Springfield, MO

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Supplemental insurance gives help to disabled

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Disabled Missourians who are enrolled in Medicare can buy supplemental insurance for the first time without fear of rejection at an average cost of $653 a year for the most basic plan, according to Missouri's Department of Insurance.

Average costs, however, can rise to $2,561 annually for the broader coverage found in some of the 10 standardized plans allowed under federal law.

The annual premiums for the disabled are somewhat higher than the most common rates of $526 and $547 rates available to 65-year-old Medicare basic plan enrollees.

But new state regulations impose a cap on disabled rates to keep them affordable, a release from the insurance department said.

Beginning June 30, disabled Missourians gained the right to buy what are called Medigap policies during the first six months after they enroll in Medicare or during a special six-month open enrollment period for the 86,000 disabled residents already receiving Medicare benefits.

That open enrollment period runs until Dec. 30.

Previously, only people 65 or older in the Medicare program had that guarantee, and the 17 companies that sold coverage to disabled Medicare enrollees could deny coverage based on individual medical histories.

Medicare supplemental, or Medigap, insurance covers the enrollee's out-of-pocket costs for physician and outpatient hospital charges.

The various plans also can pay for skilled nursing care, prescription drugs and other services not fully covered by Medicare.

Medicare pays for no outpatient drugs, and enrollees who need such coverage rely on Medigap.

The insurance department released rates for companies writing new business in its free Medicare Supplemental Insurance Cost Comparison Guide, the agency's most popular consumer publication.

The Missouri Department of Insurance already has distributed about 5,000 copies.

Now available is a special insert on disabled pricing for 55 companies.

Jay Angoff, director for the department, said 55 Missouri insurers now are selling individual Medigap policies to disabled Missourians.

Other insurers make plans available through professional, fraternal, military and other groups.

Insurers must make policies available at or below the average cost charged to people 65 and older in each of the 10 plan categories. No company is allowed to sell new policies only to seniors.

The rates for disabled Missourians still reflect the range of pricing that exists for seniors in the Medigap program, with high-cost policies often priced more than twice as much as low-end coverage with the same benefits.

For Plan A the most basic policy rates for the disabled range from $414 a year at Central Benefits National Life to $1,092 from Humana Insurance Company.

The average was $653.

Plan A coverage with a limited choice of providers Medicare select plans rather than the traditional fee-for-service model runs from $420 at Humana to $1,080 at Blue Cross and Blue Shield of Kansas City.

For Plan F considered the best-selling of the 10 categories annual premiums ranged from a low of $905 at Health and Life Insurance Company of America to a high of $2,066 at American Family Life Assurance Company of Columbus. The average was $1,280.

The Medicare select version of Plan F averaged $1,060 with a range from $831 at Healthy Alliance Life Insurance (a member of the Blue Cross/Blue Shield of Missouri group) to $1,400 at Blue Cross and Blue Shield of Kansas City.

Select plans typically are less expensive than regular Medigap policies with similar benefits, because insurers have negotiated discounts with their provider networks. In regular policies, providers are paid customary charges.

The department's 1998 Medicare Supplemental Insurance Cost Comparison Guide is available by calling 800-726-7390.

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