| Part A Hospital Services | F |
|---|---|
| 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) |
 |
|
|
| 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 | F |
| 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 | F |
| Out of Pocket Limit | NA |
| Hospice coverage | |
| Foreign Travel Emergency | |
| Monthly Rates & Brochures | F |
| Anthem | S: 277.83 I: Additional benefits included with Anthem Innovative plan rider
|
| Blue Shield to 6/30/2024 | 230.00 |
| Continental (Aetna) | 354.27 |
| Health Net | S: 247.00 Additional benefits included with Health Net Innovative plan rider
|
| Humana Achieve to 7/31/2024 | 188.63 |
| ManhattanLife | 196.25 |
| National Health Ins | 236.56 |
| Physicians Mutual | 205.56 |
| United American eff 5/1/2024 | 331.00 |
| UHC to 5/31/2024 | 225.09 |
|
Prepared for June
Zip code: 95127 Age: 71 |
|
UHC rates based on Part B effective less than 10 years
|