Outline of Medicare Supplement Coverage Cover Page 1 of 2 Benefit Plans E and J
|
|
- Candace Edwards
- 6 years ago
- Views:
Transcription
1 Outline of Supplement Coverage Cover Page 1 of 2 Benefit Plans E and J See Outlines of Coverage sections for details about ALL plans These charts show the benefits included in each of the standardized Supplement plans. Every company must make available Plan A. Some plans may not be available in your state. The HCA is offering Plans E and J. BASIC BENEFITS for Plans A - J Hospitalization: coinsurance plus coverage for 365 additional days after benefits end. Medical Expenses: coinsurance (generally 20% of -approved expenses) or copayments for hospital outpatient services. Blood: First three pints of blood each year. A B C D E F F* G H I J J* Basic Basic Basic Basic Basic Basic Basic Basic Basic Benefits Benefits Benefits Benefits Benefits Benefits Benefits Benefits Benefits Skilled Skilled Skilled Skilled Skilled Skilled Skilled Skilled Nursing Coinsurancinsurancinsurancinsurancinsurancinsurancinsurance Nursing Coinsurance Basic Benefits ( ) An Independent Licensee of the Blue Cross Blue Shield Association At-Home Recovery Preventive Care Not Covered By Excess (100%) Excess (80%) At-Home Recovery Excess (100%) At-Home Recovery Excess (100%) At-Home Recovery Preventive Care Not Covered By *Plans F and J also have an option called a high deductible F and a high deductible plan J. These high deductible plans pay the same benefits as Plans F and J after one has paid a calendar year $2,000 deductible. Benefits from high deductible plans F and J will not begin until out-of-pocket expenses exceed $2,000. Out-of-pocket expenses for this deductible are expenses that would ordinarily be paid by the contract. These expenses include the deductibles for and B but do not include the plan's separate foreign travel emergency deductible. Premera Blue Cross does not offer the high deductible plan F or J.
2 Outline of Supplement Coverage Cover Page 2 Benefit Plans E and J BASIC BENEFITS for Plans K and L include similar services as plans A J, but cost-sharing for the basic benefits is at different levels. 2 J K** L** Basic Benefits 100% of Hospitalization Coinsurance plus coverage for 365 Days after Benefits End 100% of Hospitalization Coinsurance plus coverage for 365 Days after Benefits End 50% Hospice cost-sharing 75% Hospice cost-sharing 50% of -eligible expenses for the first three pints of blood. 50% Coinsurance, except 100% Coinsurance for Preventative services 75% of -eligible expenses for the first three pints of blood. 75% Coinsurance, except 100% Coinsurance for Preventative Services Skilled Nursing Coinsurance 50% Skilled Nursing Facility Coinsurance 75% Skilled Nursing Facility Coinsurance 50% 75% Excess (100%) At-Home Recovery Preventive Care Not Covered By $4,620 Out-of-pocket Annual Limit*** $2,310 Out-of-pocket Annual Limit*** **Plans K and L provide for different cost-sharing for items and services than A J. Once you reach the annual limit, the plans pay 100% of the 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 -approved amounts, called "Excess Charges." You will be responsible for paying excess charges. ***The out-of-pocket annual limit will increase each year for inflation. See Outlines of Coverage for details and exceptions.
3 SUBSCRIPTION CHARGES AND PAYMENT MODES: Rates Effective January 1, 2010 Eligibility by Age Eligibility by Disability PLAN E $ PBC Total Monthly Rate $ PBC Total Monthly Rate $ PEBB Retiree Subsidized Rate: $ PEBB Retiree Subsidized Rate: $ PEBB Retiree Subsidized Rate: $ PEBB Retiree Subsidized Rate: $ State Resident Rate: $ State Resident Rate: $ State Resident Rate: $ State Resident Rate: PLAN J $ PBC Total Monthly Rate $ PBC Total Monthly Rate $ PEBB Retiree Subsidized Rate: $ PEBB Retiree Subsidized Rate: $ PEBB Retiree Subsidized Rate: $ PEBB Retiree Subsidized Rate: $ State Resident Rate: $ State Resident Rate: $ State Resident Rate: $ State Resident Rate: 3
4 SUBSCRIPTION CHARGES INFORMATION We, Premera Blue Cross (PBC), can only raise your subscription charges if we raise the subscription charge for all contracts like yours in this state. DISCLOSURES Use this outline to compare benefits and subscription charges among contracts. READ YOUR CONTRACT VERY CAREFULLY This is only an outline describing your contract's most important features. You must read the contract itself to understand all of the rights and duties of both you and your supplement carrier. RIGHT TO RETURN CONTRACT If you find that you are not satisfied with your coverage, you may return it to th St. S.W., Mountlake Terrace, Washington If you send the contract back to us within thirty (30) days after you receive it, we will treat the contract as if it had never been issued and return all of your payments. POLICY REPLACEMENT If you are replacing another health insurance policy, do NOT cancel it until you have actually received your new contract and are sure you want to keep it. This contract may not fully cover all of your medical costs. NOTICE Premera Blue Cross is not connected with. This outline of coverage does not give all the details of coverage. Contact your local Social Security office or consult and You for more details. COMPLETE ANSWERS ARE VERY IMPORTANT Review the application carefully before you sign it. Be certain that all information has been properly recorded. 4
5 PLANS E & J MEDICARE (PART A) - HOSPITAL SERVICES - PER BENEFIT PERIOD * 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. PLAN E PLAN J SERVICES MEDICARE PAYS PLAN E PAYS YOU PAY PLAN J PAYS YOU PAY Hospitalization* Semiprivate room and board, general nursing and miscellaneous services and supplies - First 60 days - 61st thru 90th day - 91st day and after: --- While using 60 lifetime reserve days --- Once lifetime reserve days are used: --- Additional 365 days 5 All but $1,100 All but $275 a day All but $550 a day --- Beyond the additional 365 days Skilled Nursing Facility Care* You must meet 's requirements, including having been in a hospital for at least 3 days and entered a -approved facility within 30 days after leaving the hospital - First 20 days All approved amounts - 21st thru 100th day All but $ a day - 101st day and after Blood - First 3 pints - Additional amounts Hospice Care Available as long as your doctor certifies you are terminally ill and you elect to receive these services 100% All but very limited coinsurance for outpatient drugs and inpatient respite care $1,100 ( deductible) $275 a day $550 a day 100% of eligible expenses Up to $ a day 3 pints ** $1,100 ( deductible) $275 a day $550 a day 100% of eligible expenses Up to $ a day 3 pints ** Balance Balance **NOTICE: When your hospital benefits are exhausted, the carrier stands in the place of and will pay whatever amount would have paid for up to an additional 365 days as provided in the contract's "Core 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 would have paid.
6 PLANS E & J (continued) MEDICARE (PART B) - MEDICAL SERVICES - PER CALENDAR YEAR * Once you have been billed $155 of -Approved amounts for covered services (which are noted with an asterisk), your will have been met for the calendar year. PLAN E PLAN J SERVICES MEDICARE PAYS PLAN E PAYS YOU PAY PLAN J 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 $155 of approved amounts* - Remainder of approved amounts excess charges (Above approved amounts) Generally 80% Generally 20% $155 ( deductible) $155 ( deductible) Generally 20% 100% Blood - First 3 pints - Next $155 of approved amounts* - Remainder of approved amounts 80% 20% $155 ( deductible) $155 ( deductible) 20% Clinical Laboratory Services - Blood Tests For Diagnostic Services 100% 6
7 PLANS E & J (continued) PARTS A & B PLAN E PLAN J SERVICES MEDICARE PAYS PLAN E PAYS YOU PAY SERVICES YOU PAY Home Health Care- Approved Services --- Medically necessary skilled care services and medical supplies --- Durable medical equipment First $155 of approved amounts* Remainder of approved amounts 100% 80% 20% $155 ( deductible) $155 ( deductible) 20% At-home Recovery Services - Not Covered By Home care certified by your doctor, for personal care during recovery from an injury or sickness for which approved a Home Care Treatment Plan --- Benefit for each visit All Costs Actual charges to $40 a visit Balance --- Number of visits covered (must be received within 8 weeks of last approved visit) All Costs Up to the number of Approved visits, not to exceed 7 each week Calendar year maximum $1600 7
8 PLANS E & J (continued) OTHER BENEFITS - NOT COVERED BY MEDICARE PLAN E PLAN J SERVICES MEDICARE PAYS PLAN E PAYS YOU PAY PLAN J PAYS YOU PAY - Not Covered by Medically necessary emergency care services beginning during the first 60 days of each trip outside the USA First $250 each calendar year $250 $250 Remainder of charges 80% to a lifetime maximum benefit of $50,000 20% and amounts over the $50,000 lifetime maximum 80% to a lifetime maximum benefit of $50,000 20% and amounts over the $50,000 lifetime maximum ***Preventive Medical Care Benefit Not Covered By Some annual physical and preventive tests and services administered or ordered by your doctor when not covered by - First $120 each calendar year - Additional charges $120 *** benefits are subject to change. Please consult the latest Guide to Health Insurance for People with. $120 8
Medicare Supplement Outline of Coverage
Medicare Supplement Outline of Coverage Plans A, F & N Anthem Blue Cross and Blue Shield New Hampshire 2016 This booklet includes premium rates, Medicare deductibles, copays and maximum out-of-pocket costs.
More informationBasic, including 100% Part B coinsurance. Foreign Travel Emergency
BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA An Independent Licensee of the Blue Cross and Blue Shield Association OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE 1 of 2: BENEFIT PLANS A, C, L and N
More informationA B C D F F* G K L M N. Basic, including 100% Part B coinsurance. Basic, including 100% Part B coinsurance
Independence Blue Cross and Highmark Blue Shield Outline of Medicare Supplement Coverage MedigapSecurity Plans A, B, and C Benefit Chart of Medicare Supplement Plans sold on or After June 1, 2010 This
More informationBasic, Including 100% Part B Coinsurance. Part B Coinsurance. Coinsurance* 50% Skilled Nursing Facility Coinsurance. Skilled Nursing Facility
AMERICAN RETIREMENT LIFE INSURANCE COMPANY P. O. BOX 26580 AUSTIN, TX 78755-0580 866-459-4272 Outline of Medicare Supplement Coverage - Benefit Plans A, F, G and N This chart shows the benefits included
More informationBasic, including 100% Part B coinsurance. Coinsurance Part A Deductible Part A Deductible Part A Deductible Part A Deductible Part A Deductible
BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA An Independent Licensee of the Blue Cross and Blue Shield Association OUTLINE OF BLUECARE COVERAGE COVER PAGE 1 of 2: BENEFIT PLANS A, F with High Deductible,
More informationUNITED WORLD LIFE INSURANCE COMPANY A Mutual of Omaha Company OUTLINE OF MEDICARE SUPPLEMENT COVERAGE - COVER PAGE 1 BENEFIT PLANS A, B, C, D, F AND G
UNITED WORLD LIFE INSURANCE COMPANY A Mutual of Omaha Company OUTLINE OF MEDICARE SUPPLEMENT COVERAGE - COVER PAGE 1 BENEFIT PLANS A, B, C, D, F AND G These charts show the benefits included in each of
More informationTHE MANHATTAN LIFE INSURANCE COMPANY Outline of Medicare Supplement Coverage-Cover Page Benefit Plans A, C, F, G, AND N
THE MANHATTAN LIFE INSURANCE COMPANY Outline of Medicare Supplement Coverage-Cover Page Benefit Plans A, C, F, G, AND N These charts show the benefits included in each of the standard Medicare supplement
More informationRegence Bridge. Medicare Supplement (Medigap) Plans
OUTLINE OF COVERAGE Regence Bridge Medicare Supplement (Medigap) Plans Regence BlueShield serves select counties in the state of Washington and is an Independent Licensee of the Blue Cross and Blue Shield
More informationK L M N Basic, including 100% Part B. Basic, including 100% Part B Co- Insurance; other basic benefits paid at 50%
Companion Life Insurance Company Administrative Office PO Box 14158 Clearwater, Florida 33766-4158 (888) 220-0466 Outline of Medicare Supplement Coverage Cover Page Benefit Plans A, B, F and G - See Outlines
More informationBasic, Including 100% Part B Coinsurance. Part B Coinsurance. Coinsurance* 50% Skilled Nursing Facility Coinsurance. Skilled Nursing Facility
AMERICAN RETIREMENT LIFE INSURANCE COMPANY P. O. BOX 26580 AUSTIN, TX 78755-0580 866-459-4272 Outline of Medicare Supplement Coverage - Benefit Plans A, F, G and N This chart shows the benefits included
More informationBlue Select Policy Comparison Chart Effective January 1, 2018 Blue Select Part A Hospital Insurance Covered Services
SERVICE MEDICARE PLAN A Hospitalization Semiprivate room and board. General nursing and miscellaneous hospital services and supplies. Network Hospital First 60 s Blue Select Policy Comparison Chart Part
More information2013 Outline of Medicare Supplement Coverage
Anthem Blue Cross and Blue Shield Ohio Administrative Office: P.O. Box 659806, San Antonio, TX 78265-9106 Toll Free Telephone Number: 1-866-803-5169 Benefit Chart of Medicare Supplement Plans Sold for
More informationA B C D F / F* G K L M N Basic including 100% Part B Coinsurance. Coinsurance. Coinsurance. Skilled Nursing Facility
This chart show the benefits included in each of the standard Medicare Supplement plans. Every insurer must make available Plan A. Some plans may not be available in your state. See Outlines of Coverage
More informationBasic, including 100% Part B coinsurance, except up to $20 copayment for office visit, and up to $50 copayment for ER Skilled Nursing
MUTUAL OF OMAHA INSURANCE COMPANY OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE BENEFIT PLANS A, B, C, D, F AND G These charts show the benefits included in each of the standard Medicare supplement
More informationSTONEBRIDGE LIFE INSURANCE COMPANY OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE BENEFIT PLANS A, F, G AND N
STONEBRIDGE LIFE INSURANCE COMPANY OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE BENEFIT PLANS A, F, G AND N These charts show the benefits included in each of the standard Medicare supplement plans.
More informationBasic, including 100% Part B coinsurance
BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA An Independent Licensee of the Blue Cross and Blue Shield Association OUTLINE OF BLUE SELECT COVERAGE COVER PAGE 1 of 2: BENEFIT PLANS TRADITIONAL A and BLUE
More informationIMPORTANT NOTICE PLEASE READ 2016 Medicare Cost-Sharing Amounts
IMPORTANT NOTICE PLEASE READ 2016 Medicare Cost-Sharing Amounts Dear Prospective Member: The Centers for Medicare & Medicaid Services (CMS) have not released the 2016 Medicare cost-sharing amounts as of
More informationOutline of Medicare Supplement Coverage
Outline of Medicare Supplement Coverage Cover page 1 of 2 Benefit Chart of Medicare Supplement Plans Sold on or After June 1, 2010 Plans A, F, G, N These charts show the benefits included in each of the
More informationBasic, including 100% Part B coinsurance, except up to $20 copayment for office visit, and up to $50 copayment for ER Skilled Nursing.
ASSURED LIFE ASSOCIATION A Fraternal Benefit Society OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE BENEFIT PLANS A, B, C, D, F AND G These charts show the benefits included in each of the standard
More informationBasic, including 100% Part B coinsurance. Basic, including. coinsurance. coinsurance* 50% Skilled Nursing Facility. Deductible
LOYAL AMERICAN LIFE INSURANCE COMPANY P. O. BOX 26580 AUSTIN, TX 78755-0580 866-459-4272 Outline of Medicare Supplement Coverage - Benefit Plans A, F, G, and N This chart shows the benefits included in
More informationOutline of Coverage. Medicare Supplement Insurance BENEFIT PLANS A, B, F, G, N. AAA Medicare Supplement Plans
American Automobile Association (AAA) Medicare Supplement Insurance Office 800 Crescent Centre Dr. Suite 200 Franklin, TN 37067 855 663.2201 aetnaseniorproducts.com Outline of Coverage Medicare Supplement
More informationBlueCare Policy Comparison Chart Effective January 1, 2019 BlueCare Part A Hospital Insurance Covered Services
SERVICE MEDICARE PLAN A Hospitalization Semiprivate room and board. General nursing and miscellaneous hospital services and supplies. Network Hospital First 60 s BlueCare Policy Comparison Chart Part A
More informationBasic, including 100% Part B coinsurance, except up to $20 copayment for office visit, and up to $50 copayment for ER Skilled
GOVERNMENT PERSONNEL MUTUAL LIFE INSURANCE COMPANY OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE BENEFIT PLANS A, C, F, G, AND N These charts show the benefits included in each of the standard Medicare
More informationto $20 co-payment for office Basic, including 100% Part B Co-insurance, except up visit, and up to $50copayment Co-insurance Part A Deductible
STONEBRIDGE LIFE INSURANCE COMPANY OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE BENEFIT PLANS A, F, G AND N These charts show the benefits included in each of the standard Medicare supplement plans.
More informationA B C D F F* G K L M N. coinsurance. Skilled Nursing Facility. 75% Skilled Nursing Facility coinsurance 75% Part A Deductible.
Shenandoah Life Insurance Company Administrative Office: P.O. Box 14558, Clearwater, FL 33766-4558 (855) 406-9085 Outline of Medicare Supplement Coverage Cover Page Benefit Plans A, F, G and N Benefit
More informationBasic, including 100% Part B coinsurance
BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA An Independent Licensee of the Blue Cross and Blue Shield Association OUTLINE OF BLUE SELECT COVERAGE COVER PAGE 1 of 2: BENEFIT PLANS TRADITIONAL A and BLUE
More informationA B C D F F* G K L M N. Basic, including 100% Part B. coinsurance. at 50% Skilled Nursing Facility coinsurance Part A Deductible.
Shenandoah Life Insurance Company Administrative Office: P.O. Box 14558, Clearwater, FL 33766-4558 (855) 406-9085 Outline of Medicare Supplement Coverage Cover Page Benefit Plans A, F, G and N Benefit
More informationA B C D F F* G K L M N. coinsurance. Skilled Nursing Facility. 75% Skilled Nursing Facility coinsurance 75% Part A Deductible.
Shenandoah Life Insurance Company Administrative Office: P.O. Box 14558, Clearwater, FL 33766-4558 (855) 406-9085 Outline of Medicare Supplement Coverage Cover Page Benefit Plans A, F, G and N Benefit
More informationBasic, including 100% Part B coinsurance
BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA An Independent Licensee of the Blue Cross and Blue Shield Association OUTLINE OF BLUE SELECT COVERAGE COVER PAGE 1 of 2: BENEFIT PLANS TRADITIONAL A and BLUE
More informationPlan A Plan B Plan C Plan D Plan F F* Plan G Plan K Plan L Plan M Plan N. Hospitalization: 100%; other basic benefits paid at 50%
UNITED WORLD LIFE INSURANCE COMPANY OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE BENEFIT PLANS A, F, HIGH DEDUCTIBLE F, G, AND N This chart shows the benefits included in each of the standard Medicare
More informationPART A HOSPITAL SERVICES PER BENEFIT PERIOD SERVICES MEDICARE PAYS PLAN PAYS YOU PAY HOSPITALIZATION*
For Retirees of Orange County Board of County Commissioners Your Cigna Medicare Surround Group Medicare Supplement Insurance Plan N Effective Date: January 1, 2019 through December 31, 2019 Insured by
More informationOutline of Coverage. Medicare Supplement Insurance BENEFIT PLANS A,B,F, HIGH DEDUCTIBLE F, G, N. American Continental Insurance Company
American Continental Insurance Company 800 Crescent Centre Dr. Suite 200 Franklin, TN 37067 800 264.4000 aetnaseniorproducts.com Outline of Coverage Medicare Supplement Insurance BENEFIT S A,B,F, HIGH
More informationBasic, including 100% Part B coinsurance. Skilled Nursing Facility Coinsurance Part A Deductible Part B. Part B Excess (100%) Foreign Travel Emergency
Texas OLD SURETY LIFE INSURANCE COMPANY ** 2016 ** ( effective 03/01/2016 ) Outline of Medicare Supplement Coverage Benefit Plans A and F Only are being offered by the company at this time. Benefit Plan
More informationSTONEBRIDGE LIFE INSURANCE COMPANY OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE BENEFIT PLANS A, C, F, G AND N
STONEBRIDGE LIFE INSURANCE COMPANY OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE BENEFIT PLANS A, C, F, G AND N These charts show the benefits included in each of the standard Medicare supplement
More informationBasic, including 100% Part B Coinsurance, except up to $20 copayment for office visit, and up to $50 copayment for ER Skilled Nursing.
MUTUAL OF OMAHA INSURANCE COMPANY OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE BENEFIT PLANS A, F, AND G This chart shows the benefits included in each of the standard Medicare supplement plans.
More informationOUTLINE OF COVERAGE AND RATES FOR LOUISIANA RESIDENTS
OUTLINE OF COVERAGE AND RATES FOR LOUISIANA RESIDENTS Medicare Supplement benefit plans A, F, High-Deductible F, G, and N Cigna Medicare Supplement Insurance Cigna Health and Life Insurance Company CHLIC-HHD-OC-AA-LA
More informationOUTLINE OF COVERAGE AND RATES FOR TENNESSEE RESIDENTS
OUTLINE OF COVERAGE AND RATES FOR TENNESSEE RESIDENTS Medicare Supplement benefit plans A, F, High-Deductible F, G, and N Cigna Medicare Supplement Insurance Cigna Health and Life Insurance Company CHLIC-HHD-OC-AA-TN
More informationOutline of Coverage. Medicare Supplement Insurance BENEFIT PLANS: A, B, F, G, & N. AAA Medicare Supplement Plans
American Automobile Association (AAA) Medicare Supplement Insurance Office 800 Crescent Centre Dr. Suite 200 Franklin, TN 37067 855 663.2201 aetnaseniorproducts.com Outline of Coverage Medicare Supplement
More informationBasic, including 100% Part B coinsurance
BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA An Independent Licensee of the Blue Cross and Blue Shield Association OUTLINE OF BLUE SELECT COVERAGE COVER PAGE 1 of 2: BENEFIT PLANS TRADITIONAL A and BLUE
More informationBasic, including 100% Part B Coinsurance, except up to $20 copayment for office visit, and up to $50 copayment for ER Skilled Nursing.
MUTUAL OF OMAHA INSURANCE COMPANY OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE BENEFIT PLANS A, C, D, F, AND G This chart shows the benefits included in each of the standard Medicare supplement plans.
More informationOutline of Group Medicare Supplement Coverage
Outline of Group Medicare Supplement Coverage Effective January 1, 2018 301 S. Vine St., Urbana, IL 61801-3347 1-877-933-0028 TTY 711 HealthAlliance.org med-msgrpoutcov-11 med-msgrpoutcov18-1117 November
More informationOUTLINE OF COVERAGE AND RATES FOR CONNECTICUT RESIDENTS
OUTLINE OF COVERAGE AND RATES FOR CONNECTICUT RESIDENTS Medicare Supplement benefit plans A, F, High-Deductible F, G, and N Cigna Medicare Supplement Insurance Cigna Health and Life Insurance Company CHLIC-HHD-OC.v2-CR-CT
More informationBENEFIT PLANS A, B, F, G & N
American Automobile Association (AAA) Medicare Supplement Insurance Office 800 Crescent Centre Dr. Suite 200 Franklin, TN 37067 855 663.2201 aetnaseniorproducts.com Outline of Coverage Medicare Supplement
More informationBasic, including. Hospitalization and preventive care paid. 50% Skilled Nursing. Part A Deductible. 50% Part A. Deductible
Mutual of Omaha Insurance Company OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE BENEFIT PLANS A, F, HIGH DEDUCTIBLE F, G AND N This chart shows the benefits included in each of the standard Medicare
More informationBasic, including. Hospitalization and preventive care paid. 50% Skilled Nursing. Part A Deductible. 50% Part A. Deductible
United World Life Insurance Company A Mutual of Omaha Company OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE BENEFIT PLANS A, F, HIGH DEDUCTIBLE F, G AND N This chart shows the benefits included in
More informationBasic, including. Hospitalization and preventive care paid. 50% Skilled Nursing. Part A Deductible. 50% Part A. Deductible
Omaha Insurance Company A Mutual of Omaha Company OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE BENEFIT PLANS A, F, HIGH DEDUCTIBLE F, G AND N This chart shows the benefits included in each of the
More informationMedicare Supplement Coverage Options
A Division of HealthNow New York Inc. An Independent Licensee of the BlueCross BlueShield Association Medicare Supplement Coverage Options Thank you for your interest in our Medicare Supplemental coverage
More informationA B C D F F* G K L M N. coinsurance. Skilled Nursing Facility. 75% Skilled Nursing Facility coinsurance 75% Part A Deductible.
Shenandoah Life Insurance Company Administrative Office: P.O. Box 14558, Clearwater, FL 33766-4558 (855) 406-9085 Outline of Medicare Supplement Coverage Cover Page Benefit Plans A, F, G and N Benefit
More informationAmerican Continental Application Packet
American Continental Application Packet Thank you for your interest in applying for the American Continental/Aetna Medicare Supplement plan! This application packet provides you with access to a printable
More informationBasic, including. Hospitalization and preventive care paid. 50% Skilled Nursing. Part A Deductible. 50% Part A. Deductible
Mutual of Omaha Insurance Company OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE BENEFIT PLANS A, F, HIGH DEDUCTIBLE F, G AND N This chart shows the benefits included in each of the standard Medicare
More informationBasic, including. Hospitalization and preventive care paid. 50% Skilled Nursing. Part A Deductible. 50% Part A. Deductible
United World Life Insurance Company A Mutual of Omaha Company OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE BENEFIT PLANS A, C, D, F, HIGH DEDUCTIBLE F, G AND N This chart shows the benefits included
More informationBasic, including 100% Part B coinsurance. Skilled Nursing Facility Coinsurance Part A Deductible Part B. 50% Part A
BANKERS FIDELITY LIFE INSURANCE COMPANY 4370 Peachtree Road, NE; PO Box 105185, Atlanta, GA 30348-5185 Benefit Chart of Medicare Supplement Plans Sold for Effective Dates On or After 06-01-2010 This chart
More informationBasic, including. Hospitalization and preventive care paid. 50% Skilled Nursing. Part A Deductible. 50% Part A. Deductible
Mutual of Omaha Insurance Company OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE BENEFIT PLANS A, B, C, D, F, HIGH DEDUCTIBLE F, G AND N This chart shows the benefits included in each of the standard
More informationOutline of Medicare Supplement Coverage
Outline of Medicare Supplement Coverage Effective April 1, 2016 301 S. Vine St., Urbana, IL 61801-3347 1-877-933-0028 TTY 711 HealthAllianceMedicare.org med-msoutcov-11 med-2010msoutcov-0616 April 2016
More informationBasic, including 100% Part B Coinsurance, except up to $20 copayment for office visit, and up to $50 copayment for ER Skilled Nursing.
MUTUAL OF OMAHA INSURANCE COMPANY OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE BENEFIT PLANS A, F, AND G This chart shows the benefits included in each of the standard Medicare supplement plans.
More informationHomeTown Region. Medicare Select. Benefit Plan Summaries FORM # THP-39
HomeTown Region Select Benefit Plan Summaries FORM # THP-39 Outline of Select Coverage: Cover Page The Health Plan offers Benefit Plans A, C, D and F Supplement insurance can be sold in only ten standard
More informationBasic, including 100% Part B coinsurance, except up to $20 copayment for office visit, and up to $50 copayment for.
UNITED WORLD LIFE INSURANCE COMPANY A Mutual of Omaha Company OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE BENEFIT PLANS A, B, C, D, F, G, and M These charts show the benefits included in each of
More informationPlan A Plan B Plan C Plan D Plan F F* Plan G Plan K Plan L Plan M Plan N. Hospitalization: Skilled Nursing. 50% Skilled Nursing. Facility Coinsurance
Omaha Insurance Company A Mutual of Omaha Company OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE BENEFIT PLANS A, C, F, HIGH DEDUCTIBLE F, G AND N This chart shows the benefits included in each of
More informationBasic, including 100% Part B coinsurance
Arkansas OLD SURETY LIFE INSURANCE COMPANY ** 2016 ** (effective 03/01/2016) Outline of Medicare Supplement Coverage Benefit Plans A, C and F Only are being offered by the company at this time. These charts
More informationHospitalization and preventive care paid at 100%; other basic benefits paid at 50% Skilled Nursing. 50% Skilled Nursing. Facility Coinsurance
Omaha Insurance Company A Mutual of Omaha Company OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE BENEFIT PLANS A, F, HIGH DEDUCTIBLE F, G AND N This chart shows the benefits included in each of the
More informationAetna Health & Life Application Packet
Aetna Health & Life Application Packet Thank you for your interest in applying for the Aetna Health & Life Medicare Supplement plan! This application packet provides you with access to a printable copy
More informationBasic, including 100% Part B coinsurance, Except up to $ 20 copayment for office visit, and up to $ 50 copayment for ER Skilled Nursing
Kansas OLD SURETY LIFE INSURANCE COMPANY 2014 (effective 01/01/2014) Outline of Medicare Supplement Coverage Benefit Plans A and F Only are being offered by the company at this time. Benefit Plans A and
More informationBasic, including 100% Part B Coinsurance. Part B. Deductible Part B. Deductible. Part B. Part B Excess (100%) Foreign Travel Emergency
A B C D F F G K L M N Basic, including Basic, including Part A Basic, including Skilled Part A Foreign Travel Emergency Basic, including Skilled Part A Foreign Travel Emergency Basic, including Skilled
More informationbasic benefits paid at 50% 50% Skilled Nursing Facility Skilled Nursing 50% Part A Part A Deductible Part B Part B Excess (100%)
UNITED OF OMAHA LIFE INSURANCE COMPANY A Mutual of Omaha Company OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE BENEFIT PLANS A, F, HIGH DEDUCTIBLE F, G AND N This chart shows the benefits included
More informationto $20 co-payment for office visit, and up to $50 copayment Skilled B Co-insurance, except up Basic, including 100% Part Co-insurance Deductible
STONEBRIDGE LIFE INSURANCE COMPANY OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE BENEFIT PLANS A, F, G AND N These charts show the benefits included in each of the standard Medicare supplement plans.
More informationBasic, including 100% Part B coinsurance, except up to $20 copayment for office visit, and up to $50 copayment for ER Skilled Nursing.
UNITED OF OMAHA LIFE INSURANCE COMPANY A Mutual of Omaha Company OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE BENEFIT PLANS A, F, G, AND M These charts show the benefits included in each of the standard
More informationBasic, including 100% Part B Coinsurance, except up to $20 copayment for office visit, and up to $50 copayment for ER Skilled Nursing.
MUTUAL OF OMAHA INSURANCE COMPANY OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE BENEFIT PLANS A, F, AND G This chart shows the benefits included in each of the standard Medicare supplement plans.
More informationMedicare Supplement Outline of Coverage. Plans A, F, G & N Anthem Blue Cross and Blue Shield Missouri 2018
March 2, 2018 12:01 PM OOC18_MS_MO-T_DUAL-AFGN-AOOC001M(18)-MO-T_03-01-2018 Medicare Supplement Outline of Coverage Plans A, F, G & N Anthem Blue Cross and Blue Shield Missouri 2018 This booklet includes
More informationK L M N # Basic, including 100% Part B co-insurance. Basic, including 100% Part B. co-insurance. Skilled Nursing Facility co-insurance.
Forethought Life Insurance Company Administrative Office P.O. Box 14659, Clearwater, FL 33766-4659 (877) 492-5870 Outline of Medicare Supplement Coverage Cover Page Benefit Plans A, C #, F #, G # and N
More informationBasic, including. Hospitalization and preventive care paid. 50% Skilled Nursing. Part A Deductible. 50% Part A. Deductible
United of Omaha Life Insurance Company A Mutual of Omaha Company OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE BENEFIT PLANS A, F, HIGH DEDUCTIBLE F, G AND N This chart shows the benefits included
More information2010 Medicare Supplement Insurance Plans
United of Omaha Life Insurance Company A Mutual of Omaha Company 2010 Medicare Supplement Insurance Plans Plans with coverage effective dates on and after June 1. Indiana U8183_IN_0010R UNITED OF OMAHA
More informationcopayment for ER Skilled Nursing Facility Coinsurance Skilled Nursing Facility Coinsurance Part A Deductible Part B 50% Part A
BANKERS FIDELITY LIFE INSURANCE COMPANY 4370 Peachtree Road, NE; PO Box 105185, Atlanta, GA 30348-5185 Benefit Chart of Medicare Supplement Plans Sold for Effective Dates On or After 06-01-2010 This chart
More informationGERBER LIFE INSURANCE COMPANY WHITE PLAINS, NEW YORK OUTLINE OF MEDICARE SUPPLEMENT COVERAGE - COVER PAGE
GERBER LIFE INSURANCE COMPANY WHITE PLAINS, NEW YORK OUTLINE OF MEDICARE SUPPLEMENT COVERAGE - COVER PAGE BASIC AND EXTENDED BASIC PLANS The Commissioner of Insurance of the State of Minnesota has established
More informationAPPLICATION FOR MEDICARE SUPPLEMENT INSURANCE INDIANA
HEARTLAND NATIONAL LIFE INSURANCE COMPANY Medicare Supplement Administrative Office: PO Box 10812, Clearwater, FL 33757-8812 APPLICATION FOR MEDICARE SUPPLEMENT INSURANCE INDIANA HNAPP2010IN HEARTLAND
More informationMutual of Omaha Application Packet
Mutual of Omaha Application Packet Thank you for your interest in applying for the Mutual of Omaha Medicare Supplement plan! This application packet provides you with a link to the Online Application to
More informationBasic, including 100% Part B Coinsurance, except up to $20 copayment for office visit, and up to $50 copayment for ER Skilled Nursing.
GERBER LIFE INSURANCE COMPANY OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE STANDARDIZED BENEFIT PLAN A AND SELECT BENEFIT PLANS F AND G This chart shows the benefits included in each of the standard
More informationOmaha Insurance Company Application Packet
Omaha Insurance Company Application Packet Thank you for your interest in the Omaha Insurance Company Medicare Supplement plan! This application packet provides you with a link to the Online Application
More informationUnited of Omaha Application Packet
United of Omaha Application Packet Thank you for your interest in applying for the United of Omaha Medicare Supplement plan! This application packet provides you with a link to the Online Application to
More informationPLAN F or HIGH DEDUCTIBLE PLAN F MEDICARE (PART A) HOSPITAL SERVICES PER BENEFIT PERIOD
SERVICES DS-GRMSP10(46) Page 1 MEDICARE PAYS AFTER YOU PAY $2240 PLAN PAYS HOSPITALIZATION * Semiprivate room and board, general nursing and miscellaneous services and supplies First 60 days All but $1340
More informationThe Insurance Plans of Choice for Medicare Supplemental Coverage
The Insurance Plans of Choice for Medicare Supplemental Coverage Philadelphia American Life Insurance Company P.O. Box 4884 Houston, TX 77210-4884 POLICY FORM NUMBERS: MS.A.PAL.AR, MS.C.PAL.AR, MS.D.PAL.AR,
More informationSTONEBRIDGE LIFE INSURANCE COMPANY OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE BENEFIT PLANS A, C, F, G AND N
STONEBRIDGE LIFE INSURANCE COMPANY OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE BENEFIT PLANS A, C, F, G AND N These charts show the benefits included in each of the standard Medicare supplement
More informationPLAN F MEDICARE (PART A) HOSPITAL SERVICES PER BENEFIT PERIOD 2019
PLAN F MEDICARE (PART A) HOSPITAL SERVICES PER BENEFIT PERIOD 2019 * 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
More informationOmaha Insurance Company Application Packet
Omaha Insurance Company Application Packet Thank you for your interest in the Omaha Insurance Company Medicare Supplement plan! This application packet provides you with a link to the Online Application
More informationPLAN F MEDICARE (PART A) HOSPITAL SERVICES PER BENEFIT PERIOD
PLAN F MEDICARE (PART A) HOSPITAL SERVICES PER BENEFIT PERIOD - 2018 * 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
More informationA B C D F l F* G K L M N
Aetna Life Insurance Company Outline of Medicare Supplement Coverage Benefit Plans A, B, F, G and N are Offered Benefit Chart of Medicare Supplement Plans Sold for Effective Dates on or After June 1, 2010
More informationMedicare Supplement Outline of Coverage. Plans A, F, G & N. Amerigroup Insurance Company Arizona 2018
Medicare Supplement Outline of Coverage Plans A, F, G & N Amerigroup Insurance Company Arizona 2018 This booklet includes premium rates, Medicare deductibles, copays and maximum out-of-pocket costs. Call
More informationAetna Life Insurance Company Outline of Medicare Supplement Coverage
Aetna Life Insurance Company Outline of Medicare Supplement Coverage Benefit Plans A, B, F, G and N are Offered To be eligible for coverage under an Individual Medicare Supplement you must be at least
More informationMEDICARE SUPPLEMENT INSURANCE RATES FOR KANSAS RESIDENTS
2016 MEDICARE SUPPLEMENT INSURANCE RATES FOR KANSAS RESIDENTS Medicare supplement insurance is sold in 10 standard plans plus one high-deductible plan. The information in this brochure shows the benefits
More informationOutline of Medicare Supplement Coverage
Tufts Medicare Preferred SUpplement PLANS 2014 Outline of Medicare Supplement Coverage Tufts Medicare Preferred Supplement Core Tufts Medicare Preferred Supplement One Effective January 1, 2014 December
More information2015 Outline of Medicare Supplement Coverage Cover Page (1 of 2) Plans A, F & N
Steve Shorr Insurance - Authorized Agent - 30.59.335 For more information and to very the latest details Anthem Blue Cross Administrative Office: P.O. Box 9063, Oxnard, CA 9303-9063 Toll Free Telephone
More informationMedigapSecurity Plan Information. Individual supplement plan options for people with Medicare. MedigapSecurity 5822(10/15)BKV1
2016 MedigapSecurity Plan Information Individual supplement plan options for people with Medicare MedigapSecurity 5822(10/15)BKV1 Thank you. We appreciate your interest in Independence Blue Cross. We
More informationMutual of Omaha Application Packet
Mutual of Omaha Application Packet Thank you for your interest in applying for the Mutual of Omaha Medicare Supplement plan! This application packet provides you with a link to the Online Application to
More informationAmeriHealth Medigap Plans Information. Individual health plan options for people with Medicare
2016 AmeriHealth Medigap Plans Information Individual health plan options for people with Medicare AM6830 (5/15) 5823(10/15)BKV1 Thank you. We appreciate your interest in AmeriHealth New Jersey. We look
More informationRegence BCBSO Application Packet
Regence BCBSO Application Packet Thank you for your interest in the Regence BlueCross BlueShield of Oregon Medicare Supplement plan! This application packet provides you with access to the online application,
More informationmore complete AARP MEDICARE SUPPLEMENT INSURANCE PLANS Insured by UnitedHealthcare Insurance Company 2017 Enrollment Materials
2017 Enrollment Materials more complete AARP MEDICARE SUPPLEMENT INSURANCE PLANS Insured by UnitedHealthcare Insurance Company These types of plans help with some of the out-of-pocket costs not paid by
More informationone full year from your effective date of the respond by date, these rates are Direct Notice Bank Account Credit Card payments ahead.
Issue Age Medicare Supplement Insurance s Offered in Wisconsin Underwritten by Transamerica Life Insurance Company Monthly Rate For Non-Tobacco 1 2 3 4 5 6 7 Under 65 $99.68 $154.66 $134.43 $153.56 $155.90
More informationMedicare Supplement Outline of Coverage
Medicare Supplement Outline of Coverage Plans A, F, G & N Anthem Blue Cross and Blue Shield Colorado 2017 This booklet includes premium rates, Medicare deductibles, copays and maximum out-of-pocket costs.
More informationMedicare Supplement Outline of Coverage
OOC_MS_CO-T_NTM_AOOC001M(Rev 7-16)(09-19-2017)-2019rates 9/19/2018 10:52 AM (BASE/ORIG) Medicare Supplement Outline of Coverage Plans A, F, G & N Anthem Blue Cross and Blue Shield Colorado 2019 This booklet
More information2018 Outline of Coverage McLaren Medicare Supplement Plans A, C, F, High Deductible-F, G & N
2018 Outline of Coverage McLaren Medicare Supplement Plans A, C, F, High Deductible-F, G & N McLarenHealthPlan.com/MedicareSupplement Call us toll-free (888) 327-0671, Monday - Friday from 8 a.m. 6 p.m.
More informationOUTLINE OF MEDICARE SUPPLEMENT COVERAGE
A Medicare Supplement Program Basic, including 100% Part B coinsurance A B C D F F * G Basic, including Basic, including Basic, including Basic, including Basic, including 100% Part B 100% Part B 100%
More information