| Part A Hospital Services | 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) |
$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 |
| 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 |
| 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 |
| Part B Services | 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 | G-ded |
| Out of Pocket Limit | 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 |
| Foreign Travel Emergency | |
| Monthly Rates & Brochures | G-ded |
| Anthem | |
| Blue Shield eff 7/1/2024 | |
| Health Net | 0.00 |
| Humana Achieve eff 8/1/2024 | 0.00 |
| UHC eff 6/1/2024 | |
| Choosing a Medigap Policy | |
|
Prepared for Adrienne
Zip code: 92651 Age: 73 |
|
UHC rates based on Part B effective less than 10 years
|