Part A Hospital Services G G-ded
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)		 $2800 annual deductible applies
You pay all Medicare deductibles, copays and coinsurance until you spend $2800 in a calendar year
After that coverage is 100%
after
ded
  • 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		 $2800 annual deductible applies
You pay all Medicare deductibles, copays and coinsurance until you spend $2800 in a calendar year
After that coverage is 100%
after
ded
Covers 365 Additional inpatient days after lifetime reserve has been used up365 days extra Hospital coverage
Skilled nursing facility coinsurance $2800 annual deductible applies
You pay all Medicare deductibles, copays and coinsurance until you spend $2800 in a calendar year
After that coverage is 100%
after
ded
3 Pints of (unreplaced) blood $2800 annual deductible applies
You pay all Medicare deductibles, copays and coinsurance until you spend $2800 in a calendar year
After that coverage is 100%
after
ded
Part B Services G G-ded
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 G-ded
Out of Pocket Limit NA NA
Hospice coverage $2800 annual deductible applies
You pay all Medicare deductibles, copays and coinsurance until you spend $2800 in a calendar year
After that coverage is 100%
after
ded
Foreign Travel Emergency
Monthly Rates & Brochures G G-ded
Anthem 549.18
Blue Shield eff 7/1/2024
S: 828.00
Extra Rider
  • Basic gym access through sliver sneakers fitness program (silversneakers.com)
  • Personal emergency response system
  • Physician consultation by phone or video through Teladoc
  • Over the counter items through CVS (Up to $100 one time use per quarter allowance)
  • The vision benefit includes coverage for exams, frames and lenses ($100 frame allowance)
  • Hearing aid benefit includes an annual hearing aid test and coverage for Vista brand mid-level and premium-level hearing aids for a low copay
  • Acupuncture and chiropractic, up to 20 combined visits per calendar year
  • Identity theft protection
E: 861.00
Continental (Aetna) 318.75
Humana Achieve eff 8/1/2024 312.34 96.04
ManhattanLife 322.71
National Health Ins 448.35
Physicians Mutual 255.25
United American eff 5/1/2024 0.00 0.00
Choosing a Medigap Policy
Continental: Add $20 application fee.
ManhattanLife: Add $25 application fee.
Prepared for
Zip code: 93720
Age: 46

Continental rates reflect 5% You are be eligible for a 5% discount if you reside with another
person covered by Continental Life who is either
(a) your spouse;
(b) someone with whom you are in a civil union partnership;
(c) a permanent resident in your home.household discount
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
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
(818) 769-1640
[email protected]
CA Ins Lic 398560