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Medicare Supplements
At the bottom of this page is a chart that summarizes benefits of all  plans. Following is an example of how one of the plans, Plan F, integrates with Medicare benefits. This is an approximation. Refer to policy language for exact benefits.

Part A Service

 Medicare Pays Plan F Pays Insured Pays
Hospital - 1-60 days All but $1,156 Deductible $1,156 Deductible $0
Hospital - 61-90 days All but $289 per day $289 per day $0
Hospital - 60 lifetime reserve days All but $578 per day $578 per day $0
Hospital - 365 days after lifetime reserve $0 100% $0
Hospital - Thereafter $0 $0 All
Skilled Nursing Facility - first 20 days All eligible expenses $0 $0
Skilled Nursing Facility - 21 to 100 days All but $144.50 per day $144.50 per day $0
Skilled Nursing Facility - After 100 days $0 $0 All
Blood - First 3 Pints $0 3 Pints $0
Blood - After 3 Pints 100% $0 $0
Hospice All eligible $0 $0
Part B Service Medicare Pays Plan F Pays Insured Pays
Medical expense deductible $140 $0 $140 $0
Additional eligible medical expenses 80% 20% $0
Excess medical charges $0 100% $0
Blood - first 3 pints $0 100% $0
Diagnostic tests 100% $0 $0
Part A and B Services Medicare Pays Plan F Pays Insured Pays
Home Health Care Services 100% $0 $0
Durable equipment deductible $140 $0 $140 $0
Excess durable medical equipment 80% 20% $0
Home Health Care $0 $0 100%

Other Plan F Benefits

 Medicare Pays Plan F Pays Insured Pays
Foreign Travel Deductible $0 $0 $250
Foreign Travel 60 days up to $50,000 $0 80% 20%


MEDIGAP (MEDICARE SUPPLEMENT) MODERNIZED PLANS
 
Medigap Benefits A B C D F* G K L M N
Medicare Part A Coinsurance hospital costs up to an additional 365 days aft er Medicare benefi ts are used up x x x x x x x x x x
Medicare Part B Coinsurance or Copayment x x x x x x 50% 75% X ***
Blood (First 3 Pints) x x x x x x 50% 75% x x
Part A Hospice Care Coinsurance or Copayment x x x x x x 50% 75% x x
Skilled Nursing Facility Care Coinsurance     x x x x 50% 75% x x
Medicare Part A Deductible   x x x x x 50% 75% 50% x
Medicare Part B Deductible     x   x          
Medicare Part B Excess Charges         x x        
Foreign Travel Emergency (Up to Plan Limits)**     x x x x     x x
Medicare Preventive Care Part B Coinsurance x x x x x x x x x x
 

2012 Out of Pocket Limit ►

$4,660
**		 $2,330
** 		   

 
* Plan F also off ers a high-deductible plan. Th is means you must pay for Medicare-covered
costs up to the deductible amount $2,070 in 2012 before your Medigap plan pays anything.
** After you meet your out-of-pocket yearly limit and your yearly Part B deductible ($140 in
2012), the Medigap plan pays 100% of covered services for the rest of the calendar year.
Out-of-pocket limit is the maximum amount you would pay for coinsurance and
copayments
*** Plan N pays 100% of the Part B coinsurance except up to $20 copayment for office visits
and up to $50 for emergency department visits.