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Compare Medicare Supplement Insurance Plans

 

A

B

C

F

G

K*

L*

N*

Reduced premium Medicare Select option available (Eligibility based on Zip code)

 

High deductible plan option

 

 

 

 

 

 

 

Basic benefits

100%/
50%

100%/
75%

√ (copay applies)

Skilled nursing coinsurance

 

 

50%

75%

Part A deductible

 

50%

75%

Part B deductible

 

 

 

 

 

 

Part B excess

 

 

 

100%

100%

 

 

 

Foreign travel emergency care

 

 

 

 

Annual out of pocket limit**

 

 

 

 

 

$4,640

$2,320

 


*Plans K-N provide for different cost-sharing than plans A-G.
Plans K and L pay 100% of hospitalization and preventive care Basic Benefits. All other Basic Benefits are paid at 50% (Plan K) and 75% (Plan L). Once you reach the annual limit, the plan pays 100% of the Medicare copayments, coinsurance and deductibles for the rest of the calendar year. The out-of-pocket annual limit does NOT include charges from your provider that exceed Medicare-approved amounts, called "excess charges." You are responsible for paying excess charges.
Plan N covers Basic Benefits after a $20 copay for office visits and a $50 copay for emergency room visits.
**The out-of-pocket annual limit may increase each year for inflation.

Glossary of Terms


Basic Benefits:

Hospitalization:
  •   Part A coinsurance plus coverage for 365 additional days after Medicare benefits end.
Medical Expenses:
  • Part B coinsurance (generally 20% of Medicare-approved expenses), or copayments for hospital outpatient services. Plans K, L and N require you to pay a portion of Part B coinsurance or copayments.
Blood:
  • First three pints of blood each year.
Hospice:
  • Part A coinsurance

Part B medical excess: Charges from your provider that exceed Medicare-approved amounts. Only Plan F and G cover these charges. For all other plans, you are responsible for paying excess charges. In no case can a provider charge more than 115% of the Medicare approved amount.

Skilled nursing coinsurance: Medicare pays the first 20 days of treatment in a skilled nursing facility, and an annually adjusted per diem for the 21st through 100th day. Plans with this benefit pay an additional annually adjusted per diem for the 21st through 100th day. You are responsible for all charges after the 100th day. In order to receive any Skilled Nursing Facility benefits, you must meet Medicare's requirements:

  • You were admitted to a hospital for at least three days
  • You were admitted to a Medicare-approved skilled nursing facility within 30 days of leaving the hospital

Foreign travel emergency: Medically necessary emergency care services beginning during the first 60 days of each trip outside of the United States. All plans offering this benefit require you to pay a foreign travel emergency deductible and a percent of costs after the deductible is met.

Preventive care: Some annual physical and preventive tests and services administered or ordered by your doctor when not covered by Medicare.

High deductible coverage: This high deductible plan offers the same benefits as "F" after you have paid a calendar year ($2,000) deductible. Benefits will not begin until your out-of-pocket expenses are $2,000. Out-of-pocket expenses for this deductible are expenses that would ordinarily be paid by the policy. These expenses include Medicare deductibles for part A and B, but not the plans' separate ($250) foreign travel emergency deductible.

 

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