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)
  • 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 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: 332.96
I: Additional benefits included with Anthem Innovative plan rider
  • Vision: Routine eye exam $25 copay, $100 frame allowance
  • Hearing: Hearing exam every 12 months, $750 annual allowance for hearing aids
  • Nurse help line: Speak with a Registered nurse about health related questions
  • SilverSneakers gym membership
316.38
Blue Shield eff 7/1/2024 370.00
Continental (Aetna) 355.11
Health Net
S: 311.00
Additional benefits included with Health Net Innovative plan rider
  • Routine Hearing Exam - One hearing exam every 12 months
  • Hearing Aid(s) - includes fitting evaluation. $1000 maximum for two hearing aids (one pair) or $500 for one hearing aid
  • Routine Eye Exam - One vision exam every 12 months
  • Eyewear - Up to $250 allowance for frame and lens package once every 24 months or contact lens once every 12 months
I: 317.00
Humana Achieve to 7/31/2024 225.88
ManhattanLife 261.95
National Health Ins 296.58
Physicians Mutual 231.85
United American eff 5/1/2024 439.00
UHC eff 6/1/2024 339.00
Prepared for Laura
Zip code: 94530
Age: 77

Anthem rates reflect 5%
Enrollees who reside with another Anthem Blue Cross Medicare Supplement
member may qualify for a household discount
  • For members with an original Anthem Blue Cross
    effective date after 2/28/2023 the discount is 10%
  • For those with original effective dates between
    6/1/2010 and 2/28/2023 the discount is 5%
  • The household discount is not available to persons
    enrolled before 6/1/2010
household discount
for subscriber
Humana Achieve rates 12% household discount
Manhatten Life rates reflect 7% You are eligible for a 7% household premium discount if
(a) you are married and residing with your spouse or
(b) for the past year you have resided with soneone who is at least 60 years old.household discount
National Health rates rates reflect 7%
  • You are eligible for a 7% household premium discount if you have a roommate
  • You are eligible for a 10% discount if multiple people in your household are
    covered by National Health Ins. medicare supplement policies
household discount
Physicians Mutual rates reflect 10% You are eligible for a 10% household premium discount
if you are marriied
or reside with another person age 60 or over.household discount
UHC rates based on Part B effective less than 10 years
Contact us
(866) 200-2247
[email protected]
CA Ins Lic 0B32164