| Part A Hospital Services | F | F-ded | G | G-ded | 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) |
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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 |
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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 |
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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 |
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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 |
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| Covers 365 Additional inpatient days after lifetime reserve has been used up365 days extra Hospital coverage | |
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| 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 |
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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 |
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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 |
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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 |
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| Part B Services | F | F-ded | G | G-ded | N |
| Part B Annual Deductible ($240) | |
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| Medicare covers 80% of Part B claims, you are responsible for 20%Part B Coinsurance | |
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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 |
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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 |
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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 |
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| Foreign Travel Emergency | |
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| Monthly Rates & Brochures | F | F-ded | G | G-ded | N |
| Anthem | S: 258.36 I: Additional benefits included with Anthem Innovative plan rider
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185.46 | 199.55 | ||
| Blue Shield eff 7/1/2024 | 227.00 | S: 171.00 Extra Rider
E: 188.00 |
168 | ||
| Blue Shield to 6/30/2024 | 210.00 | S: 158.00 Extra Rider
E: 174.00 |
155 | ||
| Health Net | S: 214.00 Additional benefits included with Health Net Innovative plan rider
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92.00 | S: 191.00 Additional benefits included with Health Net Innovative plan rider
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81.00 | 158.00 |
| Humana Achieve to 7/31/2024 | 231.57 | 200.91 | 67.68 | 157.16 | |
| Humana Achieve eff 8/1/2024 | 248.80 | 215.83 | 67.68 | 157.16 | |
| Physicians Mutual | 238.49 | 208.32 | 173.40 | ||
| United American | 213.00 | 37.00 | 172.00 | 37.00 | 141.00 |
| UHC to 5/31/2024 | 178.84 | 139.79 | 118.42 | ||
| UHC eff 6/1/2024 | 199.50 | 156.04 | 132.10 | ||
| Choosing a Medigap Policy | |||||
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Prepared for DEBBIE EDWARDS
Zip code: 91604 Age: 65 |
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UHC 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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