| Part A Hospital Services | F | G | 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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| 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 | |
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| Part B Services | F | G | N |
| Part B Annual Deductible ($240) | |
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| 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 | F | G | N |
| Out of Pocket Limit | NA | NA | NA |
| Hospice coverage | |
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| Foreign Travel Emergency | |
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| Monthly Rates & Brochures | F | G | N |
| Continental (Aetna) | 455.98 | 334.37 | 248.07 |
| Health Net | S: 341.00 Additional benefits included with Health Net Innovative plan rider
|
S: 303.00 Additional benefits included with Health Net Innovative plan rider
|
270.00 |
| Humana Achieve | 268.97 | 237.38 | 193.99 |
| National Health Ins | 382.68 | 326.37 | 257.58 |
| Physicians Mutual | 317.07 | 276.78 | 230.10 |
| United American | 412.00 | 341.00 | 277.00 |
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Prepared for
Zip code: 92804 Age: 77 |
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Humana Achieve rates 12% household discount |