| Part A Hospital Services | F | G |
|---|---|---|
| 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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| Covers 365 Additional inpatient days after lifetime reserve has been used up365 days extra Hospital coverage | |
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| Skilled nursing facility coinsurance | |
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| 3 Pints of (unreplaced) blood | |
|
| Part B Services | F | G |
| 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 |
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| Additional Features | F | G |
| Out of Pocket Limit | NA | NA |
| Hospice coverage | |
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| Foreign Travel Emergency | |
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| Monthly Rates & Brochures | F | G |
| Anthem | 371.13 | 274.38 |
| Blue Shield | 360.00 | 317.00 |
| Continental (Aetna) | 484.22 | 354.94 |
| Health Net | 326.00 | 290.00 |
| United American | 422.00 | 352.00 |
| UHC | 437.50 | 342.18 |
| Choosing a Medigap Policy | ||
| Continental: Add $20 application fee. | ||
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Prepared for
Zip code: 92692 Age: 75 |
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UHC rates based on Part B effective 10 or more years
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