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Benefits | Plan A | Plan B | Plan D | Plan N | Plan G | Plan C | Plan F |
---|---|---|---|---|---|---|---|
Medicare Part A Coinsurance and Hospital Costs (Up to an additional 365 days after Medicare benefits are used up) | |||||||
Medicare Part B Coinsurance or copayment | |||||||
Blood (first 3 pints) | |||||||
Part A Hospice Care Coinsurance or Copayment | |||||||
Medicare Part A Deductible | |||||||
Skilled Nursing Facility Care Coinsurance (for days 21-100) | |||||||
Foreign Travel Emergency (up to plan limits) | |||||||
Medicare Part B Excess Charges | |||||||
Medicare Part B Deductible |
Medicare Part A Coinsurance and Hospital Costs (Up to an additional 365 days after Medicare benefits are used up)
Medicare Part B Coinsurance or copayment
Blood (first 3 pints)
Part A Hospice Care Coinsurance or Copayment
Medicare Part A Deductible
Skilled Nursing Facility Care Coinsurance (for days 21-100)
Foreign Travel Emergency (up to plan limits)
Medicare Part B Excess Charges
Medicare Part B Deductible
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. 1
Note:
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/insurance producer.
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). These policies are not connected with or endorsed by the U.S. Government or the Federal Medicare program. This information is only a general description of coverage. A complete statement of coverage is found only in the policy. Policy coverage's, exclusions and limitations may vary in some states. For exact terms and conditions see: Medicare Supplement Insurance Policy series 97037HPA, 97038HPA, 97039HPA, 97041HPA, 97067PA, 97068PA, and 97069PA. For additional details on coverage and cost, contact a State Farm agent/insurance producer.
State Farm Mutual Automobile Insurance Company
Bloomington, IL
MSI-PA.3