| Part A Hospital Services | G | G-ded | 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) |
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$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 |
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$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 |
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| Covers 365 Additional inpatient days after lifetime reserve has been used up365 days extra Hospital coverage | |
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| 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 |
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| 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 |
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| Part B Services | G | G-ded | N |
| Part B Annual Deductible ($240) | |||
| Medicare covers 80% of Part B claims, you are responsible for 20%Part B Coinsurance | |
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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 |
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| Additional Features | G | G-ded | N |
| 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 |
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| Foreign Travel Emergency | |
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| Monthly Rates & Brochures | G | G-ded | N |
| Anthem | 142.21 | 176.38 | |
| Blue Shield | S: 141.00 Extra Rider
E: 157.00 |
164 | |
| Continental (Aetna) | 176.35 | 126.53 | |
| Health Net | S: 156.00 Additional benefits included with Health Net Innovative plan rider
|
46.00 | 119.00 |
| Humana Achieve | 148.57 | 50.24 | 116.28 |
| ManhattanLife | 151.08 | 128.33 | |
| National Health Ins | 233.93 | 184.85 | |
| Physicians Mutual | 169.22 | 141.02 | |
| United American to 4/30/2024 | 160.00 | 34.00 | 128.00 |
| United American eff 5/1/2024 | 172.00 | 37.00 | 141.00 |
| UHC | 141.72 | 141.28 |
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Prepared for
Zip code: 93064 Age: 65 |
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Anthem Plan G rates reflect $25.00 Welcome to Medicare discount
Blue Shield Plan G rates reflect $25 Welcome to Medicare discount
Health Net rates reflect $30 Welcome to Medicare discount
Humana Achieve rates 12% household discount UHC rates based on Part B effective less than 10 years UHC Plan G rates reflect $25 Welcome to Medicare discount
Lowest cost plans
# Office Visits per Month
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