If you visit the doctor often or take daily prescription medications, the Care Plus Plan may offer the best coverage for you because it provides coverage for Medicare Part B services (medical services and supplies) as well as Part A services (hospital stays). Prescription drug benefits are included in the plan with copays for generic and brand name preferred and non-preferred medications (the standard Medicare coverage gap applies).
The monthly rate is higher than for the Care Basic Plan, but this plan may help you better manage your overall out-of-pocket costs. One of the main differences between the Care Plus and the Care Basic Plans is Part B coverage. On the Care Plus Plan, all Medicare-eligible Part B expenses that are not paid by Medicare will be paid by your Care Plus Plan after you pay the Medicare Part B deductible.
2010 monthly rate: $218.00
(per person, per month)
| Part A Services (as defined by Medicare) |
Medicare Pays |
Care Plus Plan Pays |
You Pay1 |
|
Hospital stays:
Semi-private room and board, general nursing, and other hospital services and supplies |
- 100% days 1-60
- Costs over $275 a day for days 61-90
- Costs over $550 a day for days 91-150 (lifetime reserve days)
|
- 50%of the Part A deductible (for every benefit period)2
- $275/day for days 61-90
- $550/day for days 91-150 (lifetime reserve days); 100% after reserves are depleted
- All costs after 150 days
|
50%
of the Part A deductible2 |
| Skilled nursing facility care |
- 100% days 1-20
- Costs over $137.50 a day for days 21-100
|
Not a covered benefit |
- $137.50/day for days 21-100
- 100% after 100 days
|
| Part B Services (as defined by Medicare) |
Medicare Pays |
Care Plus Plan Pays |
You Pay1 |
|
Medical services and supplies:
Doctors' services, inpatient and outpatient medical and surgical services and supplies, physical and speech therapy, diagnostic tests, durable medical equipment and other services |
80% of Medicare-approved amounts for covered services |
Remaining 20% of Medicare-approved amounts |
$155
(Part B deductible)3 |
| Diagnostic clinical laboratory service |
100% of Medicare-approved amounts for covered services |
Nothing (Medicare covers it at 100%) |
Costs above Medicare-approved amounts are not covered by Medicare |
1You are responsible for 100% of any charges not covered by Medicare or that are above the Medicare-approved amount.
2You must pay the Part A deductible for every benefit period, which begins when you are admitted and ends when you have not received hospital or skilled nursing facility treatment for 60 days in a row.
3You pay the Part B deductible once a year.
Benefits effective January 1, 2010