
| 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) |
![]() |
![]() |
![]() |
![]() |
$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 |
![]() |
$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 |
![]() |
![]() |
![]() |
![]() |
|
|
![]() |
![]() |
![]() |
![]() |
![]() |
$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 |
![]() |
$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 | ![]() |
![]() |
![]() |
![]() |
![]() |
![]() |
![]() |
![]() |
![]() |
![]() |
![]() |
![]() |
| Skilled nursing facility coinsurance | ![]() |
![]() |
![]() |
$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 |
![]() |
$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% |
![]() |
|||
| 3 Pints of (unreplaced) blood | ![]() |
![]() |
![]() |
![]() |
![]() |
$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 |
![]() |
$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% |
![]() |
![]() |
| Part B Services | A | B | C | D | F | F-ded | G | G-ded | K | L | M | N |
| Part B Deductible ($283) | ![]() |
![]() |
||||||||||
| Medicare covers 80% of Part B claims, you are responsible for 20%Part B Coinsurance | ![]() |
![]() |
![]() |
![]() |
![]() |
$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 |
![]() |
$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% |
![]() |
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 | 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 | ![]() |
![]() |
![]() |
![]() |
![]() |
$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 |
![]() |
$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% |
![]() |
![]() |
| Foreign Travel Emergency | ![]() |
![]() |
![]() |
![]() |
![]() |
![]() |
![]() |
![]() |
![]() |
|||
| Monthly Rates & Brochures | A | B | C | D | F | F-ded | G | G-ded | K | L | M | N |
| Aflac | 306.15 | 355.50 | 309.24 | 233.37 | ||||||||
Anthem eff 3/1/2026
![]() |
220.35 | S: 414.57 I: Additional benefits included with Anthem Innovative plan rider
See page 21 or 22 in Anthem brochure for details |
313.74 | 343.81 | ||||||||
Anthem to 2/28/2026
![]() |
220.35 | S: 382.80 I: Additional benefits included with Anthem Innovative plan rider
See page 21 or 22 in Anthem brochure for details |
274.01 | 300.27 | ||||||||
Blue Shield
![]() |
194.00 | 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
361.00 |
S: 309.00 Extra Rider
E: 328.00 |
274 | ||||||||
| Cigna | 256.40 | 354.23 | 278.70 | 101.41 | 226.10 | |||||||
| Continental (Aetna) | 300.71 | 356.02 | 498.63 | 104.29 | 417.42 | 319.62 | ||||||
Health Net to 2/28/2026
![]() |
225.00 | 289.00 | S: 322.00 Additional benefits included with Health Net Innovative plan rider
|
134.00 | S: 288.00 Additional benefits included with Health Net Innovative plan rider
|
127.00 | 250.00 | |||||
Health Net eff 3/1/2025
![]() |
245.00 | 315.00 | S: 350.00 Additional benefits included with Health Net Innovative plan rider
|
146.00 | S: 313.00 Additional benefits included with Health Net Innovative plan rider
|
138.00 | 272.00 | |||||
| Humana | 356.51 | 387.83 | 473.73 | 120.97 | 416.80 | 108.71 | 193.22 | 279.10 | 307.84 | |||
| United American | 205.00 | 299.00 | 410.00 | 369.00 | 434.00 | 89.00 | 360.00 | 89.00 | 174.00 | 246.00 | 306.00 | |
UHC
![]() |
209.22 | 292.16 | 352.44 | 354.20 | 276.54 | 194.04 | 234.52 | |||||
| United World Life | 252.38 | 449.46 | 367.13 | 82.90 | 237.36 | |||||||
| Choosing a Medigap Policy | ||||||||||||
| Continental: Add $20 application fee. | ||||||||||||
|
Prepared for Zip code: 90680 Age: 73 |
| 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.
|
|
Blue ShieldYou are eligible for a 7% household premium discount
|
Cigna Cigna
|
Continental LifeContinental Life offers a 5% household premium discount
|
UHC/AARPYou can take 7% off your monthly premiums if
|
| Contact us |
| (800) 987-1234 |
| michael@lujan.com |
| CA Ins Lic 1234567 |