| Part A Hospital Services | F | 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 | F | 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 | F | G |
| Out of Pocket Limit | NA | NA |
| Hospice coverage | |
|
| Foreign Travel Emergency | |
|
| Monthly Rates & Brochures | F | G |
| Anthem | S: 440.06 I: Additional benefits included with Anthem Innovative plan rider
|
311.76 |
| Blue Shield | 447.00 | S: 369.00 Extra Rider
E: 385.00 |
| Continental (Aetna) | 416.25 | 304.88 |
| Health Net | S: 345.00 Additional benefits included with Health Net Innovative plan rider
|
S: 308.00 Additional benefits included with Health Net Innovative plan rider
|
| Humana Achieve | 307.34 | 273.14 |
| ManhattanLife | 346.83 | 283.33 |
| National Health Ins | 372.08 | 316.96 |
| Physicians Mutual | 325.02 | 283.71 |
| United American eff 5/1/2024 | 352.00 | 295.00 |
| UHC eff 6/1/2024 | 423.75 | 331.25 |
|
Prepared for
Zip code: 92056 Age: 82 |
|