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Social Security Medicare Part B premiums are now excluded from income.

PACE Facts:

• A single person’s total income from last year must be $14,500 or less.
• A married couple’s total combined income from last year must be $17,700 or less.
• Covered drugs (based on 30-day supply): $6 Generic co-pay, $9 Brand co-pay.

PACENET Facts:

• A single person’s total income from last year must be between $14,501 and $23,500.
• A married couple’s total combined income from last year must be between $17,701 and $31,500.
• Covered drugs (based on 30-day supply): $8 Generic co-pay, $15 Brand co-pay (PACENET members may have a monthly premium to pay at the pharmacy.)

*Pro-tip: PACE/PACENET looks at your total income of the previous year. If married, they will look at the total income between both spouses. So, if one passes away, you should apply again to have them only review the surviving spouses portion to qualify.

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The rules of AEP are for MAPD and PDP only and do not apply to Medigap. You can purchase or change your Medigap (Medicare Supplement) plan at any time of year. The only downside is that you must complete a health underwriting questionnaire to be reviewed for approval.

Guaranteed issue (GI) rights or “Medigap protections” are your rights to buy certain Medigap policies in limited situations outside of your Medigap Open Enrollment Period. In these situations, an insurance company:

• Must sell you a Medigap policy.
• Must cover all your pre‑existing health conditions.
• Can’t charge you more for a Medigap policy because of past or present health problems.

Typically a GI right lasts between 60-63 days and allows you to purchase only plan letters A, B, D, G, K, or L. You must purchase plan letters C or F (instead of D or G) if you have Part A of Original Medicare prior to 2020.

Pro-tips:

1. Some carriers allow you to downgrade your plan letter without going through the underwriting process - Capital Blue Cross and UnitedHealthcare.
2. Commissions are less for guaranteed issue applications - ask to see a commission schedule.
3. Some carriers allow you to write more plan letters than the rule states - Capital Blue Cross and UnitedHealthcare allow Plan N for GI.

Learn more: Choosing a Medigap Policy

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Hospital indemnity insurance is a supplemental insurance plan that you can purchase in addition to your health insurance. Here's how it works:

• You pay a monthly premium.
• If you end up spending time in the hospital, you receive a fixed benefit amount paid directly to you to help cover expenses.
• The benefit amount is usually paid per day for each hospital confinement, and the insurance company pays this daily benefit amount for up to a year.
• It is considered a supplement to, rather than a replacement for, major medical insurance.

For example, you are hospitalized and have a Medicare per admission co-pay of $350. You pay that out of pocket per your coverage. Later you can submit a claim to your hospital indemnity plan to reimburse you cash benefits for services.

We have several carriers that offer this ancillary benefits if you are contracted to sell their Medicare Supplement plans.

See carriers: https://www.urlinsgroup.com/medicare-product-info/senior-ancillary-products.html