

| Part A Hospital Services |
| 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) |
|
| Covers 365 Additional inpatient days after lifetime reserve has been used up365 days extra Hospital coverage |
| Skilled nursing facility coinsurance |
| 3 Pints of (unreplaced) blood |
| Part B Services |
| 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 |
| Out of Pocket Limit |
| Hospice coverage |
| Foreign Travel Emergency |
| Monthly Rates & Brochures |