Medicare Supplemental Plans

Medicare Standardized Supplemental Plans

Plan A	Plan B	Plan C	Plan D	Plan E	Plan F	Plan G	Plan H	Plan I	Plan J
B a s i c B e n e f i t s
		Skilled Nursing Coinsurance	Skilled Nursing Coinsurance	Skilled Nursing Coinsurance	Skilled Nursing Coinsurance	Skilled Nursing Coinsurance	Skilled Nursing Coinsurance	Skilled Nursing Coinsurance	Skilled Nursing Coinsurance
	Part A Deductible	Part A Deductible	Part A Deductible	Part A Deductible	Part A Deductible	Part A Deductible	Part A Deductible	Part A Deductible	Part A Deductible
		Part B Deductible			Part B Deductible
					Part B Excess (100%)	Part B Excess (80%)		Part B Excess (100%)	Part B Excess (100%)
		Foreign Travel Emergency	Foreign Travel Emergency	Foreign Travel Emergency	Foreign Travel Emergency	Foreign Travel Emergency	Foreign Travel Emergency	Foreign Travel Emergency	Foreign Travel Emergency
			At Home Recovery			At Home Recovery		At Home Recovery	At Home Recovery
							Basic Drugs ($1,250 Limit)	Basic Drugs ($1,250 Limit)	Basic Drugs ($3,000 Limit)
				Preventive Care					Preventive Care

Basic Benefits:

Included in all Plans

Hospitalization:

Part A coinsurance plus coverage for 365 days after Medicare benefits end.

Medical Expenses:

Part B coinsurance (20% of Medicare approved expenses).

Blood:

First three pints of blood each year.

This is an outline of Medicare benefits. This outline does not create or confer any rights. If you have any questions, call Medicare at 1-800-633-4227 for additional help.