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Plan F

Most popular and comprehensive plan. Plan F provides 100% coverage for Medicare covered services. Deductibles and cost shares are covered.

Common Terms

Medicare (Part A) - Hospital Services - Per Benefit Period

Medicare (Part A) - Hospital Services - Per Benefit Period
Services Medicare Pays Plan F Pays You Pay
Hospitalization*
Semi-private room and board, general nursing and miscellaneous services and supplies
     
First 60 days All but $1,216 $1,216 (Part A Deductible) $0
61st through 90th day All but $304 a day $304 a day $0
91st day and after:
(while using 60 lifetime reserve days)
All but $608 a day $608 a day $0
Once lifetime reserve days are used:
Additional 365 days
$0 100% of Medicare eligible expenses $0**
Once lifetime reserve days are used:
Beyond the additional 365 days
$0 $0 All costs
Skilled Nursing Facility Care*
You must meet Medicare's requirements, including having been in a hospital for at least 3 days and entered a Medicare-approved facility within 30 days after leaving the hospital
     
First 20 days All approved amounts $0 $0
21st through 100th day All but $152 a day Up to $152 a day $0
101st day and after $0 $0 All costs
Blood
     
First 3 pints $0 3 pints $0
Additional amounts 100% $0 $0
Hospice Care
You must meet Medicare's requirements, including a doctor's certification of terminal illness.
All but very limited copayment/coinsurance for outpatient drugs and inpatient respite care Medicare copayment / coinsurance $0

Medicare (Part B) - Medical Services - Per Calendar Year

Medicare (Part B) - Medical Services - Per Calendar Year
Services Medicare Pays Plan F Pays You Pay
Medical Expenses
In or out of the Hospital and Outpatient Hospital Treatment, such as physician's services, inpatient and outpatient medical and surgical services and supplies, physical and speech therapy, diagnostic tests, durable medical equipment.
     
First $147 of Medicare approved amounts*** $0 $147 (Part B Deductible) $0
Remainder of Medicare approved amounts Generally 80% Generally 20% $0

Part B Excess Charges

(Above Medicare approved amounts)
$0 100% $0
Blood
     
First 3 pints $0 All costs $0
Next $147 of Medicare approved amounts*** $0 $147 (Part B Deductible) $0
Remainder of Medicare approved amounts 80% 20% $0
Clinical Laboratory Services
Tests For Diagnostic Services
100% $0 $0

Medicare (Parts A and B)

Medicare (Parts A and B)
Services Medicare Pays Plan F Pays You Pay
Home Health Care
Medicare approved services
     

Medically Necessary Skilled Care Services and Medical Supplies

 
100% $0 $0

Durable Medical Equipment

 
     
First $147 of Medicare approved amounts*** $0 $147 (Part B Deductible) $0
Remainder of Medicare approved amounts 80% 20% $0

Other Benefits - Not Covered by Medicare

Other Benefits - Not Covered by Medicare
Services Medicare Pays Plan F Pays You Pay
Foreign Travel (Not covered by Medicare)
Medically necessary emergency care services beginning during the first 60 days of each trip outside the USA
     
First $250 each calendar year $0 $0 $250
Remainder of charges $0 80% to a lifetime maximum benefit of $50,000 20% and amounts over the $50,000 lifetime maximum

These plans are available for enrollment effective dates that begin on or after January 1, 2014. For more details and information, please review the Outline of Coverage (.pdf).

*A benefit period begins on the first day you receive service as an inpatient in a hospital and ends after you have been out of the hospital and have not received skilled care in any other facility for 60 days in a row.

**NOTICE: When your Medicare Part A hospital benefits are exhausted, the carrier stands in the place of Medicare and will pay whatever amount Medicare would have paid for up to an additional 365 days as provided in the plan’s Basic Benefits. During this time, the hospital is prohibited from billing you for the balance based on any difference between its billed charges and the amount Medicare would have paid.

***Once you have been billed $147 of Medicare-approved amounts for covered services (which are noted with three asterisks), your Part B deductible will have been met for the calendar year.

Rates as low as
$70 a month.
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Medicare Information