Benefits 65 Plus

The following chart illustrates 65 Plus fills all the major benefit gaps in Medicare Parts A and B

SERVICE:	BENEFIT:	MEDICARE PAYS:	BLUECROSS BLUESHIELD 65 PLUS PAYS:	YOU PAY:
Part A Hospitalization Semiprivate room and board, general nursing, miscellaneous hospital services and supplies. Includes meals, special care units, drugs, lab tests, diagnostic x-rays, medical supplies, operating and recovery room, anesthesia, and rehabilitation services	First 60 days 61^st – 90^th day 91^st – 150^th day Beyond 150 days	All but Part A deductible All but Medicare co-payment amount for each day All but Medicare co-payment amount for each day Nothing	Part A deductible Medicare co-payment amount for each day Medicare co-payment amount for each day 365 additional days during your lifetime	Nothing Nothing Nothing Nothing
Post-Hospital Skilled Nursing Care In a facility approved by Medicare, you must have been in a hospital for at least three consecutive days and enter the facility within 30 days after the hospital charge	First 20 days Additional days Beyond 100 days	100% of costs All but Medicare co-payment amount for each day Nothing	Nothing Medicare co-payment amount for each day Nothing	Nothing Nothing All
Blood		100% of costs except non-replacement fees (blood deductible) for first three points in each benefit period	Reasonable cost of first three (3) pints in each calendar year	Nothing
Parts A & B Home Health Care Services		Intermittent skilled nursing care and services in the home ( daily skilled nursing care for up to 21 days or longer in some areas)	20% co-payment for durable medical equipment covered under Part B	Nothing
Part B Professional Services Expenses	Doctor/Professional Provider services inpatient and outpatient medical services and supplies at a hospital, physical and speech therapy, and ambulance	80% of Medicare’s reasonable charge after an annual Part B deductible	The deductible plus 20% of Medicare’s reasonable charge	Balance, if any, of provider charge over Medicare approved amount
Blood		80% of costs except non-replacement fees (blood deductible) for first three points in each benefit period	Reasonable cost of first three (3) pints in each calendar year	Nothing

Benefits 65 Plus (continued)

§ If hospice benefits under the Federal Medicare program are exhausted, additional benefits are available under this program.

§ When you are hospitalized outside the United States in a short-term acute care general hospital which would qualify under Federal Medicare if it were within the United States, we will pay for up to 90 days in a benefit period.

Note: Your best source of information about Medicare is your local Social Security office and federal publications, such as the “Medicare Handbook.”