Plan A Plan B Plan C Plan D Plan F* Plan G Plan K Plan L Plan M Plan N
Plan Details Plan Details Plan Details Plan Details Plan Details Plan Details Plan Details Plan Details Plan Details Plan Details
Basic Benefits Basic Benefits Basic Benefits Basic Benefits Basic Benefits; Hospitilization and preventative care paid at 100% Basic Benefits; Hospitilization and preventative care paid at 100% Hospitilization and preventative care paid at 100%; Other basic benefits paid at 50% Hospitilization and preventative care paid at 100%; Other basic benefits paid at 75% Basic benefits including 100% Part B coinsurance Basic benefits including 100% Part B coinsurance except up to $20 copayment for office visit and up to $50 copayment for ER
Skilled Nursing Facility Coinsurance Skilled Nursing Facility Coinsurance Skilled Nursing Facility Coinsurance Skilled Nursing Facility Coinsurance 50% Skilled Nursing Facility Coinsurance 75% Skilled Nursing Facility Coinsurance Skilled Nursing Facility Coinsurance Skilled Nursing Facility Coinsurance
100% Part A Deductible 100% Part A Deductible 100% Part A Deductible 100% Part A Deductible 100% Part A Deductible 50% Part A Deductible 75% Part A Deductible 50% Part A Deductible 100% Part A Deductible
100% Part B Deductible 100% Part B Deductible
Part B Excess (100%) Part B Excess (100%)
80% Foreign Travel Emergency 80% Foreign Travel Emergency 80% Foreign Travel Emergency 80% Foreign Travel Emergency 80% Foreign Travel Emergency 80% Foreign Travel Emergency
Out of pocket limit of $5,240 paid at 100% after limit reachged Out of pocket limit of $2,620 paid at 100% after limit reachged
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