Part A Hospital Services F 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 F 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 F G G-ded
Out of Pocket Limit NA 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 F G G-ded
Anthem 236.74 182.73
Blue Shield eff 7/1/2024 216.48 194.16
Continental (Aetna) 262.73 192.61
Health Net 215.00 181.00 78.00
ManhattanLife 206.58 168.25
National Health Ins 211.52 180.38
Physicians Mutual 203.48 177.19
UHC eff 6/1/2024 240.14 187.40
Choosing a Medigap Policy
Continental: Add $20 application fee.
ManhattanLife: Add $25 application fee.
Prepared for
Zip code: 93611
Age: 70

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
Anthem rates reflect $2 automatic checking discount
Blue Shield rates reflect 7% You are eligible for a 7% household premium discount if you reside with another person
who is on the same Blue Shield Medicare Supplement plan, including same Dental plan.
Only one policy will be issued, the second party will be covered as a dependent.household discount
Blue Shield rates reflect $3 automatic checking discount
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
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 $5 automatic checking discount
UHC rates based on Part B effective less than 10 years
UHC rates reflect $2 automatic checking discount
Contact us
(818) 877-6477
[email protected]
CA Ins Lic 12345678