146.02 x x x 124.21

Area 3

Area 4

Standard


Area 1 144.16 x 206.26 x x x 147.22 x x x 125.23

Area 2 164.35 x 235.14 x x x 167.83 x x x 142.77

Area 3

Area 4



Area 1

Area 2

Area 3

Area 4

Atlantic Coast Life Insurance Company

Other

Yes or No


888-805-8680

www.aclico.com


KEY

Medicare N Plan

Medicare G Plan

Medicare K Plan

Medicare L Plan

Medicare A Plan

Medicare B Plan

Medicare C Plan

Medicare D Plan

Medicare F Plan


P.O. Box 20010, Charleston, SC 29413

Zip Codes Covered

716-719, 723-729

720-722

Medicare M Plan

Rev 2.03.2019 17


Company

Address





Waiting Period A

B


D

Areas F

Area 1 HD-F

Area 2 G

Area 3 K

Area 4 L

M




Area 1 137.00 x x x 202.00 54.00 153.00 87.00 x x x

Area 2 122.00 x x x 181.00 48.00 137.00 78.00 x x x

Area 3

Area 4

Standard


Area 1 164.00 x x x 243.00 65.00 183.00 103.00 x x x

Area 2 147.00 x x x 218.00 58.00 163.00 93.00 x x x

Area 3

Area 4



Area 1

Area 2

Area 3

Area 4

Bankers Fidelity Life Insurance Company

Yes or No


4350 Peachtree Rd., N.E. Atlanta, GA 30319

866-458-7504 x 876

www.bflic.com


KEYNo

Medicare K Plan

Medicare L Plan

Medicare A Plan

Medicare B Plan

Medicare C Plan

Medicare D Plan

Medicare F Plan


Zip Codes Covered

720-722

Rest of State

Medicare M Plan

Medicare N Plan

Medicare G Plan

Rev 2.03.2019 18


Company

Address





Waiting Period A

B


D

Areas F

Area 1 HD-F

Area 2 G

Area 3 K

Area 4 L

M




Area 1 222.87 210.52 x 157.68 249.10 46.94 216.95 70.80 143.79 180.18 152.43

Area 2

Area 3

Area 4

Standard


Area 1 247.63 233.89 x 175.20 276.75 52.15 241.05 78.66 159.75 200.19 169.37

Area 2

Area 3

Area 4



Area 1 275.14 259.90 x 194.66 307.50 57.94 267.82 87.39 177.33 222.43 188.19

Area 2

Area 3

Area 4

Zip Codes Covered

Whole State

Medicare M Plan

Medicare N Plan

Medicare G Plan

Medicare K Plan

Medicare L Plan

Medicare A Plan

Medicare B Plan

Medicare C Plan

Medicare D Plan

Medicare F Plan


Colonial Penn Life Insurance Company

Other

Yes or No


800-800-2254

www.bankerslife.com


KEYYes

11825 N. Pennsylvania Street, Carmel, IN 46032

Rev 2.03.2019 19


Company

Address





Waiting Period A

B


D

Areas F

Area 1 HD-F

Area 2 G

Area 3 K

Area 4 L

M




Area 1 122.03 x x x 182.34 x 147.95 x x x x

Area 2 133.11 x x x 198.94 x 161.41 x x x x

Area 3

Area 4

Standard


Area 1 134.11 x x x 200.52 x 162.67 x x x x

Area 2 146.29 x x x 218.75 x 177.46 x x x x

Area 3

Area 4



Area 1

Area 2

Area 3

Area 4

Companion Life Insurance Company

Other

Yes or No


800-753-0404

www.CompanionLife.com


KEYNo

7909 Parklane Road, Ste 200, Columbia, SC 29223

Medicare A Plan

Medicare B Plan

Medicare C Plan

Medicare D Plan

Medicare F Plan


Zip Codes Covered

717-720, 724-729

716, 721-723

Medicare M Plan

Medicare N Plan

Medicare G Plan

Medicare K Plan

Medicare L Plan

Rev 2.03.2019 20


Company

Address








Area A B C D F HD‐F G K L M NArea 1 215.73 267.10 x x 320.88 x 299.39 x x x 233.62Area 2 190.56 235.94 x x 283.45 x 264.46 x x x 206.36Area 3 179.77 222.58 x x 267.40 x 249.49 x x x 194.68Area 4

StandardArea A B C D F HD‐F G K L M NArea 1 237.41 293.79 x x 252.97 x 329.27 x x x 257.01Area 2 209.71 259.51 x x 311.79 x 290.86 x x x 227.02Area 3 197.84 244.82 x x 294.14 x 274.39 x x x 214.17Area 4


*Area 1 ‐ 72002, 72053, 72065, 72076, 72078, 72099, 72103, 72113‐72120, 72124, 72135, 72142, 72164, 72180, 72183, 72190, 72198, 72199and all zip codes beginning with 722

Other

Yes or No


Coventry Health and Life Insurance Company

3900 Rogers Road, San Antonio, TX 78251‐3635

(800) 843‐7421




KEY


Zip Codes Covered*

All other 720 or 721 zip codesRest of state

Rev 2.03.2019 21


Company

Address








Area A B C D F HD‐F G K L M NArea 1 169.12 x x x 261.35 x x x x x 176.22Area 2Area 3Area 4

StandardArea A B C D F HD‐F G K L M NArea 1 202.09 x x x 312.65 x x x x x 210.56Area 2Area 3Area 4

Tobacco User (if different from "Standard")Area A B C D F HD‐F G K L M NArea 1 269.42 x x x 416.50 x x x x x 280.67Area 2Area 3Area 4

KEY


Zip Codes CoveredAll Arkansas zip codes



Other

Yes or No


Equitable Life and Casualty Insurance Company

3 Triad Center, Salt Lake City, UT 84180‐1200

(800) 352‐5170


Rev 2.03.2019 22


Company

Address





Waiting Period A

B


D

Areas F

Area 1 HD-F

Area 2 G

Area 3 K

Area 4 L

M




Area 1 196.23 240.92 x x 288.69 x 268.90 x x x 180.14

Area 2 173.34 212.81 x x 255.01 x 237.53 x x x 159.12

Area 3 163.52 200.76 x x 240.57 x 224.08 x x x 150.11

Area 4

Standard


Area 1 215.82 265.00 x x 317.58 x 295.79 x x x 198.12

Area 2 190.65 234.08 x x 280.53 x 261.28 x x x 175.01

Area 3 179.85 220.83 x x 264.65 x 246.49 x x x 165.10

Area 4



Area 1

Area 2

Area 3

Area 4

**Area 2: All other Zip Codes beginning with 720 or 721

Medicare N Plan

Medicare G Plan

Medicare K Plan

Medicare L Plan


Zip Codes Covered

*

**

Rest of State

Medicare M Plan

3200 Highland Ave., Downers Grove, IL 60515

Medicare A Plan

Medicare B Plan

Medicare C Plan

Medicare D Plan

Medicare F Plan

* Area 1: Zip Codes 72002, 72053, 72065, 72076, 72078, 72099, 72103, 72113-72120, 72124, 72135, 72142, 72164, 72180, 72183, 72190,

72198, 72199, and all Zip Codes beginning with 722.

First Health Life and Health Insurance Company

Yes or No


800-226-5116


KEY

Rev 2.03.2019 23


Company

Address





Waiting Period A

B


D

Areas F

Area 1 HD-F

Area 2 G

Area 3 K

Area 4 L

M




Area 1 158.32 228.70 191.62

Area 2 177.32 256.15 214.62

Area 3 194.74 281.31 235.70

Area 4

Standard


Area 1 181.98 262.88 220.26

Area 2 203.82 294.43 246.70

Area 3 223.84 323.35 270.72

Area 4



Area 1

Area 2

Area 3

Area 4

Gerber Life Insurance Company

Other

Yes or No


877-778-0839


KEYNo

PO Box 2271, Omaha, NE 68103-2271

Medicare L Plan

Medicare A Plan

Medicare B Plan

Medicare C Plan

Medicare D Plan

Medicare F Plan


*Area 2: Zip Codes 72001, 72003-72007, 72010-72048, 72051, 72052, 72055, 72057-72061, 72063, 72064, 72066-72075, 72079-72089, 72102,

72104-72108, 72110-72112, 72121-72123, 72125-72134, 72136, 72137, 72139-72141, 72143, 72145, 72149, 72150, 72152, 72153, 72156-72158,

72160, 72165-72170, 72173, 72175, 72176, 72178, 72179, 72181, 72182, and 72189

**Area 3: Zip Codes beginning with 722 and Zip Codes 72002, 72003, 72053, 72065, 72076, 72078, 72099, 72103, 72113-72120, 72124, 72135,

72142, 72164, 72180, 72183, 72190, 72198, and 72199

Zip Codes Covered

716-719

*

**

Medicare M Plan

Medicare N Plan

Medicare G Plan

Medicare K Plan

Rev 2.03.2019 24


Company

Address





Waiting Period A

B


D

Areas F

Area 1 HD-F

Area 2 G

Area 3 K

Area 4 L

M




Area 1 143.74 x x x 179.38 51.16 146.52 x x x 125.58

Area 2 129.07 x x x 161.04 45.94 131.57 x x x 112.77

Area 3

Area 4

Standard


Area 1 165.30 x x x 206.25 58.83 168.50 x x x 144.42

Area 2 148.43 x x x 185.21 52.83 151.30 x x x 129.68

Area 3

Area 4



Area 1

Area 2

Area 3

Area 4

Zip Codes Covered

720-722

716-719, 723-729

Medicare M Plan

Medicare N Plan

Medicare G Plan

Medicare K Plan

Medicare L Plan

Medicare A Plan

Medicare B Plan

Medicare C Plan

Medicare D Plan

Medicare F Plan


Great Southern Life Insurance Company

Other

Yes or No


800-231-0801


KEY


Rev 2.03.2019 25


Company

Address








Area A B C D F HD‐F G K L M NArea 1 104.00 172.00 197.00 x 199.00 49.00 182.00 x x x 157.00Area 2Area 3Area 4

StandardArea A B C D F HD‐F G K L M NArea 1Area 2Area 3Area 4


KEYYes


Zip Codes CoveredWhole State



Other

Yes or No


Globe Life and Accident Insurance Company

PO Box 8080, McKinney, TX 75070

800‐801‐6831

www.globecaremedsupp.com


Rev 2.03.2019 26


Company

Address








Area A B C D F HD‐F G K L M NArea 1 124.34 x 181.01 x x x x x x x 127.89Area 2 111.91 x 162.91 x x x x x x x 115.11Area 3Area 4

StandardArea A B C D F HD‐F G K L M NArea 1 138.19 x 201.05 x x x x x x x 142.09Area 2 124.38 x 180.95 x x x x x x x 127.89Area 3Area 4


Guarantee Trust Life Insurance Company

Other

Yes or No


1275 Milwaukee Ave., Glenview, IL 60025

800‐338‐7452

www.gtlic.com




720‐722716‐719, 723‐729



Rev 2.03.2019 27


Company

Address





Waiting Period A

B


D

Areas F

Area 1 HD-F

Area 2 G

Area 3 K

Area 4 L

M




Area 1 176.50 x x 230.06 250.08 x 233.67 x x 214.46 181.28

Area 2 158.85 x x 207.06 225.08 x 210.31 x x 193.02 163.16

Area 3

Area 4

Standard


Area 1 196.18 x x 255.44 277.67 x 259.51 x x 238.44 201.53

Area 2 176.57 x x 229.90 249.91 x 233.56 x x 214.60 181.38

Area 3

Area 4



Area 1

Area 2

Area 3

Area 4

Heartland National Life Insurance Company

Other

Yes or No


866-916-7971

www.heartlandnational.net


KEY

PO Box 2878, Salt Lake City, UT 84110-2878

Medicare A Plan

Medicare B Plan

Medicare C Plan

Medicare D Plan

Medicare F Plan


Zip Codes Covered

720-722

716-719, 723-729

Medicare M Plan

Medicare N Plan

Medicare G Plan

Medicare K Plan

Medicare L Plan

Rev 2.03.2019 28


Company

Address





Waiting Period A

B


D

Areas F

Area 1 HD-F

Area 2 G

Area 3 K

Area 4 L

M




Area 1 192.33 209.33 246.01 x 251.04 76.01 x 112.79 160.33 x 160.69

Area 2 184.41 200.70 235.87 x 240.69 72.88 x 108.14 153.72 x 154.07

Area 3 169.79 184.79 217.17 x 221.61 67.10 x 99.57 141.53 x 141.85

Area 4 211.36 230.03 270.34 x 275.87 83.53 x 123.95 176.18 x 176.58

Standard


Area 1 287.46 312.86 367.71 x 375.20 113.61 x 168.59 239.60 x 240.19

Area 2 275.61 299.97 352.56 x 359.74 108.93 x 161.65 229.72 x 230.29

Area 3 253.76 276.19 324.61 x 331.22 100.29 x 148.83 211.51 x 212.03

Area 4 315.89 343.80 404.08 x 412.31 124.85 x 185.27 263.29 x 263.94



Area 1

Area 2

Area 3

Area 4

Humana Insurance Company

Out of State

Yes or No


888-310-8482

www.Humana.com


KEY3 months

500 W. Main St., Loisville, KY 40202

Medicare L Plan

Medicare A Plan

Medicare B Plan

Medicare C Plan

Medicare D Plan

Medicare F Plan


*Area 2: Arkansas, Clark, Conway, Faulkner, Garland, Grant, Hot Spring, Jackson, Lonoke, Monroe, Montgomery, Perry Pike, Prairie, Saline,

Van Buren, White and Woodruff counties

**Area 3: Ashley, Baxter, Benton, Boone, Bradley, Calhoun, Carroll, Chicot, Clay, Calburne, Cleveland, Columbia, Craighead, Crawford,

Crittenden, Cross, Dallas, Desha, Drew, Franklin, Fulton, Greene, Hempstead, Howard, Independence, Izard, Jefferson, Lafayette, Lawrence,

Lee, Lincoln, Little River, Logan, Madison, marion, Miller, Mississippi, Nevada, Newton, Ouachita, Phillips, Poinsett, Pope, Randolph, St. Francis,

Scott, Searcy, Sebastian, Sevier, Sharp, Stone, Union, Washington, and Yell Counties

Zip Codes Covered

Pulaski County

*

**

Medicare M Plan

Medicare N Plan

Medicare G Plan

Medicare K Plan

Rev 2.03.2019 29


Company

Address





Waiting Period A

B


D

Areas F

Area 1 HD-F

Area 2 G

Area 3 K

Area 4 L

M




Area 1 148.89 x 204.33 x 207.36 x 154.44 x x x 129.45

Area 2 133.69 x 183.48 x 186.20 x 138.68 x x x 116.24

Area 3

Area 4

Standard


Area 1 171.18 x 234.88 x 238.39 x 177.47 x x x 148.81

Area 2 153.71 x 210.91 x 214.06 x 159.36 x x x 133.62

Area 3

Area 4



Area 1

Area 2

Area 3

Area 4

The Manhattan Life Insurance Company

Other

Yes or No


800-877-7703

www.manhattanlife.com


KEY

PO Box 925568, Houston, TX 77292-5568

Medicare A Plan

Medicare B Plan

Medicare C Plan

Medicare D Plan

Medicare F Plan


Zip Codes Covered

720-722

716-719

Medicare M Plan

Medicare N Plan

Medicare G Plan

Medicare K Plan

Medicare L Plan

Rev 2.03.2019 30


Company

Address





Waiting Period A

B


D

Areas F

Area 1 HD-F

Area 2 G

Area 3 K

Area 4 L

M




Area 1 170.24 x x 236.24 254.17 x 221.54 x x x 190.27

Area 2 151.08 x x 209.66 225.58 x 196.62 x x x 168.86

Area 3

Area 4

Standard


Area 1 195.66 x x 271.54 292.15 x 254.77 x x x 218.81

Area 2 173.65 x x 240.99 259.28 x 226.11 x x x 194.20

Area 3

Area 4



Area 1

Area 2

Area 3

Area 4

Medico Insurance Company

Yes or No


PO Box 10386, Des Moines, IA 50306

800-228-6080

www.goMedico.com


KEYMedicare A Plan

Medicare B Plan

Medicare C Plan

Medicare D Plan

Medicare F Plan


Zip Codes Covered

716, 720-723

717-719, 724-729

Medicare M Plan

Medicare N Plan

Medicare G Plan

Medicare K Plan

Medicare L Plan

Rev 2.03.2019 31


Company

Address





Waiting Period A

B


D

Areas F

Area 1 HD-F

Area 2 G

Area 3 K

Area 4 L

M




Area 1 180.16 x x x 238.16 x 209.53 x x x x

Area 2 188.95 x x x 249.77 x 219.75 x x x x

Area 3 215.31 x x x 284.63 x 250.41 x x x x

Area 4

Standard


Area 1

Area 2

Area 3

Area 4



Area 1

Area 2

Area 3

Area 4

Mutual of Omaha Insurance Company

Other

Yes or No


800-775-1000

www.mutualofomaha.com


KEY

3300 Mutual of Omaha Plaza, Omaha, NE 68175

Medicare L Plan

Medicare A Plan

Medicare B Plan

Medicare C Plan

Medicare D Plan

Medicare F Plan


** Area 3: Zip Codes beginning with 722 and zip codes 72002, 72053, 72065, 72076, 72078, 72099, 72103, 72113-72120, 72124, 72135, 72142,

72164, 72180, 72183, 72190, 72198 and 72199

Zip Codes Covered

716-719, 723-729

*

**

Medicare M Plan

*Area 2: Zip Codes 72001, 72003-72007, 72010-72048, 72051, 72052, 72055, 72057-72061, 72063, 72064, 72066-72075, 72079-72089, 72101,

72102, 72104-72108, 72110-72112, 72121-72123, 72125-72134, 72136, 72137, 72139-72141, 72143, 72145, 72149, 72150, 72152, 72153, 72156-

72158, 72160, 72165-72170, 72173, 72175, 72176, 72178, 72179, 72181, 72182, and 72189

Medicare N Plan

Medicare G Plan

Medicare K Plan

Rev 2.03.2019 32


Company

Address





Waiting Period A

B


D

Areas F

Area 1 HD-F

Area 2 G

Area 3 K

Area 4 L

M




Area 1 138.23 x x x 182.28 56.46 143.99 x x x 121.45

Area 2 124.41 x x x 164.05 50.81 129.59 x x x 109.31

Area 3

Area 4

Standard


Area 1 158.89 x x x 209.49 64.90 165.54 x x x 139.58

Area 2 143.00 x x x 188.54 58.41 148.99 x x x 125.62

Area 3

Area 4



Area 1

Area 2

Area 3

Area 4

National Health Insurance Company

Other

Yes or No


817-640-1900


KEY

1901 North State Highway 360, Grand Prairie, TX 75050

Medicare A Plan

Medicare B Plan

Medicare C Plan

Medicare D Plan

Medicare F Plan


Zip Codes Covered

720-722

Rest of State

Medicare M Plan

Medicare N Plan

Medicare G Plan

Medicare K Plan

Medicare L Plan

Rev 2.03.2019 33


Company

Address








Area A B C D F HD‐F G K L M NArea 1 206.16 x 210.10 x 233.48 x x x x x xArea 2 189.75 x 194.61 x 217.98 x x x x x xArea 3 173.43 x 179.12 x 194.61 x x x x x xArea 4

StandardArea A B C D F HD‐F G K L M xArea 1 226.78 x 231.11 x 256.83 x x x x x xArea 2 208.73 x 214.08 x 239.78 x x x x x xArea 3 190.78 x 197.04 x 214.08 x x x x x xArea 4


Zip Codes Covered722

720‐721All other Zip Codes





Old Surety Life Insurance Company

Yes or No


PO Box 54407, Oklahoma City, OK 73154

(800)272‐5466

[email protected]


KEYYes

Rev 2.03.2019 34


Company

Address








Area A B C D F HD‐F G K L M NArea 1 133.69 x x x 162.25 50.70 145.91 x x x 103.74Area 2 140.21 x x x 170.16 53.18 153.02 x x x 108.80Area 3 159.77 x x x 193.91 60.60 174.38 x x x 123.98Area 4

StandardArea A B C D F HD‐F G K L M NArea 1 144.53 x x x 190.17 54.82 157.74 x x x 114.62Area 2 151.58 x x x 199.45 57.50 165.43 x x x 120.21Area 3 159.77 x x x 227.28 65.52 188.52 x x x 136.98Area 4


**Zip Codes that begin with 722 and Zip codes 72002, 72053, 72065, 72076, 72078, 72099, 72103, 72113‐72120, 72124, 72135, 72142, 72164, 72180, 72183, 72190, 72198‐72199

Medicare L Plan

Zip Codes Covered716‐719,723‐729

***

* Zip Codes 72001, 72003‐72007, 72010‐72048, 72051, 72052, 72055, 72057‐72061, 72063, 72064, 72066‐72075, 72079‐72089, 72101, 72102, 72104‐72108, 72110‐72112, 72121‐72123, 72125‐72134, 72136, 72137, 72139‐72141, 72143, 72145, 72149, 72150, 72152, 72153, 72156‐72158, 72160, 72165‐72170, 72173, 72175, 72176, 72178, 72179, 72181, 72182, 72189



Medicare G PlanMedicare High Deductible F Plan

None

Medicare K Plan

Omaha Insurance Company

Other

Yes or No


Mutual of Omaha Plaza, Omaha, NE 68175

800‐667‐2937



Rev 2.03.2019 35


Company

Address





Waiting Period A

B


D

Areas F

Area 1 HD-F

Area 2 G

Area 3 K

Area 4 L

M




Area 1 103.03 x 167.31 147.56 181.67 32.40 155.66 x x x 129.16

Area 2 114.48 x 185.90 163.96 201.86 36.00 172.95 x x x 143.51

Area 3

Area 4

Standard


Area 1 114.48 x 185.90 163.96 201.86 36.00 172.95 x x x 143.51

Area 2 127.00 x 206.56 182.18 224.29 40.00 192.17 x x x 159.45

Area 3

Area 4



Area 1

Area 2

Area 3

Area 4

Philadelphia American Life Insurance Company

Other

Yes or No


11720 Katy Freeway, Suite 1700 Houston, TX 77079

800-552-7879

[email protected]


KEYYes

Medicare A Plan

Medicare B Plan

Medicare C Plan

Medicare D Plan

Medicare F Plan


Zip Codes Covered

Area not listed for Area 2

720-723, 755

Medicare M Plan

Medicare N Plan

Medicare G Plan

Medicare K Plan

Medicare L Plan

Rev 2.03.2019 36


Company

Address





Waiting Period A

B


D

Areas F

Area 1 HD-F

Area 2 G

Area 3 K

Area 4 L

M




Area 1 154.65 x x x 275.83 66.36 206.58 x x x 194.98

Area 2 162.79 x x x 290.34 69.85 217.45 x x x 205.24

Area 3 179.07 x x x 319.38 76.84 239.20 x x x 225.77

Area 4

Standard


Area 1 171.84 x x x 306.47 73.74 229.54 x x x 216.65

Area 2 180.88 x x x 322.60 77.62 241.62 x x x 228.05

Area 3 198.97 x x x 354.86 85.39 265.79 x x x 250.86

Area 4



Area 1

Area 2

Area 3

Area 4

Physicians Mutual Insurance Company

Other

Yes or No


800-228-9100

www.physiciansmutual.com


KEYNo

2600 Dodge Street, Omaha, NE 68131

Medicare A Plan

Medicare B Plan

Medicare C Plan

Medicare D Plan

Medicare F Plan


Zip Codes Covered

716-718, 723-729

719-721

722

Medicare M Plan

Medicare N Plan

Medicare G Plan

Medicare K Plan

Medicare L Plan

Rev 2.03.2019 37


Company

Address





Waiting Period A

B


D

Areas F

Area 1 HD-F

Area 2 G

Area 3 K

Area 4 L

M




Area 1 130.99 x x x 201.76 65.26 150.26 72.67 x x 122.00

Area 2

Area 3

Area 4

Standard


Area 1

Area 2

Area 3

Area 4



Area 1

Area 2

Area 3

Area 4

QualChoice Life and Health Insurance Company, Inc.

Other

Yes or No


800-235-7111

www.qualchoice.com/contact-us


KEY

Medicare K Plan

Medicare L Plan

Medicare A Plan

Medicare B Plan

Medicare C Plan

Medicare D Plan

Medicare F Plan


12615 Chenal Parkway, Ste 300, Little Rock, AR 72211

* Area 1: Ashley, Baxter, Benton, Boone, Bradley, Calhoun, Carroll, Clark, Columbia, Conway, Crawford, Dallas, Faulkner, Franklin, Garland,

Grant, Hempstead, Hot Spring, Howard, Jefferson, Johnson, Lafayette, Little River, Logan, Lonoke, Madison, Marion, Miller, Montgomery,

Nevada, Newton, Ouachita, Perry, Pike, Polk, Pope, Pulaski, Saline, Scott, Searcy, Sebastian, Sevier, Union, Van Buren, Washington and Yell

Zip Codes Covered

*

Medicare M Plan

Medicare N Plan

Medicare G Plan

Rev 2.03.2019 38


Company

Address








Area A B C D F HD‐F G K L M NArea 1 157.15 x 227.80 x 218.55 45.50 161.15 x x x 140.60Area 2 n/a x n/a x n/a n/a 177.25 x x x n/aArea 3Area 4

StandardArea A B C D F HD‐F G K L M NArea 1 180.65 x 262.00 x 251.40 52.30 185.30 x x x 161.70Area 2 n/a x n/a x n/a n/a 203.85 x x x n/aArea 3Area 4

Tobacco User (if different from "Standard")Area A B C D F HD‐F G K L M NArea 1 207.80 x 301.25 x 289.10 60.15 213.15 x x x 185.95Area 2 234.50Area 3Area 4

Zip Codes CoveredPlan G only: 716‐719, 724‐729

Plan G only: 720‐723





Reserve National Insurance Company

Other

Yes or No


601 E. Britton Rd., Oklahoma City, OK 73114

800‐654‐9106

[email protected]


KEY

Rev 2.03.2019 39


Company

Address





Waiting Period A

B


D

Areas F

Area 1 HD-F

Area 2 G

Area 3 K

Area 4 L

M




Area 1 151.03 190.62 151.96 178.93 223.54 179.50 x x x x x

Area 2 168.80 213.04 169.84 199.98 249.84 200.62 x x x x x

Area 3 177.68 224.25 178.77 210.50 262.98 211.17 x x x x x

Area 4 161.69 204.07 170.87 191.56 239.32 192.17 x x x x x

Standard


Area 1 167.68 211.65 247.33 198.55 248.11 199.32 x x x x x

Area 2 187.40 236.54 276.43 221.91 277.30 222.77 x x x x x

Area 3 197.26 248.99 290.97 233.58 291.89 234.49 x x x x x

Area 4 179.51 226.50 264.79 212.56 265.62 213.39 x x x x x



Area 1

Area 2

Area 3

Area 4

Royal Neighbors of America

Rest of State

Yes or No


800-627-4762

www.royalneighbors.org


KEY

230 16th Street, Rock Island, IL 61201

Medicare A Plan

Medicare B Plan

Medicare C Plan

Medicare D Plan

Medicare F Plan


Zip Codes Covered

726-729

719

720-722

Medicare M Plan

Medicare N Plan

Medicare G Plan

Medicare K Plan

Medicare L Plan

Rev 2.03.2019 40


Company

Address





Waiting Period A

B


D

Areas F

Area 1 HD-F

Area 2 G

Area 3 K

Area 4 L

M




Area 1 117.30 x x x 151.67 x x x x x x

Area 2 132.13 x x x 170.85 x x x x x x

Area 3

Area 4

Standard


Area 1 132.29 x x x 170.68 x x x x x x

Area 2 149.01 x x x 192.26 x x x x x x

Area 3

Area 4



Area 1

Area 2

Area 3

Area 4

S. USA Life Insurance Company, Inc.

Other

Yes or No


877-725-4872


KEY

460 W.34th Street, Suite 800, New York, NY 10001

Medicare A Plan

Medicare B Plan

Medicare C Plan

Medicare D Plan

Medicare F Plan


Zip Codes Covered

716-719, 723-729

720-722

Medicare M Plan

Medicare N Plan

Medicare G Plan

Medicare K Plan

Medicare L Plan

Rev 2.03.2019 41


Company

Address





Waiting Period A

B


D

Areas F

Area 1 HD-F

Area 2 G

Area 3 K

Area 4 L

M




Area 1 118.87 x x x 161.57 x 138.76 x x x x

Area 2 136.70 x x x 185.81 x 159.58 x x x x

Area 3 148.59 x x x 201.97 x 173.45 x x x x

Area 4

Standard


Area 1 136.64 x x x 185.72 x 159.50 x x x x

Area 2 157.14 x x x 213.58 x 183.43 x x x x

Area 3 170.80 x x x 232.15 x 199.38 x x x x

Area 4



Area 1

Area 2

Area 3

Area 4

***

Medicare M Plan

Medicare N Plan

Medicare G Plan

Medicare K Plan

Medicare L Plan

Medicare D Plan

Medicare F Plan


Zip Codes Covered

*

**

KEY

PO Box 27248, Salt Lake City, UT 84127

Medicare A Plan

Medicare B Plan

Medicare C Plan

*Area 1: Baxter, Benton, Boone, Carroll, Clark, Clay, Cleburne, Columbia, Craighead, Crawford, Drew, Faulkner, Franklin, Fulton, Garland,

Grant, Greene, Independence, Johnson, lawrence, Logan, Lonoke, Madison, Marion, Montgomery, Newton, Pike, Polk, Pope, Randolph, Saline,

Scott, Searcy, Sebastian, Stone, Union, Van Buren, Washington, White, and Yell

**Area 2: Bradley, Calhoun, Cleveland, Conway, Crittenden, Hempstead, Hot Spring, Howard, Izard, Jefferson, Lafayette, Lee, Lincoln, Little

River, Miller, Monroe, Poinsett, Pulaski, Sevier, Sharp and Woodruff

***Area 3: Arkansas, Ashley, Chocot, Cross, Dallas, Desha, Jackson, Mississippi, Nevada, Ouachita, Perry, Phillips, Prarie and St. Francis

Sentinel Security Life Insurance Company

Other

Yes or No


800-247-1423

[email protected]


Rev 2.03.2019 42


Company

Address





Waiting Period A

B


D

Areas F

Area 1 HD-F

Area 2 G

Area 3 K

Area 4 L

M




Area 1 149.00 x 224.82 149.60 227.12 x 149.94 x x x 116.02

Area 2

Area 3

Area 4

Standard


Area 1 163.90 x 247.31 164.56 249.84 x 164.94 x x x 127.63

Area 2

Area 3

Area 4



Area 1

Area 2

Area 3

Area 4

State Farm Mutual Automobile Insurance Company

Other

Yes or No


800-782-8332

www.statefarm.com


KEY

One State Farm Plaza, Bloomington, IL 61710

Medicare A Plan

Medicare B Plan

Medicare C Plan

Medicare D Plan

Medicare F Plan


Zip Codes Covered

Whole State

Medicare M Plan

Medicare N Plan

Medicare G Plan

Medicare K Plan

Medicare L Plan

Rev 2.03.2019 43


Company

Address








Area A B C D F HD‐F G K L M NArea 1 162.25 189.42 228.58 198.42 233.92 92.17 199.58 x x 178.67 163.67Area 2 154.50 180.42 217.67 189.00 222.75 87.75 190.08 x x 170.17 155.83Area 3 137.50 160.58 193.75 168.25 198.25 78.08 169.17 x x 151.42 138.67Area 4

StandardArea A B C D F HD‐F G K L M NArea 1 180.17 210.25 253.75 220.50 260.00 102.50 221.67 x x 198.42 181.83Area 2 171.58 200.25 241.67 210.00 247.58 97.58 211.08 x x 189.00 173.17Area 3 152.75 178.25 215.08 186.92 220.33 86.83 187.83 x x 168.25 154.08Area 4


Medicare L Plan

Zip Codes Covered*

720 and 721 not in Area 1Other

*Area 1: Zip Codes beginning with 722 and 72002, 72053, 72065, 72076, 72078, 72099, 72103, 72113‐72120, 72124, 72135, 72124, 72164, 72180,72183, 72190, 72198, 72199


Medicare G PlanMedicare K Plan



State Mutual Insurance Company

Yes or No


PO Box 10849, Clearwater, FL 33757‐8849

844‐340‐9493

https://statemutualinsurance.com


KEY

Rev 2.03.2019 44


Company

Address








Area A B C D F HD‐F G K L M NArea 1 216.85 268.42 290.75 x 277.05 x 248.43 113.91 x x 209.72Area 2 203.56 257.26 281.02 x 267.77 x 239.32 109.38 x x 202.34Area 3Area 4

StandardArea A B C D F HD‐F G K L M NArea 1 216.85 268.42 337.90 x 321.98 x 288.63 126.71 x x 243.73Area 2 203.56 257.26 326.59 x 311.19 x 278.13 127.12 x x 235.15Area 3Area 4


*Area 1: Benton, Crawford, Crittenden, Faulkner, Jefferson, Lonoke, Pulaski, Saline, Sebastian, and Washington

Medicare L Plan

Zip Codes Covered***

**Area 2: Clark, Cleburne, Cross, Franklin, Garland, Grant, Hot Spring, Jackson, Logan, Madison, Montgomery, Perry, Pike, Poinsett, Prairie, Scott, St. Francis, Van Buren, White, Woodruff, and Yell





Sterling Life Insurance Company

Other

Yes or No


PO Box 86580, Austin, TX 78755‐0580

866‐459‐1755

[email protected]


KEY

Rev 2.03.2019 45


Company

Address





Waiting Period A

B


D

Areas F

Area 1 HD-F

Area 2 G

Area 3 K

Area 4 L

M




Area 1 163.75 195.75 216.38 192.02 234.66 49.06 192.58 x 152.70 184.30 x

Area 2 146.51 175.15 193.61 171.80 209.96 43.90 172.31 x 136.77 164.90 x

Area 3 172.37 206.06 227.77 202.12 247.01 51.64 202.72 x 160.91 194.00 x

Area 4

Standard


Area 1 180.16 215.33 237.99 211.19 258.13 53.93 211.83 x 168.14 202.74 x

Area 2 161.19 192.66 212.94 188.96 230.96 48.26 189.54 x 150.44 181.40 x

Area 3 189.64 226.66 250.52 222.30 271.72 56.77 222.98 x 176.99 213.41 x

Area 4



Area 1

Area 2

Area 3

Area 4

Thrivent Financial for Lutherans

Other

Yes or No


800-847-4836

www.thrivent.com


KEY

4321 N. Ballard Rd., Appleton, WI 54919-0001

Medicare A Plan

Medicare B Plan

Medicare C Plan

Medicare D Plan

Medicare F Plan


Zip Codes Covered

720-721

716-719, 723-729

722

Medicare M Plan

Medicare N Plan

Medicare G Plan

Medicare K Plan

Medicare L Plan

Rev 2.03.2019 46


Company

Address





Waiting Period A

B


D

Areas F

Area 1 HD-F

Area 2 G

Area 3 K

Area 4 L

M




Area 1 132.00 178.00 210.00 194.00 211.00 x 195.00 97.00 144.00 177.00 166.00

Area 2

Area 3

Area 4

Standard


Area 1 145.00 195.00 231.00 214.00 232.00 x 215.00 106.00 158.00 195.00 183.00

Area 2

Area 3

Area 4



Area 1

Area 2

Area 3

Area 4

Transamerica Life Insurance Company

Other

Yes or No


800-797-2643

[email protected]


KEY

4333 Edgewood Road, NE Cedar Rapids, IA 52499

Medicare A Plan

Medicare B Plan

Medicare C Plan

Medicare D Plan

Medicare F Plan


Zip Codes Covered

Whole State

Medicare M Plan

Medicare N Plan

Medicare G Plan

Medicare K Plan

Medicare L Plan

Rev 2.03.2019 47


Company

Address





Waiting Period A

B


D

Areas F

Area 1 HD-F

Area 2 G

Area 3 K

Area 4 L

M




Area 1 147.00 238.00 271.00 256.00 224.00 45.00 257.00 x x x 161.00

Area 2

Area 3

Area 4

Standard


Area 1

Area 2

Area 3

Area 4



Area 1

Area 2

Area 3

Area 4

United American Insurance Company

Other

Yes or No


800-331-2512

www.unitedamerican.com


KEY2 months


Medicare A Plan

Medicare B Plan

Medicare C Plan

Medicare D Plan

Medicare F Plan


Zip Codes Covered

Whole State

Medicare M Plan

Medicare N Plan

Medicare G Plan

Medicare K Plan

Medicare L Plan

Rev 2.03.2019 48


Company

Address





Waiting Period A

B


D

Areas F

Area 1 HD-F

Area 2 G

Area 3 K

Area 4 L

M




Area 1 264.78 319.93 x x 371.08 x 325.43 x x x 257.42

Area 2 280.34 338.74 x x 392.91 x 344.56 x x x 272.55

Area 3 311.47 376.35 x x 436.52 x 382.81 x x x 302.80

Area 4

Standard


Area 1 331.09 400.09 x x 464.04 x 406.28 x x x 321.90

Area 2 350.57 423.61 x x 491.33 x 430.19 x x x 340.83

Area 3 389.48 470.63 x x 545.89 x 477.95 x x x 378.66

Area 4



Area 1

Area 2

Area 3

Area 4

United Commercial Travelers of America

Other

Yes or No


800-848-0123

www.uct.org/contact-us/


KEY

1801 Watermark Dr., Ste 100, Columus, OH 43215

Medicare A Plan

Medicare B Plan

Medicare C Plan

Medicare D Plan

Medicare F Plan


Zip Codes Covered

716-719, 723-729

720-721

722

Medicare M Plan

Medicare N Plan

Medicare G Plan

Medicare K Plan

Medicare L Plan

Rev 2.03.2019 49


Company

Address





Waiting Period A

B


D

Areas F

Area 1 HD-F

Area 2 G

Area 3 K

Area 4 L

M




Area 1 184.12 262.50 317.25 x 319.12 x 304.76 99.00 175.12 x 276.70

Area 2

Area 3

Area 4

Standard


Area 1 202.53 288.75 348.97 x 351.03 x 335.22 108.90 192.63 x 304.36

Area 2

Area 3

Area 4



Area 1

Area 2

Area 3

Area 4

United Healthcare Insurance Company

Other

Yes or No


800-523-5800

www.aarpmedicaresupplement.com


KEY3 months


Medicare A Plan

Medicare B Plan

Medicare C Plan

Medicare D Plan

Medicare F Plan


Zip Codes Covered

Whole State

Medicare M Plan

Medicare N Plan

Medicare G Plan

Medicare K Plan

Medicare L Plan

Rev 2.03.2019 50


Company

Address








Area A B C D F HD‐F G K L M NArea 1 120.26 x x 139.60 181.76 x 159.62 x x x 110.08Area 2 139.80 x x 162.29 211.30 x 185.56 x x x 127.97Area 3Area 4

StandardArea A B C D F HD‐F G K L M NArea 1 133.62 x x 155.11 201.96 x 177.36 x x x 122.36Area 2 155.33 x x 180.31 234.77 x 206.18 x x x 142.25Area 3Area 4



716‐719, 723‐729





United National Life Insurance Company

Other

Yes or No


PO Box 1154, Glenview, IL 60025‐1154

800‐207‐8050

[email protected]


KEY

Rev 2.03.2019 51

MEDIGAP SELECT PLANS

MEDIGAP prices are estimations only subject to change. Call company for cost

Rev 2.03.2019 52


Company

Address







MMonthly Premiums by Area and Plan NPreferred Non‐smoking

Area A B C D F HD‐F G K L M NArea 1 x x 155.70 x 174.70 x x x x x xArea 2 x x 175.40 x 196.70 x x x x x xArea 3 x x 213.80 x 239.80 x x x x x xArea 4



* Area 2 ‐ Clark, Cleburne, Conway, Cross, Dallas, Faulkner, Garland, Hempstead, Hot Spring, Howard, Indenendence, Izard, JacksonLawrence, Little River, Lonoke, Nevada, Ouachita, Perry, Pike, Pulaski, Saline, Sevier, Sharp and Van Buren

No


Zip Codes CoveredAll counties not listed in Area 2

*Out of state



Select Plans

Other

Yes or No



P.O. Box 2181, Little Rock, AR,72203‐2181

(800) 392‐2583



KEY

Rev 2.03.2019 53


Company

Address








Area A B C D F HD‐F G K L M NArea 1 187.63 197.20 221.61 x 194.71 x 170.61 75.36 x x 139.70Area 2 179.85 202.12 226.98 x 199.41 x 175.22 78.24 x x 144.52Area 3Area 4

StandardArea A B C D F HD‐F G K L M NArea 1 187.63 197.20 257.54 x 226.28 x 197.27 87.58 x x 162.36Area 2 179.85 202.12 263.79 x 231.75 x 203.64 90.92 x x 167.95Area 3Area 4


*Area 1: Benton, Crawford, Crittenden, Faulkner, Jefferson, Lonoke, Pulaski, Saline, Sebastian, and Washington

Select Plans

Sterling Life Insurance Company

Other

Yes or No


PO Box 86580, Austin, TX 78755‐0580

866‐459‐1755

[email protected]


KEY

Zip Codes Covered***


**Area 2: Clark, Cleburne, Cross, Franklin, Garland, Grant, Hot Spring, Jackson, Logan, Madison, Montgomery, Perry, Pike, Poinsett, Prairie, Scott, St. Francis, Van Buren, White, Woodruff, and Yell




Medicare L Plan

Rev 2.03.2019 54


Company

Address





Waiting Period A

B


D

Areas F

Area 1 HD-F

Area 2 G

Area 3 K

Area 4 L

M




Area 1 x x 258.75 x 259.50 x x x x x x

Area 2

Area 3

Area 4

Standard


Area 1 x x 284.62 x 285.45 x x x x x x

Area 2

Area 3

Area 4



Area 1

Area 2

Area 3

Area 4

Select Plans

Zip Codes Covered

Whole State

Medicare M Plan

Medicare N Plan

Medicare G Plan

Medicare K Plan

Medicare L Plan

Medicare A Plan

Medicare B Plan

Medicare C Plan

Medicare D Plan

Medicare F Plan



Other

Yes or No


800-523-5800



KEY3 months


Rev 2.03.2019 55


Company

Address





Waiting Period A

B


D

Areas F

Area 1 HD-F

Area 2 G

Area 3 K

Area 4 L

M




Area 1 x x 163.50 x 183.40 x x x x x x

Area 2 x x 184.20 x 206.50 x x x x x x

Area 3 x x 224.50 x 251.80 x x x x x x

Area 4

Standard


Area 1

Area 2

Area 3

Area 4



Area 1

Area 2

Area 3

Area 4

Medicare M Plan


Select Plans

Zip Codes Covered

All Counties not in Area 2

*

Out of State

PO Box 1151, Little Rock, AR 72203

Medicare N Plan

Medicare G Plan

Medicare K Plan

Medicare L Plan

Medicare A Plan

Medicare B Plan

Medicare C Plan

Medicare D Plan

Medicare F Plan

* Area 2: Clark, Cleburne, Conway, Cross, Dallas, Faulkner, Garland, Hempstead, Hot Spring, Howard, Independence, Izard, Jackson, Lawrence,

Little River, Lonoke, Nevada, Ouachita, Perry, Pike, Pulaski, Saline, Sevier, Sharp and Van Buren Counties

USAble Mutual Insurance Company

Yes or No


855-279-2398

[email protected]


KEY

Rev 2.03.2019 56

MEDIGAP PLANS FOR PEOPLE UNDER THE AGE OF 65

MEDIGAP prices are estimations only subject to change Call company for cost

Rev 2.03.2019 57


Company

Address











Under Age 65

Other

Yes or No


Aetna Health and Life Insurance Company

800 Crescent Centre Dr., Franklin,TN 37067

(800) 3624‐6290

www.aetnaseniorproducts.com


KEY



No


Zip Codes CoveredAll areas not listed for Area 2

720‐722

Rev 2.03.2019 58


Company

Address









StandardArea A B C D F HD‐F G K L M NArea 1 x x x x x x x x x x xArea 2 x x x x x x x x x x xArea 3Area 4


American Retirement Life Insurance Company

P.O. Box 26580, Austin, TX 78755‐0580

(866) 459‐4272


Medicare N Plan


Medicare L Plan

Zip Codes Covered716‐719, 723‐729

720‐722

Medicare M PlanOther

UNDER 65

KEY

Medicare High Deductible F PlanMedicare G PlanMedicare K Plan

Yes or No


Rev 2.03.2019 59


Company

Address










Tobacco User (if different from "Standard")Area A B C D F HD‐F G K L M NArea 1 141.41 x x x 177.51 x 140.23 x x x 120.38Area 2 126.98 x x x 159.56 x 125.92 x x x 108.09Area 3Area 4

Americo Financial Life and Annuity Ins. Company


(800) 231‐0801

[email protected]


Medicare N Plan


Medicare L Plan


716‐719, 723‐729


UNDER 65

KEYNo


Yes or No


Rev 2.03.2019 60


Company

Address





Waiting Period A

B


D

Areas F

Area 1 HD-F

Area 2 G

Area 3 K

Area 4 L

M




Area 1 x 642.33 x x x x x x x x x

Area 2

Area 3

Area 4

Standard


Area 1

Area 2

Area 3

Area 4



Area 1

Area 2

Area 3

Area 4

Under 65

Zip Codes Covered

Entire State

Medicare M Plan

Medicare N Plan

Medicare G Plan

Medicare K Plan

Medicare L Plan

Medicare A Plan

Medicare B Plan

Medicare C Plan

Medicare D Plan

Medicare F Plan



Yes or No


P.O. Box 2181. Little Rock, AR 72203-2181

(800) 392-2583



KEYNo

Rev 2.03.2019 61

http://www.arkansasbluecross.com/#


Company

Address





Waiting Period A

B


D

Areas F

Area 1 HD-F

Area 2 G

Area 3 K

Area 4 L

M




Area 1 501.67

Area 2 571.91

Area 3

Area 4

Standard


Area 1 576.64

Area 2 657.37

Area 3

Area 4



Area 1

Area 2

Area 3

Area 4

Under 65

Zip Codes Covered

Medicare M Plan

Medicare N Plan

Medicare G Plan

Medicare K Plan

Medicare L Plan

Medicare A Plan

Medicare B Plan

Medicare C Plan

Medicare D Plan

Medicare F Plan


P.O. Box 20010, Charleston, SC 29413

Atlantic Coast Life Insurance Company

Yes or No


888-805-8680

www.aclico.com


KEY

Rev 2.03.2019 62


Company

Address





Waiting Period A

B


D

Areas F

Area 1 HD-F

Area 2 G

Area 3 K

Area 4 L

M




Area 1 549.00 x x x x x x x x x x


Area 3

Area 4

Standard




Area 3

Area 4



Area 1

Area 2

Area 3

Area 4

Bankers Fidelity Life Insurance Company

Yes or No


4370 Peachtree Rd, N.E., Atlanta, GA 30319

866-458-7504 x 876

www.bflic.com


KEYNo

Medicare K Plan

Medicare L Plan

Medicare A Plan

Medicare B Plan

Medicare C Plan

Medicare D Plan

Medicare F Plan


Under 65

Zip Codes Covered

716-719

Rest of State

Medicare M Plan

Medicare N Plan

Medicare G Plan

Rev 2.03.2019 63


Company

Address





Waiting Period A

B


D

Areas F

Area 1 HD-F

Area 2 G

Area 3 K

Area 4 L

M





Area 2

Area 3

Area 4

Standard


Area 1

Area 2

Area 3

Area 4



Area 1

Area 2

Area 3

Area 4

Under 65

Zip Codes Covered

Whole state

Medicare M Plan

Medicare N Plan

Medicare G Plan

Medicare K Plan

Medicare L Plan

Medicare A Plan

Medicare B Plan

Medicare C Plan

Medicare D Plan

Medicare F Plan


11825 N. Pennsylvania Street, Carmel, IN 46032

Colonial Penn Life Insurance Company

Yes or No


800-800-2254

www.bankerslife.com


KEYYes

Rev 2.03.2019 64


Company

Address








Area A B C D F HD‐F G K L M NArea 1 506.97 x x x x x x x x x xArea 2 537.39 x x x x x x x x x xArea 3 608.37 x x x x x x x x x xArea 4

StandardArea A B C D F HD‐F G K L M NArea 1 557.95 x x x x x x x x x xArea 2 591.43 x x x x x x x x x xArea 3 669.54 x x x x x x x x x xArea 4


*Area 1 ‐ 72002, 72053, 72065, 72076, 72078, 72099, 72103, 72113‐72120, 72124, 72135, 72142, 72164, 72180, 72183, 72190, 72198, 72199,and all zip codes beginning with 722

Coventry Health and Life Insurance Company

3900 Rogers Road, San Antonio, TX 78251‐3635

(800) 843‐7421


Medicare N Plan


Medicare L Plan

Zip Codes Covered*

All other 720 or 721 zip codesRest of state


Under age 65

KEY


Yes or No


Rev 2.03.2019 65


Company

Address







MAnnual Premiums by Area and Plan NPreferred Non‐smoking




Medicare N Plan



720‐722716‐719, 723‐729

Medicare M Plan

No Medicare A PlanMedicare B PlanMedicare C PlanMedicare D PlanMedicare F Plan

Under 65

Equitable National Life Insurance Company

Yes or No


P.O. Box 2730, Salt Lake City, UT 84110‐2730

1‐888‐352‐5170


KEY

Rev 2.03.2019 66


Company

Address





Waiting Period A

B


D

Areas F

Area 1 HD-F

Area 2 G

Area 3 K

Area 4 L

M




Area 1 553.38

Area 2 488.82

Area 3 461.15

Area 4

Standard


Area 1 608.56

Area 2 537.56

Area 3 507.13

Area 4



Area 1

Area 2

Area 3

Area 4

**Area 2: All other Zip Codes beginning with 720 or 721

Under 65

Zip Codes Covered

*

**

Rest of State

Medicare M Plan

Medicare N Plan

Medicare G Plan

Medicare K Plan

Medicare L Plan

Medicare A Plan

Medicare B Plan

Medicare C Plan

Medicare D Plan

Medicare F Plan


* Area 1: Zip Codes 72002, 72053, 72065, 72076, 72078, 72099, 72103, 72113-72120, 72124, 72135, 72142, 72164, 72180, 72183, 72190,

72198, 72199, and all Zip Codes beginning with 722.

First Health Life & Health Insurance Company

Yes or No


3200 Highland Ave., Downers Grove, IL 60515

800-226-5116


KEY

Rev 2.03.2019 67


Company

Address








Area A B C D F HD‐F G K L M NArea 1 x 613.00 x x x x x x x x xArea 2Area 3Area 4




Under 65

KEYYes


Yes or No


Medicare F Plan

Medicare L Plan

Zip Codes CoveredWhole State

Globe Life and Accident Insurance Company


800‐801‐6831

www.globecaremedsupp.com


Medicare N Plan

Medicare A PlanMedicare B PlanMedicare C PlanMedicare D Plan

Rev 2.03.2019 68


Company

Address





Waiting Period A

B


D

Areas F

Area 1 HD-F

Area 2 G

Area 3 K

Area 4 L

M






Area 3

Area 4

Standard




Area 3

Area 4



Area 1

Area 2

Area 3

Area 4

Under 65

Zip Codes Covered

720-722

716-719, 723-729

Medicare M Plan

Medicare N Plan

Medicare G Plan

Medicare K Plan

Medicare L Plan

Medicare A Plan

Medicare B Plan

Medicare C Plan

Medicare D Plan

Medicare F Plan


Great Southern Life Insurance Company

Yes or No


300 west 11th Street, Kansas City, MO 64105

800-231-0801


KEY

Rev 2.03.2019 69


Company

Address





Waiting Period A

B


D

Areas F

Area 1 HD-F

Area 2 G

Area 3 K

Area 4 L

M








Standard








Area 1

Area 2

Area 3

Area 4

Medicare N Plan

Medicare G Plan

Under 65

Zip Codes Covered

Pulaski County

*

**

Medicare M Plan

KEY3 Months

Medicare K Plan

Medicare L Plan

Medicare A Plan

Medicare B Plan

Medicare C Plan

Medicare D Plan

Medicare F Plan


*Area 2: Arkansas, Clark, Conway, Faulkner, Garland, Grant, Hot Spring, Jackson, Lonoke, Monroe, Montgomery, Perry Pike, Prairie, Saline,

Van Buren, White and Woodruff counties

**Area 3: Ashley, Baxter, Benton, Boone, Bradley, Calhoun, Carroll, Chicot, Clay, Calburne, Cleveland, Columbia, Craighead, Crawford,

Crittenden, Cross, Dallas, Desha, Drew, Franklin, Fulton, Greene, Hempstead, Howard, Independence, Izard, Jefferson, Lafayette, Lawrence,

Lee, Lincoln, Little River, Logan, Madison, marion, Miller, Mississippi, Nevada, Newton, Ouachita, Phillips, Poinsett, Pope, Randolph, St. Francis,

Scott, Searcy, Sebastian, Sevier, Sharp, Stone, Union, Washington, and Yell Counties

Humana Insurance Company

Out of State

Yes or No


500 W. Main St., Loisville, KY 40202

888-310-8482

www.Humana.com


Rev 2.03.2019 70


Company

Address











Under 65

Lumico Life Insurance Company

Yes or No


P.O. Box 83303, Lincoln, NE 68501‐3303

1‐888‐440‐4047

[email protected]


KEYNo Medicare A Plan

Medicare B PlanMedicare C PlanMedicare D PlanMedicare F Plan

Medicare N Plan



720‐722Rest of State

Medicare M Plan

Rev 2.03.2019 71


Company

Address





Waiting Period A

B


D

Areas F

Area 1 HD-F

Area 2 G

Area 3 K

Area 4 L

M






Area 3

Area 4

Standard




Area 3

Area 4



Area 1

Area 2

Area 3

Area 4

The Manhattan Life Insurance Company

Other

Yes or No


PO Box 925568, Houston, TX 77292-5568

800-877-7703

www.manhattanlife.com


KEY

Medicare N Plan

Medicare G Plan

Medicare K Plan

Medicare L Plan

Medicare A Plan

Medicare B Plan

Medicare C Plan

Medicare D Plan

Medicare F Plan


Under 65

Zip Codes Covered

720-722

716-719, 723-729

Medicare M Plan

Rev 2.03.2019 72


Company

Address





Waiting Period A

B


D

Areas F

Area 1 HD-F

Area 2 G

Area 3 K

Area 4 L

M







Area 4

Standard


Area 1

Area 2

Area 3

Area 4



Area 1

Area 2

Area 3

Area 4

,

Under 65

*Area 2: Zip Codes 72001, 72003-72007, 72010-72048, 72051, 72052, 72055, 72057-72061, 72063, 72064, 72066-72075, 72079-72089, 72101,

72102, 72104-72108, 72110-72112, 72121-72123, 72125-72134, 72136, 72137, 72139-72141, 72143, 72145, 72149, 72150, 72152, 72153, 72156-

72158, 72160, 72165-72170, 72173, 72175, 72176, 72178, 72179, 72181, 72182, and 72189

** Area 3: Zip Codes beginning with 722 and zip codes 72002, 72053, 72065, 72076, 72078, 72099, 72103, 72113-72120, 72124, 72135, 72142,

72164, 72180, 72183, 72190, 72198 and 72199

Zip Codes Covered

716-719, 723-729

*

**

Medicare M Plan

Medicare N Plan

Medicare G Plan

Medicare K Plan

Medicare L Plan

Medicare A Plan

Medicare B Plan

Medicare C Plan

Medicare D Plan

Medicare F Plan


Mutual of Omaha Insurance Company

Yes or No


3300 Mutual of Omaha Plaza, Omaha, NE 68175

800-775-1000



KEY

Rev 2.03.2019 73


Company

Address





Waiting Period A

B


D

Areas F

Area 1 HD-F

Area 2 G

Area 3 K

Area 4 L

M




Area 1 552.92

Area 2 497.63

Area 3

Area 4

Standard


Area 1 635.56

Area 2 572.01

Area 3

Area 4



Area 1

Area 2

Area 3

Area 4

Under 65

Zip Codes Covered

720-722

Rest of State

Medicare M Plan

Medicare N Plan

Medicare G Plan

Medicare K Plan

Medicare L Plan

Medicare A Plan

Medicare B Plan

Medicare C Plan

Medicare D Plan

Medicare F Plan


1901 North State Highway 360, Grand Prairie, TX 75050

National Health Insurance Company

Yes or No


(817) 640-1900


KEY

Rev 2.03.2019 74


Company

Address








Area A B C D F HD‐F G K L M NArea 1 624.01 x x x x x x x x x xArea 2Area 3Area 4



UNDER 65

QualChoice Life and Health Insurance Company

Other

Yes or No


12615 Chenal Pkwy, Ste 300, Little Rock, AR 72211

800‐235‐7111

www.qualchoice.com


KEY

Zip Codes Covered*


* Service only in these areas: Ashley, Baxter, Benton, Boone, Bradley, Calhoun, Carroll, Clark, Columbia, Conway, Crawford, Dallas, Faulkner, Franklin, Garland, Grant, Hempstead, Hot Spring, Howard, Jefferson, Johnson, Lafayette, Little River, Logan, Lonoke, Madison, Marion, Miller, Montgomery, Nevada, Newton, Ouachita, Perry, Pike, Polk, Pope, Pulaski, Saline, Scott, Searcy, Sebastian, Sevier, Union, Van Buren, Washington and Yell




Medicare L Plan

Rev 2.03.2019 75


Company

Address








Area A B C D F HD‐F G K L M NArea 1 577.52 x x x X X X x x x XArea 2 605.69 x x x X X X x x x XArea 3 690.21 x x x X X X x x x XArea 4

StandardArea A B C D F HD‐F G K L M NArea 1 624.35 x x x X X X x x x XArea 2 654.81 x x x X X X x x x XArea 3 746.18 x x x X X X x x x XArea 4


UNDER 65

None

Medicare K Plan

Omaha Insurance Company

Other

Yes or No


Mutual of Omaha Plaza, Omaha, NE 68175

800‐667‐2937



Medicare N Plan


Medicare G PlanMedicare High Deductible F Plan

**Zip Codes that begin with 722 and Zip codes 72002, 72053, 72065, 72076, 72078, 72099, 72103, 72113‐72120, 72124, 72135, 72142, 72164, 72180, 72183, 72190, 72198‐72199

Medicare L Plan

Zip Codes Covered716‐719,723‐729

***

* Zip Codes 72001, 72003‐72007, 72010‐72048, 72051, 72052, 72055, 72057‐72061, 72063, 72064, 72066‐72075, 72079‐72089, 72101, 72102, 72104‐72108, 72110‐72112, 72121‐72123, 72125‐72134, 72136, 72137, 72139‐72141, 72143, 72145, 72149, 72150, 72152, 72153, 72156‐72158, 72160, 72165‐72170, 72173, 72175, 72176, 72178, 72179, 72181, 72182, 72189

Medicare M Plan

Rev 2.03.2019 76


Company

Address








Area A B C D F HD‐F G K L M NArea 1 824.63 x x x x x x x x x xArea 2 759.00 x x x x x x x x x xArea 3 693.73 x x x x x x x x x xArea 4

StandardArea A B C D F HD‐F G K L M xArea 1 907.10 x x x x x x x x x xArea 2 834.90 x x x x x x x x x xArea 3 763.11 x x x x x x x x x xArea 4


UNDER 65

Old Surety Life Insurance Company

Yes or No


PO Box 54407, Oklahoma City, OK 73154

(800)272‐5466

[email protected]


KEYYes Medicare A Plan


Medicare N Plan



722720‐721

All other Zip Codes

Medicare M Plan

Rev 2.03.2019 77


Company

Address





Waiting Period A

B


D

Areas F

Area 1 HD-F

Area 2 G

Area 3 K

Area 4 L

M






Area 3

Area 4

Standard




Area 3

Area 4



Area 1

Area 2

Area 3

Area 4

Under 65

Zip Codes Covered

716-719, 723-722

720-722

Medicare M Plan

Medicare N Plan

Medicare G Plan

Medicare K Plan

Medicare L Plan

Medicare A Plan

Medicare B Plan

Medicare C Plan

Medicare D Plan

Medicare F Plan


S. USA Life Insurance Company, Inc.

Yes or No


460 W. 34th St., Ste 800, New York, NY 10001


KEY

Rev 2.03.2019 78


Company

Address





Waiting Period A

B


D

Areas F

Area 1 HD-F

Area 2 G

Area 3 K

Area 4 L

M







Area 4

Standard





Area 4



Area 1

Area 2

Area 3

Area 4

Under 65

*Area 1: Baxter, Benton, Boone, Carroll, Clark, Clay, Cleburne, Columbia, Craighead, Crawford, Drew, Faulkner, Franklin, Fulton, Garland,

Grant, Greene, Independence, Johnson, lawrence, Logan, Lonoke, Madison, Marion, Montgomery, Newton, Pike, Polk, Pope, Randolph, Saline,

Scott, Searcy, Sebastian, Stone, Union, Van Buren, Washington, White, and Yell

**Area 2: Bradley, Calhoun, Cleveland, Conway, Crittenden, Hempstead, Hot Spring, Howard, Izard, Jefferson, Lafayette, Lee, Lincoln, Little

River, Miller, Monroe, Poinsett, Pulaski, Sevier, Sharp and Woodruff

Zip Codes Covered

*

**

***

Medicare M Plan

Medicare N Plan

Medicare G Plan

Medicare K Plan

Medicare L Plan

Medicare A Plan

Medicare B Plan

Medicare C Plan

Medicare D Plan

Medicare F Plan


***Area 3: Arkansas, Ashley, Chocot, Cross, Dallas, Desha, Jackson, Mississippi, Nevada, Ouachita, Perry, Phillips, Prarie and St. Francis

Sentinel Security Life Insurance Company

Yes or No



800-247-1423

[email protected]


KEY

Rev 2.03.2019 79


Company

Address











13600 A ICOT Blvd., Clearwater, FL 33760UNDER 65

Southern Guaranty Insurance Company (SGIC)

Other

Yes or No


1‐888‐912‐4767

[email protected]


KEYNo Medicare A Plan


Medicare N Plan



720‐722716‐719, 723‐729

Medicare M Plan

Rev 2.03.2019 80


Company

Address





Waiting Period A

B


D

Areas F

Area 1 HD-F

Area 2 G

Area 3 K

Area 4 L

M





Area 2

Area 3

Area 4

Standard



Area 2

Area 3

Area 4



Area 1

Area 2

Area 3

Area 4

Under 65

Zip Codes Covered

Whole State

Medicare M Plan

Medicare N Plan

Medicare G Plan

Medicare K Plan

Medicare L Plan

Medicare A Plan

Medicare B Plan

Medicare C Plan

Medicare D Plan

Medicare F Plan


State Farm Mutual Automobile Insurance Company

Yes or No


One State Farm Plaza, Bloomington, IL 61710

800-782-8332

www.statefarm.com


KEY

Rev 2.03.2019 81


Company

Address





Waiting Period A

B


D

Areas F

Area 1 HD-F

Area 2 G

Area 3 K

Area 4 L

M





Area 2

Area 3

Area 4

Standard



Area 2

Area 3

Area 4



Area 1

Area 2

Area 3

Area 4

Under 65

Zip Codes Covered

Whole State

Medicare M Plan

Medicare N Plan

Medicare G Plan

Medicare K Plan

Medicare L Plan

Medicare A Plan

Medicare B Plan

Medicare C Plan

Medicare D Plan

Medicare F Plan


Transamerica Life Insurance Company

Yes or No


4333 Edgewood Road, NE Cedar Rapids, IA 52499

800-797-2643

[email protected]


KEY

Rev 2.03.2019 82


Company

Address





Waiting Period A

B


D

Areas F

Area 1 HD-F

Area 2 G

Area 3 K

Area 4 L

M




Area 1 x 650.00 x x x 279.00 x x x x x

Area 2

Area 3

Area 4

Standard


Area 1

Area 2

Area 3

Area 4



Area 1

Area 2

Area 3

Area 4

Under 65

Zip Codes Covered

Whole State

Medicare M Plan

Medicare N Plan

Medicare G Plan

Medicare K Plan

Medicare L Plan

Medicare A Plan

Medicare B Plan

Medicare C Plan

Medicare D Plan

Medicare F Plan


United American Insurance Company

Yes or No



800-331-2512

www.unitedamerican.com


KEY2 months

Rev 2.03.2019 83


Company

Address





Waiting Period A

B


D

Areas F

Area 1 HD-F

Area 2 G

Area 3 K

Area 4 L

M





Area 2

Area 3

Area 4

Standard



Area 2

Area 3

Area 4



Area 1

Area 2

Area 3

Area 4

Under 65

Zip Codes Covered

Whole State

Medicare M Plan

Medicare N Plan

Medicare G Plan

Medicare K Plan

Medicare L Plan

Medicare A Plan

Medicare B Plan

Medicare C Plan

Medicare D Plan

Medicare F Plan



Yes or No



800-523-5800



KEY3 months

Rev 2.03.2019 84

Approved Charges, also known as allowable charges, Medicare eligible expenses, or Medicare covered charges, apply to the specific dollar amount on which Medicare will base its payment for every medical procedure under Part B. Medicare will pay 80% of this approved" amount. Assignment is the means by which doctors or suppliers receive payment directly from Medicare. When assignment is used, the provider of medical service agrees that his or her total charge for the covered Medicare Part B service will be the charge approved by the Medicare Carrier. Medicare then pays your doctor or supplier 80% of the approved charge, less any part of the $183 annual deduc ble. You are responsible for the 20% of the approved amount not paid by Medicare plus the $183 annual deduc ble. Accep ng assignment means that the doctor or medical provider will not bill you for the difference between the actual charge and the Medicare approved amount. Find out in advance whether your doctor or medical provider will accept assignment. When assignment is not accepted, you will be responsible for any amount up to 15% above the charges approved by Medicare. Using doctors or suppliers who accept assignment will save you money. Any physician may take assignment on a claim‐by‐claim basis whether he is a "par cipa ng" provider or not. Carrier is the Medicare Part B claims processor. In Arkansas, the Medicare "Carrier" is Novitas‐Solu ons (www.novitas‐solu ons.com). For ques ons about your Part B claims payments, telephone 1‐800‐633‐4227. Contestable Clause is a policy provision that gives an insurer the right to rescind your insurance policy in the event there are any material errors, omissions or misstatements on your insurance applica on or enrollment form. The contestable period is generally the two years following the effec ve date of the policy. Coordina on Of Benefits (COB) means that one of your health insurance policies may reduce its benefits if you are also covered by another insurance plan. Important! This usually applies only to employer‐sponsored plans. Private Medicare supplements ordinarily do not have COB regardless of how many policies you have. Co‐payment is the amount that you or your insurance plan must pay to supplement Medicare's payments for Part A and Part B expenses.

For example, for charges incurred in 2019, you will have a $341 per day co‐payment for days 61‐90 and a $682 per day co‐payment for days 91‐150 while in a hospital. There is also a co‐payment of $170.50 for skilled nursing days 21‐100 and a co‐payment of 20% for all Part B services a er your annual deduc ble of $185.

Deductible is the dollar amount that you will have to pay before either Medicare or your insurance plan will begin paying benefits. Your Medicare Part A deduc ble is $1364 per benefit period for 2019. Your Medicare Part B deduc ble is $185 of approved charges each calendar year.

Effective Date is the date your policy becomes effec ve. When you talk to your insurer, ask what the effec ve date will be. The effec ve date is printed on your insurance policy or cer ficate. Exclusions or Exceptions is the list of specific condi ons or circumstances that are not covered by the policy. The excep ons in Medicare supplements are limited by state law and cannot exclude or limit coverage for any specific health condi on for more than six months. Other health insurance plans such as hospital indemnity or medical‐surgical expense plans may have a 12‐month exclusion for pre‐exis ng condi ons and/or permanent exclusions for certain health condi ons. Excess Charges are addi onal charges approved by Medicare if your doctor or provider does not accept Medicare Assignment (Medicare approved amount). The maximum excess charge is 15% of the Medicare approved amount. Free Look is the me period a er you receive the policy in which you can review its benefits. State law requires Medicare supplement insurers to give the consumer 30 days to review the policy. If you return the policy within the 30‐day free look period, you will get a full refund. Other types of individually marketed health insurance plans are limited to a 10‐day free look period.

GLOSSARY

Rev 2.03.2019 85

GLOSSARY

Grace Period is the me period (usually 31 days) or the payment of an overdue premium, during which me the policy remains in force. Hospice is a program for the terminally ill. Medicare does reimburse most Hospice expenses if the Medicare pa ent chooses to take Hospice benefits instead of regular Part A and Part B benefits. There may be a co‐payment for outpa ent drugs and inpa ent respite care. Care must be provided through cer fied Hospice organiza ons. Intermediary is the Medicare Part A claims processor. In Arkansas, the Medicare Part A "intermediary" is Pinnacle Business Solu ons. For ques ons about Part A claims payments, contact Pinnacle Business Solu ons at 1‐866‐799‐2110. Limi ng Charge is the limit on the amount physicians who do not accept assignment can charge a Medicare beneficiary. The limi ng charge is no more than 15% over Medicare's approved amount. Limi ng charge informa on appears on the Medicare Summary No ce (MSN) form. Material Misrepresenta on is a misrepresenta on that was important or essen al to the decision to issue or not issue an insurance policy. Medicaid is a federal and state program that provides health insurance benefits for certain low‐income, disabled or blind individuals, and families. There are strict income eligibility guidelines. Applica ons must be made at the local county office of the Department of Human Services. 1‐800‐482‐8988 Medicare Crossover is one of the more significant service enhancements that insurance companies can offer. A "crossover" company has a contract with Medicare requiring Medicare to send the insured's remainder of the bill directly to the Medicare supplement insurance company. Medicare Advantage is a part of the Balanced Budget Act (BBA) of 1997 that authorizes the Centers for Medicare & Medicaid Services to enter into contracts with insurance companies, managed care organiza ons, and other en es to give Medicare beneficiaries a choice in how they receive their

Medicare benefits. Par cipa ng Physicians are doctors who have contracted with Medicare to accept assignment for all Medicare pa ents, file all claims for Medicare pa ents, and agree to all Medicare rules. Check the MedPard database h p://www.pinnaclemedicare.com/bene/medpard/default.aspx Non‐Par cipa ng Physicians have not signed a contract with Medicare to accept assignment, but may do so on a case‐by‐case basis. Non‐par cipa ng physicians must s ll file all claims with Medicare. Pre‐Exis ng Condi ons are health condi ons for which you have been diagnosed, treated, or had symptoms during the me before your policy's effec ve date of coverage. Pre‐Exis ng Condi on Wai ng Period is the amount of me a er your effec ve date of coverage during which

your insurance plan will not cover any pre‐exis ng condi ons. Medicare supplement law in Arkansas says your wai ng period cannot be any longer than six months. Many Medicare supplements offer plans with shorter wai ng periods. When a Medicare supplement policy replaces an exis ng Medicare supplement policy, the replacing issuer must waive any me period applicable to pre‐exis ng condi ons. Beneficiary and Family Centered Care Quality Improvement Organiza on (BFCC‐QIO) are groups of doctors and health care professionals who are paid by the federal government to review Medicare hospital admissions and reimbursements and to monitor inpa ent quality of care. BFCC‐QIO’s have the authority to deny hospital payments if care is not medically necessary. They also handle pa ent appeals and complaints the pa ent makes regarding non‐payment of service or quality of care. If you have any ques ons, please contact them at 1‐844‐430‐9504. Underwri ng is the method insurance companies use to evaluate risks and determine insurability. Usual, Customary and Reasonable (UCR) typically means the fees most frequently charged in a geographic by providers with similar training and experience for the same or like service or supply.

Rev 2.03.2019 86

Comparing Medicare drug plans can save you money. Provide a list of current medica ons and SHIIP uses

the Medicare website to compare plans www.medicare.gov

Call 1‐800‐224‐6330 for informa on

Helpful Phone Numbers

Arkansas Attorney General’s Office 1-800-482-8982

Beneficiary and Family Centered Care Quality Improvement organization (BFCC-QIO) (KEPRO)

1-844-430-9504

Arkansas SMP (Medicare Fraud) 1-866-726-2916

Marketplace (Affordable Care Act) 1-800-318-2596

Medicaid (Department of Human Services) 1-800-482-5431

Senior Health Insurance Information Program (SHIIP)

1-800-224-6330

Social Security Administration 1-800-772-1213

Tricare 1-866-773-0404

Veterans Administration 1-800-827-1000

1-800-Medicare Helpline 1-800-633-4227

www.insurance.arkansas.gov

Allen Kerr, Commissioner 1200 W 3rd St.

Li le Rock, Arkansas 72201

Toll Free: 1‐800‐224‐6330

This publica on is produced by the State of Arkansas Insurance Department division of Senior Health Insurance Informa on Program (SHIIP) with financial assistance through a grant from the Administra on for Community Living, an agency of the U.S. Department of the Health and Human Services.

Rev 2.03.2019 87

bridging the 9 - arkansas insurance department · 2019-10-24 · from the date of loss of coverage...

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