Monthly Premiums
Male - 65 years old
Preferred Rating
$107.65
$116.98
$134.56
$137.27
$52.72
$63.96
$90.06
$85.40
Monthly Premiums
Female - 65 years old
Preferred Rating
$107.37
$116.68
$134.22
$136.93
$52.59
$63.80
$89.83
$85.19
Monthly Premiums
Male - 65 years old
Standard Rating
$159.90
$173.85
$200.14
$204.17
$77.82
$94.60
$133.62
$126.65
Monthly Premiums
Female - 65 years old
Standard Rating
$159.49
$173.41
$199.63
$203.67
$77.62
$94.36
$133.28
$126.33
Benefits
Plan A
Plan B
Plan C
Plan F
High Ded
Plan F
Plan K
Plan L
Plan N
Medicare Part A Coinsurance and Hospital Benefits
Medicare Part A Deductible
50%
75%
Medicare Part B Coinsurance or Co-payment
50%
75%
3
Medicare Part B Deductible
Medicare Part B Excess Charges
Blood (First Three Pints)
50%
75%
Hospice Care Coinsurance or Co-payment
50%
75%
Skilled Nursing Coinsurance
50%
75%
Foreign Travel Emergency (Up to Plan Limits)3
Medicare Preventive Care Part B Coinsurance
Monthly premiums presented include $2 for coupon book billing method. If a policyholder elects either automatic bank withdrawal or recurring credit card transaction as a payment method, the premium
is $2 less.
Medigap Plan F offers a high deductible option. You must pay for Medicare-covered costs up to the high-deductible amount ($2,070 in 2012) before your Medigap policy pays anything
100% part B coinsurance except up to $20 copayment for office visits and up to $50 copayment for ER.
You must also pay a separate deductible for foreign travel emergency ($250 per year).
After you meet your out-of-pocket yearly limit and your yearly Part B deductible ($140 in 2012) the plan pays 100% of covered services for the rest of the calendar year (This applies only to plans K & L)
Modified Plan F offers an individual assistance program, as well as coverage for preventive dental care (available in some states)