| Part A Hospital Services | A | B | D | G | K | L | M | N |
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| 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) |
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Plan covers 50% of your out of pocket expenses Your share is capped at $5120 per year50% |
Plan covers 75% of your out of pocket expenses Your share is capped at $2560 per year75% |
Plan covers 50% Part A deductible50% | |
| Covers 365 Additional inpatient days after lifetime reserve has been used up365 days extra Hospital coverage | |
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| Skilled nursing facility coinsurance | |
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Plan covers 50% of your out of pocket expenses Your share is capped at $5120 per year50% |
Plan covers 75% of your out of pocket expenses Your share is capped at $2560 per year75% |
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| 3 Pints of (unreplaced) blood | |
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Plan covers 50% of your out of pocket expenses Your share is capped at $5120 per year50% |
Plan covers 75% of your out of pocket expenses Your share is capped at $2560 per year75% |
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| Part B Services | A | B | D | G | K | L | M | N |
| Part B Annual Deductible ($240) | ||||||||
| Medicare covers 80% of Part B claims, you are responsible for 20%Part B Coinsurance | |
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Plan covers 50% of your out of pocket expenses Your share is capped at $5120 per year50% |
Plan covers 75% of your out of pocket expenses Your share is capped at $2560 per year75% |
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You pay $20 for Dr. office visits You pay $50 for emergency room visits$20/$50 |
| 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 |
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| Additional Features | A | B | D | G | K | L | M | N |
| Out of Pocket Limit | NA | NA | NA | NA | $5120 | $2560 | NA | NA |
| Hospice coverage | |
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Plan covers 50% of your out of pocket expenses Your share is capped at $5120 per year50% |
Plan covers 75% of your out of pocket expenses Your share is capped at $2560 per year75% |
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| Foreign Travel Emergency | |
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| Monthly Rates & Brochures | A | B | D | G | K | L | M | N |
| Anthem | 118.04 | 159.63 | 165.15 | |||||
| Blue Shield | 110.00 | S: 147.00 Note: Silver Sneakers gym membership is included with all Blue Shield plans. Additonal benefits with Blue Shield Extra RiderForeign Travel - Not covered by Medicare
Physician Consultation by Phone or Video Through Teledoc
Over-the-Counter Items through CVS
Accupuncture and Chiropractic Services (provided by AHS provider network)
Vision Coverage (provided by Vision Service Plan)
Hearing Aid Services (provided by Epic Hearing Healthcare)
E: 163.00 |
144 | |||||
| Continental (Aetna) | 128.95 | 163.10 | 167.52 | 120.20 | ||||
| Health Net | 133.00 | 156.00 | S: 170.00 Additional benefits included with Health Net Innovative plan rider
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135.00 | ||||
| Humana Achieve | 154.58 | 164.09 | 119.62 | |||||
| Physicians Mutual | 155.93 | 169.22 | 141.02 | |||||
| UHC | 116.00 | 161.76 | 153.44 | 107.68 | 129.92 | |||
| Choosing a Medigap Policy | ||||||||
| Continental: Add $20 application fee. | ||||||||
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Prepared for a
Zip code: 95928 Age: 65 |
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UHC rates based on Part B effective less than 10 years
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