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The following information will allow us to ensure your doctors, prescriptions, and pharmacy are
covered by the plan. The information you provide does not affect your plan premium. *

If you would prefer to skip these questions, click skip below.

*Household discounts and their requirements vary by state and individual enrollment requirements. To see if you meet the discount requirements, click “apply now” and one of our licensed agents will contact you with more information.

**If you are at least age 65 and apply for coverage within six months of your Part B effective date, you may qualify for a discounted premium rate for the first 3 years of enrollment in your plan. Early enrollment discounts and their requirements vary by state and carrier. To see if you meet the specific requirements, click ‘Apply Now’ and one of our licensed agents will contact you with more information.

DO NOT CANCEL ANY HEALTH INSURANCE COVERAGE YOU CURRENTLY HAVE OR DECLINE COBRA BENEFITS UNTIL YOU RECEIVE AN APPROVAL LETTER AND INSURANCE POLICY (ALSO KNOWN AS AN INSURANCE CONTRACT OR CERTIFICATE) FROM THE INSURANCE COMPANY YOU SELECTED. MAKE SURE YOU UNDERSTAND AND AGREE WITH THE TERMS OF THE INSURANCE POLICY. PAY SPECIAL ATTENTION TO THE EFFECTIVE DATE, PREMIUM AMOUNT, WAITING PERIOD, BENEFITS, LIMITATIONS, EXCLUSIONS, AND RIDERS.

The quotes or rates shown above are estimates only. Your premium may be subject to change based on your medical history (pursuant to state law of residence), the underwriting practices of the insurance company, the optional benefits you selected, if any, and other relevant factors, such as changes in rates which take effect before your requested effective date. The insurance company always determines your actual premium. Insurance companies reserve the right to change the terms of a policy upon proper notification.

The Monthly Cost amounts shown may be subject to change on an annual basis.

For the latest rating, access www.ambest.com

Aetna Disclaimers:

Aetna is the brand name for insurance products issued by the subsidiary insurance companies controlled by Aetna, Inc. The Medicare Supplement Insurance Plans are insured by Aetna Health Insurance Company, an Aetna Company.

When we say Aetna, we mean Aetna Health and Life Insurance Company.

Not connected with or endorsed by the U.S. Government or the Federal Medicare Program.
This is a solicitation of insurance. Contact may be made by a Licensed Insurance Agent or Insurance Company. The Medicare Supplement Insurance Plans are guaranteed renewable as long as the required premium is paid by the end of each grace period. The policies have exclusions, limitations, terms under which the policy may be continued in force or discontinued. Plans do not pay benefits for any service and supply of a type not covered by Medicare, including but not limited to dental care or treatment, eyeglasses and hearing aids. See Plan documents for a complete description of benefits, exclusions, limitations and conditions of coverage. AN OUTLINE OF COVERAGE IS AVAILABLE UPON REQUEST. In some states, Medicare Supplement Insurance Plans are available to under age 65 individuals that are eligible for Medicare due to disability or ESRD (end stage renal disease). Plans not available in all States.

EXCLUSIONS
We will not pay for:

1. Loss incurred while your policy is not in force, except as provided in the Extension of Benefits section of your policy;
2. Hospital or Skilled Nursing Facility confinement incurred during a Medicare Part A Benefit Period while this policy is not in force, subject to the Extension of Benefits section of your policy;
3. That portion of any Loss incurred which is paid for by Medicare;
4. Services for non-Medicare Eligible Expenses, including, but not limited to, routine exams, take-home
5. drugs and eye refractions;
6. Services for which a charge is not normally made in the absence of insurance;
7. Loss that is payable under any other Medicare supplement insurance policy or certificate; or
8. Loss that is payable under any other insurance which paid benefits for the same Loss on an expense incurred basis.

GUARANTEED RENEWABLE: You have the right to renew this policy, for consecutive terms, by paying the required premium before the end of each grace period. You have the right to renew this policy regardless of changes in your physical, mental or health conditions.

POLICY TERMINATION
Your policy will terminate on the earliest of:

1. The date we receive your written request to cancel your policy (in which case the grace period will not apply);
2. The date your policy is replaced by another Medicare supplement or Medicare Select policy or by a
3. Part C Medicare Advantage plan (in which case the grace period will not apply);
4. The Premium Due Date, subject to the grace period; or
5. The date and time of your death.

In the event of cancellation or death, we will promptly return the unearned portion of any premium paid in accordance with the laws in your state of residence.

Rates
(1) the rates are illustrative only;

(2) a person should not send money to the issuer of the health benefit plan in response to the advertisement;

(3) a person cannot obtain coverage under the health benefit plan until the person completes an application for coverage; and

(4) benefit exclusions and limitations may apply to the health benefit plan.

The benefits and premiums under your Medicare supplement policy can be suspended, if requested, during your entitlement to benefits under Medicaid for 24 months. You must request this suspension within 90 days of becoming eligible for Medicaid. If you are no longer entitled to Medicaid, your policy will be reinstituted if requested within 90 days of losing Medicaid eligibility.

Contact us to find out if you qualify for open enrollment or guaranteed issue

RIGHT TO EXAMINE POLICY FOR THIRTY (30) DAYS: You have 30 days after receipt of this policy to examine its provisions. During that 30-day period, if you are dissatisfied with the policy, it may be returned to the company at its Medicare Supplement Administrative Office, to any state office of the company or to the agent from whom it was purchased. Immediately upon such return, this policy shall be void from the beginning and any premium paid will be refunded.

Plans C & F will only be available to applicants that are Medicare eligible before 2020.

Policy forms issued in TX: AHIMSP18A TX, AHIMSP18B TX, AHIMSP18F TX, AHIMSP18HF TX, AHIMSP18G TX, AHIMSP18N TX

Aetna Plan Basics:

Plan A Basic Benefits

Plan B Basic Benefits
Medicare Part A deductible

Plan F Basic Benefits
Medicare Part B Deductible
Medicare Part B excess charges
Foreign Travel Emergency Skilled Nursing Facility coinsurance
Skilled Nursing Facility coinsurance
Medicare Part A deductible

Plan HF2200 Annual Deductible applies
Skilled Nursing facility coinsurance
Medicare Part A deductible
Medicare Part B Deductible
Basic Benefits
Medicare Part B excess charges
Foreign Travel Emergency

Plan G Basic Benefits
Medicare Part B excess charges
Foreign Travel Emergency
Skilled Nursing facility coinsurance
Medicare Part A deductible

Plan N Basic Benefits
Medicare Part A deductible
You may pay up to $20 for some office visits and up to $50 for emergency room visits
Skilled Nursing facility coinsurance
Foreign Travel Emergency
Premium rates are subject to change and may vary based on the effective date of coverage.

Actual premium rate may change for individuals who have used tobacco products within the past [12] months and are applying outside of a Medicare Supplement Open Enrollment or Guaranteed Issue period.

(1)The rates are illustrative only; (2) a person should not send money to the issuer of the health benefit plan in response to the advertisement; (3) a person cannot obtain coverage under the health benefit plan until the person completes an application for coverage; and (4) benefit exclusions and limitations may apply to the health benefit plan.

*To be eligible for the Household Discount, you must enroll in an Aetna Medicare Supplement insurance policy at the same time as another Medicare eligible adult or the other Medicare eligible adult must currently be covered by an Aetna Medicare Supplement insurance policy. The Medicare eligible adult must be (a) your spouse; or (b) someone with whom you are in a civil union partnership; and (c) someone with whom you have continuously resided with for the past 12 months.

Not connected or endorsed by the U.S. Government or Federal Medicare Program. This is a solicitation of insurance. You may be contacted by an agent or insurance company.

The policies have exclusions, limitations, terms under which the policy may be continued in force or discontinued. Plans do not pay benefits for any service and supply of a type not covered by Medicare, including but not limited to dental care or treatment, eyeglasses and hearing aids.

Humana Disclaimers:

PLEASE NOTE: Medicare Supplement insurance is available to those age 65 and older enrolled in Medicare Parts A and B and, in some states, to those under age 65 eligible for Medicare due to disability or End-Stage Renal disease.

The purpose of this communication is the solicitation of insurance. Contact will be made by an insurance agent/producer or insurance company.

Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program.

Coverage may be limited to Medicare-eligible expenses. Benefits vary by insurance plan and the premium will vary with the amount of benefits selected. Depending on the insurance plan chosen, you may be responsible for deductibles and coinsurance before benefits are payable. These policies have exclusions and limitations.

The information transmitted is intended only for the person or entity to which it is addressedand may contain CONFIDENTIAL material. If you receive this material/information in error,please contact the sender and delete or destroy the material/information.

Humana Inc. and its subsidiaries comply with applicable Federal civil rights laws anddo not discriminate on the basis of race, color, national origin, age, disability, sex,sexual orientation, gender identity, or religion. Humana Inc. and its subsidiaries do notexclude people or treat them differently because of race, color, national origin, age,disability, sex, sexual orientation, gender identity, or religion.

English: ATTENTION: If you do not speak English, language assistance services, freeof charge, are available to you. Call 1‐877‐320‐1235 (TTY: 711).

Español (Spanish): ATENCIÓN: Si habla español, tiene a su disposición serviciosgratuitos de asistencia lingüística. Llame al 1‐877‐320‐1235 (TTY: 711).

繁體中文(Chinese):注意:如果您使用繁體中文,您可以免費獲得語言援助服務。請致電 1‐877‐320‐1235 (TTY: 711)。

Kreyòl Ayisyen (Haitian Creole): ATANSION: Si w pale Kreyòl Ayisyen, gen sèvis èdpou lang ki disponib gratis pou ou. Rele 1‐877‐320‐1235 (TTY: 711).

Polski (Polish): UWAGA: Jeżeli mówisz po polsku, możeszskorzystać z bezpłatnejpomocy językowej.Zadzwoń pod numer 1‐877‐320‐1235 (TTY: 711).

한국어 (Korean): 주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다. 1‐877‐320‐1235 (TTY: 711)번으로 전화해 주십시오.

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