Start Of Main Content
| Benefits | Plan A | 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
1 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.
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). 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. For exact terms and conditions see: Medicare Supplement Insurance Policy series 97037HVT, 97038HVT, 97039HVT, 97067VT, 97068VT, and 97069VT. Contact a State Farm agent/insurance producer for additional details.
State Farm Mutual Automobile Insurance Company
Bloomington, IL
MSI-VT.3