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Notice of Changes in Medicare

The following chart briefly describes the modifications in Medicare Part A & B and in your Medicare supplement coverage. Please read this carefully!

Medicare Part A services and supplies 

Medicare Part A Benefits
Services per benefit period Medicare benefits Your Medicare supplement coverage
In 2016, Medicare paid... Effective 1/1/2017, Medicare pays... In 2016, your coverage paid... Effective 1/1/2017, your coverage pays...
Hospitalization

Semi-private room and board, miscellaneous hospital services and supplies, such as drugs, X-rays, lab tests and operating room

All but $1,288 for first 60 days

All but $1,316 for the first 60 days

$1,288 for first 60 days (except Basic and Plan A)

 

Plan L paid $966 (75% of Part A deductible) for first 60 days

$1,316 for first 60 days (except Basic and Plan A)

 

Plan L pays $987 (75% of Part A deductible) for first 60 days

All but $322 a day for 61st - 90th days

All but $329 a day for 61st - 90th days

$322 a day for 61st - 90th days

$329 a day for 61st - 90th days

All but $644 a day for 91st - 150th days (if you choose to use 60 nonrenewable lifetime reserve days)

All but $658 a day for 91st - 150th days (if you choose to use 60 nonrenewable lifetime reserve days)

$644 a day for 91st - 150th days

$658 a day for 91st - 150th days

Nothing beyond 150 days

Nothing beyond 150 days

Lifetime maximum of 365 additional days beyond 150th day paid at 100% (except Basic paid at 90%)

Lifetime maximum of 365 additional days beyond 150th day pays at 100% (except Basic pays at 90%)

Blood All costs except non-replacement fees (blood deductible) for first 3 pints each calendar year All costs except non-replacement fees (blood deductible) for first 3 pints each calendar year

First 3 pints

Plan L paid 75% for first 3 pints

First 3 pints

Plan L pays 75% for first 3 pints

Skilled nursing facility care

There is a 3-day prior hospital confinement requirement

There is a 3-day prior hospital confinement requirement

There is a 3-day prior hospital confinement requirement

There is a 3-day prior hospital confinement requirement

100% of costs for first 20 days

100% of costs for first 20 days

Nothing for first 20 days

Nothing for first 20 days

All but $161 a day for 21st - 100th days

All but $164.50 a day for 21st - 100th days

$161 a day for 21st - 100th days (except Plan A)

Plan L paid $120.75 per day for 21st-100th days

$164.50 a day for 21st - 100th days (except Plan A)

Plan L pays $123.37 per day for 21st-100th days

Nothing beyond 100 days

Nothing beyond 100 days

Programs I, II & III paid 30 additional days per benefit period beyond 100 days

Basic and Plans A, C, E, F, J and L paid nothing beyond 100th day

Programs I, II & III pay 30 additional days per benefit period beyond 100 days

Basic and Plans A, C, E, F, J and L pay nothing beyond 100th day

Depending on your Medicare supplement plan, you have coverage to help pay for health care costs and some services not covered by Medicare. Refer to your benefits policy for your plan details.

Medicare Part B services and supplies

Medicare Part B Benefits
Services Medicare benefits Your Medicare supplement coverage
In 2016, Medicare paid... Effective 1/1/2017, Medicare pays... In 2016, your coverage paid... Effective 1/1/2017, your coverage pays...
Physician and Outpatient Services and Supplies

(Including Medicare Part B Drugs)

80% of approved amounts (after $166 deductible per calendar year)

80% of approved amounts (after $183 deductible per calendar year

Basic & Plans I, A and E: 20% of approved amount after $166 annual deductible

Plans II and C: $166 deductible plus 20% of approved amounts

Plans III, F and J: $166 deductible plus 20% of approved amount plus any difference between charge and approved amount (Plan III paid up to our UCR amount)

Plan L: paid 15% of approved amounts after $166 annual deductible

Basic & Plans I, A and E: 20% of approved amount after $183 annual deductible

Plans II and C: $183 deductible plus 20% of approved amounts

Plans III, F and J: $183 deductible plus 20% of approved amount plus any difference between charge and approved amount (Plan III pays up to our UCR amount)

Plan L: pays 15% of approved amounts after $183 annual deductible

Blood

80% of all costs except non-replacement fees (blood deductible) for first 3 pints in each calendar year (after $166 deductible/calendar year)

80% of all costs except non-replacement fees (blood deductible) for first 3 pints in each calendar year (after $183 deductible/calendar year)

$166 deductible and 20% of costs plus first 3 pints (Note: Basic and Plans I, A and E did not pay $166 deductible)

Plan L: paid 75% of the first 3 pints and 15% following

$183 deductible and 20% of costs plus first 3 pints (Note: Basic and Plans I, A and E do not pay $183 deductible)

Plan L: pays 75% of the first 3 pints and 15% following

 

Out-of-pocket limit
blank cell Medicare benefits Your Medicare supplement coverage
In 2016, Medicare paid... Effective 1/1/2017, Medicare pays... In 2016, your coverage paid... Effective 1/1/2017, your coverage pays...
Out-of-pocket limit

Not applicable (Plan L only)

Not applicable (Plan L only)

Plan L: You paid $2,480

Plan L: You pay $2,560