| 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) |
 |
|
|
| 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 Coinsurance | You 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 | 372.03 |
| Blue Shield eff 7/1/2024 | 385 |
| Blue Shield to 6/30/2024 | 355 |
| Continental (Aetna) | 290.55 |
| Health Net | 344.00 |
| Humana Achieve to 7/31/2024 | 310.12 |
| Humana Achieve eff 8/1/2024 | 310.12 |
| ManhattanLife | 340.75 |
| National Health Ins | 326.72 |
| Physicians Mutual | 290.16 |
| United American | 329.00 |
| UHC to 5/31/2024 | 259.68 |
| UHC eff 6/1/2024 | 289.68 |
| Choosing a Medigap Policy | |
| Continental: Add $20 application fee. | |
| ManhattanLife: Add $25 application fee. | |
|
Prepared for
Zip code: 91346 Age: 85 |
|
UHC rates based on Part B effective 10 or more years
|