Plan L in New Hampshire
2024 Medicare Supplement Insurance Plan (Medigap)
Monthly Premium
$107-$536
Covered Benefits
- Skilled nursing facility
- Part A deductible
- Part B deductible
- Part B excess charges
- Foreign travel emergency
*Monthly costs shown do not include the standard Part B premium. 2024 Medicare Part B premium is $174.70 per month.
Coverage Overview
Part A - Hospital - Deductible
$408
(what you pay)Part B - Medical - Deductible
$240
(what you pay)Part B - Medical - Coinsurance
5%
(what you pay)Coverage Details
Part A Coinsurance
(what you pay)
Hospital stays
Days 1-60: $408 (Part A deductible)
Days 61-90: $0
Days 91-150: $0 while using your 60 lifetime reserve days
Additional 365 days: $0 for Medicare-eligible services
After the additional 365 days: All costs
Skilled nursing facility (for Medicare-covered stays)
Day 1-20: $0
Days 21-100: $51 per day
After 100 days: All costs
Blood (during a hospital stay)
First 3 pints: 25% of cost
After 3 pints: $0
Hospice care
25% of Medicare copay/coinsurance
Part B Coinsurance
(what you pay)
Covered Part B services
First: $240 (Part B deductible)
Then: Generally 10% until you pay a total of $3,530. Then, you'll pay $0 for the rest of the year.
Preventive services
All costs above Medicare-approved amounts
Part B excess charges
All costs (and they do not count toward annual out-of-pocket limit of $3,530)
Blood (outside a hospital stay)
First 3 pints: 25% of cost
After 3 pints: $240 (Part B deductible), then generally 5%
Tests for diagnostic services
$0
Home Healthcare - Part A & B Services
(what you pay)
Home health care (for Medicare-approved services)
$0
Durable medical equipment (covered by Medicare)
First: $240 (Part B deductible)
Then: 5% of cost
Extra Benefits
(what you pay)
Foreign travel emergency
All costs
Insurance Companies Offering This Plan
-
AARP - UnitedHealthcare Insurance Company
-
Transamerica Life Insurance Company
-
United American Insurance Company
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