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Medicare Supplement Insurance — Ohio

Medicare Supplement Insurance is currently available through State Farm Mutual Automobile Insurance Company. Details about coverages and benefits are listed below. Please read a brief description of the Medicare Supplement Insurance plans State Farm® offers in Ohio.

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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 Medicare 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.

 

Benefits Plan A Plan D Plan N Plan G Plan C Plan F
Medicare Part A coinsurance and hospital coverage (up to an additional 365 days after Medicare benefits are used up)
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Medicare Part B coinsurance or copayment
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Blood (first 3 pints)
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Part A hospice care coinsurance or copayment
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Medicare Part A deductible not checked
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Skilled nursing facility care coinsurance (for days 21-100) not checked
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Foreign travel emergency (up to plan limits) not checked
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Medicare Part B excess charges not checked not checked not checked
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return to reference1 Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits that don’t result in an inpatient admission.

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Disclosures

This is a marketing tool intended for use in the sale of insurance. Completion of an application for a State Farm insurance policy will require contact with a State Farm agent/licensed insurance producer.

The State Farm agent/broker is making the sale on behalf of State Farm Mutual Automobile Insurance Company. You may verify the agent/broker and State Farm Mutual Automobile Insurance Company's information by contacting:

The Ohio Department of Insurance
50 W. Town Street Third Floor - Suite 300
Columbus, OH 43215

Consumer Hotline: 800-686-1526 or TDD Number: (614) 644-2658.

Not connected with, sponsored by, nor endorsed by the federal or state government, the Social Security Administration, the Centers for Medicare and Medicaid Services, or the Department of Health and Human Services. The purpose of this communication is the solicitation of insurance.

In some states coverage is available if you are under age 65 and are Medicare eligible due to disability and/or End Stage Renal Disease (permanent kidney failure requiring dialysis or a kidney transplant). This information is only a general description of coverage. A complete statement of coverage is found only in the policy. Renewal premiums may increase periodically depending on your age. This policy has exclusions, limitations, and terms under which the policy may be continued in force or discontinued. For exact terms and conditions see: Medicare Supplement Insurance Policy series 97037H, 97038H, 97039H, 97067OH, 97068OH, and 97069OH. For additional details on coverage and cost, contact a State Farm agent/licensed insurance producer.

State Farm Mutual Automobile Insurance Company
Bloomington, IL

MSI-OH.4