| Part A Hospital Services | F-ded | G | G-ded |
|---|---|---|---|
| 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) |
$2700 annual deductible applies You pay all Medicare deductibles, copays and coinsurance until you spend $2700 in a calendar year After that coverage is 100% after ded |
 |
$2700 annual deductible applies You pay all Medicare deductibles, copays and coinsurance until you spend $2700 in a calendar year After that coverage is 100% after ded |
|
$2700 annual deductible applies You pay all Medicare deductibles, copays and coinsurance until you spend $2700 in a calendar year After that coverage is 100% after ded |
|
$2700 annual deductible applies You pay all Medicare deductibles, copays and coinsurance until you spend $2700 in a calendar year After that coverage is 100% after ded |
| Covers 365 Additional inpatient days after lifetime reserve has been used up365 days extra Hospital coverage | |
|
|
| Skilled nursing facility coinsurance | $2700 annual deductible applies You pay all Medicare deductibles, copays and coinsurance until you spend $2700 in a calendar year After that coverage is 100% after ded |
|
$2700 annual deductible applies You pay all Medicare deductibles, copays and coinsurance until you spend $2700 in a calendar year After that coverage is 100% after ded |
| 3 Pints of (unreplaced) blood | $2700 annual deductible applies You pay all Medicare deductibles, copays and coinsurance until you spend $2700 in a calendar year After that coverage is 100% after ded |
|
$2700 annual deductible applies You pay all Medicare deductibles, copays and coinsurance until you spend $2700 in a calendar year After that coverage is 100% after ded |
| Part B Services | F-ded | G | G-ded |
| 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-ded | G | G-ded |
| Out of Pocket Limit | NA | NA | NA |
| Hospice coverage | $2700 annual deductible applies You pay all Medicare deductibles, copays and coinsurance until you spend $2700 in a calendar year After that coverage is 100% after ded |
|
$2700 annual deductible applies You pay all Medicare deductibles, copays and coinsurance until you spend $2700 in a calendar year After that coverage is 100% after ded |
| Foreign Travel Emergency | |
|
|
| Monthly Rates & Brochures | F-ded | G | G-ded |
| Anthem | 311.76 | ||
| Blue Shield eff 7/1/2024 | S: 384.00 Extra Rider
E: 400.00 |
||
| Blue Shield to 6/30/2024 | S: 354.00 Extra Rider
E: 369.00 |
||
| Continental (Aetna) | 76.97 | 301.38 | |
| Health Net | 149.00 | S: 308.00 Additional benefits included with Health Net Innovative plan rider
|
141.00 |
| Humana Achieve | 262.40 | 87.60 | |
| ManhattanLife | 269.42 | ||
| National Health Ins | 105.81 | 307.75 | |
| Physicians Mutual | 275.59 | ||
| United American to 4/30/2024 | 70.00 | 274.00 | 70.00 |
| United American eff 5/1/2024 | 76.00 | 295.00 | 76.00 |
| UHC to 5/31/2024 | 237.50 | ||
| UHC eff 6/1/2024 | 265.00 |
|
Prepared for davis
Zip code: 92069 Age: 81 |
|
UHC rates based on Part B effective less than 10 years
Lowest cost plans
|