Part A Hospital Services A B C D F F-ded G G-ded K L M 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 facility
Part 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
  • 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
$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
Plan covers 50% of your out of pocket expenses
Your share is capped at $5120 per year
50%
Plan covers 75% of your out of pocket expenses
Your share is capped at $2560 per year
75%
Plan covers 50% Part A deductible50%
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
Plan covers 50% of your out of pocket expenses
Your share is capped at $5120 per year
50%
Plan covers 75% of your out of pocket expenses
Your share is capped at $2560 per year
75%

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
Plan covers 50% of your out of pocket expenses
Your share is capped at $5120 per year
50%
Plan covers 75% of your out of pocket expenses
Your share is capped at $2560 per year
75%
Part B Services A B C D F F-ded G G-ded K L M N
Part B Annual Deductible ($240)









Medicare covers 80% of Part B claims, you are responsible for 20%Part B Coinsurance Plan covers 50% of your out of pocket expenses
Your share is capped at $5120 per year
50%
Plan covers 75% of your out of pocket expenses
Your share is capped at $2560 per year
75%
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 A B C D F F-ded G G-ded K L M N
Out of Pocket Limit NA NA NA NA NA NA NA NA $5120 $2560 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
Plan covers 50% of your out of pocket expenses
Your share is capped at $5120 per year
50%
Plan covers 75% of your out of pocket expenses
Your share is capped at $2560 per year
75%
Foreign Travel Emergency


Monthly Rates & Brochures A B C D F F-ded G G-ded K L M N
Anthem 292.62


S: 490.87
I: Additional benefits included with Anthem Innovative plan rider
  • Vision: Routine eye exam $25 copay, $100 frame allowance
  • Hearing: Hearing exam every 12 months, $750 annual allowance for hearing aids
  • Nurse help line: Speak with a Registered nurse about health related questions
  • SilverSneakers gym membership
473.96

347.17



366.30
Blue Shield eff 7/1/2024 295.00


576.00
S: 474.00
Extra Rider
  • Basic gym access through sliver sneakers fitness program (silversneakers.com)
  • Personal emergency response system
  • Physician consultation by phone or video through Teladoc
  • Over the counter items through CVS (Up to $100 one time use per quarter allowance)
  • The vision benefit includes coverage for exams, frames and lenses ($100 frame allowance)
  • Hearing aid benefit includes an annual hearing aid test and coverage for Vista brand mid-level and premium-level hearing aids for a low copay
  • Acupuncture and chiropractic, up to 20 combined visits per calendar year
  • Identity theft protection
E: 494.00




399
Continental (Aetna) 260.73 329.95

461.98 86.55 338.61



254.56
Health Net 281.00

373.00
S: 403.00
Additional benefits included with Health Net Innovative plan rider
  • Routine Hearing Exam - One hearing exam every 12 months
  • Hearing Aid(s) - includes fitting evaluation. $1000 maximum for two hearing aids (one pair) or $500 for one hearing aid
  • Routine Eye Exam - One vision exam every 12 months
  • Eyewear - Up to $250 allowance for frame and lens package once every 24 months or contact lens once every 12 months
I: 408.00
174.00
S: 358.00
Additional benefits included with Health Net Innovative plan rider
  • Routine Hearing Exam - One hearing exam every 12 months
  • Hearing Aid(s) - includes fitting evaluation. $1000 maximum for two hearing aids (one pair) or $500 for one hearing aid
  • Routine Eye Exam - One vision exam every 12 months
  • Eyewear - Up to $250 allowance for frame and lens package once every 24 months or contact lens once every 12 months
I: 372.00
164.00


323.00
Humana Achieve to 7/31/2024 273.14


351.15
311.82 101.84


259.69
UHC eff 6/1/2024 273.68 382.65 462.06
464.12
362.37

253.75
306.68
Choosing a Medigap Policy
Continental: Add $20 application fee.
Prepared for mike
Zip code: 92056
Age: 82

Anthem rates reflect $2 automatic checking discount

Blue Shield rates reflect $3 automatic checking discount

Humana Achieve rates reflect $2 automatic checking discount

UHC rates based on Part B effective 10 or more years
UHC rates reflect $2 automatic checking discount
Contact us
(858) 405-6266
[email protected]
CA Ins Lic 0D89161