
| Part A Hospital Services | A | B | C | D | F | F-ded | G | G-ded | K | L | M | N |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| The Part A deductible is $1736 per benefit period A benefit period starts when you are admitted to a facility and ends 60 days after you last received inpatient care at any facilityPart A Deductible ($1736) |
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$2950 annual deductible applies You pay all Medicare deductibles, copays and coinsurance until you spend $2950 in a calendar year After that coverage is 100% after ded |
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$2950 annual deductible applies You pay all Medicare deductibles, copays and coinsurance until you spend $2950 in a calendar year After that coverage is 100% after ded |
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$2950 annual deductible applies You pay all Medicare deductibles, copays and coinsurance until you spend $2950 in a calendar year After that coverage is 100% after ded |
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$2950 annual deductible applies You pay all Medicare deductibles, copays and coinsurance until you spend $2950 in a calendar year After that coverage is 100% after ded |
Plan covers 50% of your out of pocket expenses Your share is capped at $5120 per year50% |
Plan covers 75% of your out of pocket expenses Your share is capped at $2560 per year75% |
Plan covers 50% Part A deductible50% | ![]() |
| Covers 365 Additional inpatient days after lifetime reserve has been used up365 days extra Hospital coverage | ![]() |
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| Skilled nursing facility coinsurance | ![]() |
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$2950 annual deductible applies You pay all Medicare deductibles, copays and coinsurance until you spend $2950 in a calendar year After that coverage is 100% after ded |
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$2950 annual deductible applies You pay all Medicare deductibles, copays and coinsurance until you spend $2950 in a calendar year After that coverage is 100% after ded |
Plan covers 50% of your out of pocket expenses Your share is capped at $5120 per year50% |
Plan covers 75% of your out of pocket expenses Your share is capped at $2560 per year75% |
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| 3 Pints of (unreplaced) blood | ![]() |
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$2950 annual deductible applies You pay all Medicare deductibles, copays and coinsurance until you spend $2950 in a calendar year After that coverage is 100% after ded |
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$2950 annual deductible applies You pay all Medicare deductibles, copays and coinsurance until you spend $2950 in a calendar year After that coverage is 100% after ded |
Plan covers 50% of your out of pocket expenses Your share is capped at $5120 per year50% |
Plan covers 75% of your out of pocket expenses Your share is capped at $2560 per year75% |
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| Part B Services | A | B | C | D | F | F-ded | G | G-ded | K | L | M | N |
| Part B Deductible ($283) | ![]() |
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| Medicare covers 80% of Part B claims, you are responsible for 20%Part B Coinsurance | ![]() |
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$2950 annual deductible applies You pay all Medicare deductibles, copays and coinsurance until you spend $2950 in a calendar year After that coverage is 100% after ded |
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$2950 annual deductible applies You pay all Medicare deductibles, copays and coinsurance until you spend $2950 in a calendar year After that coverage is 100% after ded |
Plan covers 50% of your out of pocket expenses Your share is capped at $5120 per year50% |
Plan covers 75% of your out of pocket expenses Your share is capped at $2560 per year75% |
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You pay $20 for Dr. office visits You pay $50 for emergency room visits$20/$50 |
| Doctors who do not take Medicare Assignment can charge 15% above what medicare allows Some Medicare Supplement plans cover that extra 15%Part B Excess Charges |
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| Additional Features | A | B | C | D | F | F-ded | G | G-ded | K | L | M | N |
| Out of Pocket Limit | NA | NA | NA | NA | NA | NA | NA | NA | $5120 | $2560 | NA | NA |
| Hospice coverage | ![]() |
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$2950 annual deductible applies You pay all Medicare deductibles, copays and coinsurance until you spend $2950 in a calendar year After that coverage is 100% after ded |
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$2950 annual deductible applies You pay all Medicare deductibles, copays and coinsurance until you spend $2950 in a calendar year After that coverage is 100% after ded |
Plan covers 50% of your out of pocket expenses Your share is capped at $5120 per year50% |
Plan covers 75% of your out of pocket expenses Your share is capped at $2560 per year75% |
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| Foreign Travel Emergency | ![]() |
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| Monthly Rates & Brochures | A | B | C | D | F | F-ded | G | G-ded | K | L | M | N |
| Aflac | 313.91 | 359.19 | 317.08 | 237.94 | ||||||||
Anthem eff 3/1/2026
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257.17 | S: 483.80 I: Additional benefits included with Anthem Innovative plan rider
See page 21 or 22 in Anthem brochure for details |
366.15 | 401.24 | ||||||||
Anthem to 2/28/2026
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257.17 | S: 446.72 I: Additional benefits included with Anthem Innovative plan rider
See page 21 or 22 in Anthem brochure for details |
319.78 | 350.43 | ||||||||
Blue Shield
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245.00 | About Blue Shield Plan F Blue Shield no longer sells Standard plan F This quote refelects the rate for Plan F Extra Plan F Extra includes all Plan F Standard benefits plus additional "Extra" benefits About Blue Shield Plan F Extra rider
451.00 |
S: 387.00 Extra Rider
E: 405.00 |
334 | ||||||||
| HealthSpring | 299.96 | 414.39 | 326.04 | 118.64 | 264.50 | |||||||
| Continental (Aetna) | 306.29 | 362.19 | 507.55 | 106.29 | 425.00 | 329.95 | ||||||
Health Net to 2/28/2026
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257.00 | 339.00 | S: 368.00 Additional benefits included with Health Net Innovative plan rider
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153.00 | S: 327.00 Additional benefits included with Health Net Innovative plan rider
|
147.00 | 291.00 | |||||
Health Net eff 3/1/2025
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280.00 | 369.00 | S: 401.00 Additional benefits included with Health Net Innovative plan rider
|
166.00 | S: 356.00 Additional benefits included with Health Net Innovative plan rider
|
160.00 | 317.00 | |||||
| Humana | 407.52 | 443.35 | 541.60 | 138.08 | 476.49 | 124.07 | 220.74 | 318.98 | 351.86 | |||
| United American to 4/30/2026 | 216.00 | 320.00 | 447.00 | 406.00 | 474.00 | 102.00 | 396.00 | 102.00 | 183.00 | 260.00 | 338.00 | |
| United American eff 5/1/2026 | 216.00 | 349.00 | 488.00 | 442.00 | 545.00 | 117.00 | 455.00 | 117.00 | 200.00 | 283.00 | 388.00 | |
UHC
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237.75 | 332.00 | 400.50 | 402.50 | 314.25 | 220.50 | 266.50 | |||||
| United World Life | 293.07 | 521.92 | 426.32 | 94.66 | 275.63 | |||||||
| Choosing a Medigap Policy | ||||||||||||
| Continental: Add $20 application fee. | ||||||||||||
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Prepared for Zip code: 92804 Age: 77 |
| Select all that apply |
|
If you are new to Medicare the following monthly discounts
are available for your first year of coverage
|
AflacAflac offers a 10% household premium discount
|
Enrollees who live with another Anthem Medicare Supplement
member may qualify for a household discount.
|
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Blue ShieldYou are eligible for a 7% household premium discount
|
HealthSpring HealthSpring
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Continental LifeContinental Life offers a 5% household premium discount
|
UHC/AARPYou can take 7% off your monthly premiums if
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| Contact us |
| (800) 987-1234 |
| michael@lujan.com |
| CA Ins Lic 1234567 |