CDA Insurance Services, LLC offers plans A, C, D, E, F, G
and I. The following chart provides a brief description of some of the 2005
benefits for these plans.
What Medicare leaves you to pay for
each benefit period
What a Medicare supplement plan pays
Plan Designs
A
C
D
E
F
G
I
Part A
Hospital care
$912 for a hospital stay of 1-60 days (first-day deductible)
$912
$228 per day for 61st-90th day in the hospital
$228 per day
$456 per day for 91st-150th day in the hospital
$456 per day
100% of bills after 150th day in the hospital-unlimited
dollar amount
100%
Skilled nursing facility care
$114.00 per day for 21st-100th day of a skilled nursing-facility
stay
$114.00 per day
Part B
Calendar-year deductible
$110
$110 Part B deductible
Physician services and
supplies
20% of Medicare-eligible charges for physician services
and supplies (after $110 yearly deductible)
20% of Medicare-eligible charges (after $110 yearly
deductible)-unlimited dollar amount
Excess charges
Up to balance-billing limit
100%
80%
100%
Charges for the first 3 pints of blood plus 20% of approved
amount for additional pints medically necessary
Charges for the first 3 pints of blood plus 20%
of approved amount for additional pints medically necessary
Emergency care in a foreign country
100% of bills for emergency care in a foreign country
80% of Medicare-eligible expenses (after $250 yearly
deductible)
At-home recovery-not covered by Medicare
Not covered by Medicare
Actual approved charges-up to $40 per visit for
up to 7 visits per week
Preventive care
Not covered by Medicare
Up to $120 of preventive care
Prescription Drugs
Not covered by Medicare
$250 deductible, plan pays 50%, up to $1,250 per
year
Asuris
NW Health
