Part A Hospital Services A C D 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)
  • 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 A C D 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 A C D F G
Out of Pocket Limit NA NA NA NA NA
Hospice coverage
Foreign Travel Emergency
Monthly Rates & Brochures A C D F G
Choosing a Medigap Policy

Prepared for Steve Peletz
Zip code: 94122
Age: 65
Select all that apply
    Automatic Checking Withdrawal Discount
    If you are new to Medicare the following monthly discounts
    are available for your first year of coverage
      Welcome       to Medicare discount 2 party
      Contact us
      (415) 492-0130
      [email protected]
      Tiff: [email protected]
      CA Ins Lic 6007844