Bob Bell
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Medicare Supplement Chart

 

These charts show the benefits included in each of the Standard Medicare Supplement plans. Every company must make available Plan “A.” Some Plans may not be available in your State.

Basic Benefits:
» Hospitalization:
Part A coinsurance plus coverage for 365 days after Medicare benefits end.
» Medical Expenses: Part B coinsurance (generally 20% of Medicare Approved Expenses) or, copayments for hospital outpatient services. Plans K, L and N require insureds to pay a portion of coinsurance or copayments.
» Blood: First three pints of blood each year.
» Hospice: Part A Coinsurance.

Plan A Plan B Plan C/C* Plan D Plan F/F*
Basic, Including 100%
Part B Coinsurance
Basic, Including 100%
Part B Coinsurance
Basic, Including 100%
Part B Coinsurance
Basic, Including 100%
Part B Coinsurance
Basic, Including 100%
Part B Coinsurance*
    Skilled Nursing Facility
Coinsurance
Skilled Nursing Facility
Coinsurance
Skilled Nursing Facility
Coinsurance
  Part A Deductible Part A Deductible Part A Deductible Part A Deductible
    Part B Deductible   Part B Deductible
        Part B Excess at 100%
    Foreign Travel Emergency Foreign Travel Emergency Foreign Travel Emergency
Plan G Plan K Plan L Plan M Plan N
Basic, Including 100%
Part B Coinsurance
Hospitalization and preventative care
paid at 100%;
other basic benefits
paid at 50%
Hospitalization and preventative care
paid at 100%;
other basic benefits
paid at 75%
Basic, Including 100% Part B Coinsurance Basic, including 100% Part B Coinsurance except up to $20 copayment for office visit and up to $50 copayment for ER
Skilled Nursing Facility
Coinsurance
50% Skilled
Nursing Facility
Coinsurance
75% Skilled
Nursing Facility
Coinsurance
Skilled Nursing Facility
Coinsurance
Skilled Nursing Facility
Coinsurance
Part A Deductible 50% Part A Deductible 75% Part A Deductible 50%Part A Deductible Part A Deductible
         
Part B Excess (100%)        
Foreign Travel Emergency     Foreign Travel Emergency Foreign Travel Emergency
  Out of Pocket Limit ($4,800); paid at 100% after limit is reached Out of Pocket Limit ($2,400); paid at 100% after limit reached    

*Plans C and F also have an option called a High Deductible Plan. This High Deductible Plan pays the same benefits as Plan F after one has paid a calendar year $2,110 deductible. Benefits from High Deductible Plan F will not begin until out-of-pocket expenses exceed $2,110. Out-of-pocket expenses for this deductible are for expenses that would ordinarily be paid by the policy. These expenses include the Medicare Deductibles for Part A and Part B, but do not include the plan’s separate foreign travel emergency deductible, currently $250.