| Part A Hospital Services | F | G |
|---|---|---|
| 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) |
 |
|
|
|
|
| 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 | G |
| 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 |
| Out of Pocket Limit | NA | NA |
| Hospice coverage | |
|
| Foreign Travel Emergency | |
|
| Monthly Rates & Brochures | F | G |
| Anthem | S: 281.28 I: Additional benefits included with Anthem Innovative plan rider
|
201.33 |
| Blue Shield eff 7/1/2024 | 260.19 | S: 213.69 Extra Rider
E: 228.57 |
| Blue Shield to 6/30/2024 | 243.45 | S: 199.74 Extra Rider
E: 213.69 |
| Continental (Aetna) | 355.19 | 260.40 |
| Health Net | S: 257.00 Additional benefits included with Health Net Innovative plan rider
|
S: 229.00 Additional benefits included with Health Net Innovative plan rider
|
| Humana Achieve to 7/31/2024 | 209.60 | 180.86 |
| Humana Achieve eff 8/1/2024 | 225.35 | 194.44 |
| ManhattanLife | 273.92 | 223.17 |
| National Health Ins | 296.66 | 252.99 |
| Physicians Mutual | 226.74 | 197.43 |
| United American | 364.00 | 300.00 |
| UHC to 5/31/2024 | 245.86 | 191.75 |
| UHC eff 6/1/2024 | 274.50 | 214.26 |
| Choosing a Medigap Policy | ||
| Continental: Add $20 application fee. | ||
| ManhattanLife: Add $25 application fee. | ||
|
Prepared for
Zip code: 92804 Age: 70 |
|
Anthem rates reflect 10%
Enrollees who reside with another Anthem Blue Cross Medicare Supplement member may qualify for a 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
Humana Achieve rates 12% household discount Humana Achieve rates reflect $2 automatic checking discount
Physicians Mutual rates reflect $5 automatic checking 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 UHC rates reflect $2 automatic checking discount
|