$20 & $50 Copay Plan | 50% Cost Sharing Plan | 75% Cost Sharing Plan | Basic Plan | Extended Basic Plan | High Deductible Plan | |
---|---|---|---|---|---|---|
Monthly Cost (Premium) | (See policies) | Medigap 50% Cost Sharing Plan | Medigap 75% Cost Sharing Plan | (See policies) | (See policies) | (See policies) |
Hospital (Part A) Deductible | $0 | $816 | $408 | $1,632 | $0 | $0 |
Medical (Part B) Deductible | $240 | $240 | $240 | $240 | $240 | $240 |
Part B Copays/Coinsurance | $0 with some $20 and $50 copays | 10% up to $7,060 | 5% up to $3,530 | $0 | $0 | $0 after $2,800 deductible |
Hospital Stays | $0 for Days 1-150, All costs after | $816 for Days 1-60, $0 for Days 61-150, All costs after | $408 for Days 1-60, $0 for Days 61-150, All costs after | $1,632 for Days 1-60, $0 for Days 61-150, All costs after | $0 for Days 1-150, All costs after | $0 for Days 1-150, All costs after |
Skilled Nursing Facility | $0 for Days 1-100, All costs after | $0 for Days 1-20, $102 for Days 21-100, All costs after | $0 for Days 1-20, $51 for Days 21-100, All costs after | $0 for Days 1-100, All costs after | $0 for Days 1-120, All costs after | $0 for Days 1-100, All costs after |
Blood (during a hospital stay) | $0 | 50% of cost for first 3 pints, $0 after | 25% of cost for first 3 pints, $0 after | $0 | $0 | $0 |
Hospice Care | $0 | 50% of Medicare copay/coinsurance | 25% of Medicare copay/coinsurance | $0 | $0 | $0 |
Home Health Care | $0 | $0 | $0 | $0 | $0 | $0 |
Durable Medical Equipment | $240 (Part B deductible), $0 after | $240 (Part B deductible), 10% of cost after | $240 (Part B deductible), 5% of cost after | $240 (Part B deductible), $0 after | $240 (Part B deductible), $0 after | $240 (Part B deductible), $0 after |
Covered Part B Services | $240 (Part B deductible), $0 after | $240 (Part B deductible), 10% up to $7,060, $0 after | $240 (Part B deductible), 5% up to $3,530, $0 after | $240 (Part B deductible), $0 after | $240 (Part B deductible), $0 after | $240 (Part B deductible), $0 after |
Preventive Services (covered by Medicare) | $0 | $0 | $0 | $0 | $0 | $0 |
Preventive Services (not covered by Medicare) | All costs | All costs | All costs | Generally all costs | Balance after Medigap policy pays $120 | Balance after Medigap policy pays $120 |
Part B Excess Charges | All costs | All costs | All costs | All costs | $0 | All costs |
Blood (outside a hospital stay) | $240 (Part B deductible), $0 after | 50% of cost for first 3 pints, $240 (Part B deductible), 10% after | 25% of cost for first 3 pints, $240 (Part B deductible), 5% after | $240 (Part B deductible), $0 after | $240 (Part B deductible), $0 after | $240 (Part B deductible), $0 after |
Tests for Diagnostic Services | $0 | $0 | $0 | $0 | $0 | $0 |
Physical Therapy (when covered by Medicare) | $0 | $0 | $0 | $0 | $0 | $0 |
Outpatient Mental Health Services (when covered by Medicare) | $0 | $0 | $0 | $0 | $0 | $0 |
Foreign Travel Emergency | $250 then 20% | All costs | All costs | 20% | 20% | $0 |
We are glad to be afforded the opportunity to assist residents of Minnesota, Wisconsin, and North Dakota in the selection of a health plan. Note that if you fall outside of this service area we hope to still be able to assist you in finding someone who can help.
We do not offer every plan available in your area. Currently we represent 10 organizations which offer 64 products in your area. Please contact Medicare.gv or 1-800 MEDICARE or your local State Health Insurance Program to get information on all of your options.