Page 17 - Cover Letter and Medicare Evaluation for Jamie Marshall

Comprehensive Benefits Comprehensive Benefits with Higher Cost-Sharing

High Deductible
D G K L M N
Plan F or G*

$3,100 $3,200 $1,475 $1,850 $2,600 $3,000 $2,600
97.1% 97.3% 43.5% 53.5% 72.6% 84.2% 71.5%

You pay
You pay nothing
nothing

You pay You pay You pay
You pay You pay nothing $97.25 a day $48.66 a day nothing You pay
nothing nothing
After you have You pay 2.5% & You pay 1.25%
paid the plan's $2.50 & $1.25
$2,490
deductible, you You pay $778 You pay $389 You pay
will have no $778
You pay You pay further cost- You pay $233 You pay $233 You pay You pay
$233 $233 sharing for $233 $233
Medicare-
covered You pay 10% of You pay 5% of $20 for doctor's
You pay services. Medicare- Medicare- You pay office visits;
nothing approved approved nothing $50 for ER visit
amount amount
You pay nothing

Not covered Not covered Not covered Not covered Not covered

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

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

Deductible =
$2,490
Out-of-pocket Out-of-pocket
limit = $6,620 limit = $3,310

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