Page 19 - Cover Letter and Evaluation for Patricia Stelter -- PDF version

Comprehensive Benefits Comprehensive Benefits with Higher Cost-Sharing

D G G K L M N
(High Deductible)

$1,550 $1,600 $700 $800 $1,200 $1,340 $1,200
97.1% 97.3% 43.5% 53.5% 72.6% 84.2% 71.5%

You pay nothing You pay nothing

You pay $88 a You pay $42.63 a You pay nothing
You pay nothing You pay nothing day day You pay nothing

After you have You pay 2.5% & You pay 1.25% &
paid the plan's $2.50 $1.25
$2,340
deductible, you You pay $704 You pay $352 You pay $704
will have no
further cost-
You pay $198 You pay $198 sharing for You pay $198 You pay $198 You pay $198 You pay $198
Medicare-
covered services. You pay 10% of You pay 5% of Only costs are $20
for doctor's office
You pay nothing Medicare- Medicare- You pay nothing visits; $50 for an ER
approved amount approved amount visit
You pay nothing

Not covered Not covered Not covered Not covered Not covered

Some coverage* Some coverage* Some coverage* Not covered Not covered Some coverage* Some coverage*

You pay 10% of You pay 5% of
You pay nothing You pay nothing You pay nothing You pay nothing You pay nothing
cost cost

2020 high-deductible amount = $2,340

2020 out-of-pocket limits $5,880 $2,940

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