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Plan F
Our most popular plan!!
What does Medicare
Cover?
Back
to
Medicare Supplements |
|
Plan
F - Medicare Part A - Hospital Services - Per Benefit Period
|
Services / Part
A |
In 2003
Medicare
Pays |
Plan F Pays |
You Pay |
HOSPITALIZATION*
Semiprivate room and board,
general nursing and miscellaneous
services and supplies
-First 60 Days |
All
but
$840.00 |
$840.00
(Part A
Deductible |
$0 |
| -61st
through 90th day |
All
but
$210.00 a
day |
$210.00 a
day |
$0 |
-91st
day and after
-While using 60 lifetime reserve days |
All
but
$420.00 a
day |
$420.00 a
day |
$0 |
-Once
lifetime reserve days are used:
-Additional 365 days |
$0 |
100% of
Medicare
Eligible
Expenses |
$0 |
| -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
$105.00 a day |
$105.00 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
Available as long as your doctor
certifies you are terminally ill and you
elect to receive these services |
All but very
limited
coinsurance
for outpatient
drugs and
inpatient
respite care |
$0 |
Balance |
Plan
F - Medicare Part B - Medical Services - Per Calendar Year
| Services
/ Part B |
In 2003
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 |
$0 |
$100.00
(Part B
Deductible) |
$0 |
-Remainder
of Medicare Approved
Amounts (after the Part B
Deductible) |
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
$100.00 of Medicare
Approved Amounts** |
$0 |
$100.00
(Part B
Deductible) |
$0 |
-Remainder
of Medicare
Approved Amounts |
Generally
80% |
Generally
20% |
$0 |
CLINICAL
LABORATORY
SERVICES--BLOOD TESTS FOR
DIAGNOSTIC SERVICES |
100% |
$0 |
$0 |
| |
|
|
|
| Parts
A & B |
In
2002
Medicare
Pays |
Plan F Pays |
You
Pay |
HOME
HEALTH CARE - MEDICARE
APPROVED SERVICES
Medically necessary skilled care
services and medical supplies |
100%
while
approved |
$0 |
All
charges
after
Medicare |
Durable
medical equipment
-First $100.00 of Medicare Approved
Amounts** |
$0 |
$100.00
(Part B
Deductible) |
$0 |
-Remainder
of Medicare Approved
Amounts |
80% |
20% |
$0 |
OTHER
BENEFITS-NOT COVERED BY MEDICARE Part B
(Covered
under Plan F)
| Services
/ Part B |
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 of each calendar year |
$0 |
$0 |
$250.00 |
| -Remainder
of Charges |
$0 |
80% to a
lifetime
benefit
maximum
benefit of
$50,000 |
20%
and
amounts
over the
$50,000
lifetime
maximum |
|