WPS MEDICARE COMPANION › sales-materials › files › 29595-WI...Seven reasons to choose WPS 1. Freedom to choose your own doctors and hospitals that accept Medicare anywhere in

WPS MEDICARE COMPANIONMedicare supplement plan that provides relief from unexpected health care costsRates effective January 1, 2017

Medicare made simpler with WPS! Visit wpsmedicaresolutions.com

Current as ofJan. 1, 2017

2 | wpsmedicaresolutions.com

To be eligible for WPS Medicare Companion, you:1. Have to be a Wisconsin resident when you enroll.

2. Have to be enrolled in Medicare Part A and Part B by the date the WPS Medicare Companion plan starts.

3. Can’t be covered by Medicaid.

If you’re eligible to apply, please read on. For important information about policy benefits and limitations, and your rights and responsibilities under the plan, please also see the Outline of Coverage.

ContentsMedicare alone is not enough 3

How open enrollment works 4

Seven reasons to choose WPS 5

WPS offers four great plan options 6

WPS provides convenient payment options 6

Why choose a WPS cost-sharing plan? 7

Premium rates 8-11

WPS Medicare Companion | 3

Medicare alone is not enoughThat’s why there’s WPS Medicare Companion

We’re proud the Wisconsin Retired Educators’ Association (WREA), a nearly 12,000-member statewide organization, has endorsed the WPS Medicare Companion. The WREA trusts WPS to take care of its membership in retirement, and so can you.

Medicare is a valuable benefit, but it doesn’t pay for everything. There are deductibles and coinsurance you have to pay before Medicare pays its share. And though no one likes to say it, there is always a chance a serious illness or injury could exhaust your savings if you have Medicare alone. So what can you do to protect your health and retirement savings? Take a look at the WPS Medicare Companion supplement plan.

Comprehensive coverage helps fill the gaps in MedicareEvery WPS Medicare Companion policy begins with an excellent core of benefits. Depending on the plan option you choose, WPS Medicare Companion covers all or part of your Medicare Part A (Hospitalization) and Part B (Medical) coinsur-ance—costs you would otherwise have to pay out of your own pocket. But that’s just the beginning. WPS Medicare Com-panion pays for a variety of important services, including:

» Hospitalization, skilled nursing care, and home health care services

» Medical and surgical services and supplies

» Chiropractic services

» X-rays, mammograms, and lab tests

» Licensed ambulance services

» Physical, radiation, and speech therapy

» Equipment and certain supplies to treat diabetes

» Dialysis and kidney transplant services

» Durable medical equipment and prosthetics

For a more detailed description of WPS Medicare Companion benefits, please refer to the Outline of Coverage.

Keeps pace with MedicareEach time the Centers for Medicare & Medicaid Services (CMS) increases the Medicare deductibles, your WPS Medicare Companion benefits adjust to cover the increase. You can feel secure in knowing your plan will always remain current with Medicare.


How open enrollment worksWPS offers an open enrollment period beginning the calendar month in which you turn 65 or enroll in Medicare Part B, and continuing through the next six full calendar months. You can submit your applica-tion for the WPS Medicare Companion up to three calendar months before the open enrollment period begins. If you apply during the open enrollment period, you won’t need to answer any health questions; simply complete and submit a policy enrollment application. Coverage begins the first of the month after we accept your application and premium, or with an effective date you request up to three months in the future.

What if you’re currently enrolled in Medicare Part B?You have a six-month open enrollment period beginning with the month of your 65th birthday.

Do you have other coverage that’s terminating or changing?If you have other coverage that’s terminating, you may be eligible for guaranteed acceptance of this policy. In this instance, you must apply within 63 days of receiving your final coverage termination notice or within 63 days of the date your current coverage ends. If your employer retiree plan premium increased by more than 25%, you may be eligible for guaranteed acceptance of this policy. To learn if you qualify for guaranteed acceptance, please call your agent or your WPS sales representative at 1-800-236-1448.


Seven reasons to choose WPS1. Freedom to choose your own doctors and hospitals that accept Medicare anywhere in the U.S.

With the WPS Medicare Companion, you can keep the same doctor you’ve been seeing for years. Or you can select a new doctor at any time. You have complete freedom to choose your health care providers. And if you move, your WPS Medicare Companion coverage moves with you—anywhere in the U.S.

2. You can always keep your plan as long as you pay your premium We promise your WPS Medicare supplement policy will never be canceled because of your health. As long as you pay your premium on time, the WPS Medicare Companion is guaranteed renewable for life.

3. One-year rate guarantee The initial premium for WPS Medicare Companion plans is guaranteed for the first 12 months you have the policy, unless you move into a new rating area or you change the policy benefit.

4. Save money with our household discount WPS offers a 7% discount when you and a second household member are enrolled in a WPS Medicare supplement plan.1

5. Less paperwork, fewer worries! With our automatic claims service, you don’t have to worry about filing claims or dealing with medical bills. That’s because Medicare sends your claims electronically right to WPS. We handle the claims, and you enjoy the convenience of almost no paperwork.

6. Online resources—just point and click to find what you need Visit the WPS website at wpsmedicaresolutions.com to quickly and easily verify your benefits, eligibility, and claims status. You can request a replacement WPS ID card and Member Guide. You can also find information in our online Health Center about healthy eating, managing chronic conditions, patient safety, and more, including a special area devoted to senior health issues.

7. Going the extra mile for members When you call WPS, you reach caring people right here in Wisconsin. Your questions are answered promptly and accurately by our highly trained Member Support team. We’ll go the extra mile to assist you. Outstanding member service has been our hallmark for more than 70 years.

1Household: Two or more individuals who reside together in the same dwelling. Dwelling is defined as a single home, condominium unit, or apartment unit within an apartment complex.



WPS Medicare Companion offers four great plan options

Automatic premium withdrawalWith our automatic premium withdrawal service, your premium is automatically withdrawn from your check-ing or savings account each time it’s due. It’s safe and easy to set up. No checks to write. No envelopes to mail. Plus, you’ll never have to worry that your coverage will be canceled because your payment was lost in the mail or your credit card expired. And best of all, you receive a 2% discount off your premium when you choose this option!

Credit/debit card paymentIf you choose to pay by credit/debit card, your initial premium amount will be charged to your card once your application has been approved. You also may set up regular payments on your card—monthly, quarterly, semi-annually, or annually.

Direct billingIf you choose to pay through direct billing, WPS will mail premium notices to you according to the payment schedule you select—monthly, quarterly, semiannually, or annually.

Please see the WPS Medicare Companion enrollment application for additional instructions for selecting a payment option.

1. Base plan only This is the highest level of coverage. It covers your Medicare Part A (Hospitalization) and Part B (Medical) coinsurance—costs you would otherwise have to pay out of your own pocket. This plan offers unlimited preventive benefits.1

2. Base plan with copayment or coinsurance rider This is the second-highest level of coverage. If you select this coverage, after you pay the Medicare Part B deductible, you pay a $20 copayment for office visits and up to a $50 copayment for emergency room visits, or pay the Medicare Part B coinsurance, whichever is less. This plan also offers unlimited preven-tive benefits.1

3. 25% cost-sharing plan This is the second-lowest level of coverage. After Medicare pays its share, WPS pays 75% of the remain-ing costs and you pay 25%. If you reach $2,560 in annual out-of-pocket costs on Medicare-approved services, WPS will cover 100% of additional Medicare-approved costs thereafter until the end of the year.

4. 50% cost-sharing plan This is the lowest level of coverage. After Medicare pays its share, you split the remaining costs with WPS 50/50. If you reach $5,120 in annual out-of-pocket costs on Medicare-approved services, WPS will cover 100% of additional Medicare-approved costs thereafter until the end of the year.

You can enhance the WPS Medicare Companion base plan with up to five optional benefit riders. Each rider is available at an additional cost. Optional riders include:

» Medicare 100% Part A Deductible; or Medicare 50% Part A Deductible

» Medicare Part B Deductible (available only with highest base plan option)

» Medicare Part B Excess Charges

» Additional Home Health Care coverage for up to 325 days beyond what Medicare pays

» Foreign Travel Emergency

Cost-sharing plans are eligible for the Additional Home Health Care rider only.

Please see the Outline of Coverage for a description of the benefits provided by these riders.

WPS provides convenient payment options

Beware of lowball plans!You’ve probably seen some Medicare supplements with really low premiums. Don’t fall for these lowball plans! Premiums that look too good to be true usually are. A low rate right now can quickly evolve into a sky-high rate in subsequent years.

When you choose a WPS Medicare Companion supplement plan, you can be confident that the rate you get is set by a company with a history of stable rates that don’t jump dramatically from year to year. It’s like your parents told you—you get what you pay for. Top-quality coverage from WPS helps protect your health and your finances—and that safety net is truly a relief.

Silver&Fit® program2

When you choose a base plan option, you also get this great perk! Silver&Fit gives you a health club membership at no extra cost, plus home fitness kits, a resource library, fitness challenges, and more. Take advantage of standard amenities, such as cardiovascular exercise equipment (e.g., treadmills, exercise bicycles), strength or resistance training equipment, and use of locker room and shower facilities. Facilities may include, but are not limited to, swimming pools, recreation centers, and dance, Pilates, or yoga studios.

The Silver&Fit program also provides, through its ChooseHealthy® Affinity program3, discounts for members to see participating acupuncturists, chiropractors, dietitians, and massage therapists, as well as discounts on food supplements, herbs and botanicals, sports nutrition, and more through an online store! Please see the ChooseHealthy flyer included in your information kit for details.

1Applies to Medicare Part B preventive services with no maximum benefit amount. 2The Silver&Fit program is provided by American Specialty Health Fitness, Inc., a subsidiary of American Specialty Health Incorporated (ASH). Silver&Fit is a federally registered trademark of ASH. 3 ChooseHealthy is a product of American Specialty Health Administrators, Inc., an affiliate of ASH Group and a subsidiary of American Specialty Health Incorporated.

Why choose a WPS cost-sharing plan?Pick your share of the pieCost-sharing plans are available in two different designs: a 25% plan and a 50% plan. The percentages reflect how much of your covered medical expenses you pay after Medicare pays its share. And if you hit your limit for out-of-pocket expenses, WPS generally pays everything beyond that for all Medicare approved benefits.

25% cost-sharing planIf you choose the 25% cost-sharing plan, Medicare Part B pays its 80% following the deductible, and you split the remainder of the bill with WPS. WPS pays three-fourths of that, and you pay one fourth. If you do the math, you’ll see that this requires you to pay only about five cents of every dollar of your total covered medical bill. For Part A, WPS pays 75% of the deductible. After the deductible, the hospital charges are generally covered at 100%.

50% cost-sharing planIf you want an even lower premium, you can select the 50% cost-sharing plan. For this plan, Medicare Part B still pays its 80% following the deductible of your covered medical expenses. However, you split the remainder of the bill evenly with WPS. This means that you pay about 10 cents of every dollar of your total covered health care bill and WPS picks up the other 10%. For Part A, WPS pays one half of the deductible. After the deductible, the hospital charges are generally covered at 100%.

25% Cost-Sharing Plan

Medicare 80%WPS

15%

Patient5%

Medicare 80%

WPS10%

50% Cost-Sharing Plan

Medicare Part B Example

Patient10%



WPS Medicare Companion Monthly Premium RatesEffective January 1, 2017Determine your rate area:

Area 1 = Milwaukee area and southeastern Wisconsin530__: All ZIPs that begin with these 3 numbers531__: 01-13, 16-19, 22-24, 26, 27, 29-36, 39-46, 49-55, 58-75, 77, 79-83, 85-89, 92-94, 96-99532__: All ZIPs that begin with these 3 numbers533__: All ZIPs that begin with these 3 numbers534__: All ZIPs that begin with these 3 numbers

Area 2 = Central and western Wisconsin546__: All ZIPs that begin with these 3 numbers549__: All ZIPs that begin with these 3 numbers

Area 3 = All other Wisconsin ZIP codes

IMPORTANT: » 2% Discount for Automatic Premium Withdrawal

The rates listed in the next pages include a 2% discount for members who pay using automatic premium withdrawal. Members are welcome to pay using a credit or debit card, or may receive a paper bill monthly, quarterly, semiannually, or annually. However, the rates those members pay will be higher than the rates listed here.

» 7% Discount for You and a Second Member of Your Household1

WPS offers a 7% household discount to both you and a second member of your household when you both enroll in a current WPS Medicare Companion supplement plan. To calculate, multiply your final rate by 0.93.

» Relocation These rates also apply if you move outside Wisconsin. If, in the future, you permanently relocate to another state, Area 1 rates will apply. If you relocate to another Wisconsin ZIP code, you will pay the rates for the area to which you move.

» Adding the Foreign Travel Emergency Rider You may add the foreign travel emergency rider at any time in the future without answering health questions. There is no fee to add this rider when you first apply for WPS Medicare Companion. However, if you add this rider after your original effective date, a $25 administration fee will apply.

» Premium Calculation Worksheet You will find a worksheet on the last page of the Outline of Coverage booklet. This will provide you space to calculate and record your final monthly premium with area, optional riders, and discounts factored in.

1Household: Two or more individuals who reside together in the same dwelling. Dwelling is defined as a single home, condominium unit, or apartment unit within an apartment complex.

Area 1Area 2Area 3


Area 1 RatesOptional Riders

Available only on the highest base plan option: Part B Deductible = $13.83Additional Home Health Care = $2

Current Age

Base Plan Only(Highest coverage available)

Base Plan with Copay/Coinsurance Rider (Second-highest coverage available)

Foreign Travel Emergency = $1.50

Part A Deductible (Choose one)

50% 100%

Part BExcess Charges

65 $143.47 $124.68 $14.31 $29.17 $6.71

66 $151.44 $131.60 $15.22 $31.03 $6.98

67 $159.44 $138.53 $16.13 $32.90 $7.25

68 $167.43 $145.49 $17.04 $34.79 $7.52

69 $175.41 $152.44 $17.96 $36.63 $7.83

70 $183.43 $159.40 $18.87 $38.51 $8.09

71 $191.38 $166.34 $19.80 $40.39 $8.38

72 $199.39 $173.28 $20.72 $42.26 $8.62

73 $207.38 $180.20 $21.62 $44.10 $8.94

74 $215.36 $187.15 $22.53 $45.98 $9.19

75 $223.34 $194.07 $23.46 $47.84 $9.48

76 $231.34 $201.02 $24.35 $49.72 $9.76

77 $239.34 $207.99 $25.26 $51.57 $10.04

78 $247.31 $214.93 $26.18 $53.44 $10.32

79 $255.29 $221.84 $27.09 $55.30 $10.58

80 $263.29 $228.80 $28.03 $57.19 $10.86

81 $268.52 $233.35 $28.96 $59.05 $11.14

82 $273.82 $237.95 $29.85 $60.92 $11.42

83 $279.22 $242.62 $30.78 $62.77 $11.70

84 $284.80 $247.49 $31.68 $64.65 $11.97

85+ $290.42 $252.39 $32.58 $66.52 $12.22

under 65

$379.03 $329.37 $40.73 $83.15 $15.29

Current Age 25% Cost-Sharing Plan(Second-lowest coverage available)

50% Cost-Sharing Plan(Lowest coverage available)

65-69 $101.71 $80.11

70-74 $124.95 $98.39

75-79 $149.33 $117.58

80-84 $172.08 $135.49

85+ $182.78 $143.92

under 65 $228.47 $179.94

Available with both plans:Additional Home Health Care = $2

Note: These premium rates include a 2% discount for members who enroll in automatic premium withdrawal. Those who pay by credit/debit card or monthly direct bill will pay a slightly higher monthly premium than those listed here.



Available only on the highest base plan option: Part B Deductible = $13.83Additional Home Health Care = $2Foreign Travel Emergency = $1.50


50% 100%


65 $136.95 $119.00 $13.65 $27.84 $6.41

66 $144.55 $125.62 $14.53 $29.62 $6.65

67 $152.19 $132.24 $15.40 $31.41 $6.93

68 $159.83 $138.89 $16.27 $33.20 $7.17

69 $167.44 $145.51 $17.14 $34.97 $7.47

70 $175.09 $152.15 $18.01 $36.77 $7.72

71 $182.69 $158.78 $18.89 $38.54 $8.00

72 $190.33 $165.40 $19.78 $40.34 $8.23

73 $197.95 $172.01 $20.63 $42.10 $8.53

74 $205.57 $178.64 $21.51 $43.88 $8.78

75 $213.19 $185.25 $22.39 $45.67 $9.05

76 $220.82 $191.87 $23.25 $47.46 $9.31

77 $228.46 $198.54 $24.12 $49.23 $9.58

78 $236.07 $205.16 $24.98 $51.01 $9.85

79 $243.69 $211.76 $25.86 $52.79 $10.10

80 $251.32 $218.40 $26.75 $54.59 $10.36

81 $256.31 $222.73 $27.64 $56.37 $10.64

82 $261.38 $227.14 $28.49 $58.15 $10.90

83 $266.53 $231.59 $29.38 $59.92 $11.16

84 $271.85 $236.24 $30.24 $61.71 $11.43

85+ $277.22 $240.92 $31.10 $63.50 $11.67

under 65

$361.81 $314.40 $38.88 $79.38 $14.59



65-69 $97.09 $76.47

70-74 $119.28 $93.91

75-79 $142.55 $112.23

80-84 $164.26 $129.33

85+ $174.47 $137.39

under 65 $218.09 $171.76



Current Age





Available only on the highest base plan option: Part B Deductible = $13.83

Additional Home Health Care = $2

Current Age



Foreign Travel Emergency = $1.50


50% 100%


65 $130.43 $113.34 $13.00 $26.52 $6.11

66 $137.67 $119.64 $13.84 $28.20 $6.34

67 $144.94 $125.94 $14.66 $29.91 $6.60

68 $152.21 $132.27 $15.49 $31.62 $6.83

69 $159.47 $138.58 $16.33 $33.30 $7.11

70 $166.75 $144.90 $17.15 $35.02 $7.35

71 $173.99 $151.21 $17.99 $36.71 $7.61

72 $181.26 $157.53 $18.84 $38.42 $7.84

73 $188.52 $163.82 $19.65 $40.09 $8.12

74 $195.78 $170.14 $20.48 $41.80 $8.36

75 $203.04 $176.43 $21.32 $43.49 $8.61

76 $210.31 $182.74 $22.14 $45.20 $8.87

77 $217.58 $189.08 $22.97 $46.88 $9.12

78 $224.83 $195.39 $23.79 $48.58 $9.38

79 $232.08 $201.67 $24.63 $50.27 $9.62

80 $239.36 $208.01 $25.48 $51.99 $9.87

81 $244.11 $212.13 $26.32 $53.68 $10.13

82 $248.93 $216.33 $27.14 $55.38 $10.38

83 $253.84 $220.57 $27.98 $57.07 $10.63

84 $258.91 $224.99 $28.80 $58.77 $10.88

85+ $264.02 $229.45 $29.62 $60.48 $11.11

under 65

$344.58 $299.43 $37.02 $75.60 $13.90



65-69 $92.46 $72.82

70-74 $113.59 $89.44

75-79 $135.76 $106.89

80-84 $156.44 $123.18

85+ $166.16 $130.84

under 65 $207.70 $163.58



70 Years of Serving WisconsinitesWPS Health Insurance was founded in 1946 and has been serving people on Medicare since Medicare began. Today, the WPS Medicare Companion is the most popular Wisconsin-based Medicare supplement in the state.1

1Based on enrollment data submitted to the National Association of Insurance Commissioners, 2015.22010-2016 World’s Most Ethical Companies, Ethisphere® Institute, ethisphere.com/worlds-most-ethical/wme-honorees/.

©2016 Wisconsin Physicians Service Insurance Corporation. All rights reserved. 29595-021-1608

100% Wisconsin-Based Customer ServiceWhen you call WPS Health Insurance, you talk to a caring, professional representative right here in Wisconsin. We’re here to answer your questions and help you when you need it.

Named one of the “World’s Most Ethical Companies” seven years in a row Ethics and integrity are at the core of our values, and it shows in everything we do. That’s why in 2016, the international Ethisphere® Institute named WPS one of the “World’s Most Ethical Companies” for the seventh year in a row.2 We’re eager to put our good values to work for you.

To learn more about the “World’s Most Ethical Companies” designation, please visit worldsmostethicalcompanies.ethisphere.com.

Want to learn more? Contact your local agent or call WPS today at 1-800-236-1448.

Documents

WPS MEDICARE COMPANION › sales-materials › files › 29595-WI...Seven reasons to choose WPS 1. Freedom to choose your own doctors and hospitals that accept Medicare anywhere in