Medicare Supplement Insurance — Minnesota

State Farm Medicare Supplement Insurance is designed to cover the gaps in Medicare, helping to pay deductibles, coinsurance and copayment amounts not covered by Medicare. Once you have a Medicare Supplement Plan, both your plan and the Original Medicare Plan will help pay your covered medical expenses, lowering your out-of-pocket costs and giving you the confidence that your health insurance needs are met. And at State Farm we give you the flexibility to choose between different plans to meet your individual needs and budget.

A brief description of the Plans available in your state and the coverage provided by the Plans follows.

Basic Medicare Supplement Policy

• Part A coinsurance, plus coverage after Medicare hospital benefits end
• Hospice coinsurance
• Skilled nursing facility coinsurance
• Home health care coinsurance
• Part B coinsurance
• First three pints of blood each year
• Medical Emergency Care in a Foreign Country — 80% of the billed charges for emergency care that would have been covered by Medicare, if provided in the United States.
• Additional benefits that include, but are not limited to, diabetic self management education, routine cancer screening, reconstructive surgery, and immunizations.

NOTE: The following additional benefits are available by Rider

• Part A inpatient hospital deductible
• Part B deductible coverage
• Part B excess charges coverage — 100% of the excess charge above Medicare's reasonable charge if medical provider does not accept Medicare assignment, subject to Federal/State mandated limit
• Preventive Medical Care coverage, up to $120 per calendar year

Extended Basic Medicare Supplement Policy

• Part A inpatient hospital deductible
• Part A coinsurance, plus coverage after Medicare hospital benefits end
• Hospice coinsurance
• Skilled nursing facility coinsurance
• Home health care coinsurance
• Part B deductible
• Part B coinsurance
• First three pints of blood each year
• Medical services while traveling in a foreign country — 80% of the billed charges for Medicare-eligible expenses. Once $1,000 in out–of–pocket expenses are met during a calendar year, the policy will cover 100% of the remaining expenses for that year.
• Services and supplies, such as, home health care, reconstructive surgery, medical charges in excess of Medicare allowable amounts, and durable medical equipment- when not paid by Medicare or paid under another benefit of the Medicare Supplement policy. The policy pays 80% of these covered services and supplies and after $1,000 in out-of-pocket expenses are incurred, the policy pays 100%.
• Additional benefits that include, but are not limited to, diabetic equipment and supplies, routine cancer screening, immunizations and up to $120 per calendar year for preventive health services not covered by Medicare.

This policy is not connected with or endorsed by the U.S. Government or the Federal Medicare program. This information is only a general description of coverage. It is not a contract and certain exclusions and limitations apply. A complete statement of the coverages, exclusions and limitations is found only in the policy itself. Contact a State Farm agent/insurance producer for additional details.