ZapIndex

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 CKHH	160.46
Blue Shield eff 7/1/2024 CKHH	S: 146.00 Note: Silver Sneakers gym membership is included with all Blue Shield plans. Additonal benefits with Blue Shield Extra Rider Foreign Travel - Not covered by Medicare $250 annual deductible, 80% coverage, $50,000 lifetime max (Click the Brochure link, see page 20) Physician Consultation by Phone or Video Through Teledoc No charge (see brochure page 20) Over-the-Counter Items through CVS Up to $100 allowance per quarter (see brochure page 20) Accupuncture and Chiropractic Services (provided by AHS provider network) Up to 20 visits per year, plan pays 100%, see page 21 in brochure for details Vision Coverage (provided by Vision Service Plan) Exam every 12 months, eyeglasses every 24 months, click the brochure link for details (see page 21) Hearing Aid Services (provided by Epic Hearing Healthcare) Routine hearing exams, copayments for hearing aids, see page 23 of brochure for details E: 163.00
Cigna HH	194.39
Humana Achieve CKHH	215.83	67.68
UHC CKHH	150.20
Choosing a Medigap Policy

Part A Hospital Services

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-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-ded

Out of Pocket Limit

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-ded

Anthem CKHH

160.46

Blue Shield eff 7/1/2024 CKHH

S: 146.00

Note: Silver Sneakers gym membership is included with all Blue Shield plans.

Additonal benefits with Blue Shield Extra Rider

Foreign Travel - Not covered by Medicare

$250 annual deductible, 80% coverage, $50,000 lifetime max (Click the Brochure link, see page 20)

Physician Consultation by Phone or Video Through Teledoc

No charge (see brochure page 20)

Over-the-Counter Items through CVS

Up to $100 allowance per quarter (see brochure page 20)

Accupuncture and Chiropractic Services (provided by AHS provider network)

Up to 20 visits per year, plan pays 100%, see page 21 in brochure for details

Vision Coverage (provided by Vision Service Plan)

Exam every 12 months, eyeglasses every 24 months, click the brochure link for details (see page 21)

Hearing Aid Services (provided by Epic Hearing Healthcare)

Routine hearing exams, copayments for hearing aids, see page 23 of brochure for details

E: 163.00

Cigna HH

194.39

Humana Achieve CKHH

215.83

67.68

UHC CKHH

150.20

Choosing a Medigap Policy