Senior Plan Benefits
Senior Plan
If most of your health care dollars go toward hospital stays, you primarily take generic drugs and/or you live on a limited income, the Senior Plan may work best for you. The Senior Plan does not cover Medicare Part B services, but provides coverage for Medicare Part A services (hospital stays). The monthly rate is more affordable, and the plan provides solid hospital and prescription drug coverage.
| Part A services (as defined by Medicare) |
Medicare pays |
Senior 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 $256 a day for days
61-90
- costs over $512 a day for days 91-150 (lifetime reserve days)
|
- $400 of the Part A deductible (for every benefit period)2
- $256/day for days
61-90
- $512/day for days 90-150 (lifetime reserve days); 100% after reserves are depleted
- All costs after 150 days
|
$624 (remainder of the part A deductible)2 |
| Skilled nursing facility care |
- 100% day 1-20
- Costs over $128 a day for days
21-100 |
Not a covered benefit |
- $128/day for days 21-100
- 100% after
100 days |
| Part B services (as defined by Medicare) |
Medicare pays |
Senior 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 |
Not a covered benefit |
- $135 (Part B deductible)3
- Remaining 20% of Medicare-approved amounts
|
| Diagnostic clinical laboratory service |
100% of Medicare-approved amounts for covered services |
Not a covered benefit |
Nothing |
| Retail prescription drugs |
Medicare pays |
Senior Plan pays |
You pay1 |
| (Up to a 30-day supply) |
| Generic |
Nothing |
Costs over copay amount |
$15 copay |
| Preferred |
Nothing |
60% of drug cost |
40% of drug cost |
| Non-preferred |
Nothing |
60% of drug cost |
40% of drug cost |
| Home delivery prescription drugs |
Medicare pays |
Senior Plan pays |
You pay1 |
| (Up to a 90-day supply) |
| Generic |
Nothing |
Costs over copay amount |
$30 copay |
| Preferred |
Nothing |
60% of drug cost |
40% of drug cost |
| Non-preferred |
Nothing |
60% of drug cost |
40% of drug cost |
| 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. |
|
Retired |
Actively working* |
| Senior Plan |
$95/month |
$110/month |
| *If you work more than 20 hours a week, you may be considered "actively working." Please contact GuideStone at 1-888-98-GUIDE (1-888-984-8433) for more rating information. |
|
|
Since Group Plans employers choose which plans to offer their employees, this plan may not be available to you. See your employer’s authorized benefits representative for details.
If you’d like more assistance in choosing a plan or information about how our plans coordinate with Medicare, email us or you can reach a Customer Relations specialist toll-free at 1-888-98-GUIDE (1-888-984-8433).