Medicare Supplement Plan K Beginning 06/01/2010 including 2011 updated information

Choose a letter to see the plan summary.

Modernized Plan K
MEDICARE (PART A) - HOSPITAL SERVICES - PER BENEFIT PERIOD

* A benefit period begins on the first day you receive service as an inpatient in a hospital and ends after you have been out of the hospital and have not received skilled care in any other facility for 60 days in a row.

Service:

HOSPITALIZATION*
Semiprivate room and board, general nursing and miscellaneous services and supplies:

MEDICARE PAYS

PLAN PAYS

YOU PAY**▲

First 60 days

All but $1,676

$838 (Part A Deductible)

$838**▲

61st through 90th day

All but $419 a day

$419 a day

91st day and after:

While using 60 lifetime reserve days

All but $838 a day

$838 a day

Once lifetime reserve days are used:

Additional 365 days

100% of Medicare Eligible Expenses

$0**

Beyond the Additional 365 days

All costs

Service:

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 after leaving the hospital:

First 20 days

All approved amounts

21st through 100th day

All but $209.50 a day

Up to $104.75 a day

$104.75 per day**▲

101st day and after

All costs

Service:

BLOOD

First 3 pints

50%

50%**▲

Additional amounts

100%

Service:

HOSPICE CARE
Available as long as you meet Medicare's requirements, your doctor certifies you are terminally ill and you elect to receive these services.

Outpatient Prescription Drugs

All but $5

50% co-payment / co-insurance

50% Medicare co-payment/coinsurance**▲

Inpatient Respite Care

All but 5%

50% of Medicare's approved amount

50% of Medicare's approved amount**▲

**NOTICE: When your Medicare Part A hospital benefits are exhausted, the insurer stands in the place of Medicare and will pay whatever amount Medicare would have paid for up to an additional 365 days as provided in the policy's "Core Benefits." During this time the hospital is prohibited from billing you for the balance based on any difference between its billed charges and the amount Medicare would have paid.

Modernized Plan K
MEDICARE (PART B) - MEDICAL SERVICES - PER CALENDAR YEAR*

* Once you have been billed $257 of Medicare-Approved amounts for covered services (which are noted with an asterisk), your Medicare Part B Deductible will have been met for the calendar year.

Service:

MEDICAL EXPENSES - In or Out of the Hospital and Outpatient Hospital Treatment,
such as Physician's services, inpatient and outpatient medical and surgical services and supplies, physical and speech therapy, diagnostic tests, durable medical equipment:

MEDICARE PAYS

PLAN PAYS

YOU PAY**▲

First $257 of Medicare Approved Amounts*

$257

Preventive Benefits for Medicare Covered Services

Generally 75% or more of Medicare approved amounts

Remainder of Medicare approved amounts.

All cost above Medicare approved amounts

Remainder of Medicare Approved Amounts

Generally 80%

Generally 10%

Generally 10%**▲

Part B Excess Charges (Above Medicare Approved Amounts)

All cost (and they don't count toward annual out of pocket limit of $7220

Service:

BLOOD

First 3 pints

50%

50%**▲

Next $257 of Medicare Approved Amounts*

$257 (Part B Deductible)**▲

Remainder of Medicare Approved Amounts

80%

10%

Generally 10%**▲

Service:

CLINICAL LABORATORY SERVICES

Tests for Diagnostic Services

100%

PARTS A & B*

Service:

HOME HEALTH CARE
Medicare Approved Services:

MEDICARE PAYS

PLAN PAYS

YOU PAY*

Medically necessary skilled care services and medical supplies

100%

Durable medical equipment: Medicare-approved services

$257.00**▲

Remainder of Medicare Approved Amounts

80%

10%

10%**▲

Annual out-of-pocket limit

$7220**▲

* This plan limits your annual out-of-pocket payments for Medicare-approved amounts to $7220 per calendar year. However, this limit does NOT include charges from a provider that exceed Medicare-approved amounts (these amounts are called " Excess Charges") and you will be responsible for paying the difference in the amount charged by your provider and the amount paid by Medicare for the item of service.

**▲ You will pay half the coat-sharing until you meet the annual out-of-pocket limit of $7220 each calendar year. The amounts that count toward your annual limit are noted with the (**▲)symbol's in the chart above. Once you meet the annual limit, the plan pays 100% of the co-payment and co-insurance for the rest of the calendar year. However, this limit does NOT include charges from your provider that exceed Medicare-approved amounts (these amounts are called " Excess Charges") and you will be responsible for paying the difference in the amount charged by your provider and the amount paid by Medicare for the item of service.