Medicare Supplement plan benefits do not vary between insurance companies. We offer five standardized plans. Use this chart to help you determine which plan best meets your needs:
| Items Not Covered By Medicare |
Covered by Senior Blue® |
|
A |
C |
E |
F |
L |
| Part A Hospital Services |
|
|
|
|
|
| Part A Deductible |
|
X |
X |
X |
X (75%) |
| Copayment for days 61-90 in a hospital |
X |
X |
X |
X |
X |
| Copayment for days 91-150 in a hospital |
X |
X |
X |
X |
X
|
| 100% of Medicare-allowable expenses for additional 365 days after
Medicare hospital benefits stop completely |
X |
X |
X |
X |
X |
| Calendar year blood deductible (first 3 pints of blood) if the deductible
is not met by the replacement of blood |
X |
X |
X |
X |
X (75%) |
| Copayment for 21-100 days in a skilled nursing facility |
|
X |
X |
X |
X (75%) |
| Part B Physician and Medical Services |
|
|
|
|
|
| $131 Part B deductible |
|
X |
|
X |
|
| 20% of Medicare-approved amount after $131 Part B deductible is met |
X |
X |
X |
X |
X (75%) |
| 100% of Medicare Part B excess charges |
|
|
|
X |
|
| Additional Benefits Not Covered by Medicare |
|
|
|
|
|
| Benefits for medically necessary emergency care received in a foreign
country |
|
X |
X |
X |
|
| Out-of-Pocket Annual Limit |
|
|
|
|
X |
Please refer to your Senior Blue Outline of Coverage for additional information.
