

| 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 | ![]() |
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| Part B Services | F | G |
| 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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| 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 | 301.09 | 225.92 |
| Blue Shield | 283.00 | 249.00 |
| Cigna | 290.37 | 236.51 |
| Continental (Aetna) | 398.84 | 292.38 |
| Health Net | 264.00 | 227.00 |
| Humana Achieve | 258.35 | 223.23 |
| National Health Ins | 296.66 | 252.99 |
| Physicians Mutual | 279.60 | 244.12 |
| United American | 364.00 | 300.00 |
| UHC | 276.50 | 216.26 |
| United World Life | 290.87 | 232.84 |
| Blue Shield Frozen Plan F $329 | ||
| Choosing a Medigap Policy | ||
| Continental: Add $20 application fee. | ||
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Prepared for Frank Loughry
Zip code: 90680 Age: 70 |
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UHC rates based on Part B effective less than 10 years
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