Benefit | Plan Pays |
---|---|
Preventive care, routine physicals, GYN, routine hearing and vision exams | $15 per visit |
Office visits (sick care/ non-Preventive) |
Full coverage of Medicare deductible and coinsurance after a $15 copayment per visit |
Emergency room | Full coverage of Medicare deductible and coinsurance after a $50 copayment per visit (waived if admitted for observation stay) |
Inpatient hospital care |
After a $50 calendar-quarter copayment: Full coverage of Medicare deductible and coinsurance Full coverage of lifetime reserve day coinsurance Full coverage of up to 365 additional hospital days in your lifetime when Medicare benefits are used up |
Outpatient surgery | Full coverage of Medicare deductible and coinsurance |
CT scans, MRIs, and other imaging tests | Full coverage of Medicare deductible and coinsurance |