Part A
|
| Services |
Medicare Pays |
This Plan Pays |
You Pay |
| Hospitalization |
| First 60 Days |
All But $1676 |
$0 |
$1676 (Part A Deductible) |
| 61st Through 90th Day |
All But $419 a Day |
$419 a Day |
$0 |
| 91st Day and After (60 Reserve Days) |
All But $838 a Day |
$838 a Day |
$0 |
| After Reserve (Additional 365 Days) |
$0 |
100% of Additional Expenses |
$0 |
| Beyond the Additional 365 Days |
$0 |
$0 |
All Costs |
| Skilled Nursing Facility Care |
| First 20 Days |
All Approved Amounts |
$0 |
$0 |
| 21st Through 100th Day |
All But $209.50 a Day |
$0 |
Up to $209.50 a Day |
| 101st Day and After |
$0 |
$0 |
All Costs |
| Blood |
| First Three Pints |
$0 |
100% |
$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 |