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 |
Medicare copayment or coinsurance |
$0 |
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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 |
First 3 pints of blood, or blood derivatives, unless replaced or paid for under Part B benefit |
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 |
20% of Medicare allowance after meeting the Part B deductible |
100% of the Part B deductible |
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Part B Excess Charges Above Medicare approved amounts. |
$0 |
$0 |
100% |
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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 |
20% of Medicare allowance after meeting the Part B deductible |
100% of the Part B deductible |
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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 |
80% to lifetime maximum of $50,000 after initial $250 |
Initial $250 then 20% up to the $50,000 lifetime Maximum and any amount over that Maximum |
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