A |
|
|
High Deductible F
You Pay the First $1860
|
|
You Pay $1,024 |
Plan Pays Medicare Part A
Deductible, $1,024 |
Plan Pays Medicare Part A
Deductible, $1,024 |
After you meet the deductible; Plan Pays
Medicare Part A Deductible, $1,024 |
Plan Pays Medicare Part A
Deductible, $1,024 |
| Plan Pays Medicare Part A |
| Hospitalization for Days |
| 1-60 Except Deductible, |
| $256/ day for day #61-90, |
| $512/day for day 91-150 |
|
| Plan Pays Medicare Part A |
| Hospitalization $256/day for |
| day 61-90, $512/day for day |
| 91-150 |
|
| Plan Pays Medicare Part A |
| Hospitalization $256/day for |
| day 61-90, $512/day for day |
| 91-150 |
|
| After you meet the deductible; |
| Plan Pays Medicare Part A |
| Hospitalization $256/day 61-90 |
| $512/day for day 91-150 |
|
| Plan Pays Medicare Part A |
| Hospitalization $256/day for |
| day 61-90, $512/day 91-150 |
|
You pay $128/day for day 21-100
Skilled Nursing You Pay Part B
Deductible, $135
Plan Pays Medicare Part B 20% of approved amounts
You Pay all excess charges
Plan Pays 20% of Medicare approved amount of home health care, you pay deductible $128
No Foreign Travel Coverage |
| |
|
Plan Pays Medicare Part A
Skilled Nursing up to $128 day for 21-100th a day
You Pay Part B
Deductible, $135
Plan Pays Medicare Part B 20% of approved amounts
You Pay all Excess Charges
Plan Pays 20% of Medicare approved amount of home health care, you pay deductible
$128 Plan Pays 80% up to $50,000 of the 1st 60 days of foreign travel
Emergency Costs
(You pay $250, 20% & $ over $50,000)
|
|
Plan Pays Medicare Part A
Skilled Nursing up to $128day for 21-100th a day
Plan Pays Medicare Part B
Deductible, $135
Plan Pays Medicare Part B
20% of approved amounts
Plan Pays Medicare Part B100% of Excess chgs aboveMedicare approved amount
Plan Pays Medicare deductible and 20% of Medicare aprroved health care, you pay deductible amount for home health
Plan Pays 80% up to $50,000 of the 1st 60 days of foreign travel Emerg. Costs
(You pay $250, 20% & $ over $50,000) |
|
After you meet the deductible;
Plan Pays Medicare Part A
SkilledNursing up to $128/day for 21-100th day
After you meet the deductible;
PlanPlan Pays Medicare Part B
Deductible, $135
After you meet the deductible;
Plan Pays Medicare Part B 10% approved amounts
After you meet the deductible;
Plan Pays Part B 100% of excess chgs of above Medicare approved amount
After you meet the deductible;
Plan PaysMedicare deductible & 20% of Medicare approved amount for home health care
After you meet the deductible; Plan Pays 80% up to $50,000 of the 1st 60 days offoreign travel emerg. Costs (you pay $250, 20% & $ over $50,000) |
|
Plan Pays Medicare Part A
Skilled Nursing up to $128 day for 21-100th day
You Pay $135 Deductible
Plan Pays Medicare Part B
10% of approved amount Plan Pays Medicare Part B
80% of Excess charges above Medicare approved amount
Plan Pays 20% of Home HealthCare & up to 8 add'l weeks of at Home Recovery to a max $40/per visit $1,600/year
Plan Pays 80% up to $50,000 of the 1st 60 days of foreign travel Emerg. Costs (You Pay$250, 20% & $ over $50,000) |
|
**** Rates Effective as of 10/15/09 - Rates are subject to change without notice. Please contact The Washwick Agency, Inc. for current rates
**Paying the premium quarterly, semi annually or annually will reduce the cost
**This is a summary and is subject to actual rate and benefit information from the Center for Medicare and Medicade Services and First United American Life Insurance Co |
