Hospital Services (Medicare Part A)
| Benefit: | Medicare Pays | The Plan Pays | You Pay | ||||||
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Hospitalization Semiprivate room and board, general nursing and miscellaneous services and supplies. Items not covered by Medicare Part A, including personal comfort items, private duty nurse, non-emergency services in hospital that does not participate in Medicare, and charges exceeding Florida Blue allowance. |
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Skilled Nursing Facility Care You must meet Medicare's requirements, including having been in a hospital for at least 3 days and entered a Medicare-approved facility within 30 days of leaving the hospital. |
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Hospice Care
Available as long as doctor certifies terminal illness and services are elected. |
All but a very limited copayment or coinsurance for outpatient drugs and inpatient respite care |
50% of Medicare copayment or coinsurance |
50% of Medicare copayment or coinsurance |
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Home Health Care Medicare-approved services - medically necessary skilled care services and medical supplies |
100% of Medicare allowance |
$0 |
$0 |
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Blood (Part A and Part B) Medicare Part A (Hospital Insurance) covers blood you get as a hospital inpatient. Medicare Part B (Medical Insurance) covers blood you get as a hospital outpatient. |
All costs except non-replacement fees (Blood deductible) for first 3 pints each calendar year |
50% for the first 3 pints of blood, or blood derivatives, unless replaced or paid for under Part B benefit |
50% for the first 3 pints of blood and Up to 100% of the Part B deductible |
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Medical Services (Medicare Part B)
*See any doctor or specialist that accepts Medicare
| Benefit: | Medicare Pays | The Plan Pays | You Pay |
|---|---|---|---|
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Physician Services Inpatient and outpatient medical services and supplies at a hospital, physical therapy, and ambulance, etc. Charges that exceed Medicare allowance are not covered. |
80% of Medicare allowance for preventive care and routine services |
10% of Medicare allowance for approved preventive services, 10% of Medicare allowance after meeting the Part B deductible for routine services |
100% above Medicare approved amounts for preventive services, 100% of the Part B deductible and remaining 10% of Medicare allowance for routine services |
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Part B Excess Charges Above Medicare approved amounts. |
$0 |
$0 |
100%; not credited toward annual out-of-pocket expense limit |
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Durable Medical Equipment (DME) Medically necessary medical equipment that your doctor prescribes for use in your home. Charges that exceed Medicare allowance are not covered |
80% of Medicare allowance |
10% of Medicare allowance after meeting the Part B deductible |
10% of remaining Medicare allowance after initial 100% of the Part B deductible has been met |
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Foreign Travel (Not covered by Medicare) Medically necessary emergency services beginning during the first 60 days of each trip outside the U.S.A. First $250 each calendar year and remainder of charges |
$0 |
$0 |
100% |
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Monthly APO Discount Price: You must choose the Monthly Bank Draft option during the application process to receive the APO discounted price. If you choose another method of payment, you will be billed at the regular price. The APO discount will not apply to the first month's payment. An email address is required for automatic payment option setup. Communications related to your payment will be sent electronically to this address.