Plan Benefits Comparison Grid
Medicare supplement insurance can only be sold in standard plans. This chart shows the benefits included in each plan that can be sold on or after June 1, 2010. Every insurance company must offer Plan A. Some plans may not be available.
| Plan | A | B1 | C1 | D | F / High-deductible F2 / Innovative Plan F3 |
|---|---|---|---|---|---|
| Coverage | Basic, including 100% Part B coinsurance | Basic, including 100% Part B coinsurance | Basic, including 100% Part B coinsurance | Basic, including 100% Part B coinsurance | Basic, including 100% Part B coinsurance* |
| Skilled nursing facility coinsurance | - | - | Yes | Yes | Yes |
| Part A deductible covered | - | Yes | Yes | Yes | Yes |
| Part B deductible covered | - | - | Yes | - | Yes |
| Part B excess | - | - | - | - | 100% |
| Foreign travel emergency coverage | - | - | Yes | Yes | Yes |
| Out-of-pocket limit | - | - | - | - | - |
1 Plan not currently not offered by Health Net.
2 High Deductible Plan F pays the same benefits as Plan F after one has paid a calendar year $2,800 deductible. Benefits from High Deductible Plan F will not begin until out-of-pocket expenses exceed $2,800. Out-of-pocket expenses for this deductible are expenses that would ordinarily be paid by this policy. These expenses include Medicare deductibles for Parts A and B but do not include the plan's separate foreign travel emergency deductible.
3 Innovative Plan F includes additional benefits not contained in other standardized Medicare Supplement Plans.
| Plan | G / High Deductible Plan G4 Innovative Plan G5 | K1 | L1 | M1 | N |
|---|---|---|---|---|---|
| Coverage | Basic, including 100% Part B coinsurance | Hospitalization and preventive care paid at 100%; other basic benefits paid at 50% | Hospitalization and preventive care paid at 100%; other basic benefits paid at 75% | Basic, including 100% Part B coinsurance | Basic, including 100% Part B coinsurance, except up to $20 copayment for office visit, and up to $50 copayment for ER |
| Skilled nursing facility coinsurance | Yes | 50% | 75% | Yes | Yes |
| Part A deductible covered | Yes | 50% | 75% | 50% | Yes |
| Part B deductible covered | - | - | - | - | - |
| Part B excess | 100% | - | - | - | - |
| Foreign travel emergency coverage | Yes | - | - | Yes | Yes |
| Out-of-pocket limit | - | $7,060; paid at 100% after limit reached | $3,530; paid at 100% after limit reached | - | -
|
1 Plan not currently offered by Health Net.
4 High Deductible Plan G pays the same benefits as Plan G after one has paid a calendar year $2,800 deductible. Benefits from High Deductible Plan G will not begin until out-of-pocket expenses exceed $2,800. Out-of-pocket expenses for this deductible are expenses that would ordinarily be paid by this policy. These expenses include Medicare deductibles for Parts A and B but do not include the plan's separate foreign travel emergency deductible.
5 Innovative Plan G includes additional benefits not contained in other standardized Medicare Supplement Plans.