Page 110 - Cover Letter & Evaluation for Carol Evans

View plan details

Start application

Select Plan F

$126.08 Basic Benefit: 100%

Lowest Estimated Monthly Rate*
Part A Deductible: 100%
The rate is for a non-tobacco user and is
based on the information you entered. Your Part B Deductible: 100%
actual monthly rate will be determined when
you apply. Part B Excess Charges: 100%
Edit your information
Select Hospital Directory Skilled Nursing Facility Coinsurance: 100%
Foreign Travel Emergency Care
(up to plan limits)** : 80%

View plan details

Start application

*Rates shown are based on the information entered and are for the current month. All rates are subject to change. Any rate
change will apply to all members of the same class insured under your plan who reside in your state/area.

Plan K (8 of 10 Plans)

Add to compare

$42.72 Benefits Benefit Table
100%
Part A Coinsurance:
Lowest Estimated Monthly Rate* Part B Coinsurance: 50%
The rate is for a non-tobacco user and is
based on the information you entered. Your Blood Coinsurance: 50%