Not all policies and benefits are available in every state. Americo offers : Plans A, F, G, N. In NJ : Plans A, C, F, G, N. In OH : Plans A, C, D, F, G, N. In PA : Plans A, B, F, G, N. Policy Series 500-A, 500-B, 500-C, 500-D, 500-F, 500-G, 500-N State specific Policy Form Numbers : FL – AFL500-A, AFL500-F, AFL500-G, AFL500-N; ID – AID500-A (09/16), AID500-F (09/16), AID500-G (09/16), AID500-N (09/16); OK – AOK500-A (09/16), AOK500-F (09/16), AOK500-G (09/16), AOK500-N (09/16); PA - APA500-A, APA500-B, APA500-F, APA500-G, APA500-N; TN – ATN500-A, ATN500-F, ATN500-G, ATN500-N; VA – AVA500-A, AVA500-F, AVA500-G, AVA500-N
All Medicare Supplement standardized plans available in a state are offered to qualified individuals age 65 or older.
IMPORTANT NOTE : If you receive Medicare benefits because of disability, you may apply for a Medicare Supplement policy regardless of your age, in the following states: CO, DE, FL, GA, ID, IL, KS, KY, LA, MO, MS, MT, NH, PA, SD, TN (All Plans); MD, OK, TX (Plan A only); NJ (Plan C only); NC (Plans A & F).
IMPORTANT NOTE : If you receive Medicare benefits because of disability or end-stage renal disease, you may apply for a Medicare Supplement policy regardless of your age, in the following states: DE, FL, GA, ID, IL, KS, TN.
MEDICARE SUPPLEMENT INSURANCE IS DESIGNED TO ONLY COVER THOSE MEDICARE-APPROVED EXPENSES WHICH MEDICARE DOES NOT COVER.
EXCLUSIONS
NM Disclosure: This policy has exclusions. For costs and complete details of the coverage, call or write Americo.FL EXCLUSIONS: We will not pay benefits for: (a) expense incurred while this Policy is not in force, except as provided in the EXTENSION OF BENEFITS section; (b) Hospital or Skilled Nursing Facility confinement incurred during a Medicare Part A Benefit Period that begins while this Policy is not in force; (c) that portion of any expense incurred which is paid for by Medicare; (d) any expense that duplicates payments made under any other provision of the Policy; (e) services for non-Medicare Eligible Expenses, including routine exams, take-home drugs and eye refractions; (f) services for which a charge is not normally made in the absence of insurance; (g) loss or expense that is payable under any other Medicare Supplement Insurance policy or certificate (in the case of multiple policies, the Policy will be cancelled and all premiums will be returned); or (h) expenses which are not determined to be Medicare Eligible Expenses by the Federal Medicare Program or its administrators, except to the extent provided in the Policy, regardless of whether the Insured has Part A and/or Part B of Medicare. ID EXCLUSIONS: We will not pay benefits for: (a) expense incurred while this Policy is not in force, except as provided in the EXTENSION OF BENEFITS section; (a) Hospital or Skilled Nursing Facility confinement incurred during a Medicare Part A Benefit Period that begins while this Policy is not in force; (b) that portion of any expense incurred which is paid for by Medicare; (c) any expense that duplicates payments made under any other provision of the Policy; (d) services for non-Medicare Eligible Expenses, including, but not limited to, routine exams, take-home drugs and eye refractions; (e) services for which a charge is not normally made in the absence of insurance; (f) loss or expense that is payable under any other Medicare Supplement Insurance policy or certificate; or (g) expenses which are not determined to be Medicare Eligible Expenses by the Federal Medicare Program or its administrators, except to the extent provided in the Policy. LA EXCLUSIONS: We will not pay benefits for: (a) expense incurred while this Policy is not in force, except as provided in the EXTENSION OF BENEFITS section;(b) Hospital or Skilled Nursing Facility confinement incurred during a Medicare Part A Benefit Period that begins while this Policy is not in force; (c) that portion of any expense incurred which is paid for by Medicare; (d) that portion of any expense that is payable under any other insurance plan, policy, certificate, or any employee benefit plan, which pays benefits on an expense-incurred basis. (f) any expense that duplicates payments made under any other provision of the Policy; (g) services for non-Medicare Eligible Expenses, including, but not limited to, take-home drugs and eye refractions; (h) services for which a charge is not normally made in the absence of insurance; (i) loss or expense that is payable under any other Medicare Supplement Insurance policy or certificate; or (j) expenses which are not determined to be Medicare Eligible Expenses by the Federal Medicare Program or its administrators, except to the extent provided in the Policy. MD EXCLUSIONS: We will not pay benefits for: (a) expense incurred while this Policy is not in force, except as provided in the EXTENSION OF BENEFITS section; (b) Hospital or Skilled Nursing Facility confinement incurred during a Medicare Part A Benefit Period that begins while this Policy is not in force; (c) that portion of any expense incurred which is paid for by Medicare; (d) any expense that duplicates payments made under any other provision of the Policy; (e) services for non-Medicare Eligible Expenses, including, but not limited to, routine exams, take-home drugs and eye refractions; (f) services for which a charge is not normally made in the absence of insurance; or (g) expenses which are not determined to be Medicare Eligible Expenses by the Federal Medicare Program or its administrators, except to the extent provided in the Policy. NH EXCLUSIONS: We will not pay benefits for: (a) expense incurred while this Policy is not in force, except as provided in the EXTENSION OF BENEFITS section; (b) that portion of any expense incurred which is paid for by Medicare; (c) that portion of any expense that is payable under any other insurance plan, Policy, certificate, or any employee benefit plan, which pays benefits on an expense-incurred basis; (d) any expense that duplicates payments made under any other provision of the Policy; (e) services for non-Medicare Eligible Expenses, including, but not limited to, routine exams, take-home drugs and eye refractions; (f) services for which a charge is not normally made in the absence of insurance; (g) loss or expense that is payable under any other Medicare Supplement Insurance policy or certificate; or (h) expenses which are not determined to be Medicare Eligible Expenses by the Federal Medicare Program or its administrators, except to the extent provided in the Policy. PA EXCLUSIONS: We will not pay benefits for: (a) expense incurred while this Policy is not in force, except as provided in the EXTENSION OF BENEFITS section; (b) that portion of any expense incurred which is paid for by Medicare; (c) that portion of any expense that is payable under any other insurance plan, policy, certificate, or any employee benefit plan, which pays benefits on an expense-incurred basis.(d) any expense that duplicates payments made under any other provision of the Policy; (f) services for non-Medicare Eligible Expenses, including, but not limited to, routine exams, take-home drugs and eye refractions; (g) services for which a charge is not normally made in the absence of insurance; (h) loss or expense that is payable under any other Medicare Supplement Insurance policy or certificate; or (i) expenses which are not determined to be Medicare Eligible Expenses by the Federal Medicare Program or its administrators, except to the extent provided in the Policy. TN EXCLUSIONS: We will not pay benefits for: (a)expense incurred while this policy is not in force, except as provided in the EXTENSION OF BENEFITS section; (b) that portion of any expense incurred which is paid for by Medicare; (c) any expense that duplicates payments made under any other provision of the policy; (d) services for non-Medicare Eligible Expenses, including, but not limited to, routine exams, take-home drugs and eye refractions; (e) services for which the beneficiary has no legal obligation to pay and no other person or organization has a legal obligation to provide or pay; or (f) expenses which are not determined to be Medicare Eligible Expenses by the Federal Medicare Program or its administrators, except to the extent provided in the policy. TX EXCLUSIONS: We will not pay benefits for: (a) expense incurred while this Policy is not in force, except as provided in the EXTENSION OF BENEFITS section; (b) that portion of any expense incurred which is paid for by Medicare; (c) any expense that duplicates payments made under any other provision of the Policy; (d) services for non-Medicare Eligible Expenses, including, but not limited to, routine exams, take-home drugs and eye refractions; (e) services for which a charge is not normally made in the absence of insurance; or (f) expenses which are not determined to be Medicare Eligible Expenses by the Federal Medicare Program or its administrators, except to the extent provided in the Policy.
IMPORTANT NOTICE – “A CONSUMER’S GUIDE TO HEALTH INSURANCE FOR PEOPLE ELIGIBLE FOR MEDICARE” MAY BE OBTAINED FROM YOUR LOCAL SOCIAL SECURITY OFFICE, MEDICARE.GOV, THE DEPARTMENT OF INSURANCE OR FROM AMERICO OR YOU MAY REVIEW THE DOCUMENT BY THE LINK PROVIDED ON THIS WEBSITE [CLICK HERE] .YOU MAY REQUEST AN OUTLINE OF COVERAGE FROM AMERICO OR [CLICK HERE] TO IMMEDIATELY REVIEW AN OUTLINE OF COVERAGE FOR YOUR STATE. For cost and complete details of coverage, contact Americo or an Americo agent/producer.TERM OF COVERAGE: Your coverage starts on the Effective Date at 12:01 A.M. where you live. It ends at 12:01 A.M. where You live on the first Policy Renewal Date. Each time You renew Your Policy by paying the premium within the 31-day grace period, the new term begins when the old term ends. FL only: Your coverage starts on the Policy Date shown on the Policy Data Page at 12:01 A.M. where You live. Your coverage ends at 12:01 A.M. where You live on the first of the following dates: (1) the date You cancel or do not renew this Policy on the Policy Renewal Date; or (2) on the expiration of the grace period if the required premium is not paid. NH only: Your coverage starts on the Effective Date at 12:01 A.M. where you live. It ends at 12:01 A.M. where You live on the first Policy Renewal Date. The new term begins when the old term ends subject to the terms of Your Policy.
SUSPENSION OF COVERAGE FOR MEDICAID :
If You apply for and become entitled to medical assistance under Medicaid, We will suspend benefits and premiums under this policy at Your request, as long as You notify us within 90 days after the onset of Medicaid entitlement. This suspension of coverage can last for up to 24 months while Your Medicaid entitlement continues. Upon our receipt of Your timely notification, We will refund any unearned premium for the period of time You are eligible for Medicaid. Your refunded premium will be reduced by the amount of any claims paid for the period You are eligible. If You lose entitlement to Medicaid benefits during this suspension of coverage, Your Policy will be automatically reinstituted as long as You notify Us of the loss of entitlement within 90 days after it occurs. Automatic reinstitution of coverage will be effective as of the date of Medicaid termination. You must pay the applicable Policy premium. Upon reinstitution, We will: (a) provide coverage substantially equivalent to the coverage in effect prior to the date of suspension; and (b) charge a premium at least as favorable as if coverage had not been suspended. KY ONLY: If You apply for and become entitled to medical assistance under Medicaid, We will suspend benefits and premiums under this policy at Your request, as long as You notify us within 90 days after the onset of Medicaid entitlement. This suspension of coverage can last for up to 24 months while Your Medicaid entitlement continues. Upon our receipt of Your timely notification, We will refund any unearned Premium for the period of time You are eligible for Medicaid. Your refunded premium will be reduced by the amount of any claims paid for the period You are eligible. If You lose entitlement to Medicaid benefits during this suspension of coverage, Your Policy will be automatically reinstituted as long as You notify Us of the loss of entitlement within 90 days after it occurs. Automatic reinstitution of coverage will be effective as of the date of Medicaid termination. You must pay the applicable Policy premium. Upon reinstitution, We will: (a) not provide for any waiting period with respect to treatment of preexisting conditions; (b) provide coverage substantially equivalent to the coverage in effect prior to the date of suspension; and (c) charge a premium at least as favorable as if coverage had not been suspended. MD ONLY: If You apply for and become entitled to medical assistance under Medicaid, We will suspend benefits and premiums under this policy at Your request, as long as You notify us within 90 days after the onset of Medicaid entitlement. This suspension of coverage is for a period not to exceed 24 months in which You have applied for and are determined to be entitled to medical assistance under Title XIX of the Social Security Act. Upon our receipt of Your timely notification, We will refund any unearned premium for the period of time You are eligible for Medicaid. Your refunded premium will be reduced by the amount of any claims paid for the period You are eligible. If You lose entitlement to Medicaid benefits during this suspension of coverage, Your Policy will be automatically reinstituted as long as You notify Us of the loss of entitlement within 90 days after it occurs. Automatic reinstitution of coverage will be effective as of the date of Medicaid termination. You must pay the applicable Policy premium. Upon reinstitution, We will: (a) provide coverage substantially equivalent to the coverage in effect prior to the date of suspension; and (b) charge a premium at least as favorable as if coverage had not been suspended. NH ONLY: If You apply for and become entitled to medical assistance under Medicaid, We will suspend benefits and premiums under this policy at Your request, as long as You notify us within 90 days after the onset of Medicaid entitlement. This suspension of coverage can last for up to 24 months while Your Medicaid entitlement continues. Upon our receipt of Your timely notification, We will refund any unearned premium for the period of time You are eligible for Medicaid. Your refunded premium will be reduced by the amount of any claims paid for the period You are eligible. If You lose entitlement to Medicaid benefits during this suspension of coverage, Your Policy will be automatically reinstituted as long as You notify Us of the loss of entitlement within 90 days after it occurs. Automatic reinstitution of coverage will be effective as of the date of Medicaid termination. You must pay the applicable Policy premium. Upon reinstitution, We will: (a) provide coverage substantially equivalent to the coverage in effect prior to the date of suspension; and (b) charge a premium at least as favorable as if coverage had not been suspended.
SUSPENSION OF COVERAGE WHILE COVERED UNDER A GROUP HEALTH PLAN :
If You are entitled to benefits under Section 226(b) of the Social Security Act and covered under a group health plan, We will suspend benefits and premiums under this Policy at Your request. This suspension of coverage can last as long as the period provided by federal regulation. Upon our receipt of Your timely notification, We will refund any unearned premium for the period of time You are covered under the group health plan. Your refunded premium will be reduced by the amount of any claims paid for the period You are eligible. If You lose coverage under the group health plan during this suspension of coverage, your Policy will be automatically reinstituted as long as You notify us of such loss of coverage within 90 days after it occurs. Automatic reinstitution of Your Policy's coverage will be effective as of the date of group health plan termination. You must pay the applicable Policy premium. Upon reinstitution, We will: (a) provide coverage substantially equivalent to the coverage in effect prior to the date of suspension; and (b) charge a premium at least as favorable as if coverage had not been suspended. KY ONLY: If You are entitled to benefits under Section 226(b) of the Social Security Act and covered under a group health plan, We will suspend benefits and premiums under this Policy at Your request. This suspension of coverage can last as long as the period provided by federal regulation. Upon our receipt of Your timely notification, We will refund any unearned premium for the period of time You are covered under the group health plan. Your refunded premium will be reduced by the amount of any claims paid for the period You are eligible. If You lose coverage under the group health plan during this suspension of coverage, your Policy will be automatically reinstituted as long as You notify us of such loss of coverage within 90 days after it occurs. Automatic reinstitution of Your Policy's coverage will be effective as of the date of group health plan termination. You must pay the applicable Policy premium. Upon reinstitution, We will: (a) not provide for any waiting period with respect to treatment of preexisting conditions; (b) provide coverage substantially equivalent to the coverage in effect prior to the date of suspension; and (c) charge a premium at least as favorable as if coverage had not been suspended. MD ONLY: If You are entitled to benefits under Section 226(b) of the Social Security Act and covered under a group health plan as defined in 1862(b)(1)(A)(v) of the Social Security Act, We will suspend benefits and premiums under this Policy at Your request. This suspension of coverage can last as long as the period provided by federal regulation. Upon our receipt of Your timely notification, We will refund any unearned premium for the period of time You are covered under the group health plan. Your refunded premium will be reduced by the amount of any claims paid for the period You are eligible. If You lose coverage under the group health plan during this suspension of coverage, your Policy will be automatically reinstituted as long as You notify us of such loss of coverage within 90 days after it occurs. Automatic reinstitution of Your Policy's coverage will be effective as of the date of group health plan termination. You must pay the applicable Policy premium. Upon reinstitution, We will: (a) provide coverage substantially equivalent to the coverage in effect prior to the date of suspension; and (b) charge a premium at least as favorable as if coverage had not been suspended. NH ONLY: If You are entitled to benefits under Section 226(b) of the Social Security Act for persons under age 65, also known as Social Security Disability Insurance (SSDI), and covered under a group health plan, We will suspend benefits and premiums under this Policy at Your request. This suspension of coverage can last as long as the period provided by federal regulation. Upon our receipt of Your timely notification, We will refund any unearned premium for the period of time You are covered under the group health plan. Your refunded premium will be reduced by the amount of any claims paid for the period You are eligible. If You lose coverage under the group health plan during this suspension of coverage, Your Policy will be automatically reinstituted as long as You notify us of such loss of coverage within 90 days after it occurs. Automatic reinstitution of Your Policy's coverage will be effective as of the date of group health plan termination. You must pay the applicable Policy premium. Upon reinstitution, We will: (a) provide coverage substantially equivalent to the coverage in effect prior to the date of suspension; and (b) charge a premium at least as favorable as if coverage had not been suspended.
MT ONLY SUSPENSION OF COVERAGE :
A Medicare supplement policy or certificate must provide that benefits and premiums under the policy or certificate must be suspended at the request of the policyholder or certificateholder for the period (not to exceed 24 months) in which the policyholder or certificateholder has applied for and is determined to be entitled to medical assistance under Title XIX of the Social Security Act, but only if the policyholder or certificateholder notifies the issuer of such policy or certificate within 90 days after the date the individual becomes entitled to such assistance. Upon receipt of timely notice, the issuer must either return to the policyholder or certificateholder that portion of the premium attributable to the period of Medicaid eligibility or provide coverage to the end of the term for which premiums were paid, at the option of the insured, subject to adjustment for paid claims. If a suspension occurs and if the policyholder or certificateholder loses entitlement to such medical assistance, such policy or certificate must be automatically reinstituted effective as of the date of termination of such entitlement if the policyholder or certificateholder provides notice of loss of such entitlement within 90 days after the date of such loss and pays the premium attributable to the period. Each Medicare supplement policy shall provide that benefits and premiums under the policy shall be suspended (for any period that may be provided by federal regulation) at the request of the policyholder if the policyholders entitled to benefits under 226(b) of the Social Security Act and is covered under a group health plan (as defined in 1862(b)(1)(A)(v) of the Social Security Act). If suspension occurs and if the policyholder or certificateholder loses coverage under the group health plan, the policy shall be automatically reinstituted (effective as of the date of loss of coverage) if the policyholder provides notice of loss of coverage within 90 days after the date of loss. Reinstitution of coverages as described above must not provide for any limitation period with respect to treatment of preexisting conditions or provide for resumption of coverage that is substantially equivalent to coverage in effect before the date of suspension. If suspended Medicare supplement policy or certificate provided coverage for outpatient prescription drugs, reinstitution of the policy or certificate for Medicare Part D enrollees must be without coverage for outpatient prescription drugs and must otherwise provide substantially equivalent coverage to the coverage in effect before the date of suspension; and provide for classification of premiums on terms at least as favorable to the policyholder or certificateholder as the premium classification terms that would have applied to the policyholder or certificateholder had the coverage not been suspended.
PREMIUM INFORMATION: AL, CO, DE, IA, IL, IN, KS, KY, LA, MD, MI, MS, MT, NC, ND, NE, NJ, NM, NV, OH, OK, PA, RI, SC, SD, TN, TX, UT, VA, WY, WV: Premiums are based the applicant’s Attained Age , meaning the premium is based on the applicant’s current age so the premiums go up each year. Premiums may also go up because of inflation and other factors.PREMIUM INFORMATION: AZ, FL, GA, ID, MO, NH: Premiums are based on the applicant’s Issue Age , meaning the premium is based on the age of the applicant when the Medicare Supplement policy is purchased and will not increase as they get older. However, premiums may go up because of inflation and other factors.PREMIUM INFORMATION: AR: Premiums are based on Community Rating , meaning the same monthly premium is charged to everyone who has a Medicare policy regardless of age. However, premiums may go up because of inflation and other factors.
