| 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: 481.73 I: Additional benefits included with Anthem Innovative plan rider
|
345.78 |
| Blue Shield to 6/30/2024 | 480.00 | S: 396.00 Extra Rider
E: 413.00 |
| Continental (Aetna) | 570.27 | 417.67 |
| Health Net | S: 387.00 Additional benefits included with Health Net Innovative plan rider
|
S: 345.00 Additional benefits included with Health Net Innovative plan rider
|
| United American eff 5/1/2024 | 470.00 | 393.00 |
| UHC to 5/31/2024 | 313.75 | 245.25 |
| UHC eff 6/1/2024 | 350.00 | 273.75 |
|
Prepared for Zip code: 90713 Age: 82 |
| Select all that apply |
|
If you are new to Medicare the following monthly discounts
are available for your first year of coverage
|
Enrollees who live with another Anthem Medicare Supplement
member may qualify for a household discount.
|
|
Blue ShieldYou are eligible for a 7% household premium discount
|
UHC/AARPYou can take 7% off your monthly premiums if
|
| Contact us |
| (800) 464-4941 |
| [email protected] |
| CA Ins Lic 0765088 |