Part A Hospital Services A F G 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)
  • The inpatient deductible is $1736 for each benefit period
  • Days 1-60: Medicare covers 100%
  • Days 61-90: You are responsible for $434 per day
  • Days 91 until 60 day lifetime reserve is used up: Your responsibility is $868 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 A F G N
Part B Deductible ($283)


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 A F G N
Out of Pocket Limit NA NA NA NA
Hospice coverage
Foreign Travel Emergency
Monthly Rates & Brochures A F G N
UHC 187.82 317.98 248.26 210.54
United World Life 225.39 401.41 326.90 211.37
United World Life 197.79 290.87 232.84 173.14
Choosing a Medigap Policy
Prepared for
Zip code: 92804
Age: 70

UHC rates based on Part B effective less than 10 years
Contact us
(800) 987-1234
michael@lujan.com
CA Ins Lic 1234567