Part A Hospital Services | F | F-ded | G | G-ded | N |
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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 |
$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 |
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$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 |
$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 |
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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 |
$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 |
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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 |
$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 |
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Part B Services | F | F-ded | G | G-ded | N |
Part B Annual Deductible ($240) | |||||
Medicare covers 80% of Part B claims, you are responsible for 20%Part B Coinsurance | You pay $20 for Dr. office visits You pay $50 for emergency room visits$20/$50 |
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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 |
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Additional Features | F | F-ded | G | G-ded | N |
Out of Pocket Limit | NA | NA | 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 |
$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 |
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Foreign Travel Emergency | |||||
Monthly Rates & Brochures | F | F-ded | G | G-ded | N |
Anthem | S: 486.52 I: Additional benefits included with Anthem Innovative plan rider
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354.08 | 366.31 | ||
Blue Shield eff 7/1/2024 | 433.00 | S: 343.00 Extra Rider
E: 375.00 |
330 | ||
Blue Shield to 6/30/2024 | 403.00 | S: 319.00 Extra Rider
E: 349.00 |
307 | ||
Health Net | S: 419.00 Additional benefits included with Health Net Innovative plan rider
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181.00 | S: 331.00 Additional benefits included with Health Net Innovative plan rider
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167.00 | 302.00 |
Humana Achieve to 7/31/2024 | 315.74 | 273.50 | 95.13 | 214.52 | |
Humana Achieve eff 8/1/2024 | 339.17 | 293.74 | 95.13 | 214.52 | |
Physicians Mutual | 397.07 | 346.41 | 287.79 | ||
United American | 567.00 | 101.00 | 464.00 | 101.00 | 382.00 |
UHC to 5/31/2024 | 392.54 | 306.74 | 259.90 | ||
UHC eff 6/1/2024 | 438.30 | 342.84 | 290.29 |
Prepared for
Zip code: 95946 Age: 65 Spouse: 70 |
Humana Achieve rates 12% household discount UHC rates based on Part B effective less than 10 years UHC spousal rates based on Part B effective less than 10 years
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