|
Modernized Plan B 2019
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. |
Service: |
HOSPITALIZATION*
Semiprivate room and board, general nursing and miscellaneous
services and supplies: |
|
MEDICARE PAYS |
PLAN PAYS |
YOU PAY |
First 60
days |
All but $1364 |
$1364 (Part A Deductible) |
$0 |
61st through
90th day |
All but $341 a day |
$341 a day |
$0 |
91st day and
after: |
|
|
|
While using
60 lifetime reserve days |
All but $682 a day |
$682 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 |
Service: |
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 $170.50 a day |
$0 |
Up to $170.50 a day |
101st day
and after |
$0 |
$0 |
All costs |
Service: |
BLOOD
|
First 3
pints |
$0 |
3 pints |
$0 |
Additional
amounts |
100% |
$0 |
$0 |
Service: |
HOSPICE CARE
Available as long as you
meet Medicare's requirements,
your doctor certifies
you are terminally ill
and you elect to receive
these services. |
Outpatient Prescription
Drugs |
All but $5 |
$5 |
$0 |
Inpatient Respite Care |
All but 5% |
5% of Medicare's
approved amount |
$0 |
**NOTICE: When your Medicare Part A hospital benefits are
exhausted, the insurer 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 policy'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 Medicare would have paid. |
|
Modernized Plan B 2019
MEDICARE (PART B) - MEDICAL
SERVICES - PER CALENDAR YEAR* |
* Once you have been billed $185 of Medicare-Approved amounts
for covered services (which are noted with an asterisk), your
Medicare Part B Deductible will have been met for the calendar
year. |
Service: |
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: |
|
MEDICARE PAYS |
PLAN PAYS |
YOU PAY |
First $185 of
Medicare Approved Amounts* |
$0 |
$0 |
$185 (Part B Deductible) |
Remainder of
Medicare Approved Amounts |
Generally 80% |
Generally 20% |
$0 |
Part B
Excess Charges (Above Medicare Approved Amounts) |
$0 |
$0 |
All costs |
Service: |
BLOOD |
First 3
pints |
$0 |
All cost |
$0 |
Next $185 of
Medicare Approved Amounts* |
$0 |
$0 |
$185 (Part B Deductible) |
Remainder of
Medicare Approved Amounts |
80% |
20% |
$0 |
Service: |
CLINICAL
LABORATORY SERVICES |
Blood tests
for Diagnostic Services |
100% |
$0 |
$0 |
|
MEDICARE PARTS A & B |
Service: |
HOME HEALTH
CARE
Medicare Approved Services: |
|
MEDICARE PAYS |
PLAN PAYS |
YOU PAY |
Medically
necessary skilled care services and medical supplies |
100% |
$0 |
$0 |
Durable
medical equipment: |
|
|
|
First $185
of Medicare Approved Amounts* |
$0 |
$0 |
$185 (Part B Deductible) |
Remainder of
Medicare Approved Amounts |
80% |
20% |
$0 |