Plans_and_Premiums

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					Medicare Supplemental Insurance Plans
         (also called Medigap Plans)                          A       B       C            D         E         F/F+          G        H            I            J       K           L
Part A Copayments: $238/day for hospital days 61-90;
$476 for lifetime reserve hospital days 91-150; an
additional 365 hospital days of coverage over a lifetime;     ⌧    ⌧            ⌧ ⌧                  ⌧         ⌧            ⌧          ⌧          ⌧            ⌧
the first 3 pints of blood
Part B Copayments: 20% for doctor visits


Hospital Deductible of $952 per benefit period.
                                                                   ⌧            ⌧ ⌧                  ⌧         ⌧            ⌧          ⌧          ⌧            ⌧
Skilled Nursing Facility Copayments: $119/day for days
21-100.
                                                                                ⌧ ⌧                  ⌧         ⌧            ⌧          ⌧          ⌧            ⌧
Part B Deductible of $124 per calendar year.
                                                                                ⌧                              ⌧                                               ⌧
Medicare Part B Charges in excess of approved amount.                                                         100%       80%                     100%      100%
Treatment outside the US: 80% of cost of emergency
medical treatment for the first two months of the trip
after a $250 deductible with a lifetime limit of $50,000 in                     ⌧ ⌧              ⌧             ⌧            ⌧          ⌧          ⌧            ⌧
coverage.

Home Care Assistance: up to $1600 per year for
assistance with activities of daily living while recovering
                                                                                        ⌧                                   ⌧                     ⌧            ⌧
from an illness, injury or surgery.
Preventive Care Measures: up to $120 per year for
preventive health care such as serum cholesterol or
                                                                                                     ⌧                                                       ⌧
diabetes screenings, thyroid function or hearing tests or a
physical exam.
F+ offers all the benefits of Plan F only after a high deductible is met.
 H, I and J Plans, which used to include drug benefits, can no longer be sold with drug benefits to Medicare beneficiaries enrolled in or eligible for Medicare Prescription Drug coverage starting
January 1, 2006. Medicare beneficiaries who held Plans H, I or J in 2005 will be penalized if they delay enrollment in a creditable Medicare Prescription Drug Plan.
Medicare Premiums: Part A (Hospital Insurance) is premium-free for most Social Security recipients; $216 per month for those witah 30-5DTqaryters ofcoverage sTj0-.0002 Tc 0.04452Tw 12.92350 T
                                    Medicare Supplemental (Medigap) Insurance Monthly Premiums#
                                          A     B    C      D       E     F/F+ G      H      I                                                                  J          K            L
American Progressive Life & Health Ins       $128.57*   $187.14*    $240.84*      $218.26*    $211.88*     F$249.84*     $227.07*
                                                                                                                    +
Co of NY [www.amerprog.com]                                                                                F+$99.52*
800-332-3377 or 914-934-8300
EmpireHealthChoice Assurance dba             $105.66   $127.29   $171.77                                    $172.32                  $190.13
Empire BC/BS [www.empireblue.com]            ($316.98) ($381.87) ($515.31)                                 ($516.96)                 ($570.39)
800-261-5962 (bills quarterly)
First United American                        $127       $207        $244          $227                     F$251         $243
Life Insurance Company                                                                                     F+$76+
P.O. Box 3125, Syracuse, NY 13220-3125
315-451-2544 [www.firstunitedamerican.com]
Group Health Inc. (GHI) [www.ghi.com]        $140.52    $170.57     $205.84
800-444-2333
HealthNow New York Inc. dba Blue Shield      $125.28    $167.52     $187.92                                                          $160.97
of Northeastern NY [www.healthnowny.com]
518-453-4600 or 800-888-1238
Mutual of Omaha [www.mutualofomaha.com]      $124.27,   $194.32,                                           $202.59,      $123.52,
800-775-6000 or 402-342-7600                 $131.30    $205.37                                            $214.12       $130.50
State Farm Mutual Auto [www.statefarm.com]   $162.80    $217.71     $251.97                                $277.37
866-855-1212
United Health Care’s AARP                     $90.25,     $123.50, $141.25,          $132.75, $132.75,       $142,        $133.50, $141.25,     $142.50, $161,          $65.75,    $91.50,
[www.aarphealthcareoptions.com ]              $105        $143.50     $164.25        $154.25    $154.25      $165         $155      $164        $165.50       $187      $76.25     $106.25
800-523-5800 or 888-687-2277
#
  Effective in Zip Codes beginning with 120-123 and 129-129. Some plans have different rates depending on where you live. Where two premiums are listed for the same coverage, please call the
insurer for the rate which applies to you.
  Without Drug Coverage.
Plans K & L have coinsurance and out-of-pocket limits that change annually. Call the plan for details.
*There is a one-time $25 policy fee charged at issue.
+
  There is an annual deductible in 2006 of $1790 to be met before benefits begin with an F+ High Deductible Plan.
 New York’s prescription plan for seniors, Elderly Pharmaceutical Insurance Coverage (EPIC) is available to New Yorkers at least 65 years of age with annual income below
 $35,000 for an individual; $50,000 for couples. Enrollees with income below $20,000 ($26,000 for a couple) pay annual fees based on income from $8 to $300. Fees can be paid
 quarterly. Deductibles of $530 to $1,715 are available for individuals with annual incomes above $20,000; couples above $26,000. Enrollees will pay copayments of $3 up to $20
 per prescription. Call 1-800-332-3742 for an application. Medicare beneficiaries under 65 can call the ElderSource Line for other options.
Questions? Call the ElderSource Line at 518-465-1903 Monday-Friday, 8:30 AM- 12:30 PM                                                     Courtesy of Senior Services of Albany, 11/06
                              The ElderSource Line is partially funded by United Way of Northeastern New York, Inc. and Senior Services of Albany Foundation.