Part A Hospital Services G N
The Part A deductible is $1676 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 facility
Part A Deductible ($1676)
  • The inpatient deductible is $1676 for each benefit period
  • Days 1-60: Medicare covers 100%
  • Days 61-90: You are responsible for $408 per day
  • Days 91 until 60 day lifetime reserve is used up: Your responsibility is $826 per day
  • Beyond lifetime reserve: You are responsible for all costs incurred
Hospital Coinsurance
Covers 365 Additional inpatient days after lifetime reserve has been used up365 days extra Hospital coverage
Skilled nursing facility coinsurance
3 Pints of (unreplaced) blood
Part B Services G N
Part B Deductible ($257)

Medicare covers 80% of Part B claims, you are responsible for 20%Part B Coinsurance 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

Additional Features G N
Out of Pocket Limit NA NA
Hospice coverage
Foreign Travel Emergency
Monthly Rates & Brochures G N
Aflac eff 7/1/2025 317.08 237.94
Anthem 319.78 350.43
Blue Shield to 6/30/2025
S: 351.00
Note: Silver Sneakers gym membership is included with all Blue Shield plans.
Additonal benefits with Blue Shield Extra Rider
Foreign Travel - Not covered by Medicare
  • $250 annual deductible, 80% coverage, $50,000 lifetime max (Click the Brochure link, see page 20)
Physician Consultation by Phone or Video Through Teledoc
  • No charge (see brochure page 20)
Over-the-Counter Items through CVS
  • Up to $100 allowance per quarter (see brochure page 20)
Accupuncture and Chiropractic Services (provided by AHS provider network)
  • Up to 20 visits per year, plan pays 100%, see page 21 in brochure for details
Vision Coverage (provided by Vision Service Plan)
  • Exam every 12 months, eyeglasses every 24 months, click the brochure link for details (see page 21)
Hearing Aid Services (provided by Epic Hearing Healthcare)
  • Routine hearing exams, copayments for hearing aids, see page 23 of brochure for details
E: 367.00
317
Blue Shield
S: 387.00
Extra Rider
  • Basic gym access through sliver sneakers fitness program (silversneakers.com)
  • Personal emergency response system
  • Physician consultation by phone or video through Teladoc
  • Over the counter items through CVS (Up to $100 one time use per quarter allowance)
  • The vision benefit includes coverage for exams, frames and lenses ($100 frame allowance)
  • Hearing aid benefit includes an annual hearing aid test and coverage for Vista brand mid-level and premium-level hearing aids for a low copay
  • Acupuncture and chiropractic, up to 20 combined visits per calendar year
  • Identity theft protection
E: 405.00
334
Cigna 326.04 264.50
Continental (Aetna) 425.00 329.95
Health Net
S: 327.00
Additional benefits included with Health Net Innovative plan rider
  • Vision Benefits
  • Routine Eye Exam (In network) - One vision exam every 12 months - $10 Copayment
  • Routine Eye Exam (Out of network) - One vision exam every 12 months - $45 Allowance
  • Frame & Lens Package - available from provider only (Once every 24 Months) - Up to $250 allowance
  • Contact Lenses (includes materials only - once every 24 months) - Up to $250 allowance
  • Medically necessary contact Lenses - Up to $250 allowance
  • Hearing Benefits
  • Routine Hearing Exam - One hearing exam every 12 months
  • Hearing Aid(s) - all sizes and styles offered by Hearing Care Solutions
    • Level 4 - You pay $1580
    • Level 3 - You pay $1125
    • Level 2 - You pay $700
    • Level 1 - You pay $0
See page 44 in Health Net brochure for details
I: 336.00
291.00
Humana476.49 351.86
United American 396.00 338.00
UHC 314.25 266.50
United World Life 355.26 246.10
Choosing a Medigap Policy
Continental: Add $20 application fee.
Prepared for Frank Loughry
Zip code: 92804
Age: 77


UHC rates based on Part B effective less than 10 years
Contact us
7144427931
frank@zaphelp.com
CA Ins Lic