Part A Hospital Services G
The Part A deductible is $1632 per benefit period
A benefit period starts when you are admitted to a facility
and ends 60 days after you last received inpatient care at any facilityPart A Deductible ($1632)
  • The inpatient deductible is $1632 for each benefit period
  • Days 1-60: Medicare covers 100%
  • Days 61-90: You are responsible for $408 per day
  • Days 91 until 60 day lifetime reserve is used up: Your responsibility is $826 per day
  • Beyond lifetime reserve: You are responsible for all costs incurred
Hospital Coinsurance
Covers 365 Additional inpatient days after lifetime reserve has been used up365 days extra Hospital coverage
Skilled nursing facility coinsurance
3 Pints of (unreplaced) blood
Part B Services G
Part B Annual Deductible ($240)
Medicare covers 80% of Part B claims, you are responsible for 20%Part B Coinsurance
Doctors who do not take Medicare Assignment can charge 15% above what medicare allows
Some Medicare Supplement plans cover that extra 15%Part B Excess Charges
Additional Features G
Out of Pocket Limit NA
Hospice coverage
Foreign Travel Emergency
Monthly Rates & Brochures G
UHC eff 6/1/2024 420.94

Prepared for
Zip code: 95125
Age: 81
Spouse: 82
Select all that apply
    Automatic Checking Withdrawal Discount
    If you are new to Medicare the following monthly discounts
    are available for your first year of coverage
    • United Healthcare Plan G: $25 per month
    Welcome     to Medicare discount 2 party
    UHC/AARPYou can take 7% off your monthly premiums if
    • two or more members are enrolled under the same AARP membership number
    • and each is insured under an eligible AARP-branded supplemental insurance
      policy insured by UnitedHealthcare Insurance Company.
     household discount (7%)
    Contact us
    (760) 487-1700
    [email protected]
    CA Ins Lic 0F00759