Part A Hospital Services N
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)
  • 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
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 N
Part B Annual Deductible ($240)
Medicare covers 80% of Part B claims, you are responsible for 20%Part B CoinsuranceYou 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
Additional Features N
Out of Pocket Limit NA
Hospice coverage
Foreign Travel Emergency
Monthly Rates & Brochures N
Anthem 505.85
Blue Shield eff 7/1/2024 451
Blue Shield to 6/30/2024 420
Health Net 407.00
UHC to 5/31/2024 340.71
UHC eff 6/1/2024 380.07
Prepared for
Zip code: 91325
Age: 72
Spouse: 70

UHC rates based on Part B effective less than 10 years
UHC spousal rates based on Part B effective less than 10 years
Contact us
(714) 921-9214
[email protected]
CA Ins Lic 0D57926