Part A Hospital Services A B C D F-ded 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 facilityPart 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 year50%		 Plan covers 75% of your out of pocket expenses
Your share is capped at $2560 per year75%		 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 year50%		 Plan covers 75% of your out of pocket expenses
Your share is capped at $2560 per year75%
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 year50%		 Plan covers 75% of your out of pocket expenses
Your share is capped at $2560 per year75%
Part B Services A B C D F-ded 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 year50%		 Plan covers 75% of your out of pocket expenses
Your share is capped at $2560 per year75%		 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-ded G-ded K L M N
Out of Pocket Limit 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 year50%		 Plan covers 75% of your out of pocket expenses
Your share is capped at $2560 per year75%
Foreign Travel Emergency


Monthly Rates & Brochures A B C D F-ded G-ded K L M N
Anthem 232.28







290.90
Blue Shield eff 7/1/2024 222.00







298
Continental (Aetna) 216.91 274.56

71.89



210.00
Health Net 212.00

283.00 131.00 125.00


245.00
Humana Achieve to 7/31/2024 210.75



78.05


190.68
UHC eff 6/1/2024 248.62 347.68 419.87



230.50
278.62
Choosing a Medigap Policy
Continental: Add $20 application fee.

Prepared for Diane
Zip code: 92075
Age: 78
Select all that apply
  • Anthem $2 per month
  • Humana Achieve $2 per month
Automatic Checking Withdrawal Discount
If you are new to Medicare the following monthly discounts
are available for your first year of coverage
  • Anthem Plan F: $20 Plans G: $25 per month
  • Blue Shield Plans A. F and G: $25 per month
  • Health Net All Plans: $30 per month
  • United Healthcare Plan G: $25 per month
Welcome to Medicare discount 2 party
Enrollees who live with another Anthem Medicare Supplement
member may qualify for a household discount.
  • For members with an original Anthem Blue Cross
    effective date after 2/28/2023 the discount is 10%
  • For those with original effective dates between
    6/1/2010 and 2/28/2023 the discount is 5%
  • The household discount is not available to persons
    enrolled before 6/1/2010
Anthem household discount
Blue ShieldYou are eligible for a 7% household premium discount
  • if you reside with another person who is on the same Blue Shield Medicare Supplement plan
  • including same Dental plan.
Only one policy will be issued, the second party will be covered as a dependent. household discount (7%)
Humana AchieveHumana Achieve offers a 12% household premium discount
  • if you reside with your spouse or domestic partner
  • or if you have resided with one to three adults for the past 12 months.
 household discount (12%)
UHC/AARPYou can take 7% off your monthly premiums if
  • two or more members are enrolled under the same AARP membership number
  • and each is insured under an eligible AARP-branded supplemental insurance
    policy insured by UnitedHealthcare Insurance Company.
 household discount (7%)
Contact us
(858) 405-6266
[email protected]
CA Ins Lic 0D89161