| Part A Hospital Services | 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 | 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 | G |
| Out of Pocket Limit | NA |
| Hospice coverage | |
| Foreign Travel Emergency | |
| Monthly Rates & Brochures | G |
| Anthem | 453.08 |
| Continental (Aetna) | 586.68 |
| Health Net | S: 406.00 Additional benefits included with Health Net Innovative plan rider
|
| Humana Achieve eff 8/1/2024 | 456.93 |
| United American | 445.00 |
| UHC eff 6/1/2024 | 394.20 |
| Choosing a Medigap Policy | |
| Continental: Add $20 application fee. | |
|
Prepared for
Zip code: 91602 Age: 68 Spouse: 72 |
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UHC rates based on Part B effective less than 10 years UHC spousal rates based on Part B effective less than 10 years UHC rates reflect 7% You can take 7% off your monthly premiums if
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